CAJ | 학술논문

目的：利用脉波指示剂连续心排血量监测（PICCO ）技术观察脓毒症幼猪吸入不同浓度一氧化氮（NO ）后血流动力学的变化。方法16只脓毒症幼猪随机分为两组，分别吸入浓度为10 cm3/m3和80 cm3/m3的 NO气体，利用PICCO监护仪监测心脏指数（CI）、全心舒张末容积指数（GEDI）、胸腔内血容积指数（ITBI）和体循环阻力指数（SVRI），同时抽血作血气分析。结果静脉注入内毒素能够诱导稳定的幼猪脓毒症模型。该模型的血气指标pH、HCO3－、PaO2及平均动脉压（MAP）均显著下降（均 P＜0.01）。吸入NO气体后10 cm3/m3组CI及SVRI较吸入前明显升高（均 P＜0.01），PaO2较吸入前显著升高（P＜0.01），PaCO2明显降低（P＜0.01），而中心静脉压（CVP）、GEDI及ITBI无明显变化。80 cm3/m3组各项指标变化趋势同10 cm3/m3组，且两组之间比较差异无统计学意义。结论吸入 NO气体可改善脓毒症幼猪氧合功能和心脏指数。吸入10 cm3/m3和80 cm3/m3的NO气体对脓毒症幼猪血流动力学的影响差异无统计学意义。
목적：이용맥파지시제련속심배혈량감측（PICCO ）기술관찰농독증유저흡입불동농도일양화담（NO ）후혈류동역학적변화。방법16지농독증유저수궤분위량조，분별흡입농도위10 cm3/m3화80 cm3/m3적 NO기체，이용PICCO감호의감측심장지수（CI）、전심서장말용적지수（GEDI）、흉강내혈용적지수（ITBI）화체순배조력지수（SVRI），동시추혈작혈기분석。결과정맥주입내독소능구유도은정적유저농독증모형。해모형적혈기지표pH、HCO3－、PaO2급평균동맥압（MAP）균현저하강（균 P＜0.01）。흡입NO기체후10 cm3/m3조CI급SVRI교흡입전명현승고（균 P＜0.01），PaO2교흡입전현저승고（P＜0.01），PaCO2명현강저（P＜0.01），이중심정맥압（CVP）、GEDI급ITBI무명현변화。80 cm3/m3조각항지표변화추세동10 cm3/m3조，차량조지간비교차이무통계학의의。결론흡입 NO기체가개선농독증유저양합공능화심장지수。흡입10 cm3/m3화80 cm3/m3적NO기체대농독증유저혈류동역학적영향차이무통계학의의。
Objective To observe the hemodynamic changes in piglets with sepsis after inhalation of different concentra‐tions of nitric oxide(NO)by use of pulse‐indicator continuous cardiac output (PICCO).Methods Sixteen piglets with sepsis were randomly divided into two groups ,and were allowed to inhale 10 cm3/m3 and 80 cm3/m3 NO ,respectively. PICCO was ap‐plied to monitor the cardiac index (CI) ,global end‐diastolic volume index (GEDI) ,intrathoracic blood volume index (ITBI)and systemic venous resistance index(SVRI).Artery blood gas analysis was performed as well.Results Intravenous injection of en‐dotoxin could establish piglet models of stable sepsis. Artery blood gas analysis showed pH ,HCO3- ,PaO2 ,and mean arterial pressure(MAP)were significantly decreased in the piglet models (P< 0.01 for all).CI ,SVRI and PaO2 were significantly in‐creased and PaCO2 was significantly decreased in 10 cm3/m3 NO group(P<0.01) ,while central venous pressure(CVP) ,GEDI and ITBI had no significant change. These parameters had the same changes in 80 cm3/m3 NO group pulse‐indicator continuous cardiac output(PICCO).There was no statistically significant difference in the parameters between the two groups.Conclusion Inhalation of NO gas may improve oxygenation and cardiac index in piglets with sepsis. There was no significant difference in the hemodynamic changes after inhalation of 10 cm3/m3 or 80 cm3/m3 NO gas.