Robinson D A, Wang P, Chaudry I H
Department of Surgery, Michigan State University, East Lansing 48824, USA.
J Surg Res. 1997 Apr;69(1):159-65. doi: 10.1006/jsre.1997.5065.
Although adenosine triphosphate (ATP)-MgCl2 has been shown to improve cardiac performance under normal and postischemic conditions, it is not known whether this agent has any salutary effects on cardiac performance following trauma-hemorrhage and crystalloid resuscitation. To determine this, rats underwent laparotomy (i.e., trauma induction) and were bled to and maintained at a mean arterial pressure of 40 mm Hg until 40% of the maximum shed blood volume was returned in the form of Ringer's lactate. The animals were then resuscitated with four times the volume of shed blood using Ringer's lactate over 60 min and received either ATP-MgCl2 (50 mumole/kg body wt) in 1 ml volume or an equivalent volume of normal saline intravenously over 95 min. Maximum dP/dt during contraction as well as relaxation (+/-dP/dtmax) and ventricular peak systolic pressure (VPSP) were determined 15 min prior to the end of resuscitation and every 30 min thereafter for 4 hr after the completion of resuscitation. The results indicate that both -dP/dtmax and +dP/dtmax decreased significantly beginning at 0 and 2 hr after the completion of resuscitation, respectively, and remained depressed throughout the duration of the study in saline-treated animals. In addition, VPSP was significantly depressed at 2-4 hr after resuscitation. Treatment with ATP-MgCl2, however, restored these parameters. Moreover, the depressed heart rate was also restored following ATP-MgCl2 administration. Since ATP-MgCl2 restores various left ventricular performance parameters, this agent appears to be a promising adjunct for improving cardiac function after trauma and hemorrhage, even in the absence of blood resuscitation.
尽管三磷酸腺苷（ATP）-氯化镁已被证明在正常和缺血后条件下可改善心脏功能，但尚不清楚该药物在创伤性出血和晶体液复苏后对心脏功能是否有任何有益作用。为了确定这一点，对大鼠进行剖腹手术（即诱导创伤），并将其放血至平均动脉压为40 mmHg并维持该压力，直到以乳酸林格氏液的形式回输40%的最大失血量。然后在60分钟内用四倍失血量的乳酸林格氏液对动物进行复苏，并在95分钟内静脉注射1 ml体积的ATP-氯化镁（50微摩尔/千克体重）或等量的生理盐水。在复苏结束前15分钟以及复苏完成后4小时内，此后每30分钟测定一次收缩期和舒张期的最大dP/dt（±dP/dtmax）以及心室收缩压峰值（VPSP）。结果表明，在生理盐水处理的动物中，复苏完成后分别从0小时和2小时开始，-dP/dtmax和+dP/dtmax均显著降低，并在整个研究期间持续处于较低水平。此外，复苏后2至4小时VPSP显著降低。然而，ATP-氯化镁治疗可恢复这些参数。此外，给予ATP-氯化镁后，降低的心率也得以恢复。由于ATP-氯化镁可恢复各种左心室功能参数，即使在没有血液复苏的情况下，该药物似乎也是改善创伤和出血后心脏功能的一种有前景的辅助药物。
