Distribution of normal saline and 5% albumin infusions in cardiac surgical patients
Distribution of normal saline and 5% albumin infusions in cardiac surgical patients
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DOI：
10.1097/00003246-200112000-00011
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发表时间：
2001-12-01
影响因子：
8.8
通讯作者：
Dodek, PM
中科院分区：
文献类型：
--
作者：
Ernest, D;Belzberg, AS;Dodek, PM
Objective.目的：研究心脏手术患者输注生理盐水或5%白蛋白后细胞外液体积（ECFV）内液体的相对分布及对氧输送的影响。前瞻性、随机、非盲、干预性研究。设置：一家拥有450张床位的教学医院的心脏外科重症监护室。患者：心脏外科术后患者（n = 40）。干预。输注生理盐水或5%白蛋白至患者临床医生确定的血流动力学终点。测量和主要结果。在每次液体输注之前（基线）和之后立即测量血浆容量（PV）、ECFV、心脏指数和动脉血氧含量。PV和ECFV分别通过I-131-白蛋白和[S-35]硫酸钠稀释来测量。间质液体积（ISFV）计算为ECFV-PV。治疗组间PV、ISFV、ECFV和氧输送指数的基线值无差异。输注生理盐水和5%白蛋白分别使PV增加了输注量的9 +/- 23%和52 +/- 84%（p <0.05），而生理盐水和白蛋白之间每输注量的ISFV变化无显著差异。只有5%的白蛋白显着增加心脏指数，虽然氧输送没有显着改变后，无论infration.Conclusions：在心脏手术后的患者，输注5%的白蛋白是大约5倍的效率，PV扩张器，但具有可比的影响，ISFV和氧输送相对于生理盐水的变化。
Objective. To determine the relative distribution of fluid within the extracellular fluid volume (ECFV) and the effect on oxygen delivery after infusing either normal saline or 5% albumin in cardiac surgical patients.Design. Prospective, randomized, unblinded, interventional study.Setting: Cardiac surgical intensive care unit in a 450-bed teaching hospital.Patients: Postoperative cardiac surgical patients (n = 40).Interventions. Infusion of either normal saline or 5% albumin to a hemodynamic end point determined by the patient's clinician.Measurements and Main Results. Plasma volume (PV), ECFV, cardiac index, and arterial oxygen content were measured immediately before (baseline) and after each fluid infusion. PV and ECFV were measured by dilution of I-131-albumin and [S-35]sodium sulfate, respectively. Interstitial fluid volume (ISFV) was calculated as ECFV - PV. Baseline values for PV, ISFV, ECFV, and oxygen delivery index did not differ between treatment groups. Infusion of normal saline and 5% albumin increased PV by 9 +/- 23% and 52 +/- 84% of the volume infused, respectively (p < .05), whereas there was no significant difference between saline and albumin in the change in ISFV per volume infused. Only 5% albumin significantly increased cardiac index, although oxygen delivery did not change significantly after either infusion.Conclusions: In postoperative cardiac surgical patients, infusion of 5% albumin is approximately five times as efficient as a PV expander but has comparable effects on changes in ISFV and oxygen delivery relative to normal saline.