目的研究脉搏图变异性(POP)与血容量的关系。方法全身麻醉后出现POP阳性(脉搏图变异率△POP>15%)的75例病例均分三组分别给予干预因素:Ⅰ组给予去氧肾上腺素1μg/kg静脉注射、Ⅱ组给予多巴酚丁胺10μg/kg静脉注射、Ⅲ组给予羟乙基淀...目的研究脉搏图变异性(POP)与血容量的关系。方法全身麻醉后出现POP阳性(脉搏图变异率△POP>15%)的75例病例均分三组分别给予干预因素:Ⅰ组给予去氧肾上腺素1μg/kg静脉注射、Ⅱ组给予多巴酚丁胺10μg/kg静脉注射、Ⅲ组给予羟乙基淀粉100m l/m in输注5m in,比较三种干预因素在干预前、干预后2m in和5m in三个时段△POP的变化程度。结果干预后5m in三组的△POP降低(P<0.01):Ⅰ组24.2±3.2 VS 20.7±3.8;Ⅱ组29.3±9.8 VS 21.5±4.6;Ⅲ组28.8±6.1 VS 10.0±3.0,Ⅲ组的△POP降低到正常值范围内。结论容量是影响POP的主要因素,应用POP监测血容量具有潜在的临床应用价值。展开更多
Objective To assess the possibility of using arterial pressure waveform or pulse oximetry plethysmographic waveform variation to estimate the pulmonary arterial wedge pressure (PAWP) Methods Fourteen American Socie...Objective To assess the possibility of using arterial pressure waveform or pulse oximetry plethysmographic waveform variation to estimate the pulmonary arterial wedge pressure (PAWP) Methods Fourteen American Society of Anesthesiologists grade Ⅰ-Ⅱ patients aged 33-69 years and weighing 62 0±9 5 kg scheduled for elective abdominal tumor surgery were studied Their hemoglobin exceeded 120 g/L and hematocrit exceeded 35% Pre operative acute hypervolemic hemodilution was applied immediately after general anesthestic induction and tracheal intubation PAWP, systolic pressure variation (SPV), delta down (dDown), SPV plet , dDown plet and other hemodynamic parameters were measured and recorded when total fluid volume (crystalloid and colloid) infused reached 10 ml/kg and 20 ml/kg and again at the end of the operation Central venous pressure was maintained at 10-12 mm Hg during operation Systolic blood pressure at the end of Valsalva maneuver (airway pressure was kept at 22 mm Hg) and the systolic pressure before the Valsalva manoeuvre during apnea were used to calculate arterial pressure ratio (APR) Results APR, SPV, dDown, SPV plet and dDown plet all correlated well with PAWP ( r =0 717, -0 695, -0 680, -0 522 and -0 624 respectively, P <0 01) There was a closer linear correlation between APR and PAWP than between the other parameters The regression equation was PAWP (mm Hg)=0 207×APR (%)-0 382 Conclusion During positive pressure mechanical ventilation, APR, SPV, dDown, SPV plet and dDown plet can be used to estimate PAWP effectively展开更多
Iron and manganese oxides are common components of soils. They frequently occur in nodules constituting important soil sorbents and play a crucial role in a number of chemical reactions in the soil environment. In add...Iron and manganese oxides are common components of soils. They frequently occur in nodules constituting important soil sorbents and play a crucial role in a number of chemical reactions in the soil environment. In addition, the oxides are very sensitive to environmental changes (moisture, pH, Eh) constituting important indicators of soil-forming processes and water movement in the landscape. The objectives of the study were: i) to examine the distribution and size of Fe-Mn nodules in Albeluvisols containing a fragipan horizon; ii) to determine the morphology and chemical composition of the nodules, and iii) to estimate the effect of the fragipan horizon on water movement within the soil profile. An investigation was carried out on five soil profiles containing a fragipan horizon and classified as Fragic Albeluvisols within the Carpathian Foothills in Poland. In the Albeluvisols studied, the maximum concentration of Fe-Mn nodules occurred in the horizon lying directly on the fragipan horizon. This suggests that the pan acts as a natural barrier restricting water infiltration and leads to the seasonal development of a perched water table promoting redox processes. The most common are coarse (1-0.5 mm) and medium (0.5-0.25 mm) irregular Fe-Mn nodules showing a gradual boundary and undifferentiated internal fabric. Eluvial horizons contained also larger amounts of round and dense nodules with a sharp boundary, suggesting frequent oxidation and reduction. The fragipan horizon contained mainly irregular and soft nodules, suggesting longer saturation with water during the year. Concentrations of trace elements (Cu, Zn) and P were higher within Fe-Mn nodules than in the surrounding soil materials, showing that iron and manganese oxides adsorbed and immobilised these elements.展开更多
