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兔体外循环期间胶体渗透压对脑和脑外含水量的不同影响。

Differential effect of oncotic pressure on cerebral and extracerebral water content during cardiopulmonary bypass in rabbits.

作者信息

Hindman B J, Funatsu N, Cheng D C, Bolles R, Todd M M, Tinker J H

机构信息

Department of Anesthesia, College of Medicine, University of Iowa, Iowa City.

出版信息

Anesthesiology. 1990 Nov;73(5):951-7. doi: 10.1097/00000542-199011000-00024.

Abstract

To study the effect of oncotic pressure on brain water content during cardiopulmonary bypass (CPB), 14 anesthetized New Zealand White rabbits underwent 60 min of nonpulsatile CPB at normothermia. Animals were grouped according to the composition of the circuit priming fluid. Group 1 animals (n = 7) received a priming fluid (6.5% hydroxyethyl starch in 0.72 N NaCl; 323 +/- 13 mOsm/kg [mean +/- SD]) that maintained normal colloid oncotic pressure (COP) during CPB (19.0 +/- 1.5 mmHg). Group 2 animals (n = 7) received a priming fluid (0.9 N NaCl; 324 +/- 23 mOsm/kg) that led to a hypooncotic state (COP = 6.2 +/- 1.2 mmHg). Blood chemistries and hemodynamics were recorded every 15 min during CPB. Animals were given additional priming fluid and sodium bicarbonate during CPB to maintain a circuit flow of 85 ml.kg-1.min-1 and arterial pH greater than 7.35. There were no significant differences between groups 1 and 2 with respect to temperature, central venous pressure, mean arterial pressure, PaO2, PaCO2, plasma sodium concentration, or osmolality at any time during CPB, although osmolality increased in both groups. After 60 min of bypass, animals were killed and organ water contents were determined by wet/dry weight ratios. A separate group of nine similarly prepared and anesthetized animals that did not undergo cannulation or CPB also underwent measurement of plasma chemistries and tissue water contents and served as nonbypass controls (group 3). Brain and kidney water contents were unaffected by oncotic pressure, whereas duodenum and skeletal muscle had significantly greater water content (P = 0.003 and P = 0.008, respectively) after hypooncotic CPB.(ABSTRACT TRUNCATED AT 250 WORDS)

摘要

为研究体外循环(CPB)期间胶体渗透压对脑含水量的影响,14只麻醉的新西兰白兔在常温下接受了60分钟的非搏动性CPB。根据体外循环预充液的成分将动物分组。第1组动物(n = 7)接受一种预充液(0.72 N NaCl中6.5%的羟乙基淀粉;323±13 mOsm/kg [平均值±标准差]),该预充液在CPB期间维持正常的胶体渗透压(COP)(19.0±1.5 mmHg)。第2组动物(n = 7)接受一种预充液(0.9 N NaCl;324±23 mOsm/kg),该预充液导致低渗状态(COP = 6.2±1.2 mmHg)。在CPB期间每15分钟记录一次血液化学指标和血流动力学。在CPB期间给动物补充额外的预充液和碳酸氢钠,以维持85 ml·kg-1·min-1的循环流量和动脉血pH大于7.35。在CPB期间的任何时间,第1组和第2组在温度、中心静脉压、平均动脉压、PaO2、PaCO2、血浆钠浓度或渗透压方面均无显著差异,尽管两组的渗透压均有所升高。体外循环60分钟后,处死动物,通过湿/干重比测定器官含水量。另一组9只同样准备和麻醉但未进行插管或CPB的动物也进行了血浆化学指标和组织含水量的测量,并作为非体外循环对照组(第3组)。脑和肾的含水量不受胶体渗透压的影响,而在低渗CPB后十二指肠和骨骼肌的含水量显著更高(分别为P = 0.003和P = 0.008)。(摘要截断于250字)

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