Myocardial protection during ischemic cardiac arrest. Possible deleterious effects of glucose and mannitol in coronary infusates.
Myocardial protection during ischemic cardiac arrest. Possible deleterious effects of glucose and mannitol in coronary infusates.
复制标题
缺血性心脏骤停期间的心肌保护。
DOI：
10.1016/s0022-5223(19)35667-3
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发表时间：
1978
期刊：
影响因子：
--
通讯作者：
M. Braimbridge
中科院分区：
文献类型：
--
作者：
D. Hearse;D. Stewart;M. Braimbridge
心脏停搏保护性输液的设计目的是诱导快速舒张期停搏，并减少或延迟缺血性损伤的发生。这项研究表明，使用这种输液可以极大地促进缺血后心功能的恢复。许多研究人员在他们的输液中加入葡萄糖、胰岛素或甘露醇，试图增加对缺血心肌的保护量。使用体外循环和缺血性心脏骤停的分离的工作大鼠心脏模型，我们已经证明在特定条件下，这些添加剂对组织保护是决定性的。葡萄糖和甘露醇的有害作用是剂量依赖的，可以通过在输液中加入胰岛素来改变。葡萄糖的损害效应似乎是渗透性和代谢性的，而甘露醇的损害作用是纯渗透性的。胰岛素的作用是复杂的，可能会影响许多细胞过程。
Cardioplegic protective infusates are designed to induce rapid diastolic arrest and also to reduce or delay the onset of ischemic damage. As this study shows, the use of such infusates can greatly improve postischemic recovery of cardiac function. A number of investigators include glucose, insulin, or mannitol in their infusates in an attempt to increase the amount of protection afforded to the ischemic myocardium. Using an isolated, working rat heart model of cardiopulmonary bypass and ischemic cardiac arrest, we have shown that under certain conditions these additives can be deterimental to tissue protection. The deleterious effects of glucose and mannitol are dose dependent and can be modified by the inclusion of insulin in the infusate. The damaging effects of glucose appear to be both osmotic and metabolic in origin and those of mannitol, purely osmotic. The effects of insulin are complex and may affect a number of cellular processes.