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Blutverlust, Sauerstoffatmung und primäre Hypertonie

Blood loss, oxygen breathing and primary hypertension

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Zusammenfassung

Primär hypertensive Menschen und Tiere haben eine geringere Toleranz zu Beginn einer Hämorrhagie. Sie zeigen bei gleichem Blutverlust einen größeren Blutdruckabfall und verlieren bei Ausbluten auf den gleichen hypotensiven arteriellen Druck mehr Blut, als normotensive Kontrollen. Die Atmung O2-reicher Gasgemische nach Blutverlust kann Kreislauf und Atmung stabilisieren durch

  1. 1.

    Verengung der Arteriolen,

  2. 2.

    Venokonstriktion und Entleerung der Blutspeicher mit Verbesserung der Herzfüllung,

  3. 3.

    Verstärkung der Lungenventilation durch Korrektur der atmungsdepressiv wirkenden Hirnhypoxie.

Diese O2-Effekte sind keine Reflex- sondern direkte Gewebewirkungen, d. h. sie sind auch bei ausgefallener Funktion des Gehirns vorhanden. Sie sind auch an spontan hypertensiven Ratten nachweisbar, aber schwächer als bei normotensiven Tieren.

Abstract

Primary hypertensive humans and animals show a strikingly low capacity to tolerate acute hemorrhage. They exhibit a greater drop in arterial pressure in relation to the same volume loss or lose more blood when bleeding at the same hypotensive arterial pressure than normotensive controls. Breathing hyperoxic gas mixtures improves the ability of the cardiorespiratory system to resist hemorrhage (1) by constricting systemic arterioles, (2) by increasing the overall venous tone, thus supporting cardiac filling, and (3) by enforcing alveolar ventilation, probably secondary to improved cerebral oxygenation. The beneficial effects of hyperoxia are presumably not reflex but direct tissue effects of oxygen, i.e., they are also present after severe brain damage. They are demonstrable but weaker in genetically hypertensive than in normotensive rats.

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  1. Ernst-Moritz-Arndt Universität Greifswald

    A. Honig

  2. Professor für Physiologie (i.R.), Kleine Schanze 1, 14662, Friesack

    A. Honig

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Honig, A. Blutverlust, Sauerstoffatmung und primäre Hypertonie. Notfall & Rettungsmedizin 7, 391–398 (2004). https://doi.org/10.1007/s10049-004-0680-8

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