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描述使用三种不同分析方法在猫急性出血-复苏模型中酸碱平衡。

Describing acid-base balance using three different methods of analysis in a feline acute haemorrhage-resuscitation model.

机构信息

Department of Companion Animal Clinical Studies, Faculty of Veterinary Science, University of Pretoria, Pretoria, South Africa; Anaesthesia and Critical Care Services, Valley Farm Animal Hospital, Pretoria, South Africa; Brain Function Research Group, School of Physiology, University of the Witwatersrand, Johannesburg, South Africa.

Brain Function Research Group, School of Physiology, University of the Witwatersrand, Johannesburg, South Africa.

出版信息

Vet Anaesth Analg. 2022 Jan;49(1):65-75. doi: 10.1016/j.vaa.2021.07.004. Epub 2021 Nov 3.

Abstract

OBJECTIVE

To describe acid-base status using the Henderson-Hasselbalch, Stewart and semi-quantitative methods of analysis in a feline haemorrhage-resuscitation model.

STUDY DESIGN

Randomized crossover study.

ANIMALS

A total of six domestic cats (mean age, 21 months; weight, 4.9 kg).

METHODS

Venous blood samples were taken before haemorrhage, after haemorrhage at 30 minute intervals during fluid resuscitation and at 24 hours. The cats were anaesthetized and underwent following treatments: no purposeful haemorrhage and resuscitation (NoPHR), purposeful haemorrhage followed by either lactated Ringer's solution (LRS) or 6% tetrastarch 130/0.4 (Voluven) for resuscitation. LRS and Voluven were administered at 60 and 20 mL kg hour, respectively, for 120 minutes. Variables used for the analysis methods were measured or calculated from the blood samples and then compared among treatments over time using a general linear mixed model (p < 0.05; data reported as mean and standard deviation).

RESULTS

The total blood loss at 120 minutes was 10.2 ± 2.3, 29.3 ± 9.0 and 29.1 ± 6.3 mL kg for NoPHR, LRS and Voluven, respectively. Total volumes of LRS and Voluven administered were 120 and 40 mL kg, respectively. All cats became acidaemic during anaesthesia regardless of treatment. The Henderson-Hasselbalch method indicated that anaesthetized cats undergoing severe haemorrhage and resuscitation manifest a mixed acidosis. The Stewart method indicated two counter metabolic processes that contributed to the overall pH-decrease in apparent strong ion difference (acidosis) and decrease in total weak acids (alkalosis). The semi-quantitative method identified the free water and chloride effects as variables causing acidosis and the albumin effect causing alkalosis.

CONCLUSIONS AND CLINICAL RELEVANCE

In an experimental haemorrhage and resuscitation model in cats, blood pH was similar among treatments over time regardless of severe haemorrhage and resuscitation with LRS or Voluven or mild haemorrhage and no resuscitation.

摘要

目的

描述使用 Henderson-Hasselbalch、Stewart 和半定量分析方法在猫出血复苏模型中的酸碱状态。

研究设计

随机交叉研究。

动物

六只家猫(平均年龄 21 个月,体重 4.9 千克)。

方法

在出血前、出血后 30 分钟期间的液体复苏期间以及 24 小时时采集静脉血样本。猫被麻醉并接受以下治疗:无目的出血和复苏(NoPHR)、有目的出血后接受乳酸林格氏液(LRS)或 6%四明沙 130/0.4(Voluven)复苏。LRS 和 Voluven 分别以 60 和 20 mL kg hour 的速度输注 120 分钟。使用来自血液样本的测量或计算的变量,然后使用一般线性混合模型在时间上比较不同处理之间的方法(p < 0.05;数据以平均值和标准差报告)。

结果

在 120 分钟时,NoPHR、LRS 和 Voluven 的总失血量分别为 10.2 ± 2.3、29.3 ± 9.0 和 29.1 ± 6.3 mL kg。LRS 和 Voluven 的总给药量分别为 120 和 40 mL kg。无论治疗如何,所有猫在麻醉期间都变得酸中毒。Henderson-Hasselbalch 方法表明,接受严重出血和复苏的麻醉猫表现出混合性酸中毒。Stewart 方法表明,两个代谢过程共同导致表观强离子差(酸中毒)和总弱酸(碱中毒)的整体 pH 下降。半定量方法确定自由水和氯效应作为导致酸中毒的变量,白蛋白效应导致碱中毒。

结论和临床相关性

在猫的实验性出血和复苏模型中,无论严重出血和复苏用 LRS 或 Voluven 或轻度出血和不复苏,血液 pH 在不同时间的不同处理之间相似。

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