A Study of Hemodynamic Changes and Regional Blood Flows Under Hemodilution and Controlled Hypotension

研究了氟烷麻醉和panronium麻痹的杂种狗在急性血液稀释和控制性低血压条件下的血流动力学变化和局部血流。取全血20ml/kg，同时以2倍移血量输注3%右旋糖酐加林格液，血液稀释至血细胞比容23-25%。随后，静脉滴注三磷酸腺苷（ATP）或三甲沙芬（TMP），使平均动脉压降至60mmHg，持续60分钟。这些动物被分成3组。1) HD组（单纯血液稀释），2)HD/ATP组（血液稀释+ ATP诱导低血压），3)HD/TMP组（血液稀释+ TMP诱导低血压）。对3组进行比较研究，结果如下：1；HD组心脏指数（CI）、中心静脉压（CVP）和平均动脉压（MAP）在稀释后60分钟仍高于对照组。2;HD/ATP组在低血压60分钟后心率（HR）显著降低，而诱导低血压后CI和CVP显著升高。肾皮质血流量（RCBF）显著降低。3;在HD/TMP组，诱导低血压时CI显著降低。低血压时RCBF和肝血流量（HBF）显著降低。在氧气运输能力显著下降的基础上，观察到氧气提取率的增加。从这些结果来看，HD/ATP组比HD/TMP组更安全。

Hemodynamic changes and regional blood flows under acute hemodilution and controlled hypotension were studied in mongrel dogs anesthetized with halothane and paralyzed with pancronium. Hemodilution to a hematocrit of 23-25% was produced by 20ml/kg removal of whole blood and simultaneous infusion of 3% dextran-added Ringer's solution in 2 times the volume of blood bemoved. Subsequently, hypotension to amean arterial pressure of 60mmHg was produced for 60 minutes by intravenous infusion of adenosine triposphate (ATP) or trimethaphane (TMP). The animals were divided into 3 groups. : 1) HD group (hemodilution alone), 2) HD/ATP group (hemodilution and ATP induced hypotension), 3) HD/TMP group (hemodilution and TMP inducedhy potension). These 3 groups were investigated comparatively and the results were as follows :1 ; In the HD group, the cardiac index (CI), central venous pressure (CVP), and mean arterial pressure (MAP) remained above the control value until 60 minutes after dilution.2 ; In the HD/ATP group, heart rate (HR) showed a significant decrease after 60 minutes of hypotension but CI and CVP showed a significant increase when hypotension was induced. Renal cortical blood flow (RCBF) was significantly decreased.3 ; In the HD/TMP group, CI decreased significantly when hypotension was induced. RCBF and hepatic blood flow (HBF) decreased significantly during hypotension. An increase in the oxygen extraction rates based on the significant decrease in oxygen transport capacity was observed. From these results, he HD/ATP group was considered to be a safer method than the HD/TMP group.