Helms U, Weihrauch H, Jacobitz K
Anaesthesist. 1978 Jun;27(6):298-301.
In 85 geriatric premedicated patients haemodynamic effects were investigated following rapid infusion of 500 ml dextrane. The data measured one day preoperative revealed typical age-related changes of the cardiovascular system: decrease of cardiac output, stroke volume and heart rate; increase of peripheral vascular resistance and mean arterial pressure. After infusion of dextran central venous pressure rose by 4.9 mm Hg (mean), mean arterial pressure by 7.5 mm Hg (8.5%) and cardiac output by 1.04 1/min (24.3%). Heart rate alterations were insignificant, but total peripheral resistance decreased significantly by 12.5%. Pulmonary capillary pressure rose to 15.4 +/- 3.4 mm Hg. We conclude that it is possible to increase cardiopulmonary efficiency by extracardiac measures preoperatively even in aged patients. In no case critical left- or right ventricular filling pressure exceeded, so we cannot accept the often expressed warnings against induced hypervolaemia in patients with no cardiac failure except old age.
在85例老年术前用药患者中,快速输注500毫升右旋糖酐后对血流动力学效应进行了研究。术前一天测得的数据显示出心血管系统典型的与年龄相关的变化:心输出量、每搏输出量和心率下降;外周血管阻力和平均动脉压升高。输注右旋糖酐后,中心静脉压平均升高4.9毫米汞柱,平均动脉压升高7.5毫米汞柱(8.5%),心输出量增加1.04升/分钟(24.3%)。心率变化不显著,但总外周阻力显著下降12.5%。肺毛细血管压升至15.4±3.4毫米汞柱。我们得出结论,即使在老年患者中,术前通过心外措施提高心肺效率也是可能的。在任何情况下,临界左或右心室充盈压均未超过,因此除老年外,对于无心力衰竭患者诱导性高血容量的常见警告,我们不能接受。