Homann B, Klaue P, Trenkel K, Hockerts T
Chir Forum Exp Klin Forsch. 1978(1978):149-53.
During massive autotransfusion in the dog, the different anticoagulation processes have an important influence on heart work and performance. This is especially marked with citrate, depending on the amount and the transfusion rate. In spite of normovolemia both parameters show a transient decrease up to 40% - 50% with ACD and up to 60% - 70% with CPD. These different reactions may be due to the corresponding composition of each stabilizer. The effect is abolished by simultaneous use of citrate and calcium, which may prove that the observed changes are caused mainly by a depletion of ionized calcium caused by the rapid transfusion. This is comparable to the well-known citrate intoxication. In contrast both cardiac parameters decrease only about 10% with heparin anticoagulation. Heparinization seems to be preferable to citrate as regards heart work and performance during massive autotransfusion. Also the two citrate stabilizers significantly differ in their effect on both cardiac parameters, the use of ACD being favoured.
在对狗进行大量自体输血期间,不同的抗凝过程对心脏功能和表现有重要影响。这在使用柠檬酸盐时尤为明显,具体取决于其用量和输血速度。尽管血容量正常,但使用ACD时这两个参数会出现高达40% - 50%的短暂下降,使用CPD时则高达60% - 70%。这些不同的反应可能归因于每种稳定剂的相应成分。同时使用柠檬酸盐和钙可消除这种影响,这可能证明观察到的变化主要是由快速输血导致的离子钙耗竭引起的。这与众所周知的柠檬酸盐中毒情况类似。相比之下,使用肝素抗凝时,这两个心脏参数仅下降约10%。就大量自体输血期间的心脏功能和表现而言,肝素化似乎比柠檬酸盐更可取。此外,两种柠檬酸盐稳定剂对这两个心脏参数的影响也存在显著差异,使用ACD更为有利。