缺氧性肺血管收缩
呼吸性碱中毒
呼吸性酸中毒
肺气压
碱中毒
酸中毒
缺氧(环境)
代谢性碱中毒
代谢性酸中毒
麻醉
内科学
血管收缩
医学
呼吸系统
心脏病学
化学
氧气
有机化学
作者
Serge Brimioulle,Philippe Lejeune,Jean-Luc Vachiery,Marc Leeman,Christian Melot,Robert Naeije
出处
期刊:American Journal of Physiology-heart and Circulatory Physiology
[American Physical Society]
日期:1990-02-01
被引量:52
标识
DOI:10.1152/ajpheart.1990.258.2.h347
摘要
We studied the effects of metabolic and respiratory acidosis (pH 7.20) and alkalosis (pH 7.60) on pulmonary vascular tone in 32 pentobarbital-anesthetized dogs ventilated with hyperoxia (inspired oxygen fraction, FIO2 0.40) and with hypoxia (FIO2 0.10). Ventilation, pulmonary capillary wedge pressure (Ppw), and cardiac output (3 l.min–1.m-2) were maintained constant to prevent passive changes in pulmonary arterial pressure (Ppa). Metabolic acidosis and alkalosis were induced with HCl (2 mmol.kg-1.h-1) and NaHCO3-Na2CO3 (5 mmol.kg-1.h-1) infusions, respectively, and respiratory acidosis and alkalosis by modifying the inspiratory CO2 fraction. The hypoxia-induced rise in Ppa-Ppw gradient increased from 5 to 9 mmHg in metabolic acidosis (P less than 0.001), decreased from 6 to 1 mmHg in metabolic alkalosis (P less than 0.001), remained unchanged in respiratory acidosis, and decreased from 5 to 2 mmHg in respiratory alkalosis (P less than 0.001). Linear relationships were found between pH and Ppa-Ppw gradients. These data indicate that in intact anesthetized dogs, metabolic acidosis and alkalosis, respectively, enhance and reverse hypoxic pulmonary vasoconstriction (HPV). Respiratory acidosis did not affect HPV and respiratory alkalosis blunted HPV, which suggests an pH-independent vasodilating effect of CO2.
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