PICCO评估吸入一氧化氮对脓毒症幼猪血流动力学的影响  

Hemodynamic Monitoring with Pulse-indicator Continuous Cardiac Output(PICCO)in Piglets with Sepsis after Nitric Oxide Inhalation

作　　者：喻莉[1] 武晓灵[1] 张远超[1] 胡波[2] 项辉[2] 许涛[3] 

机构地区：[1]华中科技大学同济医学院附属武汉市中心医院重症医学科,武汉430014 [2]武汉大学中南医院重症监护室,武汉430071 [3]华中科技大学同济医学院附属武汉市普爱医院重症医学科,武汉430032

出　　处：《华中科技大学学报（医学版）》2015年第1期78-81,共4页Acta Medicinae Universitatis Scientiae et Technologiae Huazhong

基　　金：武汉市卫计委临床医学科研资助项目(No.WX10V09)

摘　　要：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10cm3/m3和80cm3/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10cm3/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。80cm3/m3组各项指标变化趋势同10cm3/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10cm3/m3和80cm3/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。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 cm^3/m^3 and 80 cm^3/m^3 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 cm^3/m^3 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 cm^3/m^3 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 cm^3/m^3 or 80 cm^3/m^3 NO gas.

关 键 词：脉波指示剂连续心排血量监测 一氧化氮 脓毒症 血流动力学 

分 类 号：R331.3[医药卫生—人体生理学]