Effect of Rectal Distension on Cardiac Function and Blood Flow Distribution

直腸膨脹心臟功能和血流分佈的影響

甯學寒(Xue-Han Hing) ； Zheng-Feng Ba ； Darrell R. Sawmiller ； Adamu Alemayehu ； Ching C. Chou

《慈濟醫學雜誌》 6卷4期 (1994/12) Pp. 245-255

https://doi.org/10.6440/TZUCMJ.199412.0245

摘要

In order to investigate the effect of rectal dissension on the general cardiovascular system, we measured systemic arterial pressure (BP), left ventricular pressure (LVP), +dP/dt, -dP/dt and blood flows to various peripheral tissues (microsphere technique) before and during rectal distension in 35 rats. The rectal distension (intra-rectal pressure increased to 36±12 mmHg by placement of 0.7 ml normal saline into rectal ballon) significantly decreased BP from 134±17 to 114±18 mmHg, LVP (-14%), +dP/dt max (-20%) and –dP/dt max(-20%). These variables returned to control levels by 1.5 to 3.5 min following the end of the 3.5 Min distension period. Rectal distension also produced recurrent ectopic beasts, particularly when extrasystoles were occationally present before the distension. Rectal distension increased anal-rectal blood flow 0.26±0.07 to 0.64±0.14 ml min-1 g-1 (p＜0.05); significantly decreased (p＜0.05) the blood flows to the colon, cecum , ileum, jejunum, stomach, liver, pancreas, kidney and spleen, and had no effect on the blood flows to the esophagus, duodenum, right and left ventricle, brain, diaphragm, thoracic or abdominal skeletal muscles, and abdominal skin. Rectal distension tended to decrease the cardiac output index (COI) form 25±8 to 20±6 ml min-1 100g-1 BW (0.1＞P＞0.05). When the above tissue blood flows were standarsized as a ratio to COI, rectal distension increased the ration to the anal-rectum, but the ratio decreased in spleen and has no effect on the ration of flow to the other gastrointestinal organs, kidneys and peripheral tissues. Therefore, the decreases in the gastro-intestinal and renal blood flows were partially due to the decrease in the cardiac output. These results indicate that rectal distension increases anal—rectal blood flow, but decreased the blood flows to the other gastro-intestinal organs, possibly via cardiac depression. (Tzu-Chi Med j 1994; 6: 245-255)

關鍵字

直腸膨脹 ； 心臟功能 ； 血流

並列摘要

In order to investigate the effect of rectal dissension on the general cardiovascular system, we measured systemic arterial pressure (BP), left ventricular pressure (LVP), +dP/dt, -dP/dt and blood flows to various peripheral tissues (microsphere technique) before and during rectal distension in 35 rats. The rectal distension (intra-rectal pressure increased to 36±12 mmHg by placement of 0.7 ml normal saline into rectal ballon) significantly decreased BP from 134±17 to 114±18 mmHg, LVP (-14%), +dP/dt max (-20%) and –dP/dt max(-20%). These variables returned to control levels by 1.5 to 3.5 min following the end of the 3.5 Min distension period. Rectal distension also produced recurrent ectopic beasts, particularly when extrasystoles were occationally present before the distension. Rectal distension increased anal-rectal blood flow 0.26±0.07 to 0.64±0.14 ml min-1 g-1 (p＜0.05); significantly decreased (p＜0.05) the blood flows to the colon, cecum , ileum, jejunum, stomach, liver, pancreas, kidney and spleen, and had no effect on the blood flows to the esophagus, duodenum, right and left ventricle, brain, diaphragm, thoracic or abdominal skeletal muscles, and abdominal skin. Rectal distension tended to decrease the cardiac output index (COI) form 25±8 to 20±6 ml min-1 100g-1 BW (0.1＞P＞0.05). When the above tissue blood flows were standarsized as a ratio to COI, rectal distension increased the ration to the anal-rectum, but the ratio decreased in spleen and has no effect on the ration of flow to the other gastrointestinal organs, kidneys and peripheral tissues. Therefore, the decreases in the gastro-intestinal and renal blood flows were partially due to the decrease in the cardiac output. These results indicate that rectal distension increases anal—rectal blood flow, but decreased the blood flows to the other gastro-intestinal organs, possibly via cardiac depression. (Tzu-Chi Med j 1994; 6: 245-255)

並列關鍵字

rectal distension ； cardiac function ； blood flow