de Vries P M, Kouw P M, Meijer J H, Oe L P, Schneider H, Donker A J
Department of Internal Medicine (Division of Nephrology), Free University Hospital, Amsterdam, The Netherlands.
ASAIO Trans. 1988 Jul-Sep;34(3):623-6.
Hypotension is one of the complications frequently seen during hemodialysis. The decrease in intravascular volume caused by ultrafiltration plays an important role in its pathogenesis. A transcellular fluid shift from the extracellular to the intracellular compartment may aggravate this depletion. Continuous recording of blood volume during dialysis would be beneficial in detecting hypovolemia at an early stage. The purpose of this study was to evaluate the use of an electrical conductivity method in detecting hypovolemia and changes in red cell volume. Blood and plasma conductivities were measured, as was hematocrit. Erythrocytes were counted and blood and plasma volume changes were calculated from reciprocal erythrocyte counts. Blood and plasma conductivities were substituted into an equation to calculate hematocrit. Red cell volume (MCV) was calculated from hematocrit and erythrocyte counts. The MCV decreased 3%, and calculated hematocrit corresponded very well with measured hematocrit. Blood and plasma volume decreased by 13.5 and 17.5%, respectively. In summary, it was possible to estimate hematocrit by the conductivity method. The MCV did not change significantly. This method offers the possibility of measuring blood volume on-line.
低血压是血液透析过程中常见的并发症之一。超滤导致的血管内容量减少在其发病机制中起重要作用。细胞外液向细胞内液的跨细胞液转移可能会加重这种容量耗竭。透析过程中持续记录血容量有助于早期发现血容量不足。本研究的目的是评估使用电导率法检测血容量不足和红细胞体积变化的情况。测量了血液和血浆的电导率以及血细胞比容。计数红细胞,并根据红细胞计数的倒数计算血液和血浆体积变化。将血液和血浆电导率代入方程计算血细胞比容。根据血细胞比容和红细胞计数计算红细胞体积(MCV)。MCV下降了3%,计算得到的血细胞比容与测量得到的血细胞比容非常吻合。血液和血浆体积分别下降了13.5%和17.5%。总之,通过电导率法可以估算血细胞比容。MCV没有显著变化。这种方法提供了在线测量血容量的可能性。