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Korean Journal of Anesthesiology 1981;14(4):361-371.
DOI: https://doi.org/10.4097/kjae.1981.14.4.361   
The Effect of Dextran Administration on Serum Colloid Osmotic Pressure, Oxygen Utilization and Pulmonary Shunt Ratio in Acute Hemorrhagic Dogs .
Seong Deok Kim
Department of Anesthesiology, College of Medicine, Seoul National University, Seoul, Korea.
Abstract
Changes in Serum colloid osmotic pressure(COP), blood gas tensions, alveolar-arterial oxygen tension difference(A-aDo2) and oxygen extraction ratio(O2ER) were studied after bleeding dogs (20 ml/kg) and then giving low molecular weight dextran(LMWD) infusion(20 ml/kg and additional 60ml/kg which were designated as "1x LMWD" and "4x" LMWD) respectively in twelve dogs. Colloid osmotie pressures were increased from 19+/-1.7 torr of control to 22+/-3. 1 torr after LMWD infusion and 29+/-2.4 torr after 4 x LMWD infusion, A-aD(o2) and pulmonary Qs/QT were increased from 100+/-50.5 torr and 8+/-4. 2% to 259+/-56.4 torr and 15+/-4.2% by bleeding, but returned to control level(105+/-36.3 torr, 7+/-2.4%) by 1 x LMWD infusion, and then increased. To 319+/-42.6 torr and 20+/-3.5% after 4 x LMWD infusion respectively. The mechanism of this increase may be related to metabolic acidosis(pH; 7. 309+/-0.1041) and uneven ventilation/perfusion ratio. Even though oxygen carrying capacity was decreased with progressive decrease in hemoglobin and hematocrit, oxygen flux was rather increased after LMWD infusion due to marked compensatory increase in the cardiac output. Furthermore oxygen consumption and oxygen the extraction ratio were increased in parallel with the increase in cardiac output and oxygen flux, Measurement of COP can simplify the assessment of fluid balance and the cardiopulmonry status. It can serve as a prognostic indicator, and aid in prescribing the form of fluid therapycrystalloid versus colloid and diuretic therapy for critically ill patients.


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