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肠道缺血性休克大鼠复苏时胶体浓度与容量扩张的关系

Relation of colloid concentration to volume expansion for resuscitation of rats subjected to intestinal ischemic shock.

作者信息

Dawidson I, Ottoson J, Eriksson B, Hedman L, Soderberg R

出版信息

Crit Care Med. 1982 Sep;10(9):597-9. doi: 10.1097/00003246-198209000-00008.

Abstract

This study was undertaken to determine the volumes of colloids (albumin and dextran 40) with concentrations varying from 0% (Ringer's solution) to 10% solutions required to obtain the same hemodilution. Shock was produced in rats by exteriorization of the small intestine with added complete occlusion of the superior mesenteric vessels with a rubber clamp. After 1 h the clamp was removed, the intestines returned, and the abdomen closed. Over a 6-h period, the fluids were infused continuously in volumes needed to maintain similar hematocrit. Each concentration was given over a wide range of volumes in order to obtain volume-hematocrit curves. Based on these curves, the effect of varying colloid concentration on blood volume expansion was calculated. Albumin and dextran 40 had similar volume expansion/g colloid substance regardless of concentration. When hematocrit of 50% was chosen, as an arbitrary endpoint for volume infusion, the colloid concentration in relation to volume required to be infused is expressed by the equation F50 (formula: see text) where C = colloid concentration and where F50 is the volume factor, or the number of times the volume required for a 10% solution, when a 10% solution is given the volume factor of 1. This relationship is now being used to find the optimal colloid concentration with regard to survival rate in animals subjected to the same intestinal shock.

摘要

本研究旨在确定浓度从0%(林格氏液)到10%的胶体(白蛋白和右旋糖酐40)的用量,以实现相同程度的血液稀释。通过将小肠外置并使用橡胶夹完全阻断肠系膜上血管来使大鼠产生休克。1小时后移除夹子,将肠管回纳,关闭腹腔。在6小时期间,持续输注维持相似血细胞比容所需体积的液体。每个浓度都在很宽的用量范围内给予,以获得用量-血细胞比容曲线。根据这些曲线,计算不同胶体浓度对血容量扩充的影响。无论浓度如何,白蛋白和右旋糖酐40每克胶体物质的扩容效果相似。当选择50%的血细胞比容作为输液用量的任意终点时,与所需输注体积相关的胶体浓度由方程F50表示(公式:见正文),其中C = 胶体浓度,F50是体积因子,即当10%溶液的体积因子为1时,达到相同血细胞比容所需10%溶液体积的倍数。目前正在利用这种关系来确定在遭受相同肠源性休克的动物中,关于存活率的最佳胶体浓度。

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