Guidet B, Staikowsky F, Vassal T, Offenstadt G, Amstutz P
Service de Réanimation polyvalente, Hôpital Saint-Antoine, Paris.
Ann Fr Anesth Reanim. 1992;11(5):534-9. doi: 10.1016/s0750-7658(05)80760-9.
This study aimed to compare two plasma substitution regimens used during plasma exchanges (PE). It was a prospective cross-over randomized trial. Each patient (n = 12) had two PE at a 48 h interval. During one PE, only albumin was administered (PEA), and during the other one, equal volumes of albumin and low molecular weight hydroxyethylstarch (HES) (Elohes) were given (PEA+E). The order in which these different protocols were used was random. Plasma was separated by filtration, and the total volume extracted was one and a half the plasma volume. The parameters recorded every 15 min until 1 h after the end of PE, were heart rate, blood pressure and central venous pressure (CVP). Plasma volume, calculated from the mean body haematocrit and blood volume, was measured before and after PE. The clinical and biological tolerance of the rapid infusion of a large volume of HES was also assessed. PE characteristics were similar in both groups. For PEA and PEA+E, PE lasted 152 +/- 21 min and 154 +/- 25 min; the plasma volume extracted was 3,907 +/- 772 ml and 3,933 +/- 717 ml; the volume of plasma substitute infused was 4,097 +/- 617 ml and 3,933 +/- 717 ml, respectively. As haemodynamic and biochemical values were not significantly different in both groups, they were pooled together irrespective of the order of PE.(ABSTRACT TRUNCATED AT 250 WORDS)
本研究旨在比较血浆置换（PE）过程中使用的两种血浆置换方案。这是一项前瞻性交叉随机试验。每位患者（n = 12）每隔48小时进行两次PE。在一次PE期间，仅给予白蛋白（PEA），而在另一次PE期间，给予等量的白蛋白和低分子羟乙基淀粉（HES）（Elohes）（PEA + E）。使用这些不同方案的顺序是随机的。通过过滤分离血浆，提取的总体积为血浆体积的1.5倍。在PE结束后1小时内，每15分钟记录一次参数，包括心率、血压和中心静脉压（CVP）。根据平均体血细胞比容和血容量计算血浆体积，并在PE前后进行测量。还评估了快速输注大量HES的临床和生物学耐受性。两组的PE特征相似。对于PEA和PEA + E，PE持续时间分别为152±21分钟和154±25分钟；提取的血浆体积分别为3907±772毫升和3933±717毫升；输注的血浆代用品体积分别为4097±617毫升和3933±717毫升。由于两组的血流动力学和生化值无显著差异，因此无论PE顺序如何，均将它们合并在一起。（摘要截断于250字）
