Murday H K, Jungblut M
Institut für Anästhesiologie, Rheinische Friedrich-Wilhelms-Universität Bonn.
Anasth Intensivther Notfallmed. 1990 Oct;25(5):335-9.
The aim of this study was to evaluate isovolaemic haemodilution (IHD) as a method to reduce the use of homologous blood in high-risk geriatric patients undergoing cardiac surgery. Haemodynamics were continuously assessed in both the systemic and the pulmonary circulation, and, in addition, the EEG was continuously analysed by on-line power spectrum analysis. The mean blood use in this series could be reduced from 4.2 units to 1.12 units (67 patients). 73% of the patients needed intraoperatively no blood at all. The haemodynamic response to haemodilution in these patients consisted of an increase in stroke volume by 9%, and decreases in systemic vascular resistance and myocardial-O2 consumption (as reflected by the rate/pressure product RPP) by 9% and 10%, respectively. At the same time, O2 transport capacity increased by 8%. No signs of oxygen balance impairment were found in either ECG or EEG during haemodilution. It is concluded that moderate IHD can be safely performed in the geriatric cardiac patient and represents a useful method to reduce homologous blood use in these patients.
本研究的目的是评估等容血液稀释（IHD）作为一种减少高危老年心脏手术患者同种异体血使用的方法。对体循环和肺循环的血流动力学进行持续评估，此外，通过在线功率谱分析对脑电图进行持续分析。本系列患者的平均用血可从4.2单位减少至1.12单位（67例患者）。73%的患者术中完全不需要输血。这些患者对血液稀释的血流动力学反应包括每搏量增加9%，体循环血管阻力和心肌氧耗（以心率/血压乘积RPP表示）分别降低9%和10%。同时，氧运输能力增加8%。血液稀释期间，心电图或脑电图均未发现氧平衡受损的迹象。结论是，中度等容血液稀释可在老年心脏手术患者中安全进行，是减少这些患者同种异体血使用的一种有效方法。
