견에서 저산소성 폐혈관 수축 및 스테로이드의 영향에 관한 실험적 연구 : An Experimental Study on Hypoxic Pulmonary Vasoconstriction and the Effects of Steroids in Dogs.

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김용락; 김성덕; 김건열; 김기환; 노준량

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서울대학교 의과대학
Seoul J Med, Vol.24 No.4, pp. 427-436
The effects of unilateral hypoxic ventilation and
steroids on pulmonary hemodynamics, alveolar-arterial oxygen tension differenee(A-aDO,) and
intrapulmonary shunt in 10 dogs were studied under
unilateral hypoxic ventilation with nitrogen.
Heart rate, mean arterial pressure, central venous
pressure, mean pulmonary arterial pressure. pulmonary
capillary wedge pressure, cardiac output, blood
gases and hemoglobin were measured during controlled
ventilation with 100% oxygen and unilateral hypoxic
ventilation, and after intravenous administration of
30mg/kg of methylprednisolone.
Using above data, pulmonary hemodynamics. AaDO,
and intrapulmonary shunt were calculated and
the following results were obtained.
1. Mean pulmonary arterial pressure significantly
increased(20%) from 20. G,_t2. GOmmHgto 21. S±2.1G
mmHg(p<0.005) and pulmonary vascular resistance
also significantly increased(13%) from 131±GS.1 dynes.
sec/em' to G05±81. 0 dynes.sec/cm'(p<0.005),
whereas cardiac output decreased(S%) from 1. 92±
0.23 l/min. to 1. 7G±0. 21 l/min(p<0.05) after unilateral
hypoxic ventilation. After methylprednsiolone
administration, there was further significant increase
in mean pulmonary artery pressure from 24. 8±2. 4
mmHg to 26. 5±2. 5ImmHg(p<0. 05) and pulmonary
vascular resistance from 605±8I. 0 dynes. sec/em' to
655±95.3 dynes.sec/cm'(p<0.05), whereas cardiac
output did not change significantly.
2. Alveolar-arterial oxygen tension difference significantly
increased from 180±23.2mmHg to 470±
31. 9mmHg(p<0. 005) after unilateral hypoxic ventilation
but decreased significantly from 470±31. 9mmHg
to 431±2S. 8mmHg after methylprednisolone administration.
3. Intrapulmonary shunt significantly increased
from 9. 5±1. 40?~ to 24. 8j:2. 02% (p<0.005) after
unilaterial hypoxic ventilatien, but it was much lower
than the mathematically expected value (40% over)
and there was significant decrease in intrapulmonary
shunt from 21. 8±2. 02% to 22. 6±2. 51% (p<0.05)
after methylprednisolone administration.
The above findings suggest the operation of the
protective mechanism which causes hypoxic pulmonary
vasoconstriction in the unilateral hypoxic lung,
and diverts blood flow from hypoxic to non-hypoxic
lung and so minimizes the hypoxic effect on the arterial blood, and tbat tbe administration of methylprednisolone
intensifies the hypoxic pulmonary vasoconstrictive
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College of Medicine/School of Medicine (의과대학/대학원)Dept. of Medicine (의학과)The Seoul Journal of MedicineThe Seoul Journal of Medicine Vol. 24 No.4 (1983)
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