危及生命的芬太尼过量服用超出了呼吸中的髓性抑郁
Annick Judenherc-Haouzi1,2, Tristan Lewis2, Amanda Reinhardt2
1Department of Cardiovascular Medicine, Cleveland Clinic, Cleveland, Ohio, United States.
概括
高剂量的芬太尼会导致心脏输出和氧气输送的立即严重下降,导致低氧化和潜在的心脏骤停. 这突出了芬太尼.
科学领域:
- 心血管生理学心血管生理学
- 麻醉学 麻醉学
- 毒理学 毒理学 毒理学
背景情况:
- 芬太尼是一种强大的合成阿片类药物,经常与过量死亡有关.
- 了解高剂量芬太尼的急性生理影响对于管理过量至关重要.
- 氧气输送 (Do2) 和氧气消耗 (Vo2) 之间的平衡对于细胞功能至关重要.
研究的目的:
- 调查高剂量静脉注射芬太尼对氧气输送和消耗的直接影响.
- 在老鼠模型中确定对通风,气体交换,血液动力学和酸状态的影响.
主要方法:
- 27只未被麻醉的老鼠接受了150μg/kg的芬太尼静脉注射.
- 测量了通风,气体交换,心脏功能和血液气体的急性变化.
- 血液动力学参数包括心脏输出量 (Q·c) 和心率持续监测.
主要成果:
- 芬太尼引起了立即昏迷和中央呼吸暂停,随后出现呼吸抑制.
- 心脏输出量 (Q·c) 严重下降,原因是严重的胸和缩小的收缩能力.
- 严重的低氧化症发展并持续,Do2下降的程度比Vo2更严重.
结论:
- 高剂量的芬太尼会导致心脏输出和氧气输送的快速,不成比例的减少.
- 胸和循环效应是芬太尼过量致死的主要原因.
- 这些发现与了解过量服用芬太尼尔后人类缺氧心脏骤停有关.
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