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等容血液稀释期间心脏的血流动力学、氧需求及氧摄取(作者译)

[Haemodynamics, oxygen demand and oxygen uptake of the heart during isovolaemic haemodilution (author's transl)].

作者信息

Kettler D, Hellberg K, Klaess G, Kontokollias J S, Loos W, de Vivie R

出版信息

Anaesthesist. 1976 Apr;25(4):131-6.

PMID:1275210
Abstract
  1. In experiments on 5 closed chest dogs an isovolaemic haemodilution with 6% dextran resulted in a drop of haemoglobin content to 6,4g%. Except for a small decrease of arterial pO2 and O2-saturation the body oxygen supply remained undisturbed. -- 2. According to only very small haemodynamic alterations (except compensatory cardiac output increase) myocardial O2-demand increased very little and mainly is caused by moderate augmentation of ventricular wall tension. The decrease of arterial O2 content was fully compensated by an increase of myocardial blood flow. O2 supply to the myocardium was not critically changed. -- 3. In accordance with other investigators it is concluded that in case of coronary insufficiency or increased myocardial O2 demand intentional hemodilution should be avoided. Patients with myocardial insufficiency considered for therapeutic hemodilution should be digitalized preoperatively.
摘要
  1. 在对5只闭胸犬进行的实验中,用6%的右旋糖酐进行等容血液稀释后,血红蛋白含量降至6.4g%。除动脉血氧分压和血氧饱和度略有下降外,机体的氧供应未受干扰。——2. 仅根据非常小的血流动力学改变(除代偿性心输出量增加外),心肌氧需求增加很少,主要是由心室壁张力适度增加引起的。动脉血氧含量的降低通过心肌血流量的增加得到了充分补偿。心肌的氧供应没有发生严重变化。——3. 与其他研究者一致,得出结论:在冠状动脉供血不足或心肌氧需求增加的情况下,应避免故意进行血液稀释。考虑进行治疗性血液稀释的心肌功能不全患者应在术前进行洋地黄化。

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