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首页> 外文期刊>Physiological Reports >The influence of esmolol on right ventricular function in early experimental endotoxic shock
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The influence of esmolol on right ventricular function in early experimental endotoxic shock

机译：艾司洛尔对早期实验性内毒素性休克对右心室功能的影响

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The mechanism by which heart rate (HR) control with esmolol improves hemodynamics during septic shock remains unclear. Improved right ventricular (RV) function, thereby reducing venous congestion, may play a role. We assessed the effect of HR control with esmolol during sepsis on RV function, macrocirculation, microcirculation, end‐organ‐perfusion, and ventricular‐arterial coupling. Sepsis was induced in 10 healthy anesthetized and mechanically ventilated sheep by continuous IV administration of lipopolysaccharide (LPS). Esmolol was infused after successful resuscitation of the septic shock, to reduce HR and stopped 30‐min after reaching targeted HR reduction of 30%. Venous and arterial blood gases were sampled and the small intestines’ microcirculation was assessed by using a hand‐held video microscope (CytoCam‐IDF). Arterial and venous pressures, and cardiac output (CO) were recorded continuously. An intraventricular micromanometer was used to assess the RV function. Ventricular–arterial coupling ratio (VACR) was estimated by catheterization‐derived single beat estimation. The targeted HR reduction of 30% by esmolol infusion, after controlled resuscitation of the LPS induced septic shock, led to a deteriorated RV‐function and macrocirculation, while the microcirculation remained depressed. Esmolol improved VACR by decreasing the RV end‐systolic pressure. Stopping esmolol showed the reversibility of these effects on the RV and the macrocirculation. In this animal model of acute severe endotoxic septic shock, early administration of esmolol decreased RV‐function resulting in venous congestion and an unimproved poor microcirculation despite improved cardiac mechanical efficiency.
机译：艾司洛尔控制心率（HR）改善败血性休克期间血液动力学的机制尚不清楚。改善右心室（RV）功能，从而减少静脉充血，可能起到一定作用。我们评估了败血症期间艾司洛尔的HR控制对RV功能，大循环，微循环，终末器官灌注和心室-动脉耦合的影响。通过连续静脉内注射脂多糖（LPS），在10只健康麻醉和机械通气的绵羊中诱发败血症。成功恢复败血性休克后输注艾司洛尔以降低HR，并在达到30％的目标HR降低后停止30分钟。采样静脉和动脉血气，并使用手持视频显微镜（CytoCam‐IDF）评估小肠的微循环。连续记录动脉和静脉压力以及心输出量（CO）。脑室内显微压力计用于评估RV功能。心室-动脉耦合比（VACR）通过导管插入术的单搏估计来估计。在进行LPS诱导的败血性休克控制性复苏后，艾司洛尔输注将HR降低的目标> 30％，从而导致RV功能和大循环变差，而微循环仍然不明显。艾司洛尔通过降低RV末期收缩压来改善VACR。停止艾司洛尔显示这些作用对RV和大循环的可逆性。在这种急性严重内毒素性败血性休克动物模型中，尽早给予艾司洛尔可降低RV功能，导致静脉充血，尽管改善了心脏机械效率，但微循环不良。

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