ドーパミンは,心不全の患者において,微小呼吸を抑制する
P van de Borne1, R Oren, V K Somers
1Department of Internal Medicine and the Cardiovascular Center, University of Iowa Hospitals and Clinics, Iowa City, USA.
Circulation
|July 29, 1998
まとめ
低用量のドーパミンは,健康な個体において低酸素に対する体の反応を悪化させ,心不全患者の呼吸を低下させることがあります. この効果は,低酸素症の患者,特に心不全の患者のアウトカムに悪影響を及ぼす可能性があります.
科学分野:
- 心血管生理学 心血管の生理学
- クリティカルケア・メディシン
- 呼吸器生理学 呼吸器生理学について
背景:
- 低用量のドーパミンは,集中治療施設で一般的に投与されます.
- ドーパミンの投与は,化学受容体アフェレンツを阻害することによって,潜在的に低酸素に対する化学反射感受性を低下させる可能性があります.
研究 の 目的:
- 健康な被験者のノルモキシアとヒポキシア中の心臓呼吸器反応に対する低用量のドーパミンの影響を調査する.
- 重度の心不全患者の呼吸にドーパミンの影響を調べる.
主な方法:
- 10人の健康な若い被験者を対象に,ダブルブラインド,ランダム化,クロスオーバー研究が行われました.
- 測定には,酸素飽和度,呼吸量,およびノルモキシアとヒポキシア中の交感神経の活動が含まれていました.
- ドーパミンに対する呼吸器の反応は,重度の心不全の8人の患者と,年齢を合わせた8人の対照群でも評価されました.
主要な成果:
- 健康な被験者の場合,ドーパミンはノルモキシア中の1分間の換気を変化させなかったが,ヒポキシア中の1分間の換気を減少させた (12.9対15.8L/分).
- ドーパミン (78%) とプラセボ (84%) と比較して,低毒性酸素飽和度は低かった.
- ドーパミンは心不全患者の呼吸を抑えたが,対照群ではそうではなかったが,酸素飽和度が低下し,PETCO2.2が増加した.
結論:
- 低用量のドーパミンは,ヒトの低酸素に対する化学反射反応を阻害し,主に同情活動よりも換気に影響します.
- ドーパミンはまた,ノルモキシ性心不全患者の呼吸を抑制します.
- ドーパミンによって引き起こされる呼吸器の阻害は,ヒポキシクスの患者,特に心不全の患者での結果を悪化させる可能性があります.
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