Randell T, Orko R, Höckerstedt K
Department of Anaesthesia, Helsinki University Central Hospital, Finland.
Acta Anaesthesiol Scand. 1990 Oct;34(7):592-5. doi: 10.1111/j.1399-6576.1990.tb03151.x.
Brain-dead organ donors are often dehydrated and have serum electrolyte disorders. This study was designed to analyse the haemodynamic condition and serum electrolyte balance of liver donors. Two different fluid management plans for the harvesting operation were studied. Sixteen consecutive organ donors were included. They were randomly infused either with a combination of colloid (hydroxy ethyl starch) and electrolyte solution (group COL) or with crystalloid fluid alone (group CR). Arterial pressures, heart rate, central venous pressure and oesophageal temperature were monitored and serum electrolytes were analysed before the beginning of the operation and during harvesting. The amount of fluid needed in the COL group was significantly less (P less than 0.01) than in the CR group. There were no statistical differences between the groups in the haemodynamic parameters during the study period. The oesophageal temperature was maintained in both groups. All donors were initially hypernatraemic, but the serum sodium values returned towards normal during surgery in both groups. Immediate function was seen in all livers. In conclusion, the haemodynamic stability is maintained with a smaller infused volume if hydroxyethyl starch is combined with crystalloid fluids. The formation of interstitial oedema will be less when colloids are used, but its significance in organ donation needs further evaluation.
脑死亡器官捐献者常存在脱水及血清电解质紊乱。本研究旨在分析肝脏捐献者的血流动力学状况及血清电解质平衡。研究了两种不同的肝脏获取手术液体管理方案。纳入了连续的16例器官捐献者。他们被随机输注胶体（羟乙基淀粉）和电解质溶液的组合（COL组）或仅输注晶体液（CR组）。在手术开始前及获取过程中监测动脉压、心率、中心静脉压和食管温度，并分析血清电解质。COL组所需液体量显著少于CR组（P<0.01）。研究期间两组血流动力学参数无统计学差异。两组食管温度均维持稳定。所有捐献者最初均为高钠血症，但两组手术期间血清钠值均恢复至正常。所有肝脏均立即发挥功能。总之，羟乙基淀粉与晶体液联合使用时，以较小的输注量即可维持血流动力学稳定。使用胶体时组织间水肿的形成会减少，但其在器官捐献中的意义尚需进一步评估。
