Kasper S M, Dahlmann H, Mellinghoff H, Ellering J, Baumann M, Buzello W
Department of Anesthesiology, University of Cologne, Germany.
Vox Sang. 1998;75(1):26-31.
The study was designed to evaluate whether volume replacement following blood donation can prevent arterial hypotension in autologous blood donors with cardiovascular disease.
One hundred nineteen autologous blood donors with known cardiovascular disease were randomly allocated to receive, following withdrawal of 500 ml of blood, either no infusion (control group) or a 25 ml/min intravenous infusion of either 1,500 ml of lactated Ringer's solution (LRS) or 500 ml of 6% hydroxyethyl starch (HES). Starting before phlebotomy, arterial blood pressure was measured oscillometrically every 5 min until 90 min after donation.
Group means showed little difference between the groups in blood pressure throughout the monitoring period. The proportion of patients who at least once had a > or = 20% decrease from baseline in systolic blood pressure was 3-5 times greater in the control group than in the LRS and the HES group (50 vs. 10 and 15%, respectively; p < 0.001 on chi 2 analysis for a 2 x 3 table). Systolic hypertensive episodes (> or = 20% increase over baseline) were observed more frequently in the LRS group than in the control and the HES group (41 vs. 10 and 18%, respectively; p = 0.003).
Both LRS and HES, administered at a volume ratio to blood loss of 3:1 and 1:1, respectively, significantly reduced the incidence of systolic hypotensive episodes in autologous blood donors with cardiovascular disease. LRS at a 3:1 volume ratio to blood loss was associated with a high rate of systolic hypertension.
本研究旨在评估献血后补充液体量是否可预防患有心血管疾病的自体供血者发生动脉低血压。
119名已知患有心血管疾病的自体供血者，在抽取500ml血液后，被随机分配为不输液（对照组）或按25ml/min的速度静脉输注1500ml乳酸林格氏液（LRS）或500ml 6%羟乙基淀粉（HES）。从放血前开始，每隔5分钟用示波法测量动脉血压，直至献血后90分钟。
在整个监测期内，各组间的血压均值差异不大。收缩压至少有一次较基线水平下降≥20%的患者比例，对照组比LRS组和HES组高3至5倍（分别为50%、10%和15%；对于2×3表格的卡方分析，p<0.001）。LRS组收缩期高血压发作（较基线水平升高≥20%）的发生率高于对照组和HES组（分别为41%、10%和18%；p = 0.003）。
分别以失血量3:1和1:1的比例给予LRS和HES，可显著降低患有心血管疾病的自体供血者收缩期低血压发作的发生率。失血量与LRS的体积比为3:1时，收缩期高血压发生率较高。
