Hardy J D, Hardy K P, Turner M D
Ann Surg. 1975 Nov;182(5):644-9. doi: 10.1097/00000658-197511000-00018.
The objectives of this study were to compare in dogs the effects of massive infusion of Ringer's lactate, 5% dextrose in water, and whole blood. Special interest centered upon lung function, central venous pressure, and dilutional effects upon the blood components. Three groups of 5 healthy dogs each received respectively Ringer's lactate, 5% dextrose, or whole blood over 60 minutes in the amount of 135 ml/kg. Arterial blood gases and pH, right atrial and systemic arterial pressures, hemoglobin and hematocrit values, and plasma sodium, chloride, potassium and protein levels were determined. Coagulograms and serum osmolality were examined in the early experiments. The purpose of the whole blood infusion was primarily to serve for comparison in the study of dilutional effects upon blood components. There was no statistically significant change in the arterial blood gas values or pH following Ringer's lactate infusion. The infusion of 5% dextrose in water produced moderate decline in arterial Pco2 and a temporary, slight fall in blood pH. Ringer's lactate infusion produced a prompt and statistically significant rise in central venous pressure. The infusion of 5% dextrose was followed by a late moderate decline in arterial blood pressure, possibly due to marked dilution of plasma sodium, chloride and potassium. It is concluded that massive Ringer's lactate infusion is capable of increasing right atrial pressure and presumably cardiac output. In healthy dogs, lung function was not impaired sufficiently to alter arterial blood gas values. However, where other previous or concomitant factors have diminished pulmonary reserve, fluid overload may impose a serious additional burden upon cardiopulmonary function.
本研究的目的是比较在犬体内大量输注乳酸林格氏液、5%葡萄糖水溶液和全血的效果。特别关注的是肺功能、中心静脉压以及对血液成分的稀释作用。三组，每组5只健康犬，分别在60分钟内接受135 ml/kg的乳酸林格氏液、5%葡萄糖或全血。测定动脉血气和pH值、右心房和体动脉压、血红蛋白和血细胞比容值以及血浆钠、氯、钾和蛋白质水平。在早期实验中检查了凝血图和血清渗透压。输注全血的主要目的是用于在研究对血液成分的稀释作用时进行比较。输注乳酸林格氏液后，动脉血气值或pH值无统计学显著变化。输注5%葡萄糖水溶液导致动脉Pco2适度下降，血液pH值暂时略有下降。输注乳酸林格氏液使中心静脉压迅速且有统计学显著升高。输注5%葡萄糖后，动脉血压后期适度下降，可能是由于血浆钠、氯和钾的显著稀释。得出的结论是，大量输注乳酸林格氏液能够增加右心房压力，推测也能增加心输出量。在健康犬中，肺功能未受到足够损害以改变动脉血气值。然而，在先前存在其他因素或同时存在其他因素导致肺储备减少的情况下，液体超负荷可能给心肺功能带来严重的额外负担。
