Brace R A
Am J Obstet Gynecol. 1983 Dec 1;147(7):777-81. doi: 10.1016/0002-9378(83)90036-4.
The purpose of this study was to determine to what extent the volume of blood circulating in the fetus can be increased by intravascular infusions of either isotonic saline solution or high-molecular weight dextran in saline solution. Unanesthetized, chronically catheterized fetal sheep that averaged 130 days' gestation were studied. In seven fetuses, 50 to 100 ml of warm saline solution (i.e., an average of 19.5% of the initial fetal blood volume) was infused into a vein over 5 minutes, and changes in blood volume were determined 10, 20, and 30 minutes after the infusion was begun. At these times, an average of only 15%, 9%, and 7%, respectively, of the infused volume remained in the fetal circulation. A second infusion of saline solution into these fetuses gave intravascular retentions that averaged 17%, 6%, and 6% at 10, 20, and 30 minutes, respectively. In five fetuses, a 6% solution of dextran 70 that averaged 14.9% of the initial fetal blood volume was infused over 5 minutes. The intravascular retentions averaged 80%, 63%, and 55%, respectively, at 10, 20, and 30 minutes after the infusions were started. Under comparable conditions in the adult, blood volume expansion 30 minutes after rapid infusions averages 20% to 40% of the infused volume for saline solution and 150% to 200% for 6% dextran 70. Thus, the present study suggests that intravascular infusions of crystalloid solutions have very little effect on fetal blood volume, whereas oncotic solutions cause only moderate blood volume expansion.
本研究的目的是确定通过向血管内输注等渗盐溶液或盐溶液中的高分子量右旋糖酐,能在多大程度上增加胎儿体内循环的血量。对平均妊娠130天、未麻醉且长期插管的胎羊进行了研究。在7只胎儿中,在5分钟内将50至100毫升温盐溶液(即平均为初始胎儿血量的19.5%)输注到一条静脉中,并在输注开始后10、20和30分钟测定血量变化。在这些时间点,输注的液体平均分别仅有15%、9%和7%留在胎儿循环中。对这些胎儿再次输注盐溶液,在10、20和30分钟时血管内留存率平均分别为17%、6%和6%。在5只胎儿中,在5分钟内输注平均为初始胎儿血量14.9%的6%右旋糖酐70溶液。输注开始后10、20和30分钟时,血管内留存率平均分别为80%、63%和55%。在成体的类似条件下,快速输注后30分钟,盐溶液的血容量扩充平均为输注量的20%至40%,6%右旋糖酐70为150%至200%。因此,本研究表明,血管内输注晶体溶液对胎儿血量影响很小,而胶体溶液仅引起适度的血容量扩充。