Beards S C, Watt T, Edwards J D, Nightingale P, Farragher E B
Intensive Care Unit, University Hospital South Manchester, UK.
Crit Care Med. 1994 Apr;22(4):600-5. doi: 10.1097/00003246-199404000-00015.
To compare the hemodynamic and oxygen transport responses to a rapid (< 10-min) infusion of 500 mL of modified fluid gelatin (group A) or hydroxyethyl starch (group B) in patients suffering from acute hypovolemia.
Prospective, randomized, noncrossover study.
University hospital, general intensive care unit.
Twenty-eight patients with hypovolemia mechanically ventilated for concurrent acute respiratory failure.
Patients were mechanically ventilated. Pulmonary and femoral artery catheters were used for hemodynamic monitoring.
Hemodynamic and oxygen transport variables were determined at baseline, 15 mins, and 30 mins after the infusion of each fluid. In both groups pulmonary artery occlusion pressure, stroke volume, and cardiac index significantly increased. In neither group did heart rate decrease. Oxygen delivery increased significantly in group A patients but not in group B patients. This result was due to greater hemodilution in group B patients.
There are no significant differences in the hemodynamic responses to hydroxyethyl starch or modified fluid gelatin. The hemodynamic and oxygen transport effects of artificial colloid solutions may not be entirely predictable and should be monitored in critically ill patients.
比较急性低血容量患者快速（<10分钟）输注500毫升改良液体明胶（A组）或羟乙基淀粉（B组）后的血流动力学和氧输送反应。
前瞻性、随机、非交叉研究。
大学医院，综合重症监护病房。
28例因并发急性呼吸衰竭而接受机械通气的低血容量患者。
患者接受机械通气。使用肺动脉和股动脉导管进行血流动力学监测。
在输注每种液体后的基线、15分钟和30分钟时测定血流动力学和氧输送变量。两组患者的肺动脉闭塞压、每搏量和心脏指数均显著增加。两组患者的心率均未下降。A组患者的氧输送显著增加，而B组患者未增加。这一结果是由于B组患者的血液稀释程度更高。
羟乙基淀粉和改良液体明胶的血流动力学反应无显著差异。人工胶体溶液的血流动力学和氧输送效果可能并非完全可预测，在危重病患者中应进行监测。
