Krivchenia A, Knauf M A, Iserson K V
Section of Emergency Medicine, University of Arizona, College of Medicine, Tucson.
J Emerg Med. 1988 Jul-Aug;6(4):269-71. doi: 10.1016/0736-4679(88)90360-5.
Resuscitation with fluid and blood components is the mainstay of therapy for hypovolemic patients. This study evaluated the flow rate and resultant temperature of 6 degrees C erythrocytes admixed with warmed saline passing through a new commercial large bore tubing. The tubing is 183 cm long and is 0.57 cm in diameter. The effect on the outflow fluid temperature when catheters of various sizes were added to the system distally was also assessed. The admixed solution temperature averaged 36.2 degrees C and the outflow temperature of the mixture from the distal tubing averaged 34.9 degrees C. There was an average drop in temperature over the length of the tube of 1.5 degrees C. The filter in the Medex Hi-Flow Trauma Quad system collapsed, severely restricting fluid flow, after only four units. The problem of filter clogging was overcome by the in-line addition of a Pall filter. Addition of this in-line filter had a negligible effect on the flow rate. The flow rate with the Pall filter in-line averaged 1,150 mL/min. As the catheters that were added distally to the system diminished in size, there was a predictable decrease in the admixed fluid flow rate. A warmed saline-erythrocyte solution may be very rapidly infused through commercial large-bore tubing modified with an in-line filter. The size of the catheters used determines the ultimate flow rate.
使用液体和血液成分进行复苏是低血容量患者治疗的主要方法。本研究评估了6℃红细胞与温热盐水混合后通过一种新型商用大口径管道时的流速和最终温度。该管道长183厘米，直径0.57厘米。还评估了在系统远端添加各种尺寸导管时对流出液温度的影响。混合溶液温度平均为36.2℃，远端管道混合物的流出温度平均为34.9℃。在管道长度上温度平均下降了1.5℃。Medex Hi-Flow Trauma Quad系统中的过滤器仅在输注四个单位后就塌陷了，严重限制了液体流动。通过在线添加颇尔过滤器克服了过滤器堵塞的问题。添加这种在线过滤器对流速的影响可忽略不计。使用颇尔在线过滤器时的流速平均为1150毫升/分钟。随着在系统远端添加的导管尺寸减小，混合液流速出现了可预测的下降。温热的盐水-红细胞溶液可以通过配备在线过滤器的商用大口径管道非常快速地输注。所用导管的尺寸决定了最终流速。
