CARDIOVASCULAR-RESPONSES TO ELEVATION OF INTRA-ABDOMINAL HYDROSTATIC-PRESSURE
CARDIOVASCULAR-RESPONSES TO ELEVATION OF INTRA-ABDOMINAL HYDROSTATIC-PRESSURE
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DOI：
10.1152/ajpregu.1985.248.2.r208
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发表时间：
1985-01-01
影响因子：
--
通讯作者：
GRANGER, HJ
中科院分区：
文献类型：
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作者：
BARNES, GE;LAINE, GA;GRANGER, HJ
正压输注Tyrode溶液使麻醉犬腹腔内液量和静水压力升高。腹腔顺应性由10.8 ml .cntdot降至0.56 ml .cntdot。毫米Hg-1 .cntdot。腹膜压力升高引起横膈膜膨出，胸内压力也随之升高。腹内压升高40 mm Hg后，心输出量和脑卒中量减少36%；心率没有变化。腹腔、肠系膜上动脉和肾动脉的流量分别减少了42%、61%和70%。股静脉压力升高至46 mm Hg，股动脉血流减少65%。全身耗氧量、pH值和动脉血氧分压随腹内压升高而降低。腹膜腔具有很高的初始顺应性，在血管压力或通透性增加时，为机体暂时积聚小至中等体积的液体提供了理想的位置。心血管系统血流动力学特性的显著改变表明，当腹内液体积聚过度和腹膜压力升高到高水平时，就会发生生理变化。
Intraabdominal fluid volume and hydrostatic pressure were elevated by positive pressure infusion of Tyrode solution into the peritoneal cavity of anesthetized dogs. The compliance of the peritoneal cavity fell from 10.8 to 0.56 ml .cntdot. mm Hg-1 .cntdot. kg-1 of body wt as intraabdominal pressure increased from 0-40 mm Hg. Intrathoracic pressure also increased as elevated peritoneal pressure caused diaphragmatic bulging. Cardiac output and stroke volume were reduced by 36% after an intraabdominal pressure rise of 40 mm Hg; heart rate did not change. Flow in the celiac, superior mesenteric and renal arteies was reduced by 42, 61 and 70%, respectively. Pressure in the femoral vein increased to 46 mm Hg, while flow in the femoral artery decreased by 65%. Whole-body O2 consumption, pH and arterial PO2 [partial pressure of O2] decreased as intraabdominal pressure rose. The peritoneal cavity, with its high initial compliance, affords the body an ideal location for the temporary accumulation of small to moderate volumes of fluid during episodes of increased vascular pressure or permeability. The marked alterations in the hemodynamic properties of the cardiovascular system are indicative of the physiological changes that occur when intraabdominal fluid accumulation becomes excessive and peritoneal pressure rises to high levels.