Volume kinetics of Ringer's solution in hypovolemic volunteers
Volume kinetics of Ringer's solution in hypovolemic volunteers
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DOI：
10.1097/00000542-199901000-00013
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发表时间：
1999-01-01
期刊：
影响因子：
8.8
通讯作者：
Hahn, RG
中科院分区：
文献类型：
--
作者：
Drobin, D;Hahn, RG
背景：恢复正常血容量所需的林格氏溶液量被认为是失血量的三到五倍。这种疗法可以通过使用一个动力学模型，考虑到分配和消除的输注fluid.Methods的速率进行优化：作者注入25 ml/kg的林格氏醋酸溶液到10名男性志愿者谁是23至33岁（平均28岁）时，他们是normovolemic和后450 ml和900 ml的血液已经撤回。一个体积和两个体积的动力学：模型进行了拟合的稀释的总静脉血红蛋白和血浆白蛋白concentration.Results：撤回血液导致两个标志物的稀释-时间曲线的逐步上移。在60个分析的数据集中，有56个数据集的双体积模型在统计学上是合理的。血红蛋白变化表明，输注液体扩张的体液空间平均总体积为10.71消除速率常数（k（r））随血容量减少而降低，为133 ml/min（22 ml/min [SEM]）、100 ml/min（39 ml/min [SEM]）和34 ml/min（7 ml/min [SEM]）（P < 0.01）。血浆白蛋白显示输注液体扩张的体液空间略大，但k（r）值较小（P < 0.02）。低血容量使收缩压和舒张压降低约10 mmHg（P < 0.05）。结论：低血容量时，血液稀释度增加，输注的林格氏液在体内的滞留增加，其主要原因是消除速率常数降低。
Background: The amount of Ringer's solution needed to restore normal blood volumes is thought to be three to five times the volume of blood lost. This therapy can be optimized by using a kinetic model that takes accounts for the rates of distribution and elimination of the infused fluid.Methods: The authors infused 25 ml/kg Ringer's acetate solution into 10 male volunteers who were 23 to 33 yr old (mean, 28 yr) when they were normovolemic and after 450 ml and 900 ml blood had been withdrawn. One-volume and two-volume kinetic: models were fitted to the dilution of the total venous hemoglobin and plasma albumin concentrations.Results: Withdrawal of blood resulted in a progressive upward shift of the dilution-time curves of both markers. The two-volume model was statistically justified in 56 of the 60 analyzed data sets. The hemoglobin changes indicated that the body fluid space expanded by the infused fluid had a mean total volume of 10.71 (+/-0.9 SEM), The elimination rate constant (k(r)) decreased with the degree of hypovolemia and was 133 ml/min (22 ml/min [SEM]), 100 ml/min (39 ml/min [SEM]), and 34 ml/min (7 ml/min [SEM]), respectively (P < 0.01). Plasma albumin indicated a slightly larger body fluid space expanded by the infused fluid, but k(r) was less (P < 0.02). Hypovolemia reduced the systolic and diastolic blood pressures by approximately 10 mmHg (P < 0.05).Conclusions: The dilution of the blood and the retention of infused Ringer's solution in the body increases in the presence of hypovolemia, which can be attributed chiefly to a reduction of the elimination rate constant.