[正常血容量血液稀释对呼吸和循环系统的影响]

[Influence of normovolemic hemodilution on the respiratory and circulatory systems].

作者信息

Kobori M, Negishi H, Hosoyamada A

机构信息

Department of Anesthesiology, School of Medicine, Showa University, Tokyo.

出版信息

Masui. 1992 Feb;41(2):225-31.

PMID:1372664

Abstract

We studied respiratory and circulatory kinetics of normovolemic hemodilution in adult mongrel dogs. The dogs were divided into two groups; Dextran-40 (group A) and SALIN-HES (group B). No difference in PaO2 and PaCO2 was noted between the two groups. MPA and CI during normovolemic hemodilution were higher in group A than in group B. However, MPA, Qs/Qt and ETVI during normovolemic hemodilution were largely influenced in group A. L/P during normovolemic hemodilution was more influenced in group B than in group A. The compensatory effect with increase of the cardiac output during normovolemic hemodilution was noted until S3 (Hct = 10%), but it was not noted at S4 (Hct = 5%) and S5 (just before death). SvO2 is the most sensitive index indicating the risk of normovolemic hemodilution.

摘要

我们研究了成年杂种犬正常血容量性血液稀释的呼吸和循环动力学。这些犬被分为两组；右旋糖酐-40（A组）和生理盐水-羟乙基淀粉（B组）。两组之间的动脉血氧分压（PaO₂）和动脉血二氧化碳分压（PaCO₂）没有差异。正常血容量性血液稀释期间，A组的平均肺动脉压（MPA）和心脏指数（CI）高于B组。然而，正常血容量性血液稀释期间，A组的MPA、分流率（Qs/Qt）和呼气末容积指数（ETVI）受到的影响更大。正常血容量性血液稀释期间的肺/体循环血流量比值（L/P）在B组比在A组受到的影响更大。正常血容量性血液稀释期间，直到S3（血细胞比容 = 10%）时，随着心输出量增加的代偿作用才被观察到，但在S4（血细胞比容 = 5%）和S5（濒死期）时未观察到。混合静脉血氧饱和度（SvO₂）是表明正常血容量性血液稀释风险的最敏感指标。