Messmer K, Kreimeier U, Intaglietta M
Eur Surg Res. 1986;18(3-4):254-63. doi: 10.1159/000128533.
Preoperative intentional hemodilution is induced by isovolemic exchange of whole blood with colloid solutions in order to gain autologous blood while maintaining normovolemia. The basic mechanism that compensates for the fall of oxygen capacity of the diluted blood is the rise in cardiac output, and organ blood flow, factors that result from the improved fluidity of blood at lower hematocrits. Normal tissues maintain adequate oxygenation during hemodilution through the enhanced redistribution of blood. In ischemic tissues this effect is enhanced, and causes an increase in the oxygenation of ischemic tissues. Limited preoperative and intraoperative hemodilution are alternatives to donor blood transfusion in patients undergoing elective surgery. In shock patients the hemodilution achieved with red cell free primary volume substitutes is an effective treatment for shock-induced microcirculatory disorders; furthermore, intentional hemodilution is the most effectual hemorheological therapy for the treatment of ischemic disease.
术前通过用胶体溶液对全血进行等容置换来诱导等容性血液稀释，以便在维持血容量正常的同时获取自体血。补偿稀释血液氧容量下降的基本机制是心输出量增加以及器官血流量增加，这些是由较低血细胞比容时血液流动性改善所导致的因素。正常组织在血液稀释过程中通过增强的血液再分布来维持充足的氧合。在缺血组织中，这种效应会增强，导致缺血组织的氧合增加。有限的术前和术中血液稀释是择期手术患者替代输血的方法。在休克患者中，用无红细胞的初始容量替代物实现的血液稀释是治疗休克引起的微循环障碍的有效方法；此外，等容性血液稀释是治疗缺血性疾病最有效的血液流变学疗法。
