多沙普仑对犬失血性休克等容输血后血流动力学的影响

目的：观察多沙普仑对犬失血性休克等容输血后血流动力学的影响。方法：犬分为对照组和多沙普仑组（只数均＝５）。股动脉快速放血３０ｍｌ／ｋｇ，造成严重休克模型，３０分钟后等容输血。多沙普仑组输血后立即静脉注射多沙普仑２ｍｇ／ｋｇ。用Ｓｗａｎ－Ｇａｎｚ漂浮导管等方法分别于休克、输血前后测定血流动力学参数。结果：休克后５分钟、３０分钟ＭＡＰ、ＣＯ、ＣＩ、ＳＶ、ＬＶＳＷ、ＬＶＳＷＩ明显下降，ＳＶＲ明显增高。输血后１５分钟，多沙普仑组已恢复到休克前水平，但对照组则未能恢复。结论：多沙普仑能促进失血性休克等容输血后循环功能的恢复。     

多沙普仑纳络酮对失血性休克犬等容输血后血流动力学的影响

目的：在实验犬中观察多沙普化、纳络酮对失血性休克等容输血后血流动力学的影响。方法：实验犬分为对照组、多沙普化组和纳络酮组，每组５条，三组动物均以动脉快速放血３０ｍｌ／ｋｇ、造成严重失血性休克模型，３０ｍｉｎ后等容输血，多沙普仑组和纳络酮组分别于输血后立即静脉注射多潲普仑２ｍｇ／ｋｇ或纳络酮０．０１５ｍｇ／ｋｇ，采用Ｓｗａｎ－Ｇａｎｚ漂浮导管及心脏电脑监护仪等手段分别于动物休克、等容输血前后测定血流     

咪唑安定诱导对心脏瓣膜置换手术病人血流动力学的影响

１７例风湿性心脏病瓣膜置换术手同人，静注咪唑安定０．５ｍｇ／ｋｇ诱导，并以Ｓｗａｍ－Ｇａｎｚ导管测定血流动力学变化。ＭＡＰ、ＨＲ、ＣＩ、ＭＰＡＰ、ＰＣＷＰ、ＬＶＳＷＩ及ＲＶＳＷＩ均在诱导后明显下降，而ＲＡＰ、ＳＩ、ＳＶＲＩ及ＰＶＲＩ无明显变化，气管插ＭＡＰ、ＳＶＲＩ、ＰＶＲＩ增高。     

异丙酚诱异对心瓣膜手术病人血流动力学的影响

目的和方法：采用Ｓｗａｎ－Ｇａｎｚ导管及热稀释法检测心搏量技术,观测心瓣膜手术病人异丙酚（１．５ｍｇ／ｋｇ）诱导时的血流动力学（血动学）变化。结果：两组病人麻醉前血动学紊乱主要表现为右心后负荷及作功增加;给予异丙酚１．５ｍｇ／ｋｇ后２ｍｉｎ,ＨＲ、ＣＩ、ＭＰＡＰ、ＭＡＰ、ＭＣＷＰ、ＬＶＷＩ、ＲＶＷＩ较麻醉前明显降低,在无气管插管操作刺激的Ａ组中可一直持续,并超近１０ｍｉｎ;Ｂ组病人麻醉后３ｍｉｎ行     

腹腔镜胆囊切除术二氧化碳气腹对血流动力学的影响

通过对１０例腹腔镜胆囊切除术患者施以ｓｗａｎ—Ｇａｎｚ导管监测，探讨二氧化碳化气腹对血流动力学影响。于二氧化碳气腹前、充气后５分、２０分和放气后５分钟，分别测录血流动力学指标。结果：ＭＡＯ、ＣＶＰ、ＰＡＰ与ＰＣＷＰ于充气后５分钟，分别增加２８％、１７２％、８３％与１２１％；于充气后２ｏ分钟，分别增加３２％、２０９％、１４７％与１７３％，与充气前相比，变化非常显著（Ｐ＜０．０１）。与充气前相比，ＨＲ与ＰＶＲ于充气后５分和２０分钟均显著增加（Ｐ＜０．０１），ＳＶＲ、Ｃｌ、ＳＩ、ＬＶＳＷＩ与ＲＶＳＷＩ的变化无统计学意义（Ｐ＞０．０５）。提示我们应注意腹腔镜胆囊切除术中血流动力学的变化。     

