Kawamura M, Sakakibara K, Minamikawa O, Yokochi H, Kobayashi A
Jpn J Surg. 1977 Jun;7(2):54-64. doi: 10.1007/BF02469387.
Cardiopulmonary bypass with 17 to 57 per cent dilution of hemoglobin for repair of ventricular septal defect (VSD) was applied to 26 infants weighing less than 10 kg at normal temperature. The higher flow rate was required to compensate the reduced oxygen carrying capacity and to maintain an adequate arterial pressure in proportion to a decrease of hemoglobin value. Perfusion index resulted in 3.0 to 6.5 L/m2/min in this series. When the dilution ratio of hemoglobin became more than 50 per cent and high flow rate was required, however, oxygen transfer ratio decreased remarkably on account of inadequate oxygen delivery and imparied venous return. In these cases, it was difficult to remove the diluent immediately after the operation in spite of powerful diuretic therapy. The results of the present study indicate that the safe limits of hemodilution is 50 per cent in cardiopulmonary bypass at normal temperature in infants.
对26例体重不足10公斤的婴幼儿在常温下采用心肺转流术，血红蛋白稀释度为17%至57%，用于室间隔缺损（VSD）修复。需要较高的流量速率来补偿降低的携氧能力，并根据血红蛋白值的降低维持足够的动脉压。本系列中灌注指数为3.0至6.5升/平方米/分钟。然而，当血红蛋白稀释率超过50%且需要高流量速率时，由于氧输送不足和静脉回流受损，氧转运率显著下降。在这些情况下，尽管进行了强力利尿治疗，但术后仍难以立即清除稀释剂。本研究结果表明，婴幼儿常温心肺转流术中血液稀释的安全限度为50%。
