Ischemia/Reperfusion-induced Myocardial Damage: Role of Carbon Dioxide

缺血/再灌注引起的心肌损伤：二氧化碳的作用

• 批准号: 23592023
• 负责人: YAMAMOTO Hiroshi
• 金额: $ 3.49万
• 依托单位: Akita University
• 依托单位国家: 日本
• 项目类别: Grant-in-Aid for Scientific Research (C)
• 财政年份: 2011
• 资助国家: 日本
• 起止时间: 2011 至 2013
• 项目状态: 已结题
• 来源: https://kaken.nii.ac.jp/grant/KAKENHI-PROJECT-23592023/
• 关键词: 心筋虚血再灌流; 二酸化炭素; ナトリウム/水素交換; ナトリウム/カルシウム交換; 心筋保護; 開心術; 心筋虚血; 虚血再灌流; 塩素イオン; 重炭酸イオン; 心筋虚血再灌流傷害; 好気的代謝; 二酸化炭素産生; イオン移動; CO2産生

We investigated the acid-base characteristic alterations of blood cardioplegia (BCP) during aortic cross-clamping in hearts arrested with BCP and during in vitro simulated ischemia. In 40 patients undergoing cardiac surgery following an aortic cross clamp, hearts were infused with a hypothermic BCP intermittently and lastly with a normothermic BCP prior to aortic cross clamp release. We measured pH, pCO2, [HCO3-], and [Cl-] of the coronary sinus effluent in the final BCP. BCP was assessed under in-vitro gassing at with 95% N2 + 5% CO2 (n = 6), 50% N2 + 50% CO2 (n = 3), or 100% CO2 (n = 6). The coronary sinus effluent, compared with the pre-infused BCP, exhibited significantly lower pH and greater pCO2 with no change in the [HCO3-] level. In vitro, the 100% CO2 gassing groups exhibited a significant increase in [HCO3-] under high pCO2-induced acidification. Under anoxia and CO2 retention during aortic cross-clamping, BCP can be a bicarbonate donor to the myocardium.

我们研究了心脏停跳液 (BCP) 在主动脉交叉钳夹心脏停搏期间和体外模拟缺血期间的酸碱特性变化。在 40 名接受主动脉交叉钳夹后接受心脏手术的患者中，间歇性地向心脏注入低温 BCP，最后在主动脉交叉钳松开之前注入常温 BCP。我们测量了最终 BCP 中冠状窦流出物的 pH、pCO2、[HCO3-] 和 [Cl-]。 BCP 在 95% N2 + 5% CO2 (n = 6)、50% N2 + 50% CO2 (n = 3) 或 100% CO2 (n = 6) 的体外充气条件下进行评估。与预输注的 BCP 相比，冠状窦流出物的 pH 值显着降低，pCO2 更高，[HCO3-] 水平没有变化。在体外，100% CO2 通气组在高 pCO2 诱导的酸化下表现出 [HCO3-] 显着增加。在主动脉阻断期间缺氧和 CO2 潴留的情况下，BCP 可以成为心肌的碳酸氢盐供体。