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

在氟烷麻醉和潘克罗宁麻醉的杂种犬上，观察了急性血液稀释和控制性降压下的血流动力学变化和局部血流量。血液稀释至红细胞压积23~25%的方法是：取全血20ml/kg，同时输注加入3%右旋糖苷的林格氏液，稀释倍数为失血量的2倍。随后，静脉滴注三磷酸腺苷(ATP)或三甲酚(TMP)，使平均动脉压降至60 mm Hg，持续60分钟。实验动物分为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)。结果如下：(1)HD组稀释后60min心脏指数(CI)、中心静脉压(CVP)和平均动脉压(MAP)仍高于对照组；2 HD/ATP组降压60min后心率(HR)显著降低，降压后CI和CVP显著升高。肾皮质血流量(RCBF)明显降低。3.HD/TMP组低血压时CI明显降低。低血压时RCBF和肝血流量(HBF)显著降低。在氧气输送能力显著下降的基础上，氧提取速率有所增加。因此，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.