体外循环结束后血流动力学稳定性研究

运用Ｓｗａｎ－Ｇａｎｚ导管监测技术对一组换瓣术病人ＣＰＢ结束后的血流动力学特点及影响因素进行了研究。结果显示，ＣＰＢ停机后ＣＩ明显增高，ＭＡＰ、ＭＰＡＰ、ＰＣＷＰ、ＰＶＲＩ及ＳＶＲＩ明显降低；随后ＣＩ略回降，ＭＡＰ渐上升至麻醉前值；但ＰＶＲＩ和ＳＶＲＩ仍明显低于麻醉前。ＣＰＢ后ＲＡＰ略高于麻醉前；ＬＶＷＩ有所增加，ＲＶＷＩ有所减低。Ｈｃｔ在停时最低，随后逐渐回升。相关分析显示ＣＩ与ＬＶＷＩ和ＲＶＷ     

咪唑安定硬膜外注射时患者血流动力学及通气功能变化

咪唑安定（ＭＩＤ）硬膜外注射的节段性镇痛效应及其对患者血流动力学（ＭＡＰ、ＨＲ、ＳＩ、ＣＩ、ＴＦＩ、ＶＥＴ、ＥＶＩ、ＳＶＲＩ、ＩＣ、ＰＥＩ、ＬＶＷＩ、ＲＰＰ）与通气功能（ＶＴ、ＲＲ、ＶＥ、ＦＥＶ１、Ｉ－ＥｔＯ２、ＰＥＴＣＯ２、ＳｐＯ２）的影响。４４例患者随机分成四组：Ｅ１组硬外注ＭＩＤ０．０５ｍｇ／ｋｇ，Ｅ２组硬外注ＭＩＤ０．１ｍｇ／ｋｇ，Ｖ１、Ｖ２组为静脉组，剂量与Ｅ１、Ｅ２组相同。结果：（１）     

曲马多,哌替啶和芬太尼对血流动力学影响的比较研究

１５只健康犬随机分三组，采用 Ｓｗａｎ－Ｇａｎｚ 漂浮导管及心脏电脑监测仪等手段，以哌替啶、芬太尼作对照，观察曲马多静脉用药前后血流动力学参数的变化。结果表明，曲马多（２ｍｇ／ｋｇ）血流动力学较稳定，用药后早期ＬＶＳＷ明显高于哌替啶和芬太尼组，ＳＶ也有所增加。提示：静脉应用曲马多心血管功能稳定，尤其对左室收缩功能影响较哌替啶、芬太尼更为有益。因此，曲马多用于临床是安全可行的     

大剂量安定与硫喷妥钠—安定诱导对心瓣膜手术病人血流动力…

对４３例ＣＰＢ下心瓣膜直视手术病人进行了血流动力学监测，其中采用大剂量安定诱导（Ｉ组）２２例，硫喷妥钠－安定诱导（Ⅱ组）２１例，诱导后，两组ＣＩ，ＭＰＡＰ，ＰＴＲＩ，ＬＶＷＩ及ＲＶＷＩ均降低，Ｉ组尚伴ＨＲ，ＭＡＰ，ＰＣＷＰ和ＰＶＲＩ下降，Ⅱ组ＲＡＰ及ＳＶＲＩ增加，气管插管后，两组ＲＡＰ，ＰＩＲＩ及ＳＶＲＩ显著增高Ｉ组ＭＡＰ，ＭＰＡＰ，ＰＣＷＰ增高，Ⅱ组ＣＩ下降，锯胸骨后，Ⅱ组ＣＩ，ＬＶＷＩ及ＲＶＷ     

大剂量吗啡,芬太尼及纳络酮对犬冠脉血流影响的实验研究

实验用犬９只，开胸分离冠脉左旋支，安置电磁流量仪探头，监测冠脉血流量（ＣＢＦ）。同时用生理多异议监测左室收缩压（ＬＶＳＰ）、平均动脉压（ＭＡＰ）、心率（ＨＲ）和心电图（ＥＣＧ）。给药前各指标为对照值。第１组６只，静注吗啡２ｍｇ·ｋｇ－１和纳络酮０．１ｍｇ·ｋｇ－１加吗啡２ｍｇ·ｋｇ－１。第２组３只，静注芬太尼１００ｕｇ·ｋｇ－１。结果表明：吗啡使冠脉血流量增加５６．８％，同时有ＬＶＳＰ、ＭＡＰ下降，ＨＲ无变化。上述作用可被纳络酮部分拮抗。芬太尼使ＨＲ、ＣＢＦ、ＬＶＳＰ、ＭＡＰ 下降，对循环功能有一定抑制作用。提示大剂量芬太尼用于心脏患者麻醉要慎重。而吗啡有扩张冠脉作用，用于心脏患者麻醉有利于体外循环后心脏复跳，尤其对心肌缺血患者麻醉有益。     

