Haneda K, Thomas R, Breazeale D G, Dillard D H
Department of Surgery, University of Washington School of Medicine, Seattle 98195.
J Cardiovasc Surg (Torino). 1987 Nov-Dec;28(6):614-20.
Colloid osmotic pressure (COP) during hypothermia with and without total circulatory arrest was evaluated in 20 adult mongrel dogs (average body weight = 18.6 kg). All animals were surface-cooled to 20 degrees C (rectal temperature) under halothane-diethyl ether azeotrope anesthesia and divided into 4 equal groups. In Groups I (non-arrest) and II (60 minute-arrest) 10% low molecular weight dextran (LMWD; 1 gm/kg = 10 ml/kg) was administered during cooling. Physiological saline (10 ml/kg) was given in Groups III (non-arrest) and IV (60 minute-arrest) during cooling. COP in LMWD groups increased significantly during cooling and was consistently higher than it was in the saline groups during rewarming. There were no significant differences in heart rate (HR), mean arterial pressure (MAP), central venous (CVP) and pulmonary artery wedge pressures (PAW) between the 4 groups during cooling. The increase in hematocrit (Hct) in animals that received saline was significant at the end of cooling and during rewarming. Hct was not significantly changed in Group I throughout the procedure, whereas in Group II (60 minute-arrest) it increased significantly during rewarming despite the administration of LMWD. Rewarming time in Group II was significantly shorter than in Group IV (144.2 +/- 9.6 min vs 193.2 +/- 32.6 min, respectively). We conclude that the administration of LMWD effectively reduces hemoconcentration and is also beneficial for maintaining better peripheral circulation.
在20只成年杂种犬(平均体重 = 18.6千克)身上评估了伴有和不伴有完全循环停止的低温期间的胶体渗透压(COP)。所有动物在氟烷 - 乙醚共沸物麻醉下体表冷却至20摄氏度(直肠温度),并分为4个相等的组。在I组(非停止)和II组(60分钟停止)中,在冷却期间给予10%低分子量右旋糖酐(LMWD;1克/千克 = 10毫升/千克)。在III组(非停止)和IV组(60分钟停止)的冷却期间给予生理盐水(10毫升/千克)。LMWD组的COP在冷却期间显著增加,并且在复温期间始终高于生理盐水组。在冷却期间,4组之间的心率(HR)、平均动脉压(MAP)、中心静脉压(CVP)和肺动脉楔压(PAW)没有显著差异。接受生理盐水的动物的血细胞比容(Hct)在冷却结束时和复温期间显著增加。I组在整个过程中Hct没有显著变化,而在II组(60分钟停止)中,尽管给予了LMWD,但在复温期间Hct仍显著增加。II组的复温时间明显短于IV组(分别为144.2±9.6分钟和193.2±32.6分钟)。我们得出结论,给予LMWD可有效降低血液浓缩,并且对维持更好的外周循环也有益。