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KMID : 0356019940090010057
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Koean Jounral of Critical Care Medicine
1994 Volume.9 No. 1 p.57 ~ p.62
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Effect of Nitroglycerin Administration on the Intrapulmonary Shunt During Descending Thoracic Aortic Cross Clamp
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Abstract
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To evaluate the effect of nitroglycerin on the intrapulmonary shunt during thoracic aortic cross clamping, we cross-clamped desending thoracic aorta at 10 cm distalto left subclavian artery through thoracotomy at left 5th intercostal space under
the
halothane-oxygen endotracheal general anesthesia in 12 dog. In control group(n=6), no vasodilator was administered. In NTG group(n=6), nitroglycerin(NTG)(8 g/kg/min) was adminstered before arotic cross clamping and during 45 minutes
cross-clamping
of
descending thoracic aorta in each group. Cardiac output(CO), pulmonary artery pressure(PAP), arterial and mixed venous blood gases were measured before and at 1 min, 15 min, 30 min and 45 min during aortic cross-clamping. Intrapulmonary
shunts(Qs/Qt)
were calculated from measured data and analysed with student unpaired t-test.
1) Cardic indices(liter/min/m²) before cross clamping, just after cross clamping, 15 min, 30 min and 45 min after cross clamping were were 3.40±0.67, 2.35±0.67, 2.41±0.77, 2.41±1.03, 3.21±0.86 and 2.39±1.02 in control groups and
3.34±0.39,
3±0.80, 3.42±1.15, 3.73±1.07, and 03.03±1.00in nitroglycerin groups(P>0.05)
2) Shunt(%) before cross clamping, just after cross clamping. 15min 30min and 45 min after cross clamping were 17.29±7.69, 12.45±12.82, 11.9 16.81±14.10 and 16.40±13.7 in control groups and 15.44±10.2, 24.24±8.56, 27.51±5.3,
28.41±5.31and
32.54±5.9 in nitroglycerin group (P<0.05)
3) PaO2(mmHg)before cross clamping, just after cross clamping. 15 min 30min and 45 min after cross clamping were 384.7±85.9, 476.3±81.9, 440.5±76.6, 469.5±106.2 and 465.3±96.3 in control groups and 418.8±88.7, 349.2±54.9*(P<0.05),
355.3±48.3,
356±43.8 and 311±52.0 in nitroglycerin groups(p>0.05)
4) Pulmonary artery pressure(mmHg) before cross clamping, just after cross clamping, 15 min, 30 min and 45 min after cross clampingwere were 11.0±4.1, 15.5±2.7, 22.5±3.3, 22.5±6.2 and 22±6.0 in control groups and 9.5±4.41, 11.5±6.9,
10.5±8.4,
11±6.7*(p<0.05) and 11.5±10.4 in nitroglycerin groups(P<0.05)
These results showed that NTG therapy did not affect significant effect on the gas exchange during thoracic aortic cross clamping under halothane oxygen anesthesia in normal dog.
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KEYWORD
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