Luo X, Huang Y, Hayes J K, Wong K C, Yee J B, McJames S
Department of Anesthesiology, University of Utah, College of Medicine, Salt Lake City 84132, USA.
Acta Anaesthesiol Sin. 1997 Jun;35(2):61-71.
The present study examined how effective epinephrine (EPI), norepinephrine (NOR) and dobutamine (DOB) were for resuscitating dogs subjected to hemorrhagic shock (HS).
Dogs (n = 42) were randomly assigned to seven test groups: EPI, NOR and DOB infusion with and without HS, and HS dogs with no catecholamine. Following baseline measurements, the dogs were bled to a mean arterial blood pressure of 40 mmHg. After 3 h, the shed blood was reinfused. EPI and NOR (0.1, 0.4 and 1.6 micrograms/kg/min) and DOB (2.5, 5.0 and 10.0 micrograms/kg/min) were given and the dog allowed to stabilize for 30 min. Hemodynamic and blood gas data were obtained at 6 time points (control, shock, resuscitation and after catecholamine infusion).
There was no significant difference in myocardial performance (dP/dt) between the respective shocked and unshocked groups after blood resuscitation. In dogs without catecholamine infusion, CO and SvO2 continued to decline whereas SVR increased. DOB (2.5 to 10.0 micrograms/kg/min) with and without shock improved CO, LV dP/dt, SVR and SvO2. EPI did not further improve CO or SvO2 at infusion rates above 0.1 microgram/kg/min (with and without shock). NOR did not improve SvO2 at any infusion rate (with and without shock) and did not improve CO until the infusion rate was at 0.4 microgram/kg/min (without shock).
This study advocates the use of both volume replacement therapy and DOB for resuscitation of HS dogs.
本研究探讨了肾上腺素（EPI）、去甲肾上腺素（NOR）和多巴酚丁胺（DOB）对失血性休克（HS）犬复苏的效果。
将42只犬随机分为7个试验组：有或无HS的EPI、NOR和DOB输注组，以及无儿茶酚胺的HS犬组。在进行基线测量后，将犬放血至平均动脉血压为40 mmHg。3小时后，回输放出的血液。给予EPI和NOR（0.1、0.4和1.6微克/千克/分钟）以及DOB（2.5、5.0和10.0微克/千克/分钟），使犬稳定30分钟。在6个时间点（对照、休克、复苏和儿茶酚胺输注后）获取血流动力学和血气数据。
血液复苏后，各休克组与未休克组之间的心肌性能（dP/dt）无显著差异。在未输注儿茶酚胺的犬中，心输出量（CO）和混合静脉血氧饱和度（SvO2）持续下降，而全身血管阻力（SVR）增加。有或无休克情况下，DOB（2.5至10.0微克/千克/分钟）均可改善CO、左心室dP/dt、SVR和SvO2。EPI在输注速率高于0.1微克/千克/分钟时（有或无休克），并未进一步改善CO或SvO2。NOR在任何输注速率下（有或无休克）均未改善SvO2，且在输注速率达到0.4微克/千克/分钟之前（无休克）未改善CO。
本研究提倡使用容量替代疗法和DOB对HS犬进行复苏。
