[通过心肌钾和酸碱平衡评估不同手术诱导类型心脏骤停犬的心肌应激[作者译]。

C Franz, U Bovenkamp, H Hirche, W Hügel, B Maetzig, E Schumacher
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引用次数: 1

摘要

比较了以下几种人工心脏骤停与体外循环对杂种犬心肌应激的影响:主动脉阻塞后缺血停搏持续30或45分钟。2. 注射,心脏骤停据基尔希说持续90分钟。3.根据Bretschneider的说法,心脏骤停持续90分钟。比较以下参数:心脏骤停时细胞外钾活性([K+]e)和再流时动脉血和冠脉静脉血[K+],再流时总[K+]和酸碱平衡,心脏骤停后再流时[K+]和乳酸释放和摄取的时间过程。在我们的实验条件下,心肌[K+]和酸碱平衡的变化最低,根据Bretschneider输注心脏骤停后观察到。根据Kirsch的说法,注射-心脏截瘫对心脏的保护作用较弱,这可以通过更严重的酸中毒、更大的[K+]损失和回流期间[K+]摄取的延长来证明。以致死性心肌酸中毒为表现的中低温缺血性心脏骤停是最糟糕的人工停跳类型。
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[Myocardial stress of different surgically induced types of cardiac arrest in dogs evaluated by myocardial potassium and acid-base balance (author's transl)].

In mongrel dogs myocardial stress of the following types of artificial cardiac arrest in moderate hypothermia and cardiopulmonary bypass was compared: 1. Ischemic arrest after aortic occlusion lasting 30 or 45 minutes. 2. Injection-cardioplegia according to Kirsch lasting 90 minutes. 3. infusion-cardioplegia according to Bretschneider lasting 90 minutes. The following parameters were compared: extracellular potassium activity ([K+]e) during cardiac arrest and [K+] in arterial and coronary venous blood during reflow, total [K+] and acid-base balance during reflow, time course of [K+] and lactic acid release and uptake during reflow after cardiac arrest. In our experimental conditions the lowest alterations of myocardial [K+] and acid-base balance were observed after infusion-cardioplegia according to Bretschneider. Injection-cardioplegia according to Kirsch was less protective for the heart as evidenced by more intensive acidosis, enlarged [K+] loss and prolongation of [K+] uptake during reflow. Ischemic cardiac arrest in moderate hypothermia was the worst type of artificial standstill indicated by development of fatal myocardial acidosis.

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