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一种半自动设备可快速测定健康男性的循环血量和动静脉血的一氧化碳摄取动力学。

A semi-automated device rapidly determine circulating blood volume in healthy males and carbon monoxide uptake kinetics of arterial and venous blood.

机构信息

Department of Nutrition, Exercise and Sports (NEXS), University of Copenhagen, Copenhagen, Denmark.

Department of Public Health, Section of Sport Science, Aarhus University, Aarhus C, Denmark.

出版信息

J Clin Monit Comput. 2023 Apr;37(2):437-447. doi: 10.1007/s10877-022-00921-2. Epub 2022 Oct 6.

Abstract

We examined whether a semi-automated carbon monoxide (CO) rebreathing method accurately detect changes in blood volume (BV) and total hemoglobin mass (tHb). Furthermore, we investigated whether a supine position with legs raised reduced systemic CO dilution time, potentially allowing a shorter rebreathing period. Nineteen young healthy males participated. BV and tHb was quantified by a 10-min CO-rebreathing period in a supine position with legs raised before and immediately after a 900 ml phlebotomy and before and after a 900 ml autologous blood reinfusion on the same day in 16 subjects. During the first CO-rebreathing, arterial and venous blood samples were drawn every 2 min during the procedure to determine systemic CO equilibrium in all subjects. Phlebotomy decreased (P < 0.001) tHb and BV by 166 ± 24 g and 931 ± 247 ml, respectively, while reinfusion increased (P < 0.001) tHb and BV by 143 ± 21 g and 862 ± 250 ml compared to before reinfusion. After reinfusion BV did not differ from baseline levels while tHb was decreased (P < 0.001) by 36 ± 21 g. Complete CO mixing was achieved within 6 min in venous and arterial blood, respectively, when compared to the 10-min sample. On an individual level, the relative accuracy after donation for tHb and BV was 102-169% and 55-165%, respectively. The applied CO-rebreathing procedure precisely detect acute BV changes with a clinically insignificant margin of error. The 10-min CO-procedure may be reduced to 6 min with no clinical effects on BV and tHb calculation. Notwithstanding, individual differences may be of concern and should be investigated further.

摘要

我们研究了半自动化一氧化碳(CO)重呼吸法是否能准确检测血容量(BV)和总血红蛋白质量(tHb)的变化。此外,我们还研究了抬高腿部的仰卧位是否会缩短全身 CO 稀释时间,从而可能缩短重呼吸周期。19 名年轻健康男性参与了研究。在 16 名参与者中,在同一天内,在腿部抬高的仰卧位下进行 10 分钟的 CO 重呼吸,在采血前、采血后即刻、采血后 900ml 自体血回输前和采血后 900ml 自体血回输后进行 BV 和 tHb 的定量分析。在第一次 CO 重呼吸期间,在所有受试者中,在程序的每 2 分钟抽取动脉和静脉血样,以确定全身 CO 平衡。采血使 tHb 和 BV 分别降低(P<0.001)166±24g 和 931±247ml,而回输使 tHb 和 BV 分别增加(P<0.001)143±21g 和 862±250ml,与回输前相比。回输后,BV 与基线水平无差异,而 tHb 降低(P<0.001)36±21g。与 10 分钟的样本相比,在静脉和动脉血中分别在 6 分钟内达到 CO 完全混合。在个体水平上,tHb 和 BV 的捐赠后相对准确性分别为 102-169%和 55-165%。应用的 CO 重呼吸程序可以精确检测急性 BV 变化,误差幅度临床可忽略不计。10 分钟的 CO 程序可以缩短至 6 分钟,对 BV 和 tHb 的计算无临床影响。尽管如此,个体差异可能值得关注,需要进一步研究。

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