与体外循环相关的离子钙及其他血浆成分的变化。

Changes in ionized calcium and other plasma constituents associated with cardiopulmonary bypass.

作者信息

Westhorpe R N, Varghese Z, Petrie A, Wills M R, Lumley J

出版信息

Br J Anaesth. 1978 Sep;50(9):951-7. doi: 10.1093/bja/50.9.951.

DOI:10.1093/bja/50.9.951

Abstract

Plasma concentrations of calcium fractions, proteins, phosphate and magnesium were measured before, during and after cardiopulmonary bypass in 15 patients undergoing cardiac surgery. When calcium chloride was added to a pump priming solution which contained little or no blood, the concentrations of all calcium fractions were significantly greater after bypass than before, with a mean ionized calcium concentration of 1.52 mmol litre-1 plasma water, 30 min after completion of bypass. This iatrogenic hypercalcaemia was increased significantly by the administration of more than 10 mg kg-1 calcium chloride in the first 30 min after bypass. Other plasma constituents showed the dilutional effect of the pump prime during bypass and only the magnesium concentration failed to return towards normal values after operation.

摘要

对15名接受心脏手术的患者在体外循环前、期间和之后测量了血浆中钙组分、蛋白质、磷酸盐和镁的浓度。当向几乎不含血或无血的泵预充液中添加氯化钙时，体外循环后所有钙组分的浓度均显著高于术前，体外循环结束30分钟后，血浆水中离子钙平均浓度为1.52 mmol/L。在体外循环后最初30分钟内给予超过10 mg/kg氯化钙会显著加重这种医源性高钙血症。其他血浆成分在体外循环期间显示出泵预充液的稀释作用，术后只有镁浓度未能恢复到正常水平。