<原著>急性心筋虚血に及ぼす40%酸素, 100%酸素吸入の治療効果の比較

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The effectiveness of 40% and 100% oxygen breathings to ameliorate myocardial ischemic change was compared in 22 open-chest dogs. The flow through the left anterior descending coronary artery was reduced to induce acute ischemia and regional coronary venous blood was obtained to analyze blood oxygen content and lactate. Myocardial contractile force, electrocardiograms and myocardial pO_2 were measured. Measurements were taken as a control (A) before coronary artery constriction, and then after the constriction, during air breathing (B), during 40% oxygen breathing (C), and during 100% oxygen breathing, respectively in this order. In order to cancel out any time course change, measurements were repeated during 40% oxygen breathing (E) and air breathing (F) under the coronary constriction. Arterial pO_2 was 80.7±2.5 mmHg during air breathing (B). It was elevated to 141.4±5.5 mmHg by 40% oxygen breathing (C) and it was markedly elevated to 412±22.4 mmHg by 100% oxygen breathing (D). Heart rate, aortic pressure and aortic flow showed no consistent change by air, 40% or 100% oxygen breathings. Myocardial contractile force was markedly reduced to 66±8% of control by coronary artery constriction (from A to B) accompanied by a significant decrease from 52.0±2.6 to 35.8±4.2% in coronary venous oxygen saturation and shifting of myocardial lactate extraction to production, from 28.0±5.5 to -0.9±12.3%, all of which indicate that the myocardium became acutely ischemic. Forty percent oxygen breathing markedly reduced these ischemic changes, indicating the effectiveness of 40% oxygen breathing ; coronary venous oxygen saturation recovered from 35.8±4.2 to 41.1±4.0% and myocardial lactate extraction from -0.9±12.3 to 5.0±12.2%. By substituting 100% oxygen breathing for 40% oxygen, these improvements were more marked, indicating that 100% oxygen was more effective than 40% oxygen breathing ; coronary venous oxygen saturation from 41.1±4.0 to 50.6±4.2% and myocardial lactate extraction from 5.0±12.2 to 7.8±13.5%. ST changes on the electrocardiograms and myocardial pO_2 also indicated that 40% oxygen was effective, 100% oxygen being more effective, in reducing myocardial ischemic changes. By changing 100% oxygen to 40% oxygen (from D to E) and 40% oxygen to air breathing (from E to F), the myocardium, once markedly improved, showed again deterioration as indicated by a decrease in coronary venous oxygen saturation and myocardial lactate production. It was suggested that 40% oxygen breathing was beneficial, 100% oxygen breathing being more beneficial, in reducing acutely-induced ischemic change in the myocardium.
近畿大学の論文
1981-06-25

<原著>急性心筋虚血に及ぼす40%酸素, 100%酸素吸入の治療効果の比較

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