Nand N, Gupta M S, Sharma M
Jpn Heart J. 1986 Mar;27(2):177-82. doi: 10.1536/ihj.27.177.
Pulmonary capillary 'wedge' pressures (PCWP) were measured in 20 adult cases of chronic severe anemia (CSA) before and after transfusion of 700 ml of whole blood at a rate of 5 ml/min. The cases were randomly divided into 2 groups of 10 cases each. Group II also received 40 mg of furosemide immediately before the start of transfusion. The majority of the cases had hemoglobin values less than 4 g% and serum albumin values less than 2.5 g%. Pretransfusion intracardiac pressures were normal in all the cases. Following blood transfusion (BT), appreciable rises (p less than 0.001) in hemoglobin and arterial and venous oxygen saturation were observed. PCWP increased significantly after BT in Group I (p less than 0.001). Although it decreased by 3.75% in Group II, this was not statistically significant (p greater than 0.05). This study implies that a blood transfusion of 700 ml, given at a speed of 5 ml/min in patients with CSA, results in sufficient hemodynamic stress to cause a significant rise in PCWP, and that this is completely prevented by simultaneous administration of 40 mg of furosemide.
在20例成年慢性重度贫血(CSA)患者中,以5毫升/分钟的速度输注700毫升全血前后,测量了肺毛细血管“楔压”(PCWP)。这些病例被随机分为两组,每组10例。第二组在输血开始前还立即接受了40毫克速尿。大多数病例的血红蛋白值低于4克%,血清白蛋白值低于2.5克%。所有病例输血前的心内压均正常。输血(BT)后,观察到血红蛋白、动脉和静脉血氧饱和度明显升高(p<0.001)。第一组输血后PCWP显著升高(p<0.001)。虽然第二组下降了3.75%,但这在统计学上并不显著(p>0.05)。本研究表明,在CSA患者中以5毫升/分钟的速度输注700毫升血液会导致足够的血流动力学应激,从而使PCWP显著升高,而同时给予40毫克速尿可完全预防这种情况。