Research Unit, Södertälje Hospital, 152 86, Södertälje, Sweden.
Karolinska Institutet at Danderyds Hospital (KIDS), Stockholm, Sweden.
BMC Anesthesiol. 2020 Apr 25;20(1):95. doi: 10.1186/s12871-020-01001-1.
Induction of general anesthesia increases the hemodilution resulting from infusion of crystalloid fluid, which is believed to be due to slower distribution caused by arterial hypotension. When normal distribution returns is not known.
An intravenous infusion of 25 mL kg of Ringer's lactate was infused over 30 min to 25 volunteers just after induction of general anesthesia for open abdominal hysterectomy. A two-volume model was fitted to the repeated measurements of the blood hemoglobin concentration and the urinary excretion using mixed-effects modelling software. Individual-specific covariates were added in sequence.
Distribution of infused fluid was interrupted during the first 20 min of the infusions. During this time 16.6 mL kg of lactated Ringer's had been infused, of which virtually all remained in the circulating blood. Thereafter, the fluid kinetics was similar to that previously been found in awake volunteers except for the elimination rate constant (k), which remained to be very low (0.86 × 10 min). Redistribution of infused fluid from the interstitium to the plasma occurred faster (higher k) when the arterial pressure was low. No covariance was found between the fixed parameters and preoperatively concentrated urine, the use of sevoflurane or propofol to maintain the anesthesia, or the plasma concentrations of two degradation products of the endothelial glycocalyx, syndecan-1 and heparan sulfate.
Induction of general anesthesia interrupted the distribution of lactated Ringer's solution up to when 16.6 mL kg of crystalloid fluid had been infused. Plasma volume expansion during this period of time was pronounced.
Controlled-trials.com (ISRCTN81005631) on May 17, 2016 (retrospectively registered).
全麻诱导会增加晶体液输注引起的血液稀释，这被认为是由于动脉低血压导致分布速度较慢。目前尚不清楚正常分布何时恢复。
在全麻诱导后 30 分钟内，将 25 名志愿者静脉输注 25ml/kg 的乳酸林格氏液。使用混合效应建模软件对重复测量的血液血红蛋白浓度和尿液排泄进行双体积模型拟合。个体特异性协变量依次添加。
在输注的前 20 分钟内，输注的液体分布被中断。在此期间，输注了 16.6ml/kg 的乳酸林格氏液，其中几乎所有的液体都留在循环血液中。此后，液体动力学与以前在清醒志愿者中发现的相似，除了消除速率常数（k）仍然非常低（0.86×10min）。当动脉压较低时，从间质重新分布到血浆的液体再分配更快（k 值更高）。未发现固定参数与术前浓缩尿、使用七氟醚或异丙酚维持麻醉或内皮糖萼的两种降解产物，即 syndecan-1 和肝素硫酸盐的血浆浓度之间存在协方差。
全麻诱导中断了乳酸林格氏液的分布，直到输注了 16.6ml/kg 的晶体液。在此期间，血浆容量扩张明显。
2016 年 5 月 17 日在 Controlled-trials.com（ISRCTN81005631）注册（回顾性注册）。
