大脑与肺:在单心室患者中反循环的等级与高级腔肺连接
Mark A Fogel1, Suzanne Durning, Gil Wernovsky
1Division of Cardiology, Department of Pediatrics, The Children's Hospital of Philadelphia, The University of Pennsylvania School of Medicine, Philadelphia, Pa 19104, USA. fogel@email.chop.edu
Circulation
|September 15, 2004
概括
在高级腔肺连接 (SCPC) 生理学中,二氧化碳 (CO2) 水平升高显著增加大脑和肺血流,表明CO2
科学领域:
- 心血管生理学心血管生理学
- 儿童心脏病学 儿童心脏病学
- 呼吸系统生理学 呼吸系统生理学
背景情况:
- 大脑血管通过CO2扩大血管,通过O2收缩血管,而肺血管则表现出相反的反应.
- 在连续循环中占主导地位的反机制 (大脑与肺) 仍然不清楚.
- 高级腔肺连接 (SCPC) 生理学提供了一个独特的模型来研究竞争的血管反循环.
研究的目的:
- 在SCPC生理学中确定大脑和肺血管反机制的等级.
- 评估改变CO2和O2水平对大脑和肺部血流的影响.
- 为了评估对氧气运输和心脏输出的影响.
主要方法:
- 研究了12名单心室患者 (年龄为2.2±0.5岁) 的SCPC生理学.
- 磁共振成像 (MRI) 速度测绘评估了关静脉和大动脉中的血流.
- 在室内空气,高碳水化合物 (高CO2) 和100%O2条件下进行测量,并进行动脉血液气体分析.
主要成果:
- 增加的二氧化碳 (从40到63毫米) 显著增加脑和肺血流量 (1.5到2.7升/分钟/米2),心脏指数 (4.3到5.4升/分钟/米2).
- 心脏指数的上升与大脑和肺部的血液流量增加相关 (R=0.73,P=0.02).
- 过氧 (100% O2) 没有改变大脑和肺血流,尽管动脉O2水平显著增加.
结论:
- 在SCPC生理学中,大脑CO2反循环在肺O2反循环上占主导地位.
- 升高的二氧化碳水平显著影响大脑和肺血流的分布,改善大脑的氧化.
- 这些发现可能有助于了解SCPC患者的神经复发症和Fontan完成时间.
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