血液克里特对大脑微循环和组织氧化在深度低温旁路期间的作用
L F Duebener1, T Sakamoto, S Hatsuoka
1Department of Cardiac Surgery, Children's Hospital, Harvard Medical School, Boston, Massachusetts, USA.
Circulation
|September 25, 2001
概括
在低温心肺绕道术 (CPB) 期间保持较高的血红素 (Hct) 会改善大脑组织的氧化,并减少白细胞的激活. 严重的血液稀释 (10% Hct) 在CPB期间损害了微循环和氧化.
科学领域:
- 心血管研究研究心血管研究
- 神经科学是一个神经科学.
- 内显微镜检查 内显微镜检查
背景情况:
- 低温心肺绕道 (CPB) 期间的血液稀释旨在改善微循环.
- 在CPB期间血稀释的最佳血红素 (Hct) 水平仍未确定.
研究的目的:
- 研究不同血红素 (Hct) 水平对大脑微循环和组织氧化的影响.
- 在低温CPB和深度低温循环停止 (DHCA) 期间,评估在10%,20%和30%的Hct时的大脑微循环和氧化.
主要方法:
- 在带有头骨窗口的小猪身上使用了内存显微镜模型.
- 使用光素-异硫酸-德克斯来评估功能毛细血管密度 (FCD).
- 测量白细胞粘附和滚动在毛囊后静脉和NADH水平用于组织氧化.
主要成果:
- 功能性毛细血管密度 (FCD) 在30%Hct时显著更高,而在DHCA后早期再输血时为10%.
- 严重的血液稀释 (10% Hct) 与滚动白细胞的增加有关,相比之下,30% Hct.
- 在冷却阶段,NADH测量表明脑组织在10% Hct下氧化不足.
结论:
- 高血红素 (30%) 不会损害大脑的微循环,并减少白细胞内皮细胞激活后的DHCA.
- 严重的血液稀释 (10% Hct) 在低温CPB期间导致大脑组织氧化不足.
- 在低温CPB期间,建议血位为30%低于较低水平,特别是在使用DHCA时.
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