Neely K A, Ernest J T, Goldstick T K, Linsenmeier R A, Moss J
Department of Ophthalmology, University of Minnesota, Minneapolis 55455, USA.
Graefes Arch Clin Exp Ophthalmol. 1996 Nov;234(11):688-94. doi: 10.1007/BF00292355.
Therapeutic isovolemic hemodilution has been reported to improve blood flow and oxygen delivery. Few reliable measurements have been made, however, showing the effect of hemodilution on tissue oxygen tension.
We measured retinal oxygen tension during experimental isovolemic hemodilution in normal cats. Polarographic oxygen microelectrodes were placed in the vitreous humor within 100-200 microns of the retinal surface.
Tissue oxygen tension increased initially during isovolemic hemodilution to a maximum approximately 50% above baseline at approximately two thirds of the original hematocrit level. Hemodilution beyond this point to lower hematocrits caused a steady decline in tissue oxygen tension. Cardiac output measured in one cat undergoing isovolemic hemodilution increased as hematocrit was lowered, but the cardiac erythrocyte flux actually decreased steadily.
The observed increase in tissue oxygen tension with hemodilution appears to be explained by a lesser reduction in capillary than in systemic hematocrit, coupled with an increased capillary blood flow. The increase in tissue oxygen tension we observed could in part explain the clinically beneficial effects of hemodilution.
据报道,治疗性等容血液稀释可改善血流和氧输送。然而,很少有可靠的测量结果表明血液稀释对组织氧张力的影响。
我们在正常猫的实验性等容血液稀释过程中测量了视网膜氧张力。将极谱氧微电极放置在距视网膜表面100 - 200微米的玻璃体内。
在等容血液稀释过程中,组织氧张力最初升高,在大约三分之二的原始血细胞比容水平时达到比基线高约50%的最大值。超过这一点进一步稀释至更低的血细胞比容会导致组织氧张力稳步下降。在一只接受等容血液稀释的猫中测量的心输出量随着血细胞比容降低而增加,但心脏红细胞通量实际上稳步下降。
观察到的血液稀释导致组织氧张力升高似乎可以解释为毛细血管血细胞比容的降低小于全身血细胞比容的降低,同时毛细血管血流量增加。我们观察到的组织氧张力升高可能部分解释了血液稀释的临床有益效果。