Pulmonary Arterial and Right Ventricular Responses to Prophylactic Albumin Administration Before Aortic Unclamping During Abdominal Aortic Aneurysmectomy
Pulmonary Arterial and Right Ventricular Responses to Prophylactic Albumin Administration Before Aortic Unclamping During Abdominal Aortic Aneurysmectomy
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腹主动脉瘤切除术中主动脉钳夹前肺动脉和右心室对预防性白蛋白给药的反应
DOI：
10.1213/00000539-199811000-00007
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发表时间：
1998
影响因子：
5.7
通讯作者：
H. Ohata
中科院分区：
文献类型：
--
作者：
N. Ueda;S. Dohi;S. Akamatsu;Y. Hamaya;E. Terazawa;H. Shimonaka;H. Ohata
在39例麻醉病人中，采用改良的热稀释法，观察了腹主动脉瓣切除术（AAA）和主动脉开放术（XU）前静脉输注白蛋白对肺动脉和右心室反应的影响。第2组患者（n = 21）在XU前接受额外白蛋白给药（5%白蛋白，10 mL/kg）。XU后，各组的平均动脉压（MAP）均显著降低，组2的MAP和每搏输出量指数（SVI）均不显著高于组1。术后5min，第2组患者平均肺动脉压、肺血管阻力指数高于第1组（P <0.05），右室射血分数低于第1组（P <0.05），但SVI维持良好。这些结果表明，XU前白蛋白给药可能并不总能预防XU后低血压。它引起右心室后负荷显著增加和右心室腔显著扩张;然而，两组的右心室功能几乎保持相同。然而，由于部分患者（第2组）的SVI并未随XU后右心室舒张末期容积指数的增加而增加，因此在AAA切除术期间，应在XU前谨慎使用白蛋白。含义：我们采用改良的热稀释技术研究了腹主动脉瓣狭窄切除术中主动脉开放前给予白蛋白对肺动脉和右心室反应的影响。主动脉开放前给予白蛋白可能并不总能预防低血压，并且可能导致肺动脉压高于未给予白蛋白的患者。（Anesth Analg 1998; 87：1020 - 6）
During abdominal aortic aneurysmectomy (AAAectomy) and before aortic unclamping (XU), we studied the effects of albumin administration on pulmonary arterial and right ventricular responses in 39 anesthetized patients using a modified thermodilution technique.Group 1 patients (n = 18) were given no extra IV fluids. Group 2 patients (n = 21) were given additional albumin administration (5% albumin at 10 mL/kg) before XU. After XU, mean arterial blood pressure (MAP) decreased significantly in each group, and MAP and stroke volume index (SVI) were not significantly higher in Group 2 than in Group 1. At 5 min after XU, the patients in Group 2 had a higher mean pulmonary arterial pressure and pulmonary vascular resistance index and a lower right ventricular ejection fraction than those in Group 1 (P < 0.05), but their SVIs were well maintained. These results indicate that albumin administration before XU may not always prevent post-XU hypotension. It caused a significant increase in right ventricular afterload and a significant dilation of the right ventricular cavity; however, right ventricular function was almost equally maintained in both groups. However, because SVI did not increase in some patients (Group 2) with the increase in right ventricular end-diastolic volume index after XU, albumin administration should be performed carefully before XU during AAAectomy. Implications: We studied the effects of albumin administration before aortic unclamping on pulmonary arterial and right ventricular responses during abdominal aortic aneurysmectomy using a modified thermodilution technique. Albumin administration before aortic unclamping may not always prevent hypotension, and it may cause a higher pulmonary arterial pressure than in patients without albumin administration. (Anesth Analg 1998;87:1020-6)
下躯干缺血后的肺动脉高压和白细胞隔离。
影响因子：
9
作者：
Anner,H;KaufmanJr,RP;Kobzik,L;Valeri,CR;Shepro,D;Hechtman,HB
通讯作者：
Hechtman,HB
通过肺循环中血管张力的升高来增强α-和β-肾上腺素受体反应。
DOI：
10.1152/ajpheart.1986.250.6.h1109
发表时间：
1986
期刊：
The American journal of physiology
影响因子：
--
作者：
Hyman,AL;Kadowitz,PJ
通讯作者：
Kadowitz,PJ
热稀释右心室容量：急性热损伤中容量替代的一种新颖且更好的预测因子。
DOI：
--
发表时间：
1981
期刊：
The Journal of trauma
影响因子：
--
作者：
Martyn,JA;Snider,MT;Farago,LF;Burke,JF
通讯作者：
Burke,JF