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全身血液动力学及肝脏微血管对用全血、无基质血红蛋白溶液和氧化聚血红蛋白溶液进行33%血容量交换的反应。

Systemic hemodynamic and hepatic microvascular responses to a 33% blood volume exchange with whole blood, stroma-free hemoglobin, and oxypolyhemoglobin solutions.

作者信息

Sherman I A, Dlugosz J A, Perelman V, Hsia C J, Wong L T, Condie R M

机构信息

Aron M. Rappaport Microcirculation Laboratory, Sunnybrook Health Science Centre, University of Toronto, Ontario, Canada.

出版信息

Biomater Artif Cells Immobilization Biotechnol. 1993;21(4):537-51. doi: 10.3109/10731199309117656.

DOI:10.3109/10731199309117656
PMID:8260579
Abstract

Little is known about the microvascular effects of blood replacement solutions. This study was undertaken to develop an animal model suitable for studies of the microcirculatory effects of such solutions and to investigate microvascular responses to isovolemic transfusion with stroma-free hemoglobin (SFH), whole donor blood, or a new potential blood substitute solution containing oxypolyhemoglobin (OPH) as an oxygen carrier. Hamster livers were exposed and the microcirculation studied using intravital epifluorescent video microscopy. 33% blood volume replacement with SFH elevated systemic blood pressure by 25 Torr. Accompanying this increase in pressure was a 36% decrease in sinusoidal blood flow velocity and a 10% decrease in terminal hepatic venular diameters. Terminal portal venular diameters did not change. Decrease in liver sinusoidal perfusion was not due to neutrophil mediated injury, as myeloperoxidase activity in jejunum, liver, kidney, and lung remained unchanged. The reduction in perfusion was likely due to systemic vasoconstriction produced by SFH. In contrast, transfusion with whole blood did not change any of the measured parameters showing the excellent stability of the model. OPH transfused animals exhibited only a small 10 Torr transient increase in MAP 15 min post-transfusion. By 30 min MAP returned to the pre-infusion value. No significant changes were observed in either venular diameters or sinusoidal velocities in this group of animals. These results demonstrate suitability of this model for studies of the microcirculatory and hemodynamic effects of blood replacement solutions. Furthermore, OPH solution produced only minor transient disturbances in microvascular and systemic parameters.

摘要

关于血液替代溶液的微血管效应,人们了解甚少。本研究旨在建立一种适合研究此类溶液微循环效应的动物模型,并研究无基质血红蛋白(SFH)、全供血或含氧聚血红蛋白(OPH)作为氧载体的新型潜在血液替代溶液进行等容输血时的微血管反应。暴露仓鼠肝脏,使用活体落射荧光视频显微镜研究微循环。用SFH替代33%血容量可使全身血压升高25托。伴随血压升高,肝血窦血流速度降低36%,肝终末小静脉直径降低10%。肝门终末小静脉直径未改变。肝血窦灌注减少并非由于中性粒细胞介导的损伤,因为空肠、肝脏、肾脏和肺中的髓过氧化物酶活性保持不变。灌注减少可能是由于SFH引起的全身血管收缩。相比之下,输注全血并未改变任何测量参数,表明该模型具有出色的稳定性。输注OPH的动物在输血后15分钟MAP仅短暂小幅升高10托。到30分钟时,MAP恢复到输注前值。在该组动物中,小静脉直径和血窦速度均未观察到显著变化。这些结果证明该模型适用于研究血液替代溶液的微循环和血流动力学效应。此外,OPH溶液仅在微血管和全身参数上产生轻微的短暂干扰。

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