The influence of hemorrhage on organ perfusion during deliberate hypotension in rats.
The influence of hemorrhage on organ perfusion during deliberate hypotension in rats.
复制标题
大鼠故意低血压期间出血对器官灌注的影响。
DOI：
10.1097/00000542-199212000-00019
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发表时间：
1992
期刊：
影响因子：
8.8
通讯作者：
Longnecker,DE
中科院分区：
文献类型：
--
作者：
Sperry,RJ;Monk,CR;Durieux,ME;Longnecker,DE
目前普遍关注的是，在控制性降压过程中大量失血可能会导致严重的器官缺血，但这种反应的程度的文件仍然不清楚。为了检验这种反应，我们研究了43只雄性Sprague-Dawley大鼠，将其分为7组：对照组动物接受1 MAC（1.4%）单用异氟醚;麻醉动物接受1.4%异氟烷基线麻醉，然后通过增加异氟烷浓度（dISO），或通过加入硝普钠（SNP），或2-氯腺苷（2AD），使MAP降至51 mmHg;麻醉动物以与麻醉动物相同的方式产生低血压，但在使用深异氟烷（dISOH）、硝普钠（SNPH）或2-氯腺苷（2ADH）。在低血压或低血压加出血25分钟后，用141 Ce标记的15微米微球测量心输出量和脑、心脏、胃肠道、肾脏和肝脏的血流量。低血压与所有组中肾脏和2AD组中肝脏的血流量减少有关，而SNP和2AD组中心脏的血流量增加有关。在dISOH和2ADH组中，出血减少了控制性低血压期间脑和胃肠道的血流量，在dISOH组中减少了肝脏的血流量。我们的研究结果表明，dISO或异氟烷加2AD控制性降压期间的出血可能与器官血流量受损有关，而异氟烷和叠加SNP诱导的低血压期间出血20%后，重要器官的血流量得以维持。
There is general concern that major blood loss during deliberate hypotension could produce severe organ ischemia, but documentation of the magnitude of this response remains obscure. To examine this response, we studied 43 male Sprague-Dawley rats that were divided into seven groups: the control animals received 1 MAC (1.4%) isoflurane only; the hypotensive animals received a 1.4% isoflurane baseline anesthetic and were then rendered hypotensive by either increasing the isoflurane concentration (dISO), or by adding sodium nitroprusside (SNP), or 2-chloroadenosine (2AD) to the baseline anesthetic, decreasing the MAP to 51 mmHg; hemorrhaged animals had hypotension produced in the same manner as for the hypotensive animals, but additionally were bled 20% of estimated blood volume during deliberate hypotension produced with either deep isoflurane (dISOH), sodium nitroprusside (SNPH), or 2-chloroadenosine (2ADH). After a 25-min period of hypotension, or hypotension plus hemorrhage, cardiac output and blood flow to brain, heart, gastrointestinal tract, kidney, and liver were measured with 141Ce-labelled 15-microns microspheres. Hypotension was associated with decreased blood flow to the kidneys in all groups and to the liver in the 2AD group and an increased blood flow to the heart in the SNP and 2AD groups. Hemorrhage decreased blood flow during deliberate hypotension to the brain and the gastrointestinal tract in the dISOH and 2ADH groups and to the liver in the dISOH group. Our results suggest that hemorrhage during deliberate hypotension with dISO or isoflurane plus 2AD may be associated with compromised organ blood flow, whereas blood flow to vital organs is maintained after 20% hemorrhage during isoflurane and superimposed SNP-induced hypotension.