McBride Duana, Raisis Anthea L, Hosgood Giselle, Smart Lisa
College of Veterinary Medicine, Murdoch University, Perth, WA, Australia.
College of Veterinary Medicine, Murdoch University, Perth, WA, Australia.
Vet Anaesth Analg. 2017 May;44(3):444-451. doi: 10.1016/j.vaa.2016.05.015. Epub 2017 Mar 6.
To determine the cardiovascular and acid-base effects of 6% hydroxyethyl starch (HES) 130/0.4 and 0.9% sodium chloride (NaCl) administered to anaesthetized greyhounds with haemorrhagic shock.
Prospective, experimental, complete randomized block design.
Twelve healthy adult greyhounds.
After 60 minutes of isoflurane anaesthesia, 48 mL kg of blood was removed to induce hypotension. Dogs were randomized to receive either 20 mL kg of HES 130/0.4 or 80 mL kg of 0.9% NaCl over 20 minutes. Haemoglobin, arterial and central venous blood gas and electrolytes, lactate, mean arterial pressure (MAP) and cardiac index were measured at: T0, 60 minutes after induction of anaesthesia, immediately prior to blood removal; T1, immediately after blood removal; T2, immediately after fluid administration; and T3, 40 minutes after fluid administration. Oxygen extraction ratio (OER) was calculated at each sample time.
OER increased at T1 and decreased at T2 and T3, with no difference between the two groups. Dogs administered HES 130/0.4 had higher lactate at T2 [mean (95% confidence interval) 1.3 (0.8-1.9) mmol L] than dogs administered 0.9% NaCl [0.8 (0.5-1.1) mmol L]; p = 0.045. Dogs administered HES 130/0.4 had a higher MAP at T3 [88 (74-102) mmHg] than dogs administered 0.9% NaCl [69 (60-79) mmHg]; p = 0.019. Dogs administered 0.9% NaCl were more acidaemic at T2 and T3, including higher hydrogen ion, lower bicarbonate, lower base excess and higher chloride concentrations.
and clinical relevance The effect of 20 mL kg of HES 130/0.4 on shock, as measured by OER, was no different than that of 80 mL kg of 0.9% NaCl in dogs under general anaesthesia. Acidaemia in the NaCl group is likely attributable to hyperchloraemic metabolic acidosis from the larger volume administered.
确定在麻醉状态下发生失血性休克的灵缇犬中，给予6%羟乙基淀粉（HES）130/0.4和0.9%氯化钠（NaCl）对心血管及酸碱平衡的影响。
前瞻性、实验性、完全随机区组设计。
12只健康成年灵缇犬。
异氟烷麻醉60分钟后，抽取48 mL/kg血液以诱发低血压。将犬随机分为两组，一组在20分钟内给予20 mL/kg的HES 130/0.4，另一组在20分钟内给予80 mL/kg的0.9% NaCl。在以下时间点测量血红蛋白、动脉血和中心静脉血气及电解质、乳酸、平均动脉压（MAP）和心脏指数：T0，麻醉诱导后60分钟，即抽血前；T1，抽血后即刻；T2，补液后即刻；T3，补液后40分钟。在每个采样时间计算氧摄取率（OER）。
OER在T1时升高，在T2和T3时降低，两组间无差异。给予HES 130/0.4的犬在T2时的乳酸水平[均值（95%置信区间）1.3（0.8 - 1.9）mmol/L]高于给予0.9% NaCl的犬[0.8（0.5 - 1.1）mmol/L]；p = 0.045。给予HES 130/0.4的犬在T3时的MAP[88（74 - 102）mmHg]高于给予0.9% NaCl的犬[69（60 - 79）mmHg]；p = 0.019。给予0.9% NaCl的犬在T2和T3时更酸血症，包括更高的氢离子浓度、更低的碳酸氢根浓度、更低的碱剩余和更高的氯离子浓度。
20 mL/kg的HES 130/0.4对休克的影响（通过OER测量）与80 mL/kg的0.9% NaCl对全身麻醉犬的影响无差异。NaCl组的酸血症可能归因于所给予较大容量导致的高氯性代谢性酸中毒。
