Importance of the Infusion Rate for the Plasma Expanding Effect of 5% Albumin, 6% HES 130/0.4, 4% Gelatin, and 0.9% NaCl in the Septic Rat
Importance of the Infusion Rate for the Plasma Expanding Effect of 5% Albumin, 6% HES 130/0.4, 4% Gelatin, and 0.9% NaCl in the Septic Rat
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DOI：
10.1097/ccm.0b013e318274157e
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发表时间：
2013-03-01
影响因子：
8.8
通讯作者：
Grande, Per-Olof
中科院分区：
文献类型：
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作者：
Bark, Bjorn P.;Persson, Johan;Grande, Per-Olof
目的：在大鼠脓毒症模型中比较快速输注速率与缓慢输注速率的固定体积的5%白蛋白、合成胶体、6%羟乙基淀粉130/0.4和4%明胶以及0.9 NaCl的血浆容量（PV）扩张效应，并比较这些液体之间的血浆扩张效应。设计：前瞻性、随机动物研究。实验对象：112只成年雄性大鼠。干预措施：通过盲肠结扎和切开，然后闭合腹部诱导脓毒症。3小时后，开始输注研究中的PV扩张剂，胶体体积为12 mL/kg，0.9%NaCl体积为48 mL/kg，输注时间为15分钟或3小时。对照组进行相同的实验程序，但不给予液体。结果如下：输注开始后3小时（实验结束），胶体（尤其是白蛋白）输注速率慢于快时的血浆扩张效果更好，但NaCl组与对照组无显著差异。对照组的PV为28.7 +/- 3 mL/kg。在缓慢和快速输注组中，白蛋白分别为38.9 +/- 4.3和32.6 +/- 4.2 mL/kg（p < 0.001），羟乙基淀粉130/0.4分别为32.9 +/- 4.3和29.5 +/- 4.4 mL/kg（p < 0.05），明胶为31.8 +/- 3.9和28.2 +/- 4.1 mL/kg（p < 0.05），NaCl为31.8 +/- 5.3和30.7 +/- 6.6 mL/kg结论：该研究表明，当以慢输注速率给药时，胶体的PV扩张大于以快输注速率给药时，白蛋白的效果更明显。对于NaCl，未观察到这种差异。与其他胶体相比，NaCl的PV扩展效果较差，而白蛋白的PV扩展效果较好。(Crit护理医学2013; 41：857-866）
Objectives: To compare the plasma volume (PV) expanding effect of a fast infusion rate with that of a slow infusion rate of a fixed volume of 5% albumin, of the synthetic colloids, 6% hydroxyethyl starch 130/0.4 and 4% gelatin, and of 0.9 NaCl in a rat sepsis model and to compare the plasma-expanding effect among these fluids.Design: Prospective, randomized animal study.Setting: University hospital laboratory.Subjects: One hundred and twelve adult male rats.Interventions: Sepsis was induced by cecal ligation and incision followed by closure of the abdomen. After 3 hrs, an infusion of the PV expander under study was started at a volume of 12mL/kg for the colloids and of 48mL/kg for 0.9% NaCl, either for 15 mins or for 3 hrs. A control group underwent the same experimental procedure but no fluid was given.Measurements and Main. Results: Three hours after start of the infusion (end of experiment), the plasma-expanding effect was better with a slow than a fast infusion rate for the colloids, especially albumin, but the NaCl groups did not differ significantly from the control group. The PV for the control group was 28.7 +/- 3 mL/kg. In the slow and the fast infusion groups, it was 38.9 +/- 4.3 and 32.6 +/- 4.2 mL/kg for albumin (p < 0.001), 32.9 +/- 4.3 and 29.5 +/- 4.4 mL/kg for hydroxyethyl starch 130/0.4 (p < 0.05), 31.8 +/- 3.9 and 28.2 +/- 4.1 mL/kg for gelatin (p < 0.05), and 31.8 +/- 5.3 and 30.7 +/- 6.6 mL/kg for NaCl (n.s), respectively.Conclusions: The study showed that the PV expansion by a Colloid was greater when given at a slow than at a fast infusion rate, an effect more pronounced for albumin. This difference was not seen for NaCl. The PV-expanding effect was poor for NaCl and better for albumin than for the other colloids. (Crit Care Med 2013; 41:857-866)