每搏量变异度与患者血容量变化的相关性

目的 评价每搏量变异度(SVV)与患者血容量变化的相关性.方法 择期胃癌根治术男性患者48例,年龄50～60岁,ASA分级Ⅱ级.麻醉诱导后30 min静脉输注6%羟乙基淀粉130/0.40.67 ml·kg-1·min-1,分别于输注前、输注羟乙基淀粉剂量达2、4、6、8、10、12、14、16、18 ml/kg时,记录SVV、CO、SV、CI和CVP.SVV、CO、SV、CI和CVP与羟乙基淀粉输注量行Spearman等级相关分析.结果 SVV、CO、SV、CI和CVP与羟乙基淀粉输注量之间的相关系数分别为:rSVV=-0.91±0.06,rCO=0.83±0.04,rSV=0.86±0.09,rCI=0.86±0.09,rCVP=0.90±0.03.5个相关系数中,rSVV最高,rCVP高于rCO、rSV和rCI(P＜0.05);rCO、rSV和rCI间比较差异无统计学意义(P＞0.05).结论 SVV与患者血容量变化相关性较高,可用于指导容量治疗.     

Cardiac output estimation with a new Doppler device after off-pump coronary artery bypass surgery

OBJECTIVE: To compare cardiac output (CO), stroke volume (SV), and cardiac index (CI) as estimated with a new, noninvasive Doppler device (Ultrasonic Cardiac Output Monitor [USCOM]; USCOM Ltd, Sydney, Australia) with those measured with the bolus thermodilution (TD) technique. DESIGN: Prospective nonrandomized study. SETTING: Postcardiac surgery recovery unit of a tertiary cardiac center. PARTICIPANTS: Fifty patients after off-pump coronary artery bypass (OPCAB) surgery. MEASUREMENT AND MAIN RESULTS: Both right-sided and left-sided CO were estimated with a USCOM continuous-wave (CW) Doppler device, and CO was determined with the bolus TD technique performed in triplicate. On comparing the right-sided CO, SV, and CI with those of TD, the mean bias was 0.03 L/min, 1.6 mL, and 0.02 L/min/m(2), respectively. The comparison of left-sided CO, SV, and CI with those of TD revealed a means bias of 0.14 L/min, 1.0 mL, and 0.08 L/min/m(2), respectively. CONCLUSION: This study showed excellent agreement between the values for CO, SV, and CI as determined with USCOM and TD. Since there was only 1 time period for CO estimation in each patient with both methods, the stability of this correlation needs to be further investigated over time.     

食管超声多普勒监测急性高容量血液稀释对血液动力学的影响

目的　应用经食管超声多普勒血液动力学监测仪 ,观察全麻下急性高容量血液稀释(HHD)的血液动力学和氧供 (DO2 )变化。方法　选择 1 5例ASAI～II级择期行非心脏手术患者。麻醉诱导插管后持续监测心输出量 (CO)、每搏量 (SV)、心脏指数 (CI)、血流峰速度 (PV)、血流加速度(Acc)和左室射血时间指数 (LVETi) ,每隔 5分钟输入MAP值后计算出系统血管阻力 (SVR)值。麻醉平稳和各项监测完成后 1 0min ,在 30min内输注 6 %羟乙基淀粉 (HES) 2 0ml/kg。记录 6 %HES输注前、输注 1 5和 30min时的各项监测数据 ,并抽取动脉血液样本行血气分析并计算DO2 。结果　与HHD前相比 ,血气各参数 (pH、PaO2 、PaCO2 、BE)均无明显差异 (P >0 0 5 ) ,而 6 %HES输注 1 5和30min血红蛋白 (Hb)含量、红细胞比积 (Hct)均明显下降 (P <0 0 5和P <0 0 1 )。 6 %HES输注 1 5和 30min时的CaO2 比HHD前明显下降 (P <0 0 5 ) ,而DO2 显著增加 (P <0 0 5 )。与HHD前测量值相比 ,6 %HES输注 1 5min ,CO、SV、CI、PV和Acc明显升高 ,SVR显著降低 (P <0 0 5 ) ;6 %HES输注 30min ,SV、PV和Acc进一步升高 (P <0 0 1 ) ,而CO、CI和SVR与 6 %HES输注 1 5min时无明显变化。MAP、HR和LVETi在HHD期间无明显变化。结论　术前输注 6 %HES 2 0ml     

