麻醉对猪失血性休克模型血流动力学及氧动力学的影响

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动力学,失血性,休克,血流,麻醉
麻醉对猪失血性休克模型血流动力学及氧动力学的影响

张成;高广荣;张宝磊;蒋会勇;吕晨光;谢名双;张智丽;余筣;张雪峰

【期刊名称】《中国急救医学》【年(卷),期】2011(031)010

【摘要】Objective To investigate the effects of anesthesia on

hemodynamics and oxygen dynamics in a porcine model of hemorrhagic shock. Methods 16 Bama pigs were randomized into Lwo groups (n = 8, each); Aneslhesia (A) and Unanesthetized ( U). Venous blood (30 mL/kg) was conlinously withdrawn over 15 min in anesthetized and

unanesthetized swine to establish hemorrhagic shock model. Pulmonary arterial temperature (Tp) , heart rate(HR) , mean arterial pressure (MAP) , Pulmonary arterial pressure( PAP) , pulmonary arterial wedge

pressure( PAWP) , central venous pressure (CVP) , cardiac output(CO) , hemoglobin(Hb) , saturation of mixed venous blood(SvO2) and blood gas analysis were recorded at the baseline and different hemorrhagic shock time ( HST). The whole body oxygen delivery indices, DO2I and VO2I, and the O2 extraction ratio(O2ER) were calculated. Results Core body

temperature in group U decreased slightly after hemorrhagic shock model had been established and anesthesia resulted in more reduction in core body temperature. No difference was found in HR, MAP, PaO2, PaCO2 and pH between group A and group U, but unanesthetized animals had significantly higher levels of lactate. DO2I and VO2I decreased significantly

after hemorrhage, but DO2I, VO2I and O2ER in group U were significantly higher than group A at the baseline and different hemorrhagic shock time(HST). Conclusion Anesthesia attenuated the disorder of oxygen metabolism after hemorrhagic shock, which might be the results of induced hypothermia caused by anaesthesia.%目的探讨麻醉对猪失血性休克血流动力学及氧动力学的影响.方法巴马香猪16头随机分为:麻醉休克组和清醒休克组,每组8头.按30 mL/kg放血建立失血性休克模型,记录建模前及建模后4 h内不同时点的核心体温、心率(HR)、平均动脉压(MAP)、肺动脉压(PAP)、肺动脉楔压(PAWP)、中心静脉压(CVP)、心输出量(CO)、血红蛋白(Hb)、混合静脉血氧饱和度(SvO2)及血气分析变化,并计算氧摄取率(O2ER)、氧供指数(DO2I)和氧耗指数(VO2I).结果模型建立后清醒组动物核心体温略有下降,但麻醉组动物核心体温下降更加明显.两组的HR、MAP、PaO2、PaCO2及pH值未表现出明显差异,但清醒组乳酸水平明显高于麻醉组.尽管模型建立后两组的DO2I和VO2I都出现了相同幅度的下降,但清醒组的DO2I、VO2I和O2ER在模型建立前后都显著高于麻醉组.结论麻醉可以减轻失血性休克后的氧代谢紊乱,麻醉引起的诱导性低温可能是造成这种现象的原因.

【总页数】5页(P892-896)

【作者】张成;高广荣;张宝磊;蒋会勇;吕晨光;谢名双;张智丽;余筣;张雪峰

【作者单位】110016,沈阳,沈阳军区总医院普通外科;110016,沈阳,沈阳军区总医院普通外科;110016,沈阳,沈阳军区总医院普通外科;110016,沈阳,沈阳军区总医院普通外科;110016,沈阳,沈阳军区总医院普通外科;110016,沈阳,沈阳军区总医院普通外科;110016,沈阳,沈阳军区总医院普通外科;110016,沈阳,沈阳军区总医院普通外科;110016,沈阳,沈阳军区总医院普通外科

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