Gilmour D G, Aitkenhead A R, Hothersall A P, Ledingham I M
Br J Surg. 1980 Feb;67(2):82-4. doi: 10.1002/bjs.1800670204.
The effects of a minor degree of hypovolaemia on colonic blood flow and on systemic haemodynamics have been studied in nine greyhound dogs. A loss in blood volume of 10 per cent over 20 min produced no change in blood pressure and only a 7 per cent rise in heart rate. Cardiac output, however, fell by 26 per cent and central venous pressure also fell significantly. Colonic blood flow fell by 28 per cent and oxygen availability by 29 per cent. All these changes were statistically highly significant. Retransfusion of shed blood resulted in a slow and incomplete return to pre-bleed status. Since colonic blood flow and oxygen availability during and after surgery may be important for colonic healing, it is suggested that even the slightest degree of hypovolaemia should be avoided in cases involving colonic anastomosis. Systemic blood pressure may be an inadequate index of the need for transfusion in these cases.
在九只灵缇犬身上研究了轻度血容量不足对结肠血流和全身血流动力学的影响。在20分钟内失血10%,血压没有变化,心率仅上升了7%。然而,心输出量下降了26%,中心静脉压也显著下降。结肠血流下降了28%,氧供应下降了29%。所有这些变化在统计学上都具有高度显著性。回输失血导致恢复到出血前状态的过程缓慢且不完全。由于手术期间和术后的结肠血流和氧供应可能对结肠愈合很重要,因此建议在涉及结肠吻合术的病例中,即使是最轻微的血容量不足也应避免。在这些病例中,全身血压可能不是输血需求的充分指标。