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对快速输注乳酸林格氏液的心血管反应。

Cardiovascular response to rapid infusion of lactated Ringer's.

作者信息

Haneda K, Hessel E A, Thomas R, Huntsman L L

出版信息

Tohoku J Exp Med. 1986 Aug;149(4):397-406. doi: 10.1620/tjem.149.397.

DOI:10.1620/tjem.149.397
PMID:3775764
Abstract

Cardiovascular response to rapid infusion of lactated Ringer's was investigated in 5 adult dogs (average body weight = 21.1 kg) under 1% halothane anesthesia. Following implantation of aortic flow probe and left atrial line, the chest was closed and splenectomy was performed prior to the experiment. Warmed lactated Ringer's was administered at five different infusion rates (2.5, 5, 10, 15 and 20 ml/kg/min in random sequence) to each dog until left atrial pressure (LAP) reached 20 mmHg or a maximum of 50 ml/kg had been infused. Subsequent infusions were done after stroke volume (SV) spontaneously returned to the control level. Cardiac output (CO), SV, heart rate (HR), mean arterial pressure (MAP), LAP and central venous pressure (CVP) were monitored simultaneously during infusions. HR was stable during infusions, whereas MAP increased by 39% of control. Response of LAP to volume infused was nearly linear at fast infusion rates (10, 15 and 20 ml/kg/min). Response of LAP to slow infusion rates (2.5 and 5 ml/kg/min) was curvilinear (decelerating curve). The relationship between CVP and volume infused was similar to LAP vs. volume infused. Ventricular function curves (SV, CO and stroke work vs. LAP) were also influenced by the rate of infusion with steeper curves at slow infusion rates than curves derived from fast infusion rates. However, initial changes in SV and CO curves were not significantly affected by the rate of infusion. We conclude that the cardiovascular response to rapid infusion of lactated Ringer's is rate dependent but initial changes in SV and CO curves are not significantly affected at infusion rates of 2.5, 5, 10, 15 or 20 ml/kg/min.

摘要

在5只成年犬(平均体重=21.1千克)处于1%氟烷麻醉状态下,研究了快速输注乳酸林格氏液时的心血管反应。在植入主动脉血流探头和左心房导管后,关闭胸腔,并在实验前进行脾切除术。将温热的乳酸林格氏液以五种不同的输注速率(2.5、5、10、15和20毫升/千克/分钟,随机顺序)给予每只犬,直到左心房压力(LAP)达到20毫米汞柱或已输注的最大量达到50毫升/千克。在每搏量(SV)自发恢复到对照水平后进行后续输注。在输注过程中同时监测心输出量(CO)、SV、心率(HR)、平均动脉压(MAP)、LAP和中心静脉压(CVP)。输注过程中HR保持稳定,而MAP比对照升高了39%。在快速输注速率(10、15和20毫升/千克/分钟)时,LAP对输注量的反应几乎呈线性。LAP对缓慢输注速率(2.5和5毫升/千克/分钟)的反应呈曲线(减速曲线)。CVP与输注量之间的关系与LAP与输注量之间的关系相似。心室功能曲线(SV、CO和每搏功与LAP的关系)也受输注速率的影响,缓慢输注速率时的曲线比快速输注速率时的曲线更陡峭。然而,SV和CO曲线的初始变化不受输注速率的显著影响。我们得出结论,快速输注乳酸林格氏液时的心血管反应取决于输注速率,但在2.5、5、10、15或20毫升/千克/分钟的输注速率下,SV和CO曲线的初始变化不受显著影响。

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