Riadovoĭ G V, Tutubalin V N
Anesteziol Reanimatol. 1990 Nov-Dec(6):33-6.
Hemodynamic parameters, lung gas exchange, hemoglobin, acid-base balance, gases, blood lactate and pO2 have been studied in 105 patients with acute cardiorespiratory disturbances (CRD) after open heart surgery. The actual P50 was determined by the venous point, using the Severinghaus blood gas analyser. The method of multidimensional regression analysis was used to study the contribution of some factors determining oxyhemoglobin dissociation curve (ODC) shift. It has been shown that CRD are characterized not only by Bohr's effect and temperature impact but also by ODC shifts, which cannot be accounted for by changes in erythrocyte 2,3-diphosphoglycerate concentration. As hypoxia is universal for any CRD the index of mixed venous blood saturation with O2 (Sv-O2) was considered as a factor determining hypoxic ODC shift and a numerical contribution of hypoxia to P50 changes has been determined. The coefficient in delta Sv-O2 was 0.0025-0.0030 15% Sv-O2 changes were in Bohr's effect equivalent to ODC shift, with pH changing by 0.1. The role of hypoxia in the changes of Hb-O2 affinity in CRD is discussed.
对105例心脏直视手术后发生急性心肺功能障碍（CRD）的患者进行了血流动力学参数、肺气体交换、血红蛋白、酸碱平衡、气体、血乳酸和氧分压的研究。使用Severinghaus血气分析仪通过静脉点测定实际P50。采用多维回归分析方法研究了一些决定氧合血红蛋白解离曲线（ODC）偏移的因素的作用。结果表明，CRD不仅具有波尔效应和温度影响的特征，还具有ODC偏移的特征，而红细胞2,3-二磷酸甘油酸浓度的变化无法解释这种偏移。由于缺氧在任何CRD中都很普遍，因此将混合静脉血氧饱和度（Sv-O2）指数视为决定缺氧性ODC偏移的因素，并确定了缺氧对P50变化的数值贡献。Sv-O2变化15%时，δSv-O2系数为0.0025-0.0030，相当于ODC偏移的波尔效应，pH变化0.1。讨论了缺氧在CRD中血红蛋白-氧亲和力变化中的作用。
