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[使用乳酸林格氏液和低分子右旋糖酐进行大容量血液稀释的体外循环研究:与故意血液稀释相关的酸碱平衡改变(作者译)]

[Studies on extracorporeal circulation with large volume hemodilution using lactate ringer's solution and low molecular weight dextran: alterations of acid-base balance associated with intentional hemodilution (author's transl)].

作者信息

Yamada T

出版信息

Hokkaido Igaku Zasshi. 1975 Mar;50(2):169-96.

PMID:293
Abstract

Twenty mongrel dogs, weighing between 7.5 and 13.0 kg were used to investigate the percentage limits permissible for hemodilution using a double-helical reservoir heart-lung machine which has a 1,100 ml of priming volume. In both 40 and 50 per cent groups of intentional hemodilution by 30 minute extracorporeal circulation, remarkable anemia was inevitable and recovery was extremely slow, especially in the 50 per cent dilution group. In both 40 and 50 per cent groups of intentional hemodilutions by 30 minute extracorporeal circulation, metabolic acidosis was observed. In 50 per cent group of intentional hemodilution, no improvement of metabolic acidosis was observed even after perfusion. When sodium bicarbonate was administered to 40 per cent hemodilution group, minimum alterations of acid-base balance and of serum electrolytes were observed during and after extracorporeal perfusion. When sodium bicarbonate was administered to 50 per cent hemodilution group, metabolic acidosis was more evident than in 40 per cent hemodilution group accompanied with an increase in serum sodium concentration and a decrease in serum chloride concentration. These data qualify the use of 40 per cent intentional hemodilution using Lactate Ringer's solution or low molecular weight dextran for 30 minute extracorporeal circulation when sodium bicarbonate is administered in adequate amounts.

摘要

选用20只体重在7.5至13.0千克之间的杂种狗,使用预充量为1100毫升的双螺旋贮血式心肺机,研究血液稀释的允许百分比限度。在通过30分钟体外循环进行40%和50%的有意血液稀释组中,明显的贫血不可避免且恢复极慢,尤其是在50%稀释组。在通过30分钟体外循环进行40%和50%的有意血液稀释组中,均观察到代谢性酸中毒。在50%的有意血液稀释组中,即使在灌注后也未观察到代谢性酸中毒的改善。当向40%血液稀释组给予碳酸氢钠时,在体外灌注期间及之后观察到酸碱平衡和血清电解质的变化最小。当向50%血液稀释组给予碳酸氢钠时,代谢性酸中毒比40%血液稀释组更明显,同时伴有血清钠浓度升高和血清氯浓度降低。这些数据表明,当给予适量碳酸氢钠时,使用乳酸林格氏液或低分子量右旋糖酐进行30分钟体外循环的40%有意血液稀释是可行的。

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