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动脉血压作为评估等容性非低血压或低血压异氟烷麻醉犬液体输注反应的预测指标。

Arterial blood pressure as a predictor of the response to fluid administration in euvolemic nonhypotensive or hypotensive isoflurane-anesthetized dogs.

作者信息

Muir William W, Ueyama Yukie, Pedraza-Toscano Adriana, Vargas-Pinto Pedro, Delrio Carlos L, George Robert S, Youngblood Bradley L, Hamlin Robert L

机构信息

QTest Labs, 6456 Fiesta Dr, Columbus, OH 43235.

出版信息

J Am Vet Med Assoc. 2014 Nov 1;245(9):1021-7. doi: 10.2460/javma.245.9.1021.

DOI:10.2460/javma.245.9.1021
PMID:25313813
Abstract

OBJECTIVE

To determine the effects of rapid small-volume fluid administration on arterial blood pressure measurements and associated hemodynamic variables in isoflurane-anesthetized euvolemic dogs with or without experimentally induced hypotension.

DESIGN

Prospective, randomized, controlled study.

ANIMALS

13 healthy dogs.

PROCEDURES

Isoflurane-anesthetized dogs were randomly assigned to conditions of nonhypotension or hypotension (mean arterial blood pressure, 45 to 50 mm Hg) and treatment with lactated Ringer's solution (LRS) or hetastarch (3 or 10 mL/kg [1.4 or 4.5 mL/lb] dose in a 5-minute period or 3 mL/kg dose in a 1-minute period [4 or 5 dogs/treatment; ≥ 10-day interval between treatments]). Hemodynamic variables were recorded before and for up to 45 minutes after fluid administration.

RESULTS

IV administration of 10 mL/kg doses of LRS or hetastarch in a 5-minute period increased right atrial and pulmonary arterial pressures and cardiac output (CO) when dogs were nonhypotensive or hypotensive, compared with findings before fluid administration; durations of these effects were greater after hetastarch administration. Intravenous administration of 3 mL of hetastarch/kg in a 5-minute period resulted in an increase in CO when dogs were nonhypotensive. Intravenous administration of 3 mL/kg doses of LRS or hetastarch in a 1-minute period increased right atrial pressure and CO when dogs were nonhypotensive or hypotensive.

CONCLUSIONS AND CLINICAL RELEVANCE

Administration of LRS or hetastarch (3 or 10 mL/kg dose in a 5-minute period or 3 mL/kg dose in a 1-minute period) improved CO in isoflurane-anesthetized euvolemic dogs with or without hypotension. Overall, arterial blood pressure measurements were a poor predictor of the hemodynamic response to fluid administration.

摘要

目的

确定快速小容量液体输注对异氟烷麻醉的血容量正常犬(无论有无实验诱导的低血压)动脉血压测量值及相关血流动力学变量的影响。

设计

前瞻性、随机、对照研究。

动物

13只健康犬。

步骤

将异氟烷麻醉的犬随机分为非低血压组或低血压组(平均动脉血压45至50毫米汞柱),并分别用乳酸林格氏液(LRS)或羟乙基淀粉治疗(5分钟内给予3或10毫升/千克[1.4或4.5毫升/磅]剂量,或1分钟内给予3毫升/千克剂量[每组4或5只犬;两次治疗间隔≥10天])。在液体输注前及输注后长达45分钟记录血流动力学变量。

结果

与液体输注前相比,在5分钟内静脉给予10毫升/千克剂量的LRS或羟乙基淀粉时,无论犬处于非低血压状态还是低血压状态,右心房压和肺动脉压以及心输出量(CO)均增加;给予羟乙基淀粉后这些效应的持续时间更长。在5分钟内静脉给予3毫升/千克羟乙基淀粉时,非低血压犬的心输出量增加。在1分钟内静脉给予3毫升/千克剂量的LRS或羟乙基淀粉时,无论犬处于非低血压状态还是低血压状态,右心房压和心输出量均增加。

结论及临床意义

给予LRS或羟乙基淀粉(5分钟内给予3或10毫升/千克剂量,或1分钟内给予3毫升/千克剂量)可改善异氟烷麻醉的血容量正常犬(无论有无低血压)的心输出量。总体而言,动脉血压测量值对液体输注血流动力学反应的预测性较差。

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