Kobori M, Negishi H, Hosoyamada A
Department of Anesthesiology, School of Medicine, Showa University, Tokyo.
Masui. 1994 Nov;43(11):1680-5.
We induced various degrees of bleedings in adult mongrel dogs to determine their tolerance to bleedings. The dogs were divided into two groups: the hemodilution group (Group A: Hct 11.1 +/- 1.9%) and the non-hemodilution group (Group B: Hct 36.8 +/- 6.6%). The Group A tended to show higher tolerance to bleedings than the Group B, although the difference was not significant. Throughout the period of increasing degrees of bleedings, MAP remained higher in Group B than in Group A, but CI was higher in Group A than Group B. DO2I was kept higher in Group B than in Group A. Both PaO2 and PaCO2 showed no difference between the two groups. The results of our study indicate that hemodilution group tends to be more tolerant to bleeding than non-hemodilution group. The reason is probably that under hemodilution the oxygen delivery is maintained through an increase in cardiac output in the presence of decreased arterial oxygen content. In addition, it is considered that the safety is obtained through various factors such as preferential blood distribution to important organs (in particular to the myocardium), more efficient extraction of oxygen from the blood, and the decreased work load resulting from a reduced blood viscosity.
我们在成年杂种犬中诱导出不同程度的出血，以确定它们对出血的耐受性。这些犬被分为两组：血液稀释组（A组：血细胞比容11.1±1.9%）和非血液稀释组（B组：血细胞比容36.8±6.6%）。A组对出血的耐受性往往高于B组，尽管差异不显著。在出血程度增加的整个过程中，B组的平均动脉压（MAP）始终高于A组，但A组的心脏指数（CI）高于B组。B组的氧输送指数（DO2I）始终高于A组。两组的动脉血氧分压（PaO2）和动脉血二氧化碳分压（PaCO2）均无差异。我们的研究结果表明，血液稀释组比非血液稀释组对出血的耐受性更强。原因可能是在血液稀释状态下，尽管动脉血氧含量降低，但通过心输出量的增加维持了氧输送。此外，还认为通过多种因素确保了安全性，如血液优先分布到重要器官（特别是心肌）、从血液中更有效地提取氧气以及血液粘度降低导致的工作负荷减轻。
