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输注速率和容量对绵羊体内0.9%生理盐水和7.5%生理盐水/6.0%右旋糖酐70动力学的影响。

Influence of rate and volume of infusion on the kinetics of 0.9% saline and 7.5% saline/6.0% dextran 70 in sheep.

作者信息

Brauer Lance P, Svensén Christer H, Hahn Robert G, Kilicturgay Sadik, Kramer George C, Prough Donald S

机构信息

Department of Anesthesiology, University of Texas Medical Branch, Galveston 77555, USA.

出版信息

Anesth Analg. 2002 Dec;95(6):1547-56, table of contents. doi: 10.1097/00000539-200212000-00014.

Abstract

UNLABELLED

We examined whether volume kinetic variables obtained during infusion of a short bolus of 0.9% saline (NS) or 7.5% saline/6.0% dextran 70 (HSD) predict the dilution-time curve resulting from a 20-min infusion of the same fluid. Each of six conscious, splenectomized sheep (mean body weight, 36 +/- 3 kg), on 4 different days, in a random order, received each of 4 IV boluses: NS at a rate of 1.2 mL. kg(-1). min(-1) over 5 min or 20 min or 4.0 mL/kg of HSD over 2 min or 20 min. One, 2, and 3-volume kinetic models were fitted to the dilution of the arterial hemoglobin concentration and the urinary excretion as sampled during 180 min. The maximum dilution of arterial plasma at the end of the 5-min and 20-min infusions of NS was approximately 10% and 22%, respectively, and after the 2-min and 20-min infusions of HSD, maximum dilution was 24% and 21%, respectively. The median absolute performance error was virtually identical when the mean variable estimates from the 5-min infusion of NS were used to predict the individual dilution-time curves of the 5-min (mean, 0.027 dilution units) and 20-min (mean, 0.027) infusions and when the 2-min infusion of HSD was used to predict the dilution during the individual 2-min (mean, 0.050) and 20-min infusions (mean, 0.047). Computer simulations indicated that the difference at the end of infusion between the volume effects of NS and HSD is larger after longer infusions. We concluded that the volume kinetic variables obtained during a short infusion can be used to predict the outcome of a longer one, even if the longer infusion also delivers a larger volume.

IMPLICATIONS

Kinetic analysis of a short infusion of 7.5% saline/6% dextran or 0.9% saline accurately predicts the effects of a longer infusion of the same volume (7.5% saline/6% dextran) or of a larger volume (0.9% saline).

摘要

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我们研究了在静脉快速推注0.9%生理盐水(NS)或7.5%盐水/6.0%右旋糖酐70(HSD)期间获得的容量动力学变量,是否能预测随后20分钟输注相同液体所产生的稀释时间曲线。六只清醒的脾切除绵羊(平均体重36±3千克),在4个不同日期,按随机顺序,分别接受4次静脉推注:以1.2毫升·千克⁻¹·分钟⁻¹的速率在5分钟或20分钟内输注NS,或以4.0毫升/千克的剂量在2分钟或20分钟内输注HSD。将一、二和三室容量动力学模型应用于180分钟内采集的动脉血红蛋白浓度稀释和尿排泄情况。在5分钟和20分钟输注NS结束时,动脉血浆的最大稀释度分别约为10%和22%,在2分钟和20分钟输注HSD后,最大稀释度分别为24%和21%。当用5分钟输注NS的平均变量估计值预测5分钟(平均,0.027稀释单位)和20分钟(平均,0.027)输注的个体稀释时间曲线时,以及当用2分钟输注HSD来预测个体2分钟(平均,0.050)和20分钟输注(平均,0.047)期间的稀释情况时,中位绝对性能误差实际上是相同的。计算机模拟表明,输注时间越长,NS和HSD的容量效应在输注结束时的差异越大。我们得出结论,即使较长时间的输注输送的液体量更大,短时间输注期间获得的容量动力学变量也可用于预测较长时间输注的结果。

启示

对7.5%盐水/6%右旋糖酐或0.9%生理盐水进行短时间输注的动力学分析,能准确预测相同容量(7.5%盐水/6%右旋糖酐)较长时间输注或更大容量(0.9%生理盐水)较长时间输注的效果。

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