在血液动力学不稳定的器官捐赠者中,血管压素缺乏和压子过敏
J M Chen1, S Cullinane, T B Spanier
1Division of Cardiothoracic Surgery, Department of Surgery, Columbia University College of Physicians and Surgeons, New York, NY, USA. jmc23@columbia.edu
Circulation
|November 24, 1999
概括
血管压素缺乏症在低血压器官捐献者中很常见. 血管压素替代疗法有效地增加了血压,并减少了这些患者对catecholamine血管压缩剂的需求.
科学领域:
- 腎臟病學 (nephrology) 是一種醫學.
- 内分泌学 在内分泌学.
- 临界护理医学 临界护理医学
背景情况:
- 固体器官捐赠者经常因为血管扩张而出现低血压.
- 血管扩张状态通常与血管压素缺乏和过敏性有关.
- 这项研究研究了在没有糖尿病的低血压器官捐赠者中血管压素缺乏症.
研究的目的:
- 为了确定低血压器官捐献者中血管压素缺乏症的患病率.
- 为了评估这些捐赠者的血管压缩剂效应的血管压缩剂替代.
主要方法:
- 研究了50名血液动力学不稳定的器官捐赠者 (尽管有类甲醇胺,但平均动脉压[MAP]≤70mmHg).
- 低剂量静脉压素 (0.040.1 U/min) 给了十名符合条件的患者.
- 测量包括MAP,甲醇胺的需求,血清压缩素,以及输血压缩素注入前后的血清度.
主要成果:
- 输血压素的使用使MAP从72.2±3.5增加到89.8±4.2 mm Hg (P<0.05).
- 在40%的患者中断了catecholamine压力计,在40%的患者中降低了压力计.
- 与低血压的程度相比,血压素水平较低 (2.9±0.8 pg/mL).
结论:
- 血液动力学不稳定的器官捐赠者没有明显的无味糖尿病,表现出巴罗反射介导的血管压素分泌受损.
- 在这些患者中,低剂量的血管压素显著改善了血压.
- 血管压素治疗减少了对甲基荷胺血管压缩剂的需求.
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