Pathophysiology of multiple organ failure

严重的机体损伤会导致细胞损伤，可能导致多器官功能衰竭，但对这种情况下氧代谢的变化研究不多，因此我们尝试采用近红外光谱法对不同条件下的细胞色素氧化酶进行原位检测，并设计了新的近红外光谱仪，改进了对脑或肝的无创传感器，确定了能分离血红蛋白和细胞色素氧化酶吸收的适宜吸收波长，麻醉大鼠，用比血浆本身更有效地运输溶解氧的fluosol进行血液交换。用氟溶胶交换血液，可以忽略血红蛋白吸收对细胞色素吸收的影响。术后逐渐减少吸入氧10%左右，维持人工呼吸。只要氧浓度保持低，细胞色素氧化酶就继续处于还原状态。细胞内的氧气。在另一个系列中，血液被放血到维持50mmHg收缩压的水平。在此条件下，细胞色素氧化酶相当好地维持在正常水平相比，在缺氧系列。细胞色素氧化酶的测定可作为分析多器官功能衰竭时细胞紊乱的一个有用参数。

Severe insult to the body caused the cellular damage,which might contribute to establish the multiple organ failure.However,the changes in oxygen metabolism in such a condition were not well studied,so we tried to measure in situ cytochrome oxidase in different conditions,applying near infra-red spectrometric method.Near infra-red spectrometer was newly designed to improve the maneuver such as the innovation of the non-invasive sensor to brain or liver,suitable absorption wave lengths were determined to be able to separate hemoglobin and cytochrome oxidase absorption.Rats were anesthetized and blood was exchanged with fluosol which could transports the dissolved oxygen more effectively than the plasma itself. Blood being exchanged with fluosol,it is possible to neglect the influence of hemoglobin absorption upon cytochrome absorption. After then,inspired oxygen was gradually decreased about 10%,whereas the artificial respiration,was maintained at the same condition. As long as the oxygen concentration remained low, cytochrome oxidase was continued to be in a reduced state. The cellular oxygen. environment was shown to be severely deranged.On the other series, blood was exsanguidated to the level at which 50mmHg of systolic blood pressure was maintained. In this condition cytochome oxidase was rather well maintained at normal level compared to that in hypoxic series. Measurement of cytochrome oxidase would be a useful parameter to analyze the cellular derangement in the multiple organ failure.