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短期内毒素血症和多巴胺对猪空肠黏膜氧合的影响。

Effects of short-term endotoxemia and dopamine on mucosal oxygenation in porcine jejunum.

作者信息

Hasibeder W, Germann R, Wolf H J, Haisjackl M, Hausdorfer H, Riedmann B, Bonatii J, Gruber E, Schwarz B, Waldenberger P, Friesenecker B, Furtner B

机构信息

Department of Anesthesia, University of Innsbruck, Austria.

出版信息

Am J Physiol. 1996 Apr;270(4 Pt 1):G667-75. doi: 10.1152/ajpgi.1996.270.4.G667.

Abstract

Effects of Escherichia coli lipopolysaccharide (2 micrograms.kg-1.20 min-1; LPS), given systemically (S) or via superior mesenteric artery (M), and consecutive dopamine infusion (16 micrograms.kg-1.20 min-1) on jejunal mucosal tissue O2 tension (PO2muc) and serosal tissue O2 tension (PO2ser; Clark-type surface electrodes) and jejunal mucosal microvascular hemoglobin O2 saturation (HbO2muc; tissue reflectance spectrophotometry) were investigated in a hemodynamically stable pig model. Twenty-one pigs were anesthetized, paralyzed, and mechanically ventilated. After laparotomy, a mesenteric venous catheter was inserted and a jejunal antimesenteric enterotomy performed. LPS-infused animals developed similar degrees of pulmonary hypertension. No differences in cardiac output and mean arterial blood pressure between groups were found. PO2muc and HbO2muc were significantly lower in M animals compared with control (C) [210 min; PO2muc: 7.12 +/- 1.81 (M), 19.01 +/- 3.12 mmHg (C); HbO2muc: 28.78 +/- 3.36 (M), 49.09 +/- 3.84% (C)], whereas S animals ranged in between (PO2muc: 13.36 +/- 2.2 mmHg; HbO2muc: 40.68 +/- 4.43%). Of measured PO2muc values, 12.6 (C), 20.6 (S), and 46.3% (M) ranged from 0 to 5 mmHg. PO2ser was lower in LPS animals compared with control [59.43 +/- 5.4 (C), 45.00 +/- 6.12 (S), 47.33 +/- 4.34 (M) mmHg]. Dopamine increased PO2muc and HbO2muc to similar absolute values and significantly decreased frequency of PO2muc (0-5 mmHg) in M animals. We conclude that LPS impairs mucosal tissue oxygenation independently of systemic hemodynamics. Mucosal microvascular dysfunction depends on regional LPS concentrations. Under conditions of compromised tissue oxygenation, dopamine significantly improves PO2muc and HbO2muc.

摘要

在血流动力学稳定的猪模型中,研究了全身给药(S)或经肠系膜上动脉给药(M)的大肠杆菌脂多糖(2微克·千克⁻¹·20分钟⁻¹;LPS)以及连续输注多巴胺(16微克·千克⁻¹·20分钟⁻¹)对空肠黏膜组织氧分压(PO2muc)、浆膜组织氧分压(PO2ser;Clark型表面电极)和空肠黏膜微血管血红蛋白氧饱和度(HbO2muc;组织反射分光光度法)的影响。21只猪被麻醉、麻痹并进行机械通气。剖腹术后,插入肠系膜静脉导管并进行空肠对系膜缘肠切开术。输注LPS的动物出现了相似程度的肺动脉高压。各实验组之间的心输出量和平均动脉血压没有差异。与对照组(C)相比,M组动物的PO2muc和HbO2muc显著降低[210分钟时;PO2muc:7.12±1.81(M),19.01±3.12 mmHg(C);HbO2muc:28.78±3.36(M),49.09±3.84%(C)],而S组动物的值介于两者之间(PO2muc:13.36±2.2 mmHg;HbO2muc:40.68±4.43%)。在所测量的PO2muc值中,12.6%(C)、20.6%(S)和46.3%(M)的范围为0至5 mmHg。与对照组相比,LPS组动物的PO2ser较低[59.43±5.4(C),45.00±6.12(S),47.33±4.34(M)mmHg]。多巴胺使M组动物的PO2muc和HbO2muc升高至相似的绝对值,并显著降低PO2muc(0至5 mmHg)的频率。我们得出结论,LPS独立于全身血流动力学损害黏膜组织氧合。黏膜微血管功能障碍取决于局部LPS浓度。在组织氧合受损的情况下,多巴胺可显著改善PO2muc和HbO2muc。

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