Noirot M T, Freysz M, Letourneau B, Defrance N, Angue M
Département d'Anesthésie-Réanimation, Hôpital Général, Dijor.
Ann Fr Anesth Reanim. 1990;9(5):433-42. doi: 10.1016/s0750-7658(05)80950-5.
Rapid fluid infusion remains the cornerstone for therapy of hypovolaemic shock. The principal limitations of flow rate are governed by the four variables of Poiseuille's law: tube internal diameter and length, viscosity of the fluid passing through the tube, and the pressure gradient between the two ends of the tube. Conventional transfusion systems, with wide bore tubing (up to 5.0 mm internal diameter), large bore cannulas (8.5 French introducer catheters), high pressure (up to 300 mmHg) and diluted blood, can result in a maximum flow rate of about 1,000 ml.min-1 (for crystalloid solutions). Specific apparatus for rapid infusion can increase this to 1,500 ml.min-1 (Rapid Infusion System, Haemonetics). Dry-heat warming devices and microfiltration, to remove microaggregates and prevent non haemolytic febrile transfusion reactions, seem necessary when carrying out rapid transfusions. However, the use of microaggregate filters could be avoided by the routine production of leukocyte-poor red blood cell concentrates.
快速输液仍然是低血容量性休克治疗的基石。流速的主要限制因素由泊肃叶定律的四个变量决定：管道内径和长度、流经管道的液体粘度以及管道两端的压力梯度。传统的输血系统，采用大口径 tubing（内径可达 5.0 毫米）、大口径套管（8.5 法式导入导管）、高压（可达 300 mmHg）以及稀释血液，对于晶体溶液而言，最大流速可达约 1000 ml·min⁻¹。用于快速输液的特定设备可将此流速提高至 1500 ml·min⁻¹（血液处理系统，Haemonetics）。在进行快速输血时，干热加温装置和微滤以去除微聚集体并防止非溶血性发热输血反应似乎是必要的。然而，通过常规生产少白细胞红细胞浓缩物可避免使用微聚集体过滤器。
