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[脓毒症综合征早期输注10% 200/0.5的羟乙基淀粉对血流动力学参数的影响]

[Effects of a defined infusion of 10% HAES 200/0.5 in the early phase of a septic syndrome on hemodynamic parameters].

作者信息

Simon H B, Mertens H, Löhmer P, Agternkamp C, Klosterhalfen B, Müller F G

机构信息

Klinik für Anästhesiologie, Medizinische Fakultät der Rheinisch-Westfälischen Technischen Hochschule Aachen.

出版信息

Infusionstherapie. 1991 Dec;18(6):301-5.

PMID:1724660
Abstract

In an animal model the hemodynamic effects of three infusions of HES during the early stage of a septic syndrome were examined. In nine pigs with a body weight between 29 and 36 kg a septic syndrome was produced by infusion of E. coli endotoxin. 1, 4 and 7 hours after beginning of the endotoxin infusion 250 ml HES 200/0.5 were infused. After the 1st and 3rd infusion an increase of the cardiac output resulted, which was previously lowered, without changes of the CVP. During normal CO the 2nd infusion shows an increase of CVP and MAP. PWP did not change. The reactions of the hemodynamic parameters can be well explained physiologically. A volume supply at a reduced CO increases the latter without influence of the CVP. Normalized CO before the infusion resulted in a CVP-increase. The PWP is not evaluable under the conditions of an elevated pulmonary resistance, as it exists at the septic syndrome.

摘要

在一个动物模型中,研究了在脓毒症综合征早期三次输注羟乙基淀粉(HES)的血流动力学效应。选用9头体重在29至36千克之间的猪,通过输注大肠杆菌内毒素制造脓毒症综合征。在内毒素输注开始后1小时、4小时和7小时,分别输注250毫升200/0.5的HES。第一次和第三次输注后,先前降低的心输出量增加,而中心静脉压(CVP)无变化。在心输出量正常时,第二次输注显示CVP和平均动脉压(MAP)升高。肺毛细血管楔压(PWP)未改变。血流动力学参数的反应可以从生理学上得到很好的解释。在心输出量降低时进行容量补充可增加心输出量,而不影响CVP。输注前经归一化的心输出量导致CVP升高。在脓毒症综合征存在的情况下,由于肺阻力升高,PWP无法评估。

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