White P, Brower R, Sylvester J T, Permutt T, Permutt S
Department of Medicine, Johns Hopkins Medical Institutions, Baltimore 21205.
J Appl Physiol (1985). 1993 Mar;74(3):1374-80. doi: 10.1152/jappl.1993.74.3.1374.
In isolated perfused organs, the protein reflection coefficient (sigma) can be estimated by comparing increases in hematocrit (Hct) and protein concentration (CP) during transvascular fluid filtration. In this study, we developed an equation for sigma to examine the potential influences of perfusate leak, evaporation, and hemolysis-induced changes in red blood cell volume and perfusate water. We also performed experiments in isolated ferret lungs to quantitate the magnitude of these potential sources of error and the effects of free hemoglobin on measurements of CP. These studies demonstrated that 1) perfusate leak does not cause an error because its effects on changes in Hct and CP counteract each other; 2) evaporation causes an overestimation of sigma, but in our experiments this effect was small; 3) hemolysis-induced changes in red blood cell and perfusate water volumes may cause an over- or underestimation of sigma, but these effects are small; 4) overestimations of CP due to increasing free perfusate hemoglobin concentration can cause substantial overestimations of sigma; and 5) values of sigma calculated from previous equations and from our equation were virtually identical, suggesting that the assumptions necessary for the previous equations were not significant sources of error. In agreement with previous workers, we conclude that the most important potential source of error is hemolysis-induced increases in free perfusate hemoglobin.
在离体灌注器官中,蛋白质反射系数(σ)可通过比较跨血管液体滤过期间血细胞比容(Hct)和蛋白质浓度(CP)的增加来估算。在本研究中,我们推导了一个用于计算σ的公式,以检验灌注液渗漏、蒸发以及溶血诱导的红细胞体积和灌注液水分变化的潜在影响。我们还在离体雪貂肺中进行了实验,以量化这些潜在误差来源的大小以及游离血红蛋白对CP测量的影响。这些研究表明:1)灌注液渗漏不会导致误差,因为其对Hct和CP变化的影响相互抵消;2)蒸发会导致对σ的高估,但在我们的实验中这种影响较小;3)溶血诱导的红细胞和灌注液体积变化可能导致对σ的高估或低估,但这些影响较小;4)由于灌注液游离血红蛋白浓度增加导致的CP高估会导致对σ的大幅高估;5)根据先前公式和我们的公式计算出的σ值几乎相同,这表明先前公式所需的假设并非误差的重要来源。与先前的研究人员一致,我们得出结论,最重要的潜在误差来源是溶血诱导的灌注液游离血红蛋白增加。