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

本文观察了氟烷麻醉、潘可宁麻痹的杂种犬在急性血液稀释和控制性降压下的血流动力学和局部血流量变化。以20 ml/kg的量抽取全血，同时输注2倍于抽取血量的3%右旋糖酐林格氏液，使红细胞压积达到23-25%。然后静脉滴注三磷酸腺苷（ATP）或甲氧苄啶（TMP）使血压降至平均动脉压60 mmHg，持续60分钟。将动物分为3组。HD组（单纯血液稀释），HD/ATP组（血液稀释+ATP控制性降压），HD/TMP组（血液稀释+TMP控制性降压）。结果表明：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 min仍高于对照值; HD/ATP组，心率（HR）在降压60分钟后显示出显著降低，但CI和CVP在诱导降压时显示出显著增加。肾皮质血流量（RCBF）显著降低。3; HD/TMP组在诱导低血压时CI显著降低。低血压时RCBF和肝血流量（HBF）显著降低。氧提取率的增加的基础上的显着降低的氧运输能力进行了观察。根据这些结果，HD/ATP组被认为是比HD/TMP组更安全的方法。

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.