[Changes of blood viscosity in patients undergoing cardiac surgery during cardiopulmonary bypass].

I S Ling, C F Wang, C L Lee, C G Liu, Y T Lee, J L Wu
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Abstract

The patient undergoing open-heart surgery depends on hypothermia and cardiopulmonary bypass (CPB) to maintain organ perfusion during cardiac arrest. Increased blood viscosity during hypothermic CPB might be life-threatening, so hemodilution is imperative. Fourteen open-heart patients of ASA class II-III were included in this study. Pre- and intra-CPB viscosity changes were observed. Before CPB, 6 ml blood sample was drawn out from open-heart patients after systemic heparinization and another 6 ml blood sample was drawn out from the oxygenator after CPB was established. The hematocrit and relative viscosity of each sample in different temperatures were measured. The result revealed that as the temperature decreases, the viscosity of each sample increases apparently. As compared to the pre-CPB blood sample, the hematocrit of blood obtained intra-CPB decreases from 36.81 to 27.04, (p < 0.001), and the viscosity also decreases at all different temperatures (p < 0.001). Blood viscosity obtained at 37 degrees C pre-bypass is not statistically different from the sample at 25 degrees C during bypass. Obviously, increased viscosity due to hypothermia is buffered by hemodilution after using large amount of fluid as priming solution during CPB. Therefore, the hematocrit and viscosity remain within physiologic ranges.

[心脏手术患者体外循环期间血液粘度的变化]。
在心脏骤停期间,接受心内直视手术的患者依靠低温和体外循环(CPB)来维持器官灌注。低温CPB时血液黏稠度增高可能危及生命,因此血液稀释势在必行。本研究纳入14例ASA II-III级开胸患者。观察cpb前和cpb内的粘度变化。体外循环前,取经全身肝素化的开胸患者血样6 ml,体外循环建立后取氧合器血样6 ml。测定了各样品在不同温度下的红细胞压积和相对粘度。结果表明,随着温度的降低,各试样的黏度均明显增大。与cpb前的血液样品相比,cpb内获得的血液的红细胞压积从36.81下降到27.04,(p < 0.001),粘度在不同温度下也有所下降(p < 0.001)。在37℃的预分流血黏度与在25℃的分流血黏度无统计学差异。显然,在CPB过程中使用大量液体作为启动液后,血液稀释可以缓冲低体温引起的黏度增加。因此,红细胞压积和黏度保持在生理范围内。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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