Sex dependent effects of cardiovascular agents on hemoglobin oxygen affinity – An ex-vivo experiment

IF 3.2 3区医学 Q2 CRITICAL CARE MEDICINE Journal of critical care Pub Date : 2024-09-18 DOI:10.1016/j.jcrc.2024.154916

Simon Woyke , Marco Ronzani , Norbert Mair , Christoph Frisch , Katharina Marcher , Thomas Haller , Mathias Ströhle , Christopher Rugg

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Abstract

Background

Hemoglobin‑oxygen (Hb-O₂) affinity is an important determinant for oxygen delivery and oxygen extraction. Although cardiovascular agents such as noradrenaline, adrenaline, atropine, milrinone and levosimendan are widely used in intensive care units worldwide, nothing is known about their possible effects on Hb-O₂ affinity.

Methods

In this experimental ex-vivo trial, venous blood samples were taken from 5 male and 6 female volunteers and incubated with the particular cardiovascular agents. Oxygen dissociation curves (ODC) were measured in-vitro with a new high-throughput method.

Results

Compared to the P₅₀ in male and female controls, a significant right-shift of the ODC was found for noradrenaline and milrinone in all participants and for levosimendan in male samples only. Adrenaline decreased Hb-O₂ affinity in male samples, atropine in female samples only.

Discussion

All investigated agents decreased Hb-O₂ affinity, with marked differences between males and females. Although the underlying mechanisms remain unclear, the extent of these effects may increase oxygen extraction at the tissue level as long as pulmonary oxygen uptake is maintained.

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心血管药物对血红蛋白氧亲和力的影响与性别有关--体外实验

背景血红蛋白-氧（Hb-O2）亲和力是决定氧输送和氧提取的重要因素。尽管去甲肾上腺素、肾上腺素、阿托品、米力农和左西孟旦等心血管药物在全球重症监护病房中广泛使用，但人们对它们可能对 Hb-O2 亲和力产生的影响却一无所知。结果与男性和女性对照组的 P50 值相比，所有参与者的去甲肾上腺素和米力农的 ODC 值都出现了明显的右移，只有男性样本中的左西孟旦的 ODC 值出现了右移。肾上腺素可降低男性样本的 Hb-O2 亲和力，阿托品仅可降低女性样本的 Hb-O2 亲和力。尽管其潜在机制尚不清楚，但只要肺氧摄取量得以维持，这些影响的程度可能会增加组织水平的氧萃取。

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来源期刊

Journal of critical care 医学-危重病医学

CiteScore

8.60

自引率

2.70%

发文量

237

审稿时长

23 days

期刊介绍： The Journal of Critical Care, the official publication of the World Federation of Societies of Intensive and Critical Care Medicine (WFSICCM), is a leading international, peer-reviewed journal providing original research, review articles, tutorials, and invited articles for physicians and allied health professionals involved in treating the critically ill. The Journal aims to improve patient care by furthering understanding of health systems research and its integration into clinical practice. The Journal will include articles which discuss: All aspects of health services research in critical care System based practice in anesthesiology, perioperative and critical care medicine The interface between anesthesiology, critical care medicine and pain Integrating intraoperative management in preparation for postoperative critical care management and recovery Optimizing patient management, i.e., exploring the interface between evidence-based principles or clinical insight into management and care of complex patients The team approach in the OR and ICU System-based research Medical ethics Technology in medicine Seminars discussing current, state of the art, and sometimes controversial topics in anesthesiology, critical care medicine, and professional education Residency Education.