Hankeln K, Lenz I, Häuser B
Abteilung für Anaesthesie und Intensivmedizin, Zentralkrankenhaus Bremen-Nord.
Anaesthesist. 1988 Mar;37(3):167-72.
The hemodynamic effects of 6% hydroxyethyl starch (HES) 200,000/0.62 were investigated in 20 patients (7 female, 13 male) who required invasive (Swan-Ganz/radial artery catheter) monitoring during major surgery. In 8 patients infrarenal aneurysmectomy and implantation of a bifurcation prosthesis was carried out, in 10 patients with arteriosclerotic vessel disease a bifurcation prosthesis was implanted, in 1 patient a renal artery aneurysm was repaired, and in another abdominosacral rectum amputation was performed. After induction of general anesthesia with alcuronium 2 mg, fentanyl 0.25-0.5 mg, droperidol 2.5-7.5 mg, thiopental 250-375 mg, succinylcholine 100 mg, and alcuronium 8 mg, the patients were ventilated with an O2-N2O ratio of 1.4:3 and halothane 0.4-0.6 vol%; the left radial artery was cannulated and a Swan-Ganz catheter was introduced percutaneously via the right internal jugular vein. According to clinical needs, repetitive doses of alcuronium, droperidol, and fentanyl were administered. At pulmonary capillary wedge pressures (PCWP) of 8-10 mm Hg arterial and mixed-venous samples were drawn for blood gas analysis and saturations; arterial blood pressure (systolic, diastolic), pulmonary artery pressure (systolic and diastolic), and central venous pressure were measured. Five measurements of cardiac output were carried out with cold saline solution, the highest and lowest values discarded, and the hemodynamic variables calculated based on the average of the remaining three values. All hemodynamic data were measured with the Siemens SIRECUST 400/404 monitoring system. Measurement of injectate temperature was done by on-line thermistor GOULD SP 5045. (ABSTRACT TRUNCATED AT 250 WORDS)
在20例(7例女性,13例男性)接受大手术期间需要有创(Swan-Ganz/桡动脉导管)监测的患者中,研究了6%羟乙基淀粉(HES)200,000/0.62的血流动力学效应。8例患者进行了肾下动脉瘤切除术并植入分叉型人工血管,10例患有动脉硬化性血管疾病的患者植入了分叉型人工血管,1例患者修复了肾动脉动脉瘤,另1例患者进行了腹骶直肠切除术。在用2mg阿库氯铵、0.25 - 0.5mg芬太尼、2.5 - 7.5mg氟哌利多、250 - 375mg硫喷妥钠、100mg琥珀酰胆碱和8mg阿库氯铵诱导全身麻醉后,患者以氧气-氧化亚氮比例为1.4:3和0.4 - 0.6体积%氟烷进行通气;左桡动脉插管,经右颈内静脉经皮插入Swan-Ganz导管。根据临床需要,重复给予阿库氯铵、氟哌利多和芬太尼。在肺毛细血管楔压(PCWP)为8 - 10mmHg时,采集动脉血和混合静脉血样本进行血气分析和饱和度测定;测量动脉血压(收缩压、舒张压)、肺动脉压(收缩压和舒张压)和中心静脉压。用冷盐水溶液进行五次心输出量测量,舍弃最高值和最低值,根据其余三个值的平均值计算血流动力学变量。所有血流动力学数据均用西门子SIRECUST 400/404监测系统测量。注射液温度通过在线热敏电阻GOULD SP 5045测量。(摘要截短于250字)