Blood volumes in cardiac surgery with cardiopulmonary bypass
Blood volumes in cardiac surgery with cardiopulmonary bypass
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DOI：
10.1177/0267659114550230
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发表时间：
2015-07-01
期刊：
影响因子：
1.2
通讯作者：
Muehlschlegel, J. D.
中科院分区：
文献类型：
--
作者：
Hilberath, J. N.;Smith, T.;Muehlschlegel, J. D.
目的：总血容量（TBV）估计可能影响心脏外科护理的各个方面，包括药理学和输血干预、血流动力学和容量管理以及灌注设备选择。TBV通常在心肺转流（CPB）期间使用标准化公式计算。我们假设这些方程不能准确预测个体血容量变异性。本研究的目的是确定TBV与稀释技术，并比较结果常用TBV calculation.Methods：机构审查委员会批准后，前瞻性地收集和分析101例接受心脏直视手术的患者的数据。CPB开始前和开始后即刻的血细胞比容（Hct）用于计算TBV。结果：平均稀释TBV（男性：4684 ± 1641 ml;女性：3027 ± 1067 ml;总：4175 ± 1617 ml）显著小于（P < 0.05），且与（1）艾伦公式和（2）基于体重的标准（男性70 ml/kg（SM）;女性65 ml/kg（SF））相比，差异有显著性（P < 0.05）。
Purpose: Total blood volume (TBV) estimation potentially impacts various aspects of cardiac surgical care, including pharmacological and transfusion interventions, hemodynamic and volume management and perfusion equipment selection. TBV is commonly computed during cardiopulmonary bypass (CPB), using standardized formulae. We hypothesized that these equations fail to accurately predict individual blood volume variability. The aim of this study was to determine TBV with a dilution technique and compare the results to commonly utilized TBV calculations.Methods: After institutional review board approval, data was prospectively collected and analyzed for 101 patients undergoing open-heart surgery. Hematocrits (Hct) just prior to and immediately after the initiation of CPB were used to calculate the TBV. Results were compared to (1) the Allen formula and (2) weight-based standards (70 ml/kg for males (SM); 65 ml/kg for females (SF)).Results: The average dilution TBV (male: 4684 1641 ml; female: 3027 +/- 1067 ml; total: 4175 +/- 1617 ml) was significantly smaller (p