Zhongguo wei zhong bing ji jiu yi xue = Chinese critical care medicine = Zhongguo weizhongbing jijiuyixue · 2004
[Experimental study of hemodynamics and oxygen metabolism in pigs with severe acute pancreatitis].
Аннотация на английскомСтатьяПоддержка исследования: вне правительства СШАНазвание и аннотация: Перевод в очереди
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Zhang Zhen-huan, Li Wei-qing, Wang Hao, Yan Xiao-wen, Ying Yue, Gu Jun, Li Jie-shou
Аннотация
OBJECTIVE: To observe the changes in hemodynamics and oxygen metabolism in pigs with severe acute pancreatitis (SAP) so as to provide a theoretical basis for clinical treatment.
METHODS: A porcine model of SAP was reproduced by infusing normal saline (1 ml/kg) of sodium taurocholate (4%) and trypsin (1%) into the pancreatic duct (n=8). Heart rate (HR), central venous pressure (CVP), mean arterial pressure (MAP), pulmonary arterial wedge pressure (PAWP), mean pulmonary arterial pressure(MPAP) and cardiac output were continuously measured with the aid of Swan-Ganz catheter and electrocardiography monitor, and cardiac index (CI) was calculated. Oxygen delivery (DO(2)), oxygen consumption (VODO(2)) and oxygen extraction (ODO(2)ext) were calculated according to the analysis of the blood-gases in arterial and mixed venous blood at 0, 6, 12, 24, 36 hours after taurocholic acid injection, and the result were analyzed.
RESULTS: Compared with baseline (0 hour), MAP and CI decreased significantly 12 hours after the acid insult (all P<0.05). Both of partial pressure of artery (PaO(2)) and DO(2) showed a tendency to fall. Compared with 0 hour, PaO(2) decreased significantly at 6, 12, 24 and 36 hours (all P<0.05), and DO(2)at 24 hours (P<0.05). The trends of VO(2) and O(2)ext were consistent, both of them peaked at 6 hours (both P<0.05), then, began to lower, and the difference was statistically significance at 24 hours (both P<0.05).
CONCLUSION: There is not only hemodynamic disturbances but also oxygen metabolism dysfunction in pigs with SAP. The pathogenesis of multiple organ dysfunction syndrome might be attributable to the lowering of VO(2) and O(2)ext.
METHODS: A porcine model of SAP was reproduced by infusing normal saline (1 ml/kg) of sodium taurocholate (4%) and trypsin (1%) into the pancreatic duct (n=8). Heart rate (HR), central venous pressure (CVP), mean arterial pressure (MAP), pulmonary arterial wedge pressure (PAWP), mean pulmonary arterial pressure(MPAP) and cardiac output were continuously measured with the aid of Swan-Ganz catheter and electrocardiography monitor, and cardiac index (CI) was calculated. Oxygen delivery (DO(2)), oxygen consumption (VODO(2)) and oxygen extraction (ODO(2)ext) were calculated according to the analysis of the blood-gases in arterial and mixed venous blood at 0, 6, 12, 24, 36 hours after taurocholic acid injection, and the result were analyzed.
RESULTS: Compared with baseline (0 hour), MAP and CI decreased significantly 12 hours after the acid insult (all P<0.05). Both of partial pressure of artery (PaO(2)) and DO(2) showed a tendency to fall. Compared with 0 hour, PaO(2) decreased significantly at 6, 12, 24 and 36 hours (all P<0.05), and DO(2)at 24 hours (P<0.05). The trends of VO(2) and O(2)ext were consistent, both of them peaked at 6 hours (both P<0.05), then, began to lower, and the difference was statistically significance at 24 hours (both P<0.05).
CONCLUSION: There is not only hemodynamic disturbances but also oxygen metabolism dysfunction in pigs with SAP. The pathogenesis of multiple organ dysfunction syndrome might be attributable to the lowering of VO(2) and O(2)ext.