PULMONARY VASCULAR PRESSURE-FLOW CHARACTERISTICS - EFFECTS OF DOPAMINE BEFORE AND AFTER PULMONARY-EMBOLISM

被引:20
|
作者
DUCAS, J [1 ]
STITZ, M [1 ]
GU, S [1 ]
SCHICK, U [1 ]
PREWITT, RM [1 ]
机构
[1] UNIV MANITOBA,HLTH SCI CTR,DEPT MED,700 WILLIAM AVE,GF223,WINNIPEG R3E 0Z3,MANITOBA,CANADA
来源
AMERICAN REVIEW OF RESPIRATORY DISEASE | 1992年 / 146卷 / 02期
关键词
D O I
10.1164/ajrccm/146.2.307
中图分类号
R56 [呼吸系及胸部疾病];
学科分类号
摘要
We compared the general hemodynamic effects of dopamine and dobutamine in dogs with acute pulmonary hypertension complicated by a decrease in cardiac output (CO). The pulmonary hypertension was induced by injection of autologous blood clot. Emboli markedly increased mean pulmonary artery pressure (PpaBAR) and decreased CO (both p < 0.001). Both dopamine and dobutamine increased CO 50% (p < 0.05) and decreased pulmonary vascular resistance (PVR) (p < 0.05), calculated as (PAP - left ventricular end diastolic pressure)/CO. Mean PVR (mm Hg/L/min) decreased from 16.1 to 12.4 with dopamine and from 16. to 11.9 with dobutamine, both p < 0.05. Ventricular filling pressures were not affected. In another 12 dogs we investigated the effects of both drugs on pulmonary pressure-flow (P-Q) characteristics. P-Q characteristics were determined in dogs with normal PpaBAR values and in those with embolic pulmonary hypertension. The slope of the P-Q relationship defines the incremental vascular resistance and the extrapolated pressure intercept, the effective vascular outflow pressure. All P-Q relationships were described well by a linear equation. Despite significant systemic effects in both groups and despite a decrease in PVR with both drugs in embolized dogs, neither drug significantly affected pulmonary P-Q characteristics. The discrepancy between PVR and incremental resistance is explained by an incorrect assumption in PVR that the left ventricular filling pressure is the effective vascular outflow pressure. We conclude that both before and after the induction of pulmonary hypertension, both dopamine and dobutamine improve CO without affecting pulmonary vascular tone.
引用
收藏
页码:307 / 312
页数:6
相关论文
共 50 条
  • [1] PULMONARY VASCULAR PRESSURE-FLOW CHARACTERISTICS IN CANINE PULMONARY-EMBOLISM
    HASINOFF, I
    DUCAS, J
    SCHICK, U
    PREWITT, RM
    [J]. JOURNAL OF APPLIED PHYSIOLOGY, 1990, 68 (02) : 462 - 467
  • [2] EFFECTS OF ALTERED HEMATOCRIT ON PULMONARY-ARTERY PRESSURE-FLOW CHARACTERISTICS IN CANINE PULMONARY-EMBOLISM
    DUCAS, J
    KISCHUK, R
    SCHICK, U
    PREWITT, RM
    [J]. JOURNAL OF CRITICAL CARE, 1990, 5 (01) : 35 - 41
  • [3] SYMPATHOMIMETIC AGENTS AND PULMONARY VASCULAR PRESSURE-FLOW RELATIONSHIP IN CANINE PULMONARY-EMBOLISM (CPE)
    BOITEAU, P
    DUCAS, J
    PREWITT, RM
    [J]. CIRCULATION, 1986, 74 (04) : 240 - 240
  • [4] THE EFFECTS OF LOWERED HEMATOCRIT ON THE PULMONARY VASCULAR PRESSURE-FLOW RELATIONSHIP AFTER PULMONARY EMBOLI
    KISCHUK, R
    DUCAS, J
    PREWITT, RM
    [J]. CLINICAL AND INVESTIGATIVE MEDICINE-MEDECINE CLINIQUE ET EXPERIMENTALE, 1986, 9 (03): : A157 - A157
  • [5] THE EFFECTS OF LOWERED HEMATOCRIT ON THE PULMONARY VASCULAR PRESSURE-FLOW RELATIONSHIP AFTER PULMONARY EMBOLI
    KISCHUK, RP
    DUCAS, J
    GIRLING, L
    SCHICK, U
    PREWITT, RM
    [J]. AMERICAN REVIEW OF RESPIRATORY DISEASE, 1986, 133 (04): : A401 - A401
  • [6] PRESSURE-FLOW CHARACTERISTICS OF OVERPERFUSED PULMONARY VASCULAR BEDS
    FRIEDMAN, PJ
    [J]. INVESTIGATIVE RADIOLOGY, 1970, 5 (04) : 284 - &
  • [7] THE EFFECTS OF PGE1 ON THE PULMONARY VASCULAR PRESSURE-FLOW RELATIONSHIP AFTER PULMONARY EMBOLI
    PREWITT, RM
    DUCAS, J
    [J]. CLINICAL AND INVESTIGATIVE MEDICINE-MEDECINE CLINIQUE ET EXPERIMENTALE, 1986, 9 (03): : A152 - A152
  • [8] EFFECTS OF POSITIVE END EXPIRATORY PRESSURE (PEEP) ON PULMONARY VASCULAR PRESSURE-FLOW CHARACTERISTICS
    BOITEAU, P
    DUCAS, J
    PREWITT, RM
    [J]. CLINICAL AND INVESTIGATIVE MEDICINE-MEDECINE CLINIQUE ET EXPERIMENTALE, 1986, 9 (03): : A151 - A151
  • [9] TREATMENT OF CANINE PULMONARY-HYPERTENSION - EFFECTS OF NOREPINEPHRINE AND ISOPROTERENOL ON PULMONARY VASCULAR PRESSURE-FLOW CHARACTERISTICS
    DUCAS, J
    DUVAL, D
    DASILVA, H
    BOITEAU, P
    PREWITT, RM
    [J]. CIRCULATION, 1987, 75 (01) : 235 - 242
  • [10] PULMONARY-EMBOLISM - EFFECTS OF BRONCHIAL BLOOD-FLOW ON PULMONARY-ARTERY WEDGE PRESSURE
    BUTLER, B
    HILLS, B
    DRAKE, R
    [J]. FEDERATION PROCEEDINGS, 1985, 44 (05) : 1759 - 1759