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大肠杆菌菌血症引起的骨骼肌微循环变化因麻醉剂而异。

E. Coli bacteremia-induced changes in the skeletal muscle microcirculation vary with anesthetics.

作者信息

Lüebbe A S, Harris P D, Garrison R N

机构信息

Cecilien-Klinik, An der Martinusquelle 10, D-33175 Bad Lippspringe, Germany.

出版信息

Croat Med J. 1998 Dec;39(4):392-400.

PMID:9841938
Abstract

AIM

To test if anesthetic procedures change the hemodynamic pattern in animals with experimental septic shock.

METHODS

The effect of two anesthetics on systemic hemodynamic and skeletal muscle microcirculatory responses in high cardiac output live E. coli bacteremia was studied in rats and compared to the effect of two other anesthetic procedures in previously published studies.

RESULTS

Baseline blood pressures and cardiac outputs were similar in rats with decerebrate, ketamine/xylazine, pentobarbital or urethane/chloralose anesthesia. There was a relative baseline tachycardia in decerebrate rats. Ketamine/xylazine anesthetized rats had reduced blood pressure, cardiac output, and heart rate. In decerebrate, pentobarbital, and urethane/chloralose anesthesia, cardiac output increased initially during bacteremia but did not remain elevated in pentobarbital anesthesia. Blood pressure and heart rate remained constant in pentobarbital, decerebrate, and urethane/chloralose anesth esia. During bacteremia, cardiac output, blood pressure, and vascular resistance did not change with ketamine/xylazine, but the heart rate increased. Baseline diameters of cremaster muscle large (A1) arterioles were higher in decerebrate anesthesia. A1 arterioles constricted during high cardiac output bacteremia in decerebrate rats, and pentobarbital or urethane/chloralose-anesthetized rats. A4 arterioles in bacteremia dilated in decerebrate and pentobarbital anesthesia, but did not change under urethane/chloralose and ketamine/xylazine anesthesia.

CONCLUSION

Anesthetics influence baseline systemic variables and the response of systemic hemodynamics of rats to E. coli bacteremia. During bacteremia, anesthetics primarily affect the reactivity of skeletal muscle small arterioles. Ketamine/xylazine anesthesia has the most pronounced effect on systemic and microcirculatory variables and seems to be an inappropriate choice in sepsis experiments in rats.

摘要

目的

测试麻醉程序是否会改变实验性脓毒性休克动物的血流动力学模式。

方法

研究了两种麻醉剂对高心输出量的大肠杆菌菌血症大鼠全身血流动力学和骨骼肌微循环反应的影响,并与先前发表的研究中另外两种麻醉程序的效果进行了比较。

结果

在采用大脑切除、氯胺酮/赛拉嗪、戊巴比妥或氨基甲酸乙酯/氯醛糖麻醉的大鼠中,基线血压和心输出量相似。大脑切除的大鼠存在相对的基线心动过速。氯胺酮/赛拉嗪麻醉的大鼠血压、心输出量和心率降低。在大脑切除、戊巴比妥和氨基甲酸乙酯/氯醛糖麻醉下,菌血症期间心输出量最初增加,但在戊巴比妥麻醉下心输出量并未持续升高。戊巴比妥、大脑切除和氨基甲酸乙酯/氯醛糖麻醉下血压和心率保持恒定。菌血症期间,氯胺酮/赛拉嗪麻醉下的心输出量、血压和血管阻力未发生变化,但心率增加。大脑切除麻醉下提睾肌大(A1)小动脉的基线直径更高。大脑切除的大鼠、戊巴比妥或氨基甲酸乙酯/氯醛糖麻醉的大鼠在高心输出量菌血症期间A1小动脉收缩。菌血症时,大脑切除和戊巴比妥麻醉下A4小动脉扩张,但在氨基甲酸乙酯/氯醛糖和氯胺酮/赛拉嗪麻醉下未发生变化。

结论

麻醉剂会影响大鼠的基线全身变量以及大鼠对大肠杆菌菌血症的全身血流动力学反应。菌血症期间,麻醉剂主要影响骨骼肌小动脉的反应性。氯胺酮/赛拉嗪麻醉对全身和微循环变量的影响最为显著,似乎不是大鼠脓毒症实验的合适选择。

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