Xenon offers stable haemodynamics independent of induced hypothermia after hypoxia-ischaemia in newborn pigs
Xenon offers stable haemodynamics independent of induced hypothermia after hypoxia-ischaemia in newborn pigs
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DOI：
10.1007/s00134-011-2442-7
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发表时间：
2012-02-01
影响因子：
38.9
通讯作者：
Dingley, John
中科院分区：
文献类型：
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作者：
Chakkarapani, Elavazhagan;Thoresen, Marianne;Dingley, John
在常温下吸入50%氙气18小时的效果（新界，38.5A摄氏度）或体温过低（HT，33.5A ℃）对新生猪在诱导的围产期全面缺氧缺血性损伤（HI）后的平均动脉血压（MABP）、正性肌力支持和心率（HR）的影响。45分钟HI后（吸入氧分数降低，直到振幅整合脑电图小于7 μ V），随机分为3组（n = 45）（50%用NT、HT 12 h或HT 24 h处理18 h）或三个非处理组（n = 53）（0%用NT、HT 12 h或HT 24 h处理）。我们每分钟测量MABP和HR。低血压（MABP < 40 mmHg），如果需要，依次用2 × 10 mL/kg盐水、多巴胺、去甲肾上腺素和氢化可的松处理。（5.1 mmHg，95% CI 2.34，7.89），复温（10.1 mmHg，95% CI 6.26，13.95）和停药后（4.1 mmHg，95% CI 0.37，7.84）独立于HT、正性肌力支持和酸中毒。阿托伐他汀使正性肌力支持的持续时间缩短了12.6 h（95% CI 5.5，19.73）。变力性支持可使HT引起的HR降低在冷却期间从9 bpm/A ℃降低到5 bpm/A ℃，在复温期间从10-7 bpm/A ℃降低到4-3 bpm/A ℃。盐酸曲马多、羟色胺、正性肌力药和酸中毒之间无相互作用。HT期间，高血压可更快地清除乳酸; HI后3小时的中位（IQR）值（高血压）为2.8 mmol/L（0.9，3.1）vs.（HT）5.9 mmol/L（2.5，7.9），p = 0.0004。高血压可维持稳定的血压，从而降低给药期间和给药后的正性肌力支持需求，与诱导的HT电流新生儿脑病治疗无关。在临床神经保护研究中，甲流可提供血流动力学益处。
To assess the effect of 18 hour (h) 50% xenon (Xe) inhalation at normothermia (NT, 38.5A degrees C) or hypothermia (HT, 33.5A degrees C) on mean arterial blood pressure (MABP), inotropic support and heart rate (HR) following an induced perinatal global hypoxic-ischaemic insult (HI) in newborn pigs.Newborn pigs ventilated under inhalational anaesthesia, following a 45 min HI (inhaled oxygen fraction reduced until amplitude integrated electroencephalogram was less than 7 mu V), were randomised to three Xe (n = 45) (50% Xe 18 h with NT, HT 12 h or HT 24 h) or three non-Xe groups (n = 53) (0% Xe with NT, HT 12 h or HT 24 h) under otherwise identical conditions. We measured MABP and HR every minute. Hypotension (MABP < 40 mmHg) was treated sequentially with 2 x 10 mL/kg saline, dopamine, norepinephrine and hydrocortisone if required.Xe maintained higher MABP during HT (5.1 mmHg, 95% CI 2.34, 7.89), rewarming (10.1 mmHg, 95% CI 6.26, 13.95) and after cessation (4.1 mmHg, 95% CI 0.37, 7.84) independent of HT, inotropic support and acidosis. Xe reduced the duration of inotropic support by 12.6 h (95% CI 5.5, 19.73). Inotropic support decreased the HR reduction induced by HT from 9 to 5 bpm/A degrees C during cooling and from 10-7 to 4-3 bpm/A degrees C during rewarming. There was no interaction between Xe, HT, inotropic support and acidosis. Xe during HT cleared lactate faster; 3 h post-HI median (IQR) values of (Xe HT) 2.8 mmol/L (0.9, 3.1) vs. (HT) 5.9 mmol/L (2.5, 7.9), p = 0.0004.Xe maintained stable blood pressure, thereby reducing the inotropic support requirements during and after administration independently of induced HT-current neonatal encephalopathy treatment. Xe may offer haemodynamic benefits in clinical neuroprotection studies.