Lee W H, Rubin J W, Huggins M P
Ann Thorac Surg. 1975 May;19(5):529-36. doi: 10.1016/s0003-4975(10)64428-1.
Various hemodilution agents are now used routinely to prime heart-lung machines for cardiac operations. Hemodilution has resulted in considerable conservation of blood as well as diminution of plasma and corpuscle damage by decreasing the concentration of these elements in blood during extracorporeal circulation. Controversy has existed regarding the relative efficacy of various hemodilution solutions. This study covers 68 patients, divided into three groups, for whom hemodilution was done as follows: (1) the pump was primed with a 5% dextrose solution containing no colloid; (2) Ringer's lactate solution containing approximately 1% low-molecular-weight dextran was used; and (3) a new plasma expander, hydroxyethyl starch, was used as the colloid component of an electrolyte solution. Evaluations and comparisons were carried out for flow rates, blood pressure, urine volume, hematocrit, BUN, blood loss, clotting factors, and the patient's clinical course with regard to pulmonary and neurological complications. We conclude that a colloid is beneficial, especially with longer perfusions.
目前,各种血液稀释剂在心脏手术中常用于预充心肺机。血液稀释通过在体外循环期间降低血液中这些成分的浓度,从而实现了大量的血液保存以及血浆和血细胞损伤的减少。关于各种血液稀释溶液的相对疗效一直存在争议。本研究涵盖68例患者,分为三组,其血液稀释操作如下:(1)用不含胶体的5%葡萄糖溶液预充泵;(2)使用含约1%低分子量右旋糖酐的乳酸林格溶液;(3)一种新型血浆扩容剂羟乙基淀粉用作电解质溶液的胶体成分。针对流速、血压、尿量、血细胞比容、血尿素氮、失血量、凝血因子以及患者关于肺部和神经并发症的临床病程进行了评估和比较。我们得出结论,胶体是有益的,尤其是在较长时间灌注时。