Anaesthesia for morbidly obese patients: a study of haemodynamic changes during bariatric surgery

BACKGROUND AND AIMS: Morbid obesity with body mass index (BMI) > 40 kg/m2 requires surgical correction if the diet program fails. Laparoscopic adjustable gastric banding (LAGB) (bariatric surgery) is the standard surgical procedure. The haemodynamic effects of the typical pneumoperitoneum had been studied but, the additional effects of morbid obesity and the consequences of LAGB surgery had not. Therefore, we conducted this study to determine the haemodynamic changes under anaesthesia during bariatric surgery. MATERIALS AND METHODS: Under general anaesthesia, 7 patients (4 males) were studied. Their mean age was 36.2 yr (range 25-50 yr) and mean BMI was 49.7 kg/m2 (range 39.3-67.3). Besides routine monitoring of vital signs, non invasive cardiac output monitor (NICO, Novametrix, Wallingford, CT, USA) was used to monitor cardiac output (CO), cardiac index (CI) and stroke volume (SV). All the haemodynamic variables were taken at three phases: A) after induction of anaesthesia, B) during pneumoperitoneum and C) after gas deflation. RESULTS: The mean HR and BP showed significant high values during phase B compared to phase A. The mean values of CO were 7.2 +/- 1.1 and 9.06 +/- 2.6 L/min during phases A and B respectively with significant differences. The mean values of SV were 91.1 +/- 12.3 and 123.2 +/- 42.6 ml during phases A and B respectively with significant differences. The mean values of CI during phases A and B were 3.1 +/- 0.7 and 3.4 +/- 1.09 L/min/m2 respectively with significant differences. CONCLUSIONS: We have reported high CO and CI during pneumoperitoneum, which may be due to increased heart rate induced by sympathetic stimulation.     

Relationship between stroke volume, cardiac output and filling of the heart during tilt

Background: Cardiac function curves are widely accepted to apply to humans but are not established for the entire range of filling of the heart that can be elicited during head-up (HUT) and head-down tilt (HDT), taken to represent minimal and maximal physiological filling of the heart, respectively. With the supine resting position as a reference, we assessed stroke volume (SV), cardiac output (CO) and filling of the heart during graded tilt to evaluate whether SV and CO are maintained during an assumed maximal physiological filling of the heart elicited by 90° HDT in healthy resting humans.
Methods: In 26 subjects, central blood volume was manipulated with graded tilt from 60° HUT to 90° HDT. We measured SV, CO (Finometer^®) and cardiac filling by echocardiography of the left ventricular end-diastolic volume (LVEDV; n =12).
Results: From supine rest to 60° HUT, SV and CO decreased 23 ml [confidence intervals (CI): 16–30; P <0.001; 23%] and 0.9 l/min (0.4–1.4; P <0.0001; 14%), respectively, but neither SV nor CO changed during HDT up to 70°. However, during 90° HDT, SV decreased 12 ml (CI: 6–19; P <0.0001; 12%), with an increase of 21 ml (9–33; P =0.002; 16%) in LVEDV because HR increased 3 bpm and CO decreased 0.5 l/min (ns).
Conclusion: This study confirmed that SV and CO are maximal in resting, supine, healthy humans and decrease during HUT. However, 90° HDT was associated with increased LVEDV and induced a reduction in SV.     

