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清醒犬对液体负荷的血流动力学和体液容量反应:非排泄性肾脏影响

Haemodynamics and body fluid volumes in response to fluid loading in conscious dogs: non-excretory renal influences.

作者信息

Liard J F

出版信息

Clin Sci Mol Med. 1976 Sep;51(3):243-55. doi: 10.1042/cs0510243.

Abstract
  1. Twelve conscious, chronically instrumented dogs were subjected to rapid loading with sodium chloride solution (150 mmol/1; saline) before and 1 day after bilateral nephrectomy (six dogs) or ureterocaval anastomosis (six dogs). Measurements were performed up to 3 h after the fluid load and included cardiac output with an electromagnetic flowmeter, mean arterial pressure and right atrial pressure with chronically implanted catheters, interstitial fluid pressure with a plastic capsule, heart rate, extracellular fluid volume, erythrocyte volume, plasma volume, plasma protein concentration and other variables. 2. The increase in cardiac output in response to saline load was significantly prolonged in the anephric dogs compared with those with uretero-caval anastomosis; mean arterial pressure, right atrial pressure and heart-rate changes were similar in both groups. 3. Plasma volume appeared to increase more in the anephric dogs than in those with uretero-caval anastomosis during the first hour after the infusion, although conflicting results were obtained with different estimates of plasma volume changes. Interstitial fluid pressure increased significantly less in the anephric dogs in the early stages of the fluid load. 4. Effective vascular compliance (the ratio of the change in blood volume to the change in right atrial pressure) appeared increased in the anephric dogs. On the other hand, the change in cardiac output for a given change in right atrial pressure was found to increase after bilateral nephrectomy. 5. It is suggested that the prolonged increase in cardiac output observed in anephric dogs was not the consequence of preferential plasma volume expansion nor of decreased venous compliance, but may reflect an alteration in the cardiac function curve.
摘要
  1. 十二只清醒的、长期植入仪器的狗,在双侧肾切除(六只狗)或输尿管腔静脉吻合术(六只狗)前及术后1天,接受氯化钠溶液(150 mmol/1;生理盐水)快速输注。在液体输注后长达3小时进行测量,包括用电磁流量计测量心输出量、用长期植入的导管测量平均动脉压和右心房压、用塑料胶囊测量组织间液压力、心率、细胞外液体积、红细胞体积、血浆体积、血浆蛋白浓度及其他变量。2. 与输尿管腔静脉吻合术的狗相比,无肾狗对生理盐水输注的心输出量增加明显延长;两组的平均动脉压、右心房压和心率变化相似。3. 在输注后的第一小时内,无肾狗的血浆体积似乎比输尿管腔静脉吻合术的狗增加得更多,尽管对血浆体积变化的不同估计结果相互矛盾。在液体输注早期,无肾狗的组织间液压力增加明显较少。4. 无肾狗的有效血管顺应性(血容量变化与右心房压力变化的比值)似乎增加。另一方面,发现双侧肾切除后,右心房压力给定变化时的心输出量变化增加。5. 有人提出,无肾狗观察到的心输出量长期增加,既不是优先的血浆体积扩张的结果,也不是静脉顺应性降低的结果,而可能反映了心功能曲线的改变。

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