Kawamura M
Hokkaido Igaku Zasshi. 1975 Mar;50(2):137-67.
This report concerns the feasibility of low volume priming extracorporeal circulation. Through this study, the bubble oxygenator with Zuhdi's heat exchange was used. Moderate hypothermia with surface cooling and hemodilution perfusion with 5 per cent D/W was evaluated in 32 mongrel dogs and 16 clinical open heart cases. The results obtained here were as follow: 1) Body temperature reduction by surface cooling before bypass provided more even cooling than did core cooling by low flow partial bypass alone. 2) In regard to cardiac loading on returning the whole perfusate of the circuit to patient, approximately 20 ml/kg of 5 per cent D/W was feasible as a priming solution. 3) To reduce the blood visicosity, hemodilution technique with 5 per cent D/W was superior, and hemodilution effect during postoperative periods was temporaly. 4) The excess lactate volume postulated by Huckabee was a available index to evaluate metabolic acidosis during the extracorporeal circulation. 5) With aid of surface cooling, the acid-base balance during perfusion was kept to lesser extent than that of core cooling only. 6) This study indicated that the low priming perfusion in conjunction with surface cooling hypothermia was a reliable technique for the open heart operation and may be applied in more prolonged perfusion.
本报告探讨了小容量预充体外循环的可行性。通过本研究,使用了带有祖迪热交换器的鼓泡式氧合器。对32只杂种犬和16例临床心脏直视手术病例进行了体表降温的中度低温以及用5%葡萄糖溶液进行血液稀释灌注的评估。在此获得的结果如下:1)体外循环前通过体表降温降低体温比仅通过低流量部分体外循环进行核心降温能提供更均匀的降温效果。2)就将体外循环回路的全部灌注液回输给患者时的心脏负荷而言,约20ml/kg的5%葡萄糖溶液作为预充液是可行的。3)为降低血液粘度,用5%葡萄糖溶液进行血液稀释技术更具优势,且术后阶段的血液稀释效果是暂时的。4)哈克比提出的过量乳酸量是评估体外循环期间代谢性酸中毒的一个有用指标。5)借助体表降温,灌注期间的酸碱平衡维持程度低于仅采用核心降温时。6)本研究表明,结合体表降温低温的低预充灌注是心脏直视手术的一种可靠技术,可应用于更长时间的灌注。