Dubick M A, Kilani A F, Summary J J, Greene J Y, Wade C E
Division of Military Trauma Research, Letterman Army Institute of Research, Presidio, San Francisco, CA 94129-6800.
Circ Shock. 1993 Jul;40(3):200-5.
In previous studies, we determined that incubation of high concentrations of the 7.5% saline (HS) component of HSD with human blood, in vitro, significantly prolonged prothrombin time (PT), and reduced platelet aggregation. Considering the rapid plasma volume expansion following HSD infusion, the present study tested the hypothesis that any HS-induced effects on coagulation would have no clinical significance when HSD was infused for the treatment of hemorrhagic hypotension. Conscious, splenectomized pigs, either euvolemic (n = 11) or bled 27 ml/kg over 60 min (n = 9), were treated with the proposed therapeutic dose of 4 ml/kg HSD. Blood samples were withdrawn prior to and at the end of the hemorrhage and 0.5, 1, 2, 3, 4, 24, 48, 72, and 168 hr following HSD infusion, and PT, activated partial thromboplastin time (APTT), and platelet aggregation were determined. HSD did not significantly affect PT, APTT, or platelet aggregation in either group of swine at any time measured. In other studies, HSD did not prolong bleeding times after 1 or 2 hr in euvolemic pigs. These data further support the premise that a single dose of HSD for the prehospital treatment of hemorrhagic hypotension will not adversely affect blood coagulation.
在先前的研究中，我们确定，在体外将高渗盐溶液（HSD）中7.5%的高渗盐水（HS）成分与人血孵育，会显著延长凝血酶原时间（PT）并降低血小板聚集。考虑到输注HSD后血浆容量会迅速扩张，本研究检验了以下假设：当输注HSD用于治疗出血性低血压时，HS对凝血的任何影响均无临床意义。对清醒的、已切除脾脏的猪，分为血容量正常组（n = 11）或在60分钟内失血27 ml/kg的组（n = 9），给予建议的治疗剂量4 ml/kg HSD进行治疗。在出血前、出血结束时以及输注HSD后的0.5、1、2、3、4、24、48、72和168小时采集血样，测定PT、活化部分凝血活酶时间（APTT）和血小板聚集情况。在任何测量时间，HSD对两组猪的PT、APTT或血小板聚集均无显著影响。在其他研究中，血容量正常的猪在输注HSD 1或2小时后出血时间并未延长。这些数据进一步支持了以下前提：单剂量HSD用于院前治疗出血性低血压不会对血液凝固产生不利影响。
