Abstract
We evaluated haemodynamic and blood gas changes following the intravenous infusion of starch microemboli (63–74u). Comparisons were made between dogs receiving a single embolus and dogs receiving an equal quantity of embolus divided into small doses given at 30 minute intervals (multiple emboli). The most significant finding was that the same quantity of embolus produces different effects. In the dogs receiving a single embolus of 150 mg kg-1 of starch, Pao2 fell from 11.3 to 7.6 kPa (85 to 57 torr) (p < 0.025) and QS/QL increased from 11 to 34 per cent (p< 0.01). In the multiple emboli dogs, after a total dose of 150 mg- kg-1 of starch, there was a small but not significant fall in Pao2 from 11.6 to 10.8 kPa (87 to 81 torr), and QS/QL did not change significantly. In the single embolus dogs Q increased significantly after an embolus of l00 mg kg-1 of starch (p< 0.05). After a single embolus of 150 mg kg-1, Q was variable; 3 dogs showed a decrease, and 2 an increase, however the mean change was not significant. In the multiple emboli dogs, Q decreased significantly (p < 0.005).
Résumé
On a évalué sur l’hémodynamie et les gaz du sang le retentissement causé par la perfusion intro-veineuse de microembolies d’amidon (63–74 u). Les auteurs ont comparé entre eux des chiens qui recevaient un seul embole à des chiens qui recevaient une quantité égale d’emboles divisés en petites doses et administrés à des intervalles de 30 minutes (embolies multiples). La conclusion la plus remarquable aété que la même dose d’emboles pourrait produire des effets différents. Sur le chien qui recevait un seul embole de 150 mg kg-1 ’ d’amidon, la Pao2 a fait une chute de 11.3 à 7.6 kPa (85 à 57 torr) (p < 0.025) et le QS/QL a augmenté de 11 à 34 pour cent (p < 0.01). Sur le chien chez qui on avait fractionné les emboles, les auteurs ont constaté après une dose totale de 150 mg kg“ ’ d amidon une petite chute non significative de la Pao2 de 11.6 à 10.8kPa (87 à 81 torr), et un QS/QL inchangé. Chez les chiens ayant reçu un seul embole, le débit cardiaque a augmenté de façon significative après un embole de 100 mg kg-1 d’amidon (p < 0.05). Après un seul embole de 150mg kg-1, le débit cardiaque a été variables; il a diminué pour trois chiens, augmenté pour deux, mais ce changement n’a pas été jugé significatif. Chez les chiens à emboles multiples, le débit cardiaque a augmenté de façon significative (p < 0.005). Ces résultats soulignent l’importance et la nécessité de protocoles rigoureux lorsqu’on fait l’étude de l’embolie pulmonaire expérimentalc.
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References
Marshall, R. &Allison, P.R. Pulmonary embolism by small blood clots: Physiologic responses in the anaesthetised dog. Thorax17: 289 (1962).
Robin, E.D. Overdiagnosis and overtreatment of pulmonary embolism: The emperor may have no clothes. Ann. Int. Med.87: 775 (1977).
Williams, M.H. Jr. Mechanical versus reflex effects of diffuse pulmonary embolism in anesthetized dogs. Circ. Res.4: 325 (1956).
Weidner, M.G. Jr &Light, R.A. Role of the autonomic nervous system in the control of the pulmonary vascular bed: III. Further studies in experimental pulmonary embolism. Ann. Surg.147: 895 (1958).
Comroe, J.H., Van Lingen, B., Stroud, R.C. &Runcoroni, A. Reflex and direct cardiopulmonary effects of 5-OH-tryptamine (serotin): Their possible role in pulmonary embolism and coronary thrombosis. Am. J. Physiol.173: 379 (1953).
Clarke, S.W., Graf, P.D. &Nadel, J. A. In vivo visualisation of small airway constriction after pulmonary microembolism in cats and dogs. J. Appl. Physiol.29: 646 (1970).
Niden, A.H. &Aviado, D.M. Effects of pulmonary embolism on the pulmonary circulation with special reference to arterio-venous shunts in the lung. Circ. Research4: 67 (1956).
Swenson, E.W., Llamas, R. &Ring, G.C. Hypoxemia and edema of the lung in experimental pulmonary thromboembolism. Pulmonary Embolic Disease: Proceedings of the Symposium. Edited by Sasahara, A.A. & Stein, M., New York, Grune & Stratton, pp. 170–180 (1964).
Caldini, P. Pulmonary haemodynamics and arterial oxygen saturation in pulmonary embolism. J. Appl. Physiol.20: 184 (1965).
Dantzker, D.R., Wagner, P.D. Tornabene, N.P., Alazraki, N.P. &West, J.B. Gas exchange after pulmonary thrombocmbolisation in dogs. Circ. Research42: 92 (1978).
Fisher.J., Noble, W.H. &Kay J.C. Hypoxemia following pulmonary embolism: A dog model of altering regional perfusion. Anesthesiology54: 204 (1981).
Levy, S.E., Stein, M., Totten, R.S., Brudbrman, I., Wessler, S. &Robin, E.D. Ventilationperfusion abnormalities in experimental pulmonary embolism. J. Clin. Invest.44: 1699 (1965).
Moser, K.M. Pulmonary Embolism. Am. Rev. Resp. Dis.115: 829 (1977).
Dexter, L. &Smith, G.T. Quantitative studies of pulmonary embolism. Am. J. Med. Sci.247: 641 (1964).
McIntyre, K.M. &Sasahara, A.A. Hemodynamic and ventricular responses to pulmonary embolism. Pulmonary Emboli: Progress in Cardiovascular diseases. Edited bySasahara, A.A., Sonnenblick. E.H. &Lesch, M. New York, Grune & Stratton17: 175 (1974).
Noble, W.H. &Kay J.C. Cardiac catheterization in dogs. Can. Anaeslh. Soc. J.21: 616 (1974).
Kadiri, Y.Z., Kay, J.C., Kovacs, K. &Noble, W.H. Pulmonary embolism distribution to ventilated and unventilated lungs in the dog: a cause of hypoxaemia. Can. Anaesth. Soc. J.27: 216 (1980).
Malik, A.B. &VanderZee, Hoyte. Time course of pulmonary vascular response to microembolization. J. Appl. Physiol.43: 51 (1977).
Malik, A.B. &Kidd, B.S.L. Independent effects of changes in H+ and CO2 concentrations on hypoxic pulmonary vasoconstriction. J. Appl. Physiol.34 (3): 318 (1973).
Benumof, J.L. &Wahrenbrock, E.A. Blunted hypoxic pulmonary vasoconstriction by increased lung vascular pressures. J. Appl. Physiol.38: 846 (1975).
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Kay, J.C., Noble, W.H. & Kadiri, Y.Z. Single versus multiple pulmonary emboli: Different haemodynamic and blood gas results. Canad. Anaesth. Soc. J. 28, 550–555 (1981). https://doi.org/10.1007/BF03007151
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DOI: https://doi.org/10.1007/BF03007151