IMPLICATIONS
IMPLICATIONS
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DOI：
10.1097/00003246-198912000-00014
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发表时间：
1989-12-01
影响因子：
8.8
通讯作者：
DRAPER, E
中科院分区：
文献类型：
--
作者：
KNAUS, W;WAGNER, D;DRAPER, E
本研究的目的是确定大肠杆菌内毒素对外周血管顺应性的可能影响，并将其与伴随的中枢血流动力学紊乱联系起来。在2小时内，在6只麻醉犬中以0.25 [mu] g/kg-min输注内毒素，而另外6只动物作为对照。根据已知体循环血容量变化后CVP的变化，计算完整动物体循环的血管顺应性。在对照犬中，血管顺应性平均为2.3 ml/mm Hg·kg体重。在缓慢的内毒素输注过程中，心血管效应只有在内毒素损伤开始后一段时间后才可测量，并且包括与全身血管舒张相关的低血压。与对照值相比，全身血压从124 mmHg逐渐降至68 mmHg，而血管顺应性最终增加了100%。后一种升高是心脏前负荷降低的原因。肺楔压和中心静脉压分别从7.1降至3.4和从4.5降至2.6 mm Hg。然而，与左心室前负荷的降低平行，内毒素诱导左心室后负荷进行性降低。由于心室负荷的平衡，心输出量几乎保持不变。容量负荷（右旋糖酐30 ml/kg）后，心输出量从3.28 L/min·m ~ 2显著增加到6.24 L/min·m ~ 2，而外周血管舒张不受此动作的影响。
The aim of the present study was to determine possible effects of Escherichia coli endotoxin on peripheral vascular compliance and relate them to concomitant central hemodynamic disturbances. Endotoxin was infused at 0.25 [mu] g/kg-min during 2 h in six anesthetized dogs, while six additional animals served as controls. Vascular compliance of the systemic circulation was calculated in intact animals from the changes in CVP after known changes in systemic blood volume. In control dogs, vascular compliance averaged 2.3 ml/mm Hg-kg body weight. During slow endotoxin infusion, cardiovascular effects were measurable only after a certain period of time had elapsed from the start of endotoxin insult and consisted of hypotension associated with systemic vasodilation. Systemic BP decreased gradually from 124 to 68 mm Hg while vascular compliance was finally increased by 100%, when compared to control values. This latter rise was responsible for a reduction in the cardiac preloads. Pulmonary wedge pressure and CVP were decreased from 7.1 to 3.4 and from 4.5 to 2.6 mm Hg, respectively. However, parallel to the decrease in left ventricular preload, endotoxin induced a progressive decrease in left ventricular afterload. Because of the balance in ventricular loading, cardiac output remained almost unchanged. After volume loading (dextran 30 ml/kg), cardiac output was remarkably increased from 3.28 to 6.24 L/min-m2 while peripheral vasodilation was not affected by this maneuver.