Yap W W, Young D, Pathi V
Department of Cardiothoracic Surgery, Western Infirmary, Glasgow, United Kingdom.
Perfusion. 2007 Jan;22(1):57-61. doi: 10.1177/0267659107077903.
Perioperative volume replacement after cardiopulmonary bypass is complicated by post-bypass systemic inflammatory process. The aim of this study was to assess the effects of using two different colloid solutions as priming fluids in cardiopulmonary bypass. The study's primary end point was to measure the amount of fluid replacement needed during and post-cardiopulmonary bypass; blood loss, change in blood profile and intraocular pressure were secondary end points, used as measures of plasma oncotic pressures. Patients undergoing coronary artery bypass grafting were recruited. Both patients and surgeons were blinded to receive either Gelofusine or Voluven as priming fluids. At fixed intervals during cardiopulmonary bypass, the patients had their intraocular pressures measured. Intra and postoperative fluid replacement was in the form of 4.5% human albumin and the amount was recorded for each subject. The result did not show any significant differences in the amount of fluid needed to be replaced, in blood loss or in blood profile between the two groups. However, it showed an increase in intraocular pressure in both groups once cardiopulmonary bypass commenced. The average intraocular pressure was higher in the Gelofusine group compared to the Voluven group. The significant increase in intraocular pressure measurements in the Gelofusine group compared to the Voluven group support the hypothesis that Voluven maintains the plasma oncotic pressure better and reduces fluid shift.
体外循环后的围手术期容量补充因体外循环后的全身炎症反应而变得复杂。本研究的目的是评估在体外循环中使用两种不同胶体溶液作为预充液的效果。该研究的主要终点是测量体外循环期间及之后所需的液体补充量；失血、血液指标变化和眼压是次要终点，用作血浆胶体渗透压的衡量指标。招募接受冠状动脉搭桥术的患者。患者和外科医生均被设盲，分别接受佳乐施或万汶作为预充液。在体外循环期间的固定时间间隔，测量患者的眼压。术中及术后的液体补充采用4.5%人白蛋白的形式，并记录每个受试者的补充量。结果显示，两组在所需补充的液体量、失血量或血液指标方面均无显著差异。然而，结果显示两组在体外循环开始后眼压均升高。与万汶组相比，佳乐施组的平均眼压更高。与万汶组相比，佳乐施组眼压测量值的显著升高支持了万汶能更好地维持血浆胶体渗透压并减少液体转移这一假说。
