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[使用肝素和枸橼酸盐进行“压力自动输血”时的QT间期(作者译)]

[The QT-interval during "pressure-autotransfusion" with heparin and citrate (author's transl)].

作者信息

Homann B, Dösch C, Klaue P

出版信息

Anaesthesist. 1981 Nov;30(11):561-6.

PMID:7316129
Abstract

Nine anaesthetized, splenectomized dogs, heparinized with 300 IU/kg heparin i.v. had one tenth of their blood volume returned to them by autotransfusion under pressure. The blood was mixed with 1:5 0,9% NaCl for the "Heparin-Autotransfusion", and with 1:5 ACD-B or CPD-stabilisor for the "Citrate-Autotransfusion". The blood was removed from an opening made in the left renal artery, and autotransfused with the Bentley-System. A Stathem-Element was used to monitor the aortic pressure and the tracing obtained was divided into four phases: V is at the end of the blood loss before autotransfusion, G is at the peak, S is at the trough and ST is at the phase when the aortic pressure becomes stable. In these four phases the heart rate was also measured in the normal way using needle electrodes in the extremities. Following the method of Colletti the QT intervals of the ECG (RR, QoTc, QTc, SaTc, SoTc) were measured. Immediately after the blood loss (phase V) we found no alteration in the heart rate, depolarisation, isoelectric phase or repolarisation of myocardium. In phase G during the increase in blood volume, the heart rate slowed slightly, but the QT interval was unchanged. In the following phase S, during Heparin-Autotransfusion the heart rate was slightly reduced whilst the ECG remained unchanged. During Citrate-Autotransfusion there was a reduction in heart rate, and a corresponding prolongation of the QTc and QoTc, significantly, without any relationship to the infused dose of citrate. The prolongation of the SaTc and especially of the SoTc correlated directly with the infused dose of citrate. In phase ST using CPD only SaTc and SoTc were prolonged.

摘要

9只经麻醉、脾切除的犬,静脉注射300 IU/kg肝素进行肝素化处理,通过压力自输血将其血容量的十分之一回输给它们。血液在“肝素自输血”中与1:5的0.9%氯化钠混合,在“柠檬酸盐自输血”中与1:5的ACD - B或CPD稳定剂混合。血液从左肾动脉的开口处采集,并使用本特利系统进行自输血。使用Stathem - Element监测主动脉压力,所获得的描记图分为四个阶段:V处于自输血前失血结束时,G处于峰值,S处于谷值,ST处于主动脉压力稳定阶段。在这四个阶段,还以常规方式使用四肢针电极测量心率。按照科莱蒂的方法测量心电图的QT间期(RR、QoTc、QTc、SaTc、SoTc)。失血后立即(V阶段),我们发现心率、心肌去极化、等电位期或复极化均无改变。在血容量增加的G阶段,心率略有减慢,但QT间期未变。在随后的S阶段,肝素自输血期间心率略有降低,而心电图保持不变。柠檬酸盐自输血期间心率降低,QTc和QoTc相应延长,且显著延长,与柠檬酸盐输注剂量无关。SaTc尤其是SoTc的延长与柠檬酸盐输注剂量直接相关。在ST阶段,仅使用CPD时,SaTc和SoTc延长。

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