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豚鼠出血后6%右旋糖酐70、5%白蛋白和6%羟乙基淀粉130/0.4血浆扩容效果的比较。

Comparison of the plasma volume-expanding effects of 6% dextran 70, 5% albumin, and 6% HES 130/0.4 after hemorrhage in the guinea pig.

作者信息

Dubniks Maris, Persson Johan, Grände Per-Olof

机构信息

Department of Anesthesiology, Lund University and Lund University Hospital, Lund, Sweden.

出版信息

J Trauma. 2009 Dec;67(6):1200-4. doi: 10.1097/TA.0b013e31818d0e5d.

Abstract

BACKGROUND

We still lack comparing data of the plasma volume (PV)-expanding effect of the most commonly used colloids including dextran 70. This study compares the PV-expanding effects of 6% dextran 70, 5% albumin, and 6% hydroxyethylstarch (HES) 130/0.4 after a standardized hemorrhage.

METHODS

The prospective and randomized study on 33 anesthetized adult male guinea pigs involved three groups (n = 11 each); the dextran group, the albumin group, and the HES group. The left carotis artery was cannulated for blood pressure measurements and blood samples, and the right jugular vein was cannulated for infusions. After hemorrhage of 20 mL/kg for 8 minutes, the animals were transfused with 20 mL/kg of the colloid for 10 minutes. PV was determined with a I-albumin tracer dilution technique at baseline and 3 hours after the colloid infusion. The PV just after hemorrhage was calculated as the baseline value minus bled PV. Blood gases were measured at baseline, after hemorrhage, just after the colloid infusion and at the end of the experiment.

RESULTS

The increase in PV 3 hours after the colloid infusion, including the 20 mL infused, was 36.3 mL/kg +/- 2.3 mL/kg in the dextran group, 26.4 mL/kg +/- 4.7 mL/kg in the albumin group, and 17.6 mL/kg +/- 3.5 mL/kg in the HES group. At the end of the experiment, hematocrit was lower in the dextran group than in the albumin and the HES groups. Urine production was higher in the HES group than in the dextran and the albumin groups.

CONCLUSION

After hemorrhage, the PV-expanding capacity of 6% dextran 70 was better than that of 5% albumin, which was in turn better than that of HES 130/0.4 given in equal volumes.

摘要

背景

我们仍然缺乏包括右旋糖酐70在内的最常用胶体溶液的扩充血容量(PV)效果的对比数据。本研究比较了标准出血后6%右旋糖酐70、5%白蛋白和6%羟乙基淀粉(HES)130/0.4的扩充血容量效果。

方法

对33只麻醉的成年雄性豚鼠进行前瞻性随机研究,分为三组(每组n = 11);右旋糖酐组、白蛋白组和羟乙基淀粉组。通过左颈动脉插管测量血压和采集血样,通过右颈静脉插管进行输液。以20 mL/kg的量出血8分钟后,给动物输注20 mL/kg的胶体溶液,持续10分钟。在基线和胶体溶液输注后3小时,采用碘标记白蛋白示踪剂稀释技术测定血容量。出血后即刻的血容量通过基线值减去失血血容量来计算。在基线、出血后、胶体溶液输注后即刻和实验结束时测量血气。

结果

胶体溶液输注后3小时,包括输注的20 mL在内,右旋糖酐组血容量增加36.3 mL/kg±2.3 mL/kg,白蛋白组为26.4 mL/kg±4.7 mL/kg,羟乙基淀粉组为17.6 mL/kg±3.5 mL/kg。实验结束时,右旋糖酐组的血细胞比容低于白蛋白组和羟乙基淀粉组。羟乙基淀粉组的尿量高于右旋糖酐组和白蛋白组。

结论

出血后,6%右旋糖酐70的扩充血容量能力优于5%白蛋白,而5%白蛋白又优于等体积给予的HES 130/0.4。

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