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Influences of exclusion of pulmonary circulation on systemic circulatory conditions

排除肺循环对全身循环状况的影响

基本信息

批准号：
07457301
负责人：
TAENAKA Yoshiyuki
金额：
$ 4.61万
依托单位：
National Cardiovascular Center Reseatch Institute
依托单位国家：
日本
项目类别：
Grant-in-Aid for Scientific Research (B)
财政年份：
1995
资助国家：
日本
起止时间：
1995 至 1996
项目状态：
已结题

项目摘要

The pulmonary arterial blood flow (PAF), which plays an important role in metabolizing various vesoactive substances, is reduced during venoarterial bypass (VAB) including cardiopulmonary bypass and ECMO.The influence of reduced PAF during VAB on hemodynamic and humoral conditions ws investigated in a series of chronic animal experiments. A biventricular bypass system with two pulsatile ventricular assist devices (VADs) was first installed in adult goats. After two weeks of convalescent period, VAB was conducted using the right uptake and left-return cannular and a VAD,in combination with a compact artificial lung interposed in the return cannula. The PAF was reduced stepwise from 100% to 50,25,10, and 0% of total systemic blood flow by occluding the pulmonary artery with a baloon catheter. The animals' respiration was sufficiently maintained with the native and artificial lungs at any time of the experiments. The mean aortic pressure and the systemic vascular resistance decreased from 111(]SY.+-。[)12 to 62(]SY.+-。[)6 mmHg, and from 1089(]SY.+-。[)95 to 650(]SY.+-。[)150 dyne・sec・cm-5, respectively, in proportion to the decrease in PAf from 100 to 0%. The prostaglandin E2 concentration increased from 2.1(]SY.+-。[)1.6 to 12.5(]SY.+-。[)2.1 pg/dl in proportion to the decrease in PAF from 100 to 0%. Such proportional change to the PAF was also observed for plasma renin activity and angiotensin I and II.In contrast, the epinephrine and norepinephrine concentrations (60(]SY.+-。[)28 and 307(]SY.+-。[)194 pg/dl, respectively, at 100% of PAF) did not change appreciably even at 10% of PAF (49(]SY.+-。[)34 and 217(]SY.+-。[)141 pg/dl), but drastically elevated to 442(]SY.+-。[)285 and 628(]SY.+-。[)519 pg/dl when the PAF was completely shut off. The similar mode of change was also noted for antidiuretic hormone. In conclusion, the decrease in PAF during VAB exerts dignificant influences on hemodynamics in a proportional manner, and on vasoactive humoral factors in diverse manners.

在体外循环和体外膜肺氧合（ECMO）中，肺动脉血流量（PAF）在各种血管活性物质的代谢中起着重要作用，而在体外循环中，PAF的减少对血流动力学和体液条件的影响是通过一系列慢性动物实验来研究的。首次在成年山羊上安装了带有两个脉动心室辅助装置（VAD）的双心室旁路系统。经过两周的恢复期后，使用右摄取和左返回套管和VAD，结合插入返回套管中的紧凑型人工肺进行VAB。用球囊导管阻断肺动脉，使PAF从100%逐步降至50%、25%、10%和0%。在实验的任何时间，用天然肺和人工肺充分维持动物的呼吸。平均主动脉压和体循环血管阻力从111（±）SY. [)12至62（±）SY. [)6 1089（±）. [)95至650（±）SY. [)150 dyne·sec·cm-5，与PAf从100%降至0%成比例。前列腺素E_2浓度从2.1（± SD）增加到2.1（± SD）。[)1.6至12.5（±）SY. [)2.1 pg/dl，与PAF从100%降至0%成比例。血浆肾素活性和血管紧张素I和II也观察到与PAF成比例的变化。[)28和307（]SY. ±. [)194在100% PAF下，分别为49（± 0.5pg/dl），即使在10% PAF下也没有明显变化（49（± 0.5pg/dl），[)34和217（]SY. [)141 pg/dl），但急剧升高至442（± 1.5pg/dl）。[)285和628（]SY. [)519当PAF完全关闭时，浓度为pg/dl。抗利尿激素也有类似的变化模式。总之，VAB时PAF的降低对血流动力学有重要影响，并以不同方式影响血管活性体液因子。