Korent V A, Conhaim R L, McGrath A M, DeAngeles D A, Harms B A
Department of Surgery, University of Wisconsin-Madison, and William S. Middleton Memorial Veterans Hospital, 53705, USA.
Am J Respir Crit Care Med. 1997 Apr;155(4):1302-8. doi: 10.1164/ajrccm.155.4.9105071.
We used high performance size exclusion chromatography (HPSEC) to measure concentrations and molecular masses of hetastarch (Het) in plasma and lung lymph of unanesthetized sheep. Our goal was to assess the osmotic effectiveness of Het in the pulmonary circulation as judged by its exclusion from lung lymph. Sheep (n = 5) received 35 ml/kg of Het (6%) over 90 min. At the end of the infusion, Het concentrations in plasma reached a peak value of 2.9 +/- 0.1% (mean +/- SD). Lymph concentrations reached a peak value of 1.3 +/- 0.3% at 4.5 h. Het molecular masses in plasma averaged 650 +/- 36 kD at 90 min, but ranged from 31 to 2,942 +/- 187 kD. Masses in lung lymph averaged 373 +/- 71 kD, and ranged from 19 +/- 2 to 1,693 +/- 514 kD (p < or = 0.05 vs. plasma). Het contributed 6.7 +/- 1.5 mm Hg to the plasma macromolecular osmotic pressure, and 3.7 +/- 1.8 mm Hg to the lymph osmotic pressure. Despite the fact that Het has the largest molecular mass of any of the current macromolecular plasma volume expanders, we found that it filtered readily into lymph, raising the lymph osmotic pressure. These findings suggest that the rationale for the osmotic performance of such solutions may need to be reconsidered.
我们采用高效尺寸排阻色谱法（HPSEC）来测量未麻醉绵羊血浆和肺淋巴中羟乙基淀粉（Het）的浓度及分子量。我们的目的是通过观察其在肺淋巴中的排出情况，评估Het在肺循环中的渗透效果。绵羊（n = 5）在90分钟内输注35 ml/kg的Het（6%）。输注结束时，血浆中Het浓度达到峰值2.9 +/- 0.1%（均值 +/- 标准差）。4.5小时时，淋巴浓度达到峰值1.3 +/- 0.3%。90分钟时，血浆中Het分子量平均为650 +/- 36 kD，但范围为31至2,942 +/- 187 kD。肺淋巴中的分子量平均为373 +/- 71 kD，范围为19 +/- 2至1,693 +/- 514 kD（与血浆相比，p <= 0.05）。Het对血浆大分子渗透压的贡献为6.7 +/- 1.5 mmHg，对淋巴渗透压的贡献为3.7 +/- 1.8 mmHg。尽管Het是目前所有大分子血浆容量扩充剂中分子量最大的，但我们发现它能轻易滤入淋巴，提高淋巴渗透压。这些发现表明，此类溶液渗透性能的理论依据可能需要重新考虑。
