Demling R H, Nerlich M
Prog Clin Biol Res. 1982;108:31-50.
Animal studies have indicated that volume resuscitation is successful with salt-containing crystalloid solutions as well as colloid solutions. Hyperosmolar salt solutions appear to have benefits over isosmolar solutions. Both, however, produce hypoproteinemia, which can lead to edema formation due to changes in the transcapillary oncotic gradient and possibly by changing the interstitial matrix. The lung appears to be much more resistant to edema formation than the soft tissues. Except for the dog, the lung does not appear to be significantly altered from shock with no substantial increase in protein permeability being evident in most studies. Colloid therapy, either proteins or dextran, effectively restores cardiovascular stability after hypovolemia and also prevents the increased transcapillary fluid flux seen in the lung and soft tissues, the former not appearing to be of much clinical significance, while the latter may lead to significant tissue edema. Blood replacement is necessary to restore adequate oxygen delivery to the tissues. The ideal hematocrit appears to be around 30-35.
动物研究表明，含盐水晶体溶液和胶体溶液进行容量复苏均获成功。高渗盐溶液似乎比等渗溶液更具优势。然而，二者都会导致低蛋白血症，这可能由于跨毛细血管胶体渗透压梯度改变以及可能通过改变间质基质而导致水肿形成。肺似乎比软组织对水肿形成更具抵抗力。除犬类外，在大多数研究中，休克后肺似乎没有明显改变，蛋白质通透性也没有显著增加。胶体疗法，无论是使用蛋白质还是右旋糖酐，在低血容量后都能有效恢复心血管稳定性，还能防止在肺和软组织中出现的跨毛细血管液体通量增加，前者似乎没有太大临床意义，而后者可能导致显著的组织水肿。必须进行输血以恢复向组织输送足够的氧气。理想的血细胞比容似乎在30 - 35左右。
