三区外周静脉输注多巴胺后血流动力学效应发生率的比较

Deokkyu Kim, J. Son, W. Choi, Y. Han, Jun-Rae Lee, Hyungsun Lim
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摘要

背景多巴胺是一种经常被选择用于连续输注的增力剂。为了血液动力学的稳定性,输注速率控制在5-15μg/kg/min的范围内。本研究旨在比较通过三种不同的外周静脉(头静脉[CV]、大隐静脉[GSV]和颈外静脉[EJV])给药多巴胺时,从给药多巴胺到其血液动力学效应开始的时间间隔。方法第1组、第2组和第3组患者分别在CV、GSV和EJV中接受多巴胺输注。无创连续心输出量监测仪(NICCOMO™, Medis,Ilmenau,Germany)用于评估心输出量(CO)和全身血管阻力(SVR)。插管后6分钟,记录基线心率(HR)、收缩压(BP)、舒张压、平均动脉压(MAP)、CO和SVR值,并开始以10μg/kg/min的剂量输注多巴胺。记录灌注后0、4、8、12和15分钟的血液动力学变化。结果三组患者血流动力学变化率差异无统计学意义。在所有组中,收缩压、舒张压、MAP和SVR在前4分钟下降后趋于增加;相反,HR和CO下降到8分钟,之后趋于平稳。结论在全麻下接受10μg/kg/min多巴胺的患者中,通过三种不同的外周静脉给予多巴胺的效果没有临床差异。
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Comparing the Rates of Dopamine Hemodynamic Effect Onset after Infusion through Peripheral Veins in Three Regions
Background Dopamine is an inotropic agent that is often selected for continuous infusion. For hemodynamic stability, the rate of infusion is controlled in the range of 5-15 μg/kg/min. This study aimed to compare the time intervals from the administration of dopamine to the onset of its hemodynamic effects when dopamine was administered through three different peripheral veins (the cephalic vein [CV], the great saphenous vein [GSV], and the external jugular vein [EJV]). Methods Patients in group 1, group 2, and group 3 received dopamine infusions in the CV, GSV, and EJV, respectively. A noninvasive continuous cardiac output monitor (NICCOMO™, Medis, Ilmenau, Germany) was used to assess cardiac output (CO) and systemic vascular resistance (SVR). Six minutes after intubation, baseline heart rate (HR), systolic blood pressure (BP), diastolic BP, mean arterial pressure (MAP), CO, and SVR values were recorded and dopamine infusion was initiated at a dose of 10 μg/kg/min. Hemodynamic changes at 0, 4, 8, 12, and 15 minutes postinfusion were recorded. Results No statistically significant differences were observed among the three groups with respect to the rate of hemodynamic change. In all groups, systolic BP, diastolic BP, MAP, and SVR tended to increase after decreasing for the first 4 minutes; in contrast, HR and CO decreased until 8 minutes, after which they tended to reach a plateau. Conclusions For patients under general anesthesia receiving dopamine at 10 μg/kg/min, there were no clinical differences in the effect of dopamine administered through three different peripheral veins.
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