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连续血液密度测定法:动物分级出血后的液体转移

Continuous blood densitometry: fluid shifts after graded hemorrhage in animals.

作者信息

Hinghofer-Szalkay H

出版信息

Am J Physiol. 1986 Mar;250(3 Pt 2):H342-50. doi: 10.1152/ajpheart.1986.250.3.H342.

Abstract

To evaluate rapid fluid shifts after graded hemorrhage in splenectomized animals, four pigs and two dogs were bled 15-23 ml/kg body wt in steps of 2.2-6.0 ml/kg. Arterial blood density (BD), mean arterial pressure (MAP), and central venous pressure (CVP) were recorded continuously, and arterial plasma density (PD) and hematocrit (Hct) were determined from blood samples. Erythrocyte density was computed from PD, BD, and Hct. Starting with stable control conditions, MAP, CVP, and BD fell from the beginning of hemorrhage. Each blood withdrawal was followed by an immediate and rapid decrease in BD, even at the lowest (less than 3 ml/kg) initial blood losses. The time course of BD change mirrored that of the volume replacement, with time constants of 3.0-9.6 min and amplitudes depending on the magnitude of the relative volume loss. The PD decrease was significant (P less than 0.01) after 5.4 +/- 0.7 ml/kg hemorrhage. At 15 ml/kg blood loss the mean PD and BD had dropped by 0.99 +/- 0.15 and 2.42 +/- 0.26 g/l, respectively, and Hct had dropped by 2.40 +/- 0.47 units. Calculations suggest that either the inward-shifted fluid has a higher density than normal ultrafiltrate and/or there is a rise of the whole-body-to-large vessel Hct (F cell ratio). The rapid fluid replacement ranged from 5.8 +/- 0.8 to 10.6 +/- 2.0% of the initial plasma volume, or one-fifth to one-third of the lost volume with a 20% hemorrhage. Transvascular fluid shifts can be monitored with continuous high-precision blood densitometry.

摘要

为评估脾切除动物分级出血后的快速液体转移情况,对4头猪和2只狗按2.2 - 6.0 ml/kg的步长放血15 - 23 ml/kg体重。连续记录动脉血密度(BD)、平均动脉压(MAP)和中心静脉压(CVP),并从血样中测定动脉血浆密度(PD)和血细胞比容(Hct)。根据PD、BD和Hct计算红细胞密度。从稳定的对照条件开始,MAP、CVP和BD从出血开始时就下降。每次放血后,即使在最低(小于3 ml/kg)的初始失血量时,BD也会立即快速下降。BD变化的时间进程反映了容量补充的情况,时间常数为3.0 - 9.6分钟,幅度取决于相对容量损失的大小。在出血5.4±0.7 ml/kg后,PD下降显著(P<0.01)。在失血15 ml/kg时,平均PD和BD分别下降了0.99±0.15和2.42±0.26 g/l,Hct下降了2.40±0.47个单位。计算表明,向内转移的液体密度高于正常超滤液和/或全身与大血管的Hct(F细胞比值)升高。快速液体补充量为初始血浆量的5.8±0.8%至10.6±2.0%,或在20%出血时为失血量的五分之一至三分之一。经血管液体转移可用连续高精度血液密度测定法监测。

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