Mechanism of Increased Spinal Cord Blood Flow due to Noradrenaline Administration Using Vascular Resistance: An Experimental Study Using a Canine Model.

IF 1.4 Q3 CARDIAC & CARDIOVASCULAR SYSTEMS
Yuya Kise, Yukio Kuniyoshi, Keita Miyaishi, Mizuki Ando, Shotaro Higa, Tatuya Maeda, Moriyasu Nakaema, Hitoshi Inafuku, Kojiro Furukawa
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引用次数: 0

Abstract

Background: During thoracoabdominal aortic surgery, the spinal cord is placed under ischemic conditions. Elevation of systemic blood pressure is thus recommended as a method of increasing the blood supply from collateral networks. This study examined the mechanisms by which noradrenaline administration increases spinal cord blood flow (SCBF) by elevating systemic blood pressure.

Methods: In beagles (n = 7), the thoracoabdominal aorta and L2-L7 spinal cord segmental arteries (SAs) were exposed and a distal perfusion bypass was created to simulate clinical practice. SCBF was measured by laser flowmetry at the L5 dura mater and spinal cord perfusion pressure (SCPP) was measured inside the clamped aorta. The six pairs of SAs from L2 to L7 were clamped, and mean systemic blood pressure (mSBP), SCBF, and SCPP were measured before and after clamping and after starting continuous infusion of noradrenaline at 0.5 µg/kg/min. Rates of change in systemic vascular resistance (SVR) and spinal cord vascular resistance (SCVR) were calculated from the measured values.

Results: With no SA clamping (control), the rate of increase in SCVR was 0.74 times the rate of increase in SVR (y = 0.2 + 0.74x, r = 0.889, r2 = 0.789; P < 0.01). When all six pairs of SAs were clamped, a weak correlation was evident between rate of change in SCVR and rate of change in SVR, and the rate of increase in SCVR was lower than the rate of increase in SVR (y = 0.39 + 0.07x, r = 0.209, r2 = 0.039; P < 0.01). When all six pairs of SAs were clamped in the absence of distal perfusion, a weak correlation was also evident between rate of change in SCVR and rate of change in SVR, and the rate of increase in SCVR was lower than the rate of increase in SVR (y = 0.19 + 0.08x, r = 0.379, r2 = 0.144; P < 0.01).

Conclusions: The rate of increase in SCVR induced by noradrenaline administration was lower than the rate of increase in SVR in the control group with no spinal cord SA clamping and in both experimental groups with clamped SAs (with and without distal perfusion), creating an environment conducive to spinal cord flow distribution.

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血管阻力对去甲肾上腺素给药后脊髓血流量增加的影响机制:犬模型实验研究。
背景:在胸腹主动脉手术中,脊髓处于缺血状态。因此,建议将体表血压升高作为增加侧枝网络供血的一种方法。本研究探讨了去甲肾上腺素通过升高全身血压来增加脊髓血流量(SCBF)的机制。方法:取比格犬(n = 7),暴露胸腹主动脉和L2-L7脊髓节段动脉(SAs),建立远端灌注旁路模拟临床。采用激光血流仪测量L5硬脑膜SCBF,测定夹紧主动脉内脊髓灌注压(SCPP)。夹持L2 ~ L7的6对SAs,分别在夹持前后和开始以0.5µg/kg/min持续输注去甲肾上腺素后测量平均体血压(mSBP)、SCBF、SCPP。根据测量值计算全身血管阻力(SVR)和脊髓血管阻力(SCVR)的变化率。结果:未夹持SA组(对照组)SCVR的增加率是SVR增加率的0.74倍(y = 0.2 + 0.74x, r = 0.889, r2 = 0.789;P < 0.01)。当所有6对sa均夹持时,SCVR变化率与SVR变化率之间呈明显的弱相关,SCVR的增加速率低于SVR的增加速率(y = 0.39 + 0.07x, r = 0.209, r2 = 0.039;P < 0.01)。在没有远端灌注的情况下夹持所有6对sa时,SCVR变化率与SVR变化率之间也存在明显的弱相关,SCVR的增加速率低于SVR的增加速率(y = 0.19 + 0.08x, r = 0.379, r2 = 0.144;P < 0.01)。结论:未夹持脊髓SA的对照组和夹持脊髓SA(有远端灌注和无远端灌注)的实验组,去甲肾上腺素诱导SCVR的增加率低于SVR的增加率,创造了有利于脊髓血流分布的环境。
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来源期刊
Cardiology Research
Cardiology Research CARDIAC & CARDIOVASCULAR SYSTEMS-
CiteScore
2.50
自引率
0.00%
发文量
42
期刊介绍: Cardiology Research is an open access, peer-reviewed, international journal. All submissions relating to basic research and clinical practice of cardiology and cardiovascular medicine are in this journal''s scope. This journal focuses on publishing original research and observations in all cardiovascular medicine aspects. Manuscript types include original article, review, case report, short communication, book review, letter to the editor.
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