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Cardiodynamic Study on the Low Pressure System Under Anesthesia

麻醉下低压系统的心动力研究

基本信息

批准号：
63480355
负责人：
MUTEKI Takesuke
金额：
$ 3.78万
依托单位：
Kurume University
依托单位国家：
日本
项目类别：
Grant-in-Aid for General Scientific Research (B)
财政年份：
1988
资助国家：
日本
起止时间：
1988 至 1990
项目状态：
已结题

项目摘要

Our research work has been aimed to document clinical significance of Venous Return (VR) mechanism in circulatory management for critically ill and surgical patients. In order to extend clinical significance of monitoring of Central Venous Pressure (CVP) and its waveforms, electromechanical analysis of CVP waveforms was made with an aid of fiber optic technique and microcomputer under critical care, and clinical measurement of mean circulatory filling pressure (Pms) was newly accomplished by graphic analysis. Venous Return Resistance (VRR) was then calculated by the equation of Pms - CVP/VR. Rvr was changed correlatively by a decrease of Pms than that of CVP and was reduced in higher cardiac out group under circulatory management with vasodilator such as GTN and PGE_1. Cardiodynamic analysis of venous return flow during closed chest cardiac massage was carried out and regurgitant fraction of venous return flow to RV was found in closed - chest cardiac massage with a fundamental study o … More n changes of blood flow and dimension of inferior caval vein with use of pulsed doppler flow/dimension system. It was therefore suggested that closed chest cardiac massage should be carefully performed in order to maintain cardiac output efficiently during restricted time in cardiac resuscitation.Interrelation between right cardiac hemodynamics and plasma levels of alpha - ANP was investigated in three groups of mongrel dogs under various modes of mechanical ventilation. HFJV improved diuretic function, while CPPV impaired a release of alpha - ANP. HFJV also facilitated cardiodynamic performance of the right heart and increased urinary output under elevated intra - thoracic pressure. These results suggested that facilitatory action on venous return to the heart and a secretion of alpha - ANP may contribute to improve diuretic function during HFJV, where as continuous distention of the lung under CPPV may impair venous return and secretion of alpha - ANP, and consequently, may depress diuretic functions. Our research work pertaining to venous return hemodynamics particularly suggested that clinical measurement of Pms and Rvr in surgical patients is useful in order to develop a new aspect of circulatory management during anesthesia. Less

我们的研究工作旨在证明静脉回流（VR）机制在危重病人和外科病人循环管理中的临床意义。为了拓展中心静脉压（CVP）及其波形监测的临床意义，利用光纤技术和微机对危重监护下中心静脉压（CVP）波形进行了机电分析，并利用图形分析新完成了临床平均循环充血压力（Pms）的测量。用Pms - CVP/VR公式计算静脉回流阻力（VRR）。与CVP相比，Pms的降低与Rvr的变化相关，在使用血管扩张剂GTN和PGE_1进行循环管理的高心输出组Rvr降低。应用脉冲多普勒血流/维数系统对下腔静脉血流及维数的变化进行了初步的研究，并对闭式胸部心脏按摩时静脉回流血流进行了心动力学分析，发现静脉回流至右室的反流部分。因此，在心脏复苏中应谨慎进行闭式胸心按摩，以便在有限的时间内有效地维持心输出量。研究了三组杂种狗在不同机械通气模式下右心血流动力学与血浆α - ANP水平的关系。HFJV改善了利尿功能，而CPPV损害了α - ANP的释放。在胸内压升高的情况下，HFJV还能促进右心的心动力表现和增加尿量。这些结果表明，促进心脏静脉回流和α - ANP的分泌可能有助于改善HFJV期间的利尿功能，而CPPV下肺的持续扩张可能损害静脉回流和α - ANP的分泌，从而可能抑制利尿功能。我们关于静脉回流血流动力学的研究工作特别表明，手术患者Pms和Rvr的临床测量对于开发麻醉期间循环管理的新方面是有用的。少