| Japanese |
|---|
| Title | 出血性ショックと輸液療法 -臓器血液量からみたその効果- |
|---|
| Subtitle | 原著 |
|---|
| Authors | 福井明* |
|---|
| Authors(kana) | |
|---|
| Organization | *川崎医科大学麻酔科学教室 |
|---|
| Journal | 循環制御 |
|---|
| Volume | 12 |
|---|
| Number | 4 |
|---|
| Page | 701-710 |
|---|
| Year/Month | 1991/ |
|---|
| Article | 原著 |
|---|
| Publisher | 日本循環制御医学会 |
|---|
| Abstract | 「要旨」イヌに30ml/kgの脱血を5分間で行い, 平均動脈血圧を71±25mmHgに低下させ出血性ショックを作製した. 本ショックに対する高張晶質液(10%食塩水), 膠質液(6%デキストラン70生理食塩水), 高張・膠質液(10%食塩水中にデキストラン70を6%の割合いに溶解したもの)の臓器血液量に及ぼす効果を, 生理食塩水投与群を対照として検討した. 動物の頭部, 胸部, 腹部, 大腿部の体表にVALMET社製局所脳血流測定装置の検出器を固定し, 99mTcで標識した赤血球を静脈内投与し, 各部の放射能測定値とヘマトクリット値からそれぞれの部位の血液量の変化を観察した. この結果, 高張晶質液, 膠質液, 高張・膠質液投与はともに, 生理食塩水投与に比して出血後変化した心拍数, 平均動脈圧, 心係数, ならびに循環血液量を改善させた. しかし, 高張晶質液投与の心係数と循環血液量の改善効果は一時的であった. 頭部の血液量に変化を認めなかった. 胸部, ならびに大腿部の血液量は生理食塩水以外の輸液剤投与によって改善するものの, その回復には40分以上を必要とした. 腹部の血液量は, 4部位中最大の低下をきたし, 生理食塩水以外の輸液剤投与によって改善するものの, 腹部の血液量改善には輸液後80分を必要とした. 高張晶質液投与によるこれら臓器血液量の改善効果は, 膠質液, ならびに高張・膠質液に比して緩徐であった. そして, 膠質液, 高張・膠質液のこれら臓器血液量の改善効果に差を認めなかった. 大腿部の血液量の変化は, 胸部臓器の血液量変化に平行していた. |
|---|
| Practice | 基礎医学・関連科学 |
|---|
| Keywords | organ blood volume, hemorragic shock, hypertonic crystalloid solution, colloid solution, hypertonic colloid solution, fluid therapy |
|---|
| English |
|---|
| Title | Efficacy of hypertonic crystalloid solution, colloid solution and hypertonic colloid solution for the treatment of hemmorrhagic shock. |
|---|
| Subtitle | |
|---|
| Authors | Akira Fukui |
|---|
| Authors(kana) | |
|---|
| Organization | Department of Anesthesiology Kawasaki Medical School |
|---|
| Journal | Circulation Control |
|---|
| Volume | 12 |
|---|
| Number | 4 |
|---|
| Page | 701-710 |
|---|
| Year/Month | 1991/ |
|---|
| Article | Original article |
|---|
| Publisher | Japan Society of Circulation Control |
|---|
| Abstract | Therapeutic effects of hypertonic saline (10% sodium chloride：H), colloid solution (6% dextran-70 in physiological saline：C) and hypertonic colloid solution (6% dextran-70 in 10% NaCl solution：HC) were compared with regular physiological saline (S) in dogs, in whom 30 ml/kg of their blood was shed and an equal amount of the test solutions were infused. Several circulatory parameters were monitered and regional blood volume, such as the brain, thoracic, abdominal organs and femoral skeletal muscles, was measured by 99mTc labelled red cells dilution method using VALMET's cerebroflowmeter serialiy. Treatment with either the H, C or HC solution improved heart rate, arterial blood pressure, cardiac index and circulating blood volume much more than the saline solution did. Nevertheless the improvement with the H solution in the cardiac index and the circulating blood volume remained no longer. In general the organ blood volumes recovered relatively delayed with the H solution, while those recovered to the control levels with the C or HC solution within 20 minutes. No definite change was observed in the brain blood volume both after the hemorrhage and fluid infusion. The. blood volumes in thoracic and abdominal organs decreased after the hemorrhage. This decrease recovered to the control level in the thoracic organs at 60 minutes after the treartments and in the abdominal organs at 80 minutes. Changes of blood volume in the femoral region were mostly comparable with those in the thoracic organs. Further study will be required to establish the efficacy of hypertonic collid solution for the treatment of hemorrhagic shock. |
|---|
| Practice | Basic medicine |
|---|
| Keywords | organ blood volume, hemorragic shock, hypertonic crystalloid solution, hypertonic colloid solution, fluid therapy |
|---|