Hahn Robert G, Edsberg Lennart, Sjöstrand Fredrik
Department of Anesthesiology, Söder Hospital, Royal Institute of Technology, Stockholm, Sweden.
Cell Biochem Biophys. 2003;39(3):211-22. doi: 10.1385/CBB:39:3:211.
Volume kinetics is a mathematical tool for macroscopic (whole-body) evaluation of the distribution and elimination of fluid given by intravenous infusion. Although the kinetic system has mostly been applied to crystalloid fluids, such as Ringer's solution, it has more recently been extended to glucose solution, which is characterized by interdependence between glucose and fluid kinetics. The elimination of glucose, as estimated by a one-compartment open model, serves as the driving force for cellular uptake of glucose and, by virtue of osmosis, of water. Key findings include the observation that the infused fluid, besides being accumulated in the cells, occupies a central body fluid space (V1), which is no larger than 3-4 L, and that the cellular hydration has a much longer time-course than the hydration of V1. This explains the risk of hypovolemia associated with rapid infusion of 5% glucose; the dilution of V1, which is quite substantial owing to the small size of this space at baseline, stimulates a brisk diuresis while the excess water is being "trapped" in the cells along with the glucose. Model linearity has been demonstrated for 2.5% glucose solution and this allows the construction of nomograms for administration of such fluid during surgery and critical illness.
容量动力学是一种用于宏观（全身）评估静脉输注液体分布和消除情况的数学工具。尽管动力学系统大多应用于晶体液，如林格氏液，但最近它已扩展到葡萄糖溶液，其特点是葡萄糖动力学和液体动力学相互依存。通过一室开放模型估算的葡萄糖消除，是细胞摄取葡萄糖以及因渗透作用摄取水的驱动力。主要发现包括观察到输注的液体除了积聚在细胞内，还占据一个中心体液空间（V1），其大小不超过3 - 4升，并且细胞水合作用的时间进程比V1的水合作用长得多。这解释了快速输注5%葡萄糖相关的低血容量风险；由于基线时该空间较小，V1的稀释相当显著，会刺激快速利尿，而多余的水则与葡萄糖一起“被困”在细胞内。已证明2.5%葡萄糖溶液的模型具有线性，这使得能够构建手术和危重病期间此类液体给药的列线图。
