Cardiodynamic response to Escherichia coli endotoxemia: effects of fluid resuscitation.
Cardiodynamic response to Escherichia coli endotoxemia: effects of fluid resuscitation.
复制标题
对大肠杆菌内毒素血症的心脏动力学反应：液体复苏的影响。
DOI：
10.1097/00024382-199409000-00008
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发表时间：
1994
期刊：
影响因子：
--
通讯作者：
Adams,HR
中科院分区：
文献类型：
--
作者：
Zhong,J;Rubin,LJ;Parker,JL;Adams,HR
我们测试了体内容量复苏对内毒素血症豚鼠左心室（LV）制备物固有收缩特性的影响。将注射大肠杆菌内毒素（LPS）的动物分为非复苏组和复苏组。容量复苏改善心输出量和每搏输出量，增加动脉pH值和体温，降低死亡率。在注射LPS后4小时分离的等容LV制备物中，在液体复苏（42+/-3）和无液体复苏（42+/-2）的情况下，LPS的LV收缩压（mmHg）始终低于对照值（70+/-3）。在LPS未复苏的心脏中，LV舒张末期压力-容积（顺应性）降低，而LPS复苏的心脏的LV顺应性与对照组相似。因此，血管内容量扩张选择性地改善了LPS心脏的LV舒张顺应性，而不影响LV收缩功能。这些结果表明，左室收缩和舒张功能障碍与内毒素血症和革兰氏阴性脓毒症可能涉及不同的致病机制。
We tested the influence of in vivo volume resuscitation on intrinsic contractile properties of left ventricular (LV) preparations of endotoxemic guinea pigs. Escherichia coli endotoxin (LPS)-injected animals were divided into nonresuscitated and resuscitated groups. Volume resuscitation improved cardiac output and stroke volume, increased arterial pH and body temperature, and decreased mortality. In isovolumetric LV preparations isolated 4 h after LPS injection, LV systolic pressures (in mmHg) of LPS with (42+/-3) and without (42+/-2) fluid resuscitation were consistently less than control values (70+/-3). LV end-diastolic pressure-volume (compliance) decreased in LPS-nonresuscitated hearts, while LV compliance of LPS-resuscitated hearts was similar to control. Thus, intravascular volume expansion selectively improved LV diastolic compliance of LPS hearts without affecting LV systolic function. These findings suggest that LV systolic and diastolic dysfunctions associated with endotoxemia and Gram-negative sepsis may involve separate pathogenic mechanisms.