低熱血中のオキシヘモグロビンの解離 血中低温症の心臓麻痺の停止
W L Holman1, R D Spruell, S B Digerness
1Division of Cardiothoracic Surgery, University of Alabama, Birmingham.
Circulation
|November 1, 1992
まとめ
低体温性心症では,最初の30秒以内に酸素がヘモグロビンから解離します. 心筋は,ヘモグロビンに結合した酸素ではなく,物理的に溶けた酸素しか受け取らない.
科学分野:
- 心血管生理学 心血管の生理学
- バイオケミストリー バイオケミストリー
背景:
- 冠動脈動脈の血液は,初期低体温性心筋麻痺の輸液中に不飽和化されます.
- これは,低温とアルカリ性pHでヘモグロビンの高い酸素親和性にもかかわらず起こります.
研究 の 目的:
- 低熱性心筋麻痺停止中のオキシヘモグロビン解離を定量化するために.
- 心筋麻痺中に心筋筋膜への酸素供給を評価する.
主な方法:
- 大動脈の根のクロスクラッピング中に投与された4°Cアルカロ性血液の心臓症溶液.
- 輸液中の特定の時間点で,ペアリングされた大動脈根と冠動脈鼻腔の血液サンプルを採取した.
- 採取したサンプルのヘモグロビン飽和度と酸素 (PO2) の部分圧力を測定した.
主要な成果:
- 大動脈の根のヘモグロビン飽和度は,全体の100%にとどまった.
- 冠動脈シナスのヘモグロビン飽和度は,注射後5秒で63.0%~66.5%に大幅に低下した (p <0.05).
- 冠動脈シヌスPO2は,大動脈根のサンプルと比較して,5秒 (31-39 mm Hg) で有意に低かった (p <0.05).
結論:
- 酸素は,非 perfused 段階の間,低温,アルカロ性心不全でヘモグロビンから分離します.
- 輸液中の心筋酸素の供給は,心症の溶液に物理的に溶けた酸素に制限されます.
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