Mertes P M, el-Abbassi K, Siaghy E M, Delophont P, Michel C, Longrois-Undergureanu D, Carteaux J P, Villemot J P
Laboratoire de chirurgie expérimentale, université Nancy 1, faculté de médecine, Vandoeuvre-lès-Nancy, France.
Ann Fr Anesth Reanim. 1997;16(2):126-30. doi: 10.1016/s0750-7658(97)87193-6.
Assessment of the preventive effect on cardiovascular changes following experimental brain death (BD) in the pig by pretreatment with labetalol, an alpha and beta adrenoreceptor blocking agent.
Experimental study.
Ten 25-35 kg domestic pigs allocated either in the control group (n = 5) or the labetalol group (n = 5).
BD was achieved in anaesthetized animals by the rapid inflation of a Foley catheter inserted into the sub-dural space. In the labetalol group, the agent (total: 10 +/- 3 mg.kg-1) was administered immediately before BD and thereafter over a 20-min period, in order to maintain haemodynamic parameters at control values. The following haemodynamic data were recorded over a 3 hour period after BD: heart rate (HR), dP/dtmax, mean arterial pressure (MAP), pulmonary capillary wedge pressure (PCWP), cardiac output (CO) and left anterior descending coronary artery blood flow (CBF). Afterwards, a dynamic loading test with 500 mL of dextran over 20 min was performed.
In the control group, BD elicited a significant increase in HR (from de 96 +/- 9 to 176 +/- 11 b.min-1), dP/dtmax (from 1,960 +/- 123 to 4,904 +/- 930 mmHg.s-1), MAP (from 88 +/- 5 to 119 +/- 11 mmHg), CO (from 2.4 +/- 0.2 to 3.6 +/- 0.7 L.min-1) and CBF (from 45 +/- 6 to 73 +/- 7 mL.min-1) respectively. Apart from a slight increase in HR and a significant increase in CBF (from 34 +/- 4 to 55 +/- 6 mL.min-1), no other modifications occurred in the labetalol group. Following volume expansion, the labetalol group animals experienced a significant increase in CO (from 2.3 +/- 0.3 to 3.7 +/- 0.2 L.min-1), dP/dtmax (from 1,400 +/- 91 to 2,100 +/- 212 mmHg.s-1) and MAP (from 55 +/- 5 to 70 +/- 5 mmHg). In the opposite, a significant decrease in dP/dtmax (from 1,645 +/- 450 to 628 +/- 152 mmHg.s-1) occurred in the control group.
The protective effect of labetalol confirms the role played by the activation of the cardiac sympathetic nervous system in the cardiocirculatory changes following BD.
通过使用α和β肾上腺素能受体阻滞剂拉贝洛尔进行预处理，评估其对猪实验性脑死亡（BD）后心血管变化的预防作用。
实验研究。
10头体重25 - 35千克的家猪，分为对照组（n = 5）和拉贝洛尔组（n = 5）。
通过向硬膜下间隙快速充入Foley导管，使麻醉的动物达到脑死亡状态。在拉贝洛尔组中，在脑死亡前立即给予该药物（总量：10 ± 3毫克·千克⁻¹），并在随后的20分钟内持续给药，以将血流动力学参数维持在对照值。在脑死亡后的3小时内记录以下血流动力学数据：心率（HR）、最大dp/dt、平均动脉压（MAP）、肺毛细血管楔压（PCWP）、心输出量（CO）和左前降支冠状动脉血流量（CBF）。之后，在20分钟内进行500毫升右旋糖酐的动态负荷试验。
在对照组中，脑死亡导致HR（从96 ± 9增至176 ± 11次·分钟⁻¹）、最大dp/dt（从1960 ± 123增至4904 ± 930毫米汞柱·秒⁻¹）、MAP（从88 ± 5增至119 ± 11毫米汞柱）、CO（从2.4 ± 0.2增至3.6 ± 0.7升·分钟⁻¹）和CBF（从45 ± 6增至73 ± 7毫升·分钟⁻¹）分别显著增加。除HR略有增加和CBF显著增加（从34 ± 4增至55 ± 6毫升·分钟⁻¹）外，拉贝洛尔组未发生其他变化。容量扩张后，拉贝洛尔组动物的CO（从2.3 ± 0.3增至3.7 ± 0.2升·分钟⁻¹）、最大dp/dt（从1400 ± 91增至2100 ± 212毫米汞柱·秒⁻¹）和MAP（从55 ± 5增至70 ± 5毫米汞柱）显著增加。相反，对照组的最大dp/dt显著降低（从1645 ± 450降至628 ± 152毫米汞柱·秒⁻¹）。
拉贝洛尔的保护作用证实了心脏交感神经系统激活在脑死亡后心脏循环变化中所起的作用。
