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输注胶体溶液后献血时麻醉对液体容量动力学的影响。

Effects of anesthesia on fluid volume kinetics after infusion of colloid solution during blood donation.

机构信息

Department of Anesthesiology and Pain Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.

出版信息

Korean J Anesthesiol. 2010 Jun;58(6):514-20. doi: 10.4097/kjae.2010.58.6.514. Epub 2010 Jun 23.

Abstract

BACKGROUND

The fluid kinetics of intravenously infused colloid during inhalation anesthesia and hemorrhage have not been investigated. We therefore assessed fluid space changes during infusion of hydroxyethyl starch solution after hemorrhage in conscious and desflurane-anesthetized individuals.

METHODS

Following the donation of 400 ml of blood, 500 ml of hydroxyethyl starch solution was infused over 20 minutes into wakeful and desflurane-anesthetized volunteers. Blood was repeatedly sampled to measure hemoglobin concentration, a marker of plasma dilution, and fluid kinetic analysis was performed to evaluate changes in fluid space.

RESULTS

Using a fluid kinetic model, we found that the mean volume of fluid space was 7,724 +/- 1,788 ml in wakeful volunteers and 6,818 +/- 4,221 ml in anesthetized volunteers, and the elimination rate constants were 7.1 +/- 3.5 ml/min and 19.4 +/- 4.6 ml/min, respectively.

CONCLUSIONS

Infusion of colloid after mild hemorrhage resulted in similar expansions of plasma volume in desflurane-anesthetized and conscious individuals. During anesthesia, however, the expansion of plasma volume by colloid was decreased and of shorter duration than observed in conscious patients.

摘要

背景

静脉输注胶体在吸入麻醉和出血期间的流体动力学尚未得到研究。因此,我们评估了在清醒和地氟烷麻醉个体出血后输注羟乙基淀粉溶液期间液体空间的变化。

方法

在捐献 400 毫升血液后,500 毫升羟乙基淀粉溶液在清醒和地氟烷麻醉志愿者中输注 20 分钟。反复采血以测量血红蛋白浓度,这是血浆稀释的标志物,并进行流体动力学分析以评估液体空间的变化。

结果

使用流体动力学模型,我们发现清醒志愿者的平均液体空间体积为 7724 +/- 1788 毫升,麻醉志愿者为 6818 +/- 4221 毫升,消除速率常数分别为 7.1 +/- 3.5 毫升/分钟和 19.4 +/- 4.6 毫升/分钟。

结论

轻度出血后输注胶体导致地氟烷麻醉和清醒个体的血浆容量相似扩张。然而,在麻醉期间,胶体引起的血浆体积扩张比清醒患者观察到的要小且持续时间更短。

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