Niinikoski J, Laaksonen V, Meretoja O, Jalonen J, Arstila M, Inberg M V
Ann Clin Res. 1981;13 Suppl 33:59-64.
Oxygen transport and tissue oxygenation were investigated in twelve patients undergoing coronary bypass surgery under normovolemic moderate and extreme hemodilution. Moderate hemodilution, that was carried out after induction of anesthesia, decreased the mean hematocrit from 0.43 to 0.33. Concurrently, the cardiac index and the left ventricular filling pressure increased slightly whereas the systemic oxygen transport declined by 20%. This was associated with elevated oxygen extraction. The subcutaneous tissue oxygen tension underwent a transient increase during moderate hemodilution. During cardiopulmonary bypass and extreme hemodilution the mean hematocrit declined to 0.16. Simultaneously, the tissue PO2 decreased clearly reaching its minimum at the deepest hypothermia. After coming off bypass and reinfusion of the autologous blood the tissue PO2 approached the preoperative levels. In general, total body oxygen consumption changed parallelly with the tissue oxygen tension. Lactate concentration in the mixed venous blood increased in the beginning of the extracorporeal circulation and remained rather stationary thereafter. All patients recovered normally without any perioperative myocardial infarctions.
对12例接受冠状动脉搭桥手术的患者在正常血容量、中度和极度血液稀释情况下的氧运输和组织氧合情况进行了研究。中度血液稀释在麻醉诱导后进行，使平均血细胞比容从0.43降至0.33。同时，心脏指数和左心室充盈压略有升高，而全身氧运输下降了20%。这与氧摄取增加有关。在中度血液稀释期间，皮下组织氧张力出现短暂升高。在体外循环和极度血液稀释期间，平均血细胞比容降至0.16。同时，组织PO2明显下降，在体温最低时达到最低值。在体外循环结束并回输自体血后，组织PO2接近术前水平。总体而言，全身氧耗与组织氧张力平行变化。混合静脉血中的乳酸浓度在体外循环开始时升高，此后保持相对稳定。所有患者均正常康复，无围手术期心肌梗死发生。
