Nakamura H, Ishihara H, Okawa H, Yatsu Y, Tsubo T, Matsuki A
University of Hirosaki School of Medicine, Department of Anesthesiology, Hirosaki-Shi, Japan.
Eur J Anaesthesiol. 2005 Mar;22(3):202-8. doi: 10.1017/s0265021505000359.
Initial distribution volume of glucose (IDVG) reliably measures the central extracellular fluid volume in the presence of fluid gain or loss. We hypothesized that IDVG has a close relationship with intrathoracic blood volume (ITBV), which has recently been used as an indicator of cardiac preload. We therefore examined whether IDVG can correlate with ITBV in various fluid volume states.
Fourteen anaesthetized mongrel dogs were mechanically ventilated. ITBV and cardiac output were measured by single transpulmonary thermodilution technique. IDVG and indocyanine green derived plasma volume (PV-ICG) were determined by the administration of 100 mg kg(-1) glucose and 0.5 mg kg(-1) indocyanine green solutions, respectively, and calculated by applying a one-compartment model. Three sets of measurements were performed before and after haemorrhage (30 mL kg(-1) and subsequent fluid volume loading (90 mL kg(-1) of lactated Ringer's solution).
A linear correlation was observed between IDVG and ITBV (r2 = 0.52, n = 42, P < 0.001) and between PV-ICG and ITBV (r2 = 0.44, n = 42, P < 0.001) throughout the procedures. A linear correlation was also observed between changes in IDVG and those in ITBV (r2 = 0.76, n = 28, P < 0.001). The ITBV/IDVG ratio during normovolaemia was 0.26 +/- 0.04, which remained unchanged during the procedure.
Results showed that that IDVG has a linear correlation with ITBV, and support the concept that IDVG measurement has potential as a surrogate measure of ITBV in various fluid volume states.
在存在液体增减的情况下,葡萄糖初始分布容积(IDVG)能够可靠地测量中心细胞外液容积。我们推测IDVG与胸腔内血容量(ITBV)密切相关,而ITBV最近已被用作心脏前负荷的指标。因此,我们研究了在各种液体容量状态下IDVG是否与ITBV相关。
对14只麻醉的杂种犬进行机械通气。采用单肺热稀释技术测量ITBV和心输出量。分别给予100mg/kg葡萄糖和0.5mg/kg吲哚菁绿溶液后,测定IDVG和吲哚菁绿衍生血浆容积(PV-ICG),并应用单室模型进行计算。在出血(30mL/kg)前后以及随后的液体容量负荷(90mL/kg乳酸林格液)前后进行三组测量。
在整个过程中,IDVG与ITBV之间呈线性相关(r2 = 0.52,n = 42,P < 0.001),PV-ICG与ITBV之间也呈线性相关(r2 = 0.44,n = 42,P < 0.001)。IDVG的变化与ITBV的变化之间也呈线性相关(r2 = 0.76,n = 28,P < 0.001)。正常血容量时ITBV/IDVG比值为0.26±0.04,在整个过程中保持不变。
结果表明IDVG与ITBV呈线性相关,并支持IDVG测量在各种液体容量状态下作为ITBV替代测量指标的概念。