Greenfield R H, Bessen H A, Henneman P L
Department of Emergency Medicine, Harbor-UCLA Medical Center, Torrance 90509.
Ann Emerg Med. 1989 Jan;18(1):51-5. doi: 10.1016/s0196-0644(89)80312-9.
We evaluated the effect of IV crystalloid administration on hematocrit in 28 healthy, nonbleeding volunteers. Normal saline boluses of 10, 20, and 30 mL/kg were delivered at a mean rate of 115 +/- 4 mL/min, followed by a continuous infusion of either 1 or 5 mL/kg/hr. Hematocrit values determined immediately after bolus infusion declined from baseline a mean +/- SEM of 4.5 +/- 0.6 (P less than .001), 6.1 +/- 0.4 (P less than .001) and 6.3 +/- 0.6 points (P less than .001) in the 10, 20, and 30 mL/kg groups, respectively. Twenty minutes into the maintenance infusion, hematocrits had risen 1.5 +/- 0.8 (P = .03), 2.4 +/- 0.4 (P = .004) and 2.3 +/- 0.7 points (P = .005) when compared with post-bolus hematocrits in the 10, 20, and 30 mL/kg groups, respectively. These data show that in healthy, nonbleeding subjects, crystalloid infusion may cause significant changes in hematocrit. Calculations reveal that approximately 60% of infused saline, when delivered as a bolus, will diffuse from the intravascular space within 20 minutes of administration.
我们评估了静脉输注晶体液对28名健康、无出血志愿者血细胞比容的影响。分别以115±4 mL/min的平均速率给予10、20和30 mL/kg的生理盐水推注,随后以1或5 mL/kg/hr的速率持续输注。推注输注后立即测定的血细胞比容值与基线相比,在10、20和30 mL/kg组中分别平均下降了4.5±0.6(P<0.001)、6.1±0.4(P<0.001)和6.3±0.6个百分点(P<0.001)。维持输注20分钟时,与推注后血细胞比容相比,10、20和30 mL/kg组的血细胞比容分别升高了1.5±0.8(P=0.03)、2.4±0.4(P=0.004)和2.3±0.7个百分点(P=0.005)。这些数据表明,在健康、无出血的受试者中,晶体液输注可能会导致血细胞比容发生显著变化。计算显示,当以推注方式给药时,大约60%的输注生理盐水会在给药后20分钟内从血管内空间扩散出去。