アドレナリン肺水腫における調圧神経反射の関与
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概要
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The adrenalin pulmonary edema induced by the intravenous injection of adrenalin presents resemblance, in its marked clinical and pathological findings, with the acute pulmonary edema of man. Buffer nerve reflex has been thought to play an important role on the development of adrenalin pulmonary edema by various investigators. To elucidate this process more precisely, the author has investigated the pathogenesis of the adrenalin pulmonary edema with special reference to the buffer nerve mechanism by means of modifying the effect of the carotid sinus reflex.Methods : Lung body index, pathological findings, and mortality rate were examined in the rats weighing 100〜200 gm. in the experimental conditions described below. Four kinds of procedure were used for the modification of the buffer nerve reflex.(1) The withdrawal of blood from the femoral artery : The with-drawal of blood was made by an ordinary syringe from the femoral artery and its volume was calculated and given in percentage to the estimated total volume of the rat. According to Everett's formula total blood volume per 100 gm. of body weight was estimated 5.65 cc. The withdrawal of blood was made respectively before and 30 seconds, 1 minute and 2 minutes, after the injection of adrenalin.(2) Application of the blood reservoir was tried to be applied to the femoral artery, for the purpose of protecting the hemorrhagic shock. When a blood reservoir was connected by a rubber tube to the femoral artery, not only hardly any blood was lost, but also could the systemic blood pressure be controlled by regulating the intra-reservoir pressure.(3) The ligation of the carotid artery : In order to prevent the carotid sinus reflex from eliciting its effect the bilateral common carotid arteries were ligated. The unilateral ligation of the common carotid artery and the bilateral ligation of both the internal and the external carotid arteries were needed for comparison.(4) The influence of the various doses of adrenalin on the lung body index was investigated in the normal rats and the rats wich received bilateral sinus denervation or the bilateral ligation of the common carotid arteries.Discussion and Result : 1) Withdrawal of blood : The volume of the blood withdrawn amounted 10〜80 percent of the estimated total blood volume. When the blood was withdrawn before and 30 seconds after the injection of adrenalin, lung body index was within normal range, but when the withdrawal of blood was carried out 1 or 2 minutes following the injection, lung body reached higher level and the pulmonary edema was seen either macroscopically or microscopically. Regardless of the development of the pulmonary edema, mortality was significantly high, presumably due not only to the pulmonary edema, but also to the hemorrhagic shock.2) Application of the blood reservoir : When blood reservoir was applied before the injection of adrenalin, the lung body index remained in normal range ; when applied 1 or 2 minutes after the injection, lung body index was elevated and the pulmonary edema was found, but mortality rate was lower than those in the former experiment. In the animal to which the blood reservoir was applied prior to adrenalin, the adrenalin bradycardia lasted only for 1 minute in spite of the fact that in the latter cases the bradycardia continued for about 5 minutes.From these experiments described above, the adrenalin pulmonary edema was thought to devolop in the early period after the injection of adrenalin, because letting out the blood within 1 minute after injection was able to protect the occurence of the pulmonary edema.Though it is naturally thought that suppression of the venous return would have exerted an inhibitory effect on the pulmonary edema, the author can suggest that some other mechanism should have been acting as a preventive factor to the pulmonary edema, because (1) there was no significant correlation between the volume of blood withdrawn and the lung body index, (2) a proper t
- 社団法人日本循環器学会の論文
- 1960-12-20