Assessment of changes in blood volume in response to resuscitative fluid administration in dogs

摘要

Objective: To determine the continuous changes in blood volume in response to fluid administration using an in-line hematocrit monitor. Design: Rrospective study. Setting: Research laboratory. Animals: Four healthy dogs. Interventions: Each dog received intravenous boluses of 80 mL/kg of 0.9% saline (S), 4mL/kg of 7.5% saline (HS), 20 mL/kg of dextran 70 (D), 20 mL/kg of hetastarch (HES), or no fluids (control, C) on separate occasions. Fluids were administered at 150mL/min in the S, D, and HES groups, and at 1 mL/kg/min in the HS group. Measurements and main results: Blood volume changes were measured every 20 seconds for 240 minutes using an in-line hematocrit monitor. There was a rapid rise in blood volume during all infusions. Immediately afterthe administration of crystalloid fluids, the rapid rise in blood volume ceased. Subsequently, there was a steep decline in blood volume for 10 minutes, and a slower decline thereafter. In contrast, the rise in blood volume continued for at least 10 minutes after the infusion of the colloids was complete, and a plateau was observed for the remainder of the experiment. The blood volume effect, as measured by area under the curve, was significantly greater in the saline group than the other groups duringthe infusion time and for the 0-240 minutes time period. The areas under the curve for the two colloid solutions were not significantly different from each other during any time periods. The percent increase in blood volume immediately following the infusions was 76.4 ± 10.0 in the S group, 17.1 ± 3.2 in the HS group, 23.0 ± 10.5 in the D group, and 27.2 ± 6.4 in the HES group. At 30 minutes from the start of the infusion, the mean percent increases in blood volumes were 35.2 ± 9.3 in the S group,12.3 ± 0.9 in the HS group, 35.9 ± 7.3 in the D group, and 36.8 ± 6.5 in the HES group. At 240 h post-infusion, the mean percent increases in blood volume were 18.0 ± 9.7 in the S group, 2.9 ± 6.1 in the HS group, 25.6 ± 16.1 in the D group, and 26.6 ± 8.6 in the HES group. The C group had a mean percent change in blood volume of — 3.7 ± 3.4 at the end of the experiment. Conclusions: This study indicates that the rapid administration of saline at clinically relevant doses leads to the largest immediate increase in blood volume, although this change is transient because of rapid redistribution of the fluid. Despite a brief increase in blood volume that was almost 3 times the volume administered, hypertonic saline led to the smallest increase inblood volume post-infusion. The synthetic colloid solutions increased the blood volume by an amount greater than that infused and the effect was sustained for a longer period of time than seen following crystalloid administration, but the maximum increase in blood volume was significantly less than saline. The measurement of continuous changes in blood volume, using an in-line hematocrit monitor, was a useful means of assessing the dynamic effects of fluid administration in dogs in a research setting.