Cardiodynamic effects of propofol in comparison with thiopental: assessment with a transesophageal echocardiographic approach

In 40 patients, the cardiovascular effects of low- and high-dose propofol anesthesia (single bolus of 1.5 mg/kg in group A, 2.5 mg/kg in group C) were examined and compared with those of low- and high-dose thiopental (4 mg/kg in group B, 6.5 mg/kg in group D) (n = 10 patients per group). After induction of anesthesia with etomidate, all patients were ventilated with 70% nitrous oxide in oxygen. Peripheral arterial systolic blood pressure (SAP) and transesophageal echocardiographic short-axis measurements were used to calculate the end-systolic pressure-volume relationship (E) as an index of global myocardial contractility. In all groups SAP decreased significantly below baseline levels for the duration of the measurements (15 min after drug administration), except for the lower dose of thiopental, where SAP returned to baseline values within 10 min. Propofol at a dose of 1.5 mg/kg significantly decreased cardiac output (CO) (from 5.1 +/- 0.25 [mean +/- SEM] to 4.2 +/- 0.23 L/min), stroke volume (SV) (from 64 +/- 3 to 56 +/- 3.6 mL), and the slope of E (from 71 +/- 3.5 to 65 +/- 4.2 mm Hg/mL) until 4 min after drug administration. The higher dose of propofol significantly decreased CO (from 5.1 +/- 0.29 to 4.1 +/- 0.26 L/min), SV (from 64 +/- 3 to 52 +/- 4.6 mL), and the slope of E (from 71 +/- 3.6 to 62 +/- 3.7 mm Hg/mL) until 10 min after drug administration.(ABSTRACT TRUNCATED AT 250 WORDS)     

Antiandrogenic activities of Glycyrrhiza glabra in male rats

Abnormal levels of androgens cause many diseases like benign prostatic hyperplasia and hormone dependent cancers. Although the reduction in serum testosterone (T) by Glycyrrhiza glabra has been reported, its effects on seminal vesicle (SV) and prostate tissues have never been reported. This study was carried out to investigate different aspects of antiandrogenic properties of this plant. Immature male rats were divided into five groups ( n  = 7): castrated rats without any treatment received only vehicle; castrated rats plus T replacement; three castrated groups with T replacement plus various doses of G. glabra extract (75, 150 and 300 mg/kg). All of the injections were carried out once daily in subcutaneous manner for 7 days. On the eighth day, blood samples were collected for total T measurement. Ventral prostate (VP), SV and levator ani muscle were dissected and weighed. Slides prepared from prostate were assessed histologically. The variation in the relative and absolute volume of the prostate tissue compartments was determined. Those receiving the doses of 150 and 300 mg/kg showed a significant reduction ( p  <   0.05) in prostate weight, total T and VP epithelium/stroma ratio (V/V). These results in SV and levator ani were shown in response to 300 mg/kg of extract. Increasing in T metabolism, down-regulation of androgen receptors or activation of oestrogen receptors could be involved mechanisms. This study showed that alcoholic extract of G. glabra has antiandrogenic properties.     

Role of zatebradine and propranolol in attenuation of tachycardia produced by dobutamine in pigs

Background: Zatebradine is a new specific bradycardic agent that selectively slows the depolarization in the pacemaker cells of the sinoatrial node. The purpose of our investigation was to determine whether the tachycardia induced by dobutamine can be attenuated by the administration of zatebradine. The results were compared with those produced by propranolol, which is used in the treatment of sinus tachycardia.
Methods: Twelve pigs were anesthetized with sodium pentobarbital, intubated, and ventilated. After baseline hemodynamic measurements were obtained, dobutamine was administered until the heart rate reached 25% above baseline. Animals were randomized to one of two groups. Group I received zatebradine, 0.5 mg/kg IV, and Group II received propranolol, 0.5 mg/kg IV.
Results: Dobutamine 10 μg kg^-1 min^-1 increased the heart rate (HR) by 25%, and increased mean arterial blood pressure (MAP), left ventricular (LV) dP/dt, and cardiac output (CO) ( P < 0.05). Zatebradine decreased the HR to baseline ( P < 0.05) without affecting left ventricular systolic pressure (LVSP), left ventricular end diastolic pressure (LVEDP), LV dP/dt, or CO. Stroke volume (SV) increased significantly ( P < 0.05). Propranolol also reduced HR to baseline, but decreased LV dP/dt, LVSP, CO, and SV ( P < 0.05).
Conclusion: Zatebradine effectively attenuates the tachycardia caused by dobutamine in anesthetized pigs, without reducing cardiac performance.