Isovolemic hemodilution in experimental focal cerebral ischemia. Part 1: Effects on hemodynamics, hemorheology, and intracranial pressure.
Isovolemic hemodilution in experimental focal cerebral ischemia. Part 1: Effects on hemodynamics, hemorheology, and intracranial pressure.
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等容血液稀释在实验性局灶性脑缺血中的应用。
DOI：
10.3171/jns.1988.69.1.0072
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发表时间：
1988
影响因子：
4.1
通讯作者：
D. Karacostas
中科院分区：
文献类型：
--
作者：
Y. Tu;R. Heros;G. Candia;A. Hyodo;Karen Lagree;R. Callahan;N. Zervas;D. Karacostas
本文对76只脾切除犬进行了等容血稀释的价值和效果的研究。其中，由于技术错误，有7个没有包括在分析中。在剩下的69只狗中，35只接受血液稀释治疗；28例暂时闭塞颈内动脉远端和大脑中动脉近端6小时，7例仅行假手术，动脉操作但不闭塞。其余34只狗不进行血液稀释；其中26例接受了暂时性动脉闭塞，8例仅接受了假手术。在每一组中，动物大致平均分为1)急性方案，通过放射性微球技术测量局部脑血流量，并在急性实验结束时牺牲；2)慢性方案，生存1周，允许每日神经学评估和最终组织病理学检查，但不进行血流量测量。动脉闭塞或假手术后约1小时进行等容血液稀释，通过开窗放血和输注低分子量葡聚糖使红细胞压积达到30% ~ 32%的水平。这种处理导致粘度和纤维蛋白原水平显著降低。在慢性方案的动物中，红细胞压积的下降持续了整个星期。黏度的降低与红细胞压积的降低几乎呈线性相关。血液稀释后全身动脉压略有下降，但中心静脉压、肺动脉压或楔压无明显变化。血液稀释组和对照组的心脏指数略有下降，这可能是由于巴比妥酸盐麻醉的作用。两组测量的血容量都有轻微的增加，这可能是人为的，与计算方法有关。所有动脉闭塞动物的颅内压均随时间显著升高，但血液稀释组的颅内压升高较轻。无论血液稀释与否，假手术动物的颅内压均无明显变化。脑血流量测量的结果，评估神经系统状况，并测量梗死面积给出了在本报告的第2部分。
A total of 76 splenectomized dogs were entered in a study of the value and effects of isovolemic hemodilution. Of these, seven were not included in the analysis because of technical errors. Of the remaining 69 dogs, 35 were treated with hemodilution; 28 were subjected to a 6-hour period of temporary occlusion of the distal internal carotid artery and the proximal middle cerebral artery, and seven underwent a sham operation only, with arterial manipulation but no occlusion. The other 34 dogs were not subjected to hemodilution; 26 of these underwent temporary arterial occlusion and eight had a sham operation only. In each group the animals were about equally divided into 1) an acute protocol with regional cerebral blood flow measurements by a radioactive microsphere technique and sacrifice at the end of the acute experiment, and 2) a chronic protocol with survival for 1 week to permit daily neurological assessment and final histopathological examination but without blood flow measurements. Isovolemic hemodilution was performed about 1 hour after the arterial occlusion or sham operation and was accomplished by phlebotomy and infusions of low molecular weight dextran to bring the hematocrit to a level of 30% to 32%. This treatment resulted in a very significant reduction in viscosity and fibrinogen levels. The decrease in hematocrit lasted throughout the week in the animals in the chronic protocol. The decrease in viscosity correlated almost linearly with the decrease in hematocrit. There was a slight decrease in systemic arterial pressure with hemodilution but there were no significant changes in central venous pressure or in pulmonary arterial or wedge pressure. There was a slight decrease in cardiac index in both the hemodilution and control groups, which may have been due to the effects of barbiturate anesthesia. There was a slight increase in the measured blood volume in both groups, which was probably artifactual and related to the method of calculation. Intracranial pressure increased significantly with time in all animals subjected to arterial occlusion, but this increase was less severe in the hemodilution group. There was no significant change in intracranial pressure in sham-operated animals, whether hemodiluted or not. The results of cerebral blood flow measurements, assessment of neurological conditions, and measurement of infarct size are given in Part 2 of this report.
等容血液稀释在实验性局灶性脑缺血中的应用。
影响因子：
4.1
作者：
Tu,YK;Heros,RC;Karacostas,D;Liszczak,T;Hyodo,A;Candia,G;Zervas,NT;Lagree,K
通讯作者：
Lagree,K