重症外科手術の際に輸血を避けるため,急性高血圧血性希釈を行う
A Trouwborst1, E C van Woerkens, M van Daele
1Department of Anaesthesiology, University Hospital Dijkzigt, Erasmus University, Rotterdam, The Netherlands.
Lancet (London, England)
|November 24, 1990
まとめ
デクストラン40とリンガー乳酸を用いた急性高血圧性血中希釈は,患者が手術前の輸血を避けるのに役立ちます. このテクニックは,大手術中に赤血球の損失を安全に軽減します.
科学分野:
- 心血管の生理学 心血管の生理学
- 外科のイノベーションです.
- アネステシオロジー アネステシオロジー
背景:
- 手術前の輸血にはリスクがあります.
- 手術中に流血を最小限に抑えることは,患者の安全にとって極めて重要です.
- 急性高血圧性血液希釈は,輸血の必要性を減らすための潜在的な戦略です.
研究 の 目的:
- 術前輸血を避けるための急性高血圧血性希釈の有効性を評価する.
- この血液希釈技術の生理学的効果を評価するために.
主な方法:
- 大手外科手術を受けた16人の患者は,急性高血圧性血流希釈を受けた.
- デクストラン40とリンガー乳酸は,血液希釈に使用されました.
- ヘモダイナミックパラメータと詰まった細胞容量をモニタリングしました.
主要な成果:
- 詰まった細胞の容量と酸素の抽出量が減少した.
- 心臓指数と肺圧が上昇した.
- 血液損失のパーセントに基づいて,詰め込まれた細胞容量の有意な違いは観察されなかった.
結論:
- 急性高血圧血性希釈は,手術前の輸血を避けるための安全で効果的な方法です.
- この処置は赤血球の損失を軽減し,輸血なしで大手術を行うことができます.
- 観察された生理学的変化は,制御された液体負荷と一致していました.
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