背景:在心肺复苏期间,大脑缺血了.建议在心肺复苏期间使用肾上腺素和加压素。我们旨在研究肾上腺素和加压素在基线以及缺血和再灌注过程中对家兔脑微血管的直接影响。
方法:采用闭颅窗法观察家兔脑微循环和软脑膜小动脉直径的变化。在脑组织上局部施用肾上腺素和加压素。首先,在给予4种不同浓度肾上腺素的7只兔子中评估了肾上腺素和加压素对小动脉的影响,另外7只兔子接受了4种不同浓度的加压素。第二,在全脑缺血和再灌注期间确定肾上腺素和加压素的作用,这是由夹住头臂诱发的,左颈总动脉,左锁骨下动脉15分钟。另外21只兔子被随机分配接受人工脑脊液(aCSF)(n=7),肾上腺素10-5mol/L(n=7),或加压素10-7mol/L(n=7)。从缺血开始后5分钟到再灌注后120分钟连续输注每种药物。记录缺血前和缺血期间的脑小动脉直径,再灌注后。
结果:在基线时,肾上腺素和加压素不影响脑小动脉。在缺血期间,血管加压素,但ACSF和肾上腺素不会使血管收缩。再灌注期后期,血管加压素和aCSF组的泪液直径减小,而肾上腺素治疗的动物的泪液直径更高。
结论:在基线时,肾上腺素和加压素不影响小动脉。再灌注期间,肾上腺素可能抵消脑血管收缩。
During cardiopulmonary resuscitation, the brain becomes ischemic. Adrenaline and vasopressin have been recommended for use during cardiopulmonary resuscitation. We aimed to investigate the direct effects of adrenaline and vasopressin on the cerebral microvasculature at baseline and during ischemia and reperfusion in rabbits.
The closed cranial window method was used to visualize the cerebral microcirculation and changes in the pial arteriole diameter in rabbits. Adrenaline and vasopressin were administered topically on the brain tissue. First, the effects of adrenaline and vasopressin on pial arterioles were evaluated in 7 rabbits that were given 4 different concentrations of adrenaline, and another 7 rabbits that received 4 different concentrations of vasopressin. Second, the effects of adrenaline and vasopressin were determined during the global brain ischemia and reperfusion, which was induced by clamping the brachiocephalic, left common carotid, and left subclavian arteries for 15 min. An additional 21 rabbits were randomly assigned to receive artificial cerebrospinal fluid (aCSF) (n = 7), adrenaline 10-5 mol/L (n = 7), or vasopressin 10-7 mol/L (n = 7). Each drug was continuously infused from 5 min after the initiation of ischemia until 120 min after reperfusion. The pial arteriole diameters were recorded before and during ischemia, and after reperfusion.
At baseline, adrenaline and vasopressin did not affect the cerebral pial arterioles. During ischemia, vasopressin, but not aCSF and adrenaline constricted the pial vessels. Late in the reperfusion phase, pial diameter became reduced in the vasopressin and aCSF groups whereas pial diameter was higher in the animals treated with adrenaline.
Adrenaline and vasopressin did not affect pial arterioles at baseline. During reperfusion, adrenaline may counteract the cerebral vasoconstriction.