文摘目的研究脉搏图变异性(POP)与血容量的关系。方法全身麻醉后出现POP阳性(脉搏图变异率△POP>15%)的75例病例均分三组分别给予干预因素:Ⅰ组给予去氧肾上腺素1μg/kg静脉注射、Ⅱ组给予多巴酚丁胺10μg/kg静脉注射、Ⅲ组给予羟乙基淀粉100m l/m in输注5m in,比较三种干预因素在干预前、干预后2m in和5m in三个时段△POP的变化程度。结果干预后5m in三组的△POP降低(P<0.01):Ⅰ组24.2±3.2 VS 20.7±3.8;Ⅱ组29.3±9.8 VS 21.5±4.6;Ⅲ组28.8±6.1 VS 10.0±3.0,Ⅲ组的△POP降低到正常值范围内。结论容量是影响POP的主要因素,应用POP监测血容量具有潜在的临床应用价值。
文摘Objective To assess the possibility of using arterial pressure waveform or pulse oximetry plethysmographic waveform variation to estimate the pulmonary arterial wedge pressure (PAWP) Methods Fourteen American Society of Anesthesiologists grade Ⅰ-Ⅱ patients aged 33-69 years and weighing 62 0±9 5 kg scheduled for elective abdominal tumor surgery were studied Their hemoglobin exceeded 120 g/L and hematocrit exceeded 35% Pre operative acute hypervolemic hemodilution was applied immediately after general anesthestic induction and tracheal intubation PAWP, systolic pressure variation (SPV), delta down (dDown), SPV plet , dDown plet and other hemodynamic parameters were measured and recorded when total fluid volume (crystalloid and colloid) infused reached 10 ml/kg and 20 ml/kg and again at the end of the operation Central venous pressure was maintained at 10-12 mm Hg during operation Systolic blood pressure at the end of Valsalva maneuver (airway pressure was kept at 22 mm Hg) and the systolic pressure before the Valsalva manoeuvre during apnea were used to calculate arterial pressure ratio (APR) Results APR, SPV, dDown, SPV plet and dDown plet all correlated well with PAWP ( r =0 717, -0 695, -0 680, -0 522 and -0 624 respectively, P <0 01) There was a closer linear correlation between APR and PAWP than between the other parameters The regression equation was PAWP (mm Hg)=0 207×APR (%)-0 382 Conclusion During positive pressure mechanical ventilation, APR, SPV, dDown, SPV plet and dDown plet can be used to estimate PAWP effectively
基金Supported by the Polish State Committee for Scientific Research (No. N N305 120934)
文摘Iron and manganese oxides are common components of soils. They frequently occur in nodules constituting important soil sorbents and play a crucial role in a number of chemical reactions in the soil environment. In addition, the oxides are very sensitive to environmental changes (moisture, pH, Eh) constituting important indicators of soil-forming processes and water movement in the landscape. The objectives of the study were: i) to examine the distribution and size of Fe-Mn nodules in Albeluvisols containing a fragipan horizon; ii) to determine the morphology and chemical composition of the nodules, and iii) to estimate the effect of the fragipan horizon on water movement within the soil profile. An investigation was carried out on five soil profiles containing a fragipan horizon and classified as Fragic Albeluvisols within the Carpathian Foothills in Poland. In the Albeluvisols studied, the maximum concentration of Fe-Mn nodules occurred in the horizon lying directly on the fragipan horizon. This suggests that the pan acts as a natural barrier restricting water infiltration and leads to the seasonal development of a perched water table promoting redox processes. The most common are coarse (1-0.5 mm) and medium (0.5-0.25 mm) irregular Fe-Mn nodules showing a gradual boundary and undifferentiated internal fabric. Eluvial horizons contained also larger amounts of round and dense nodules with a sharp boundary, suggesting frequent oxidation and reduction. The fragipan horizon contained mainly irregular and soft nodules, suggesting longer saturation with water during the year. Concentrations of trace elements (Cu, Zn) and P were higher within Fe-Mn nodules than in the surrounding soil materials, showing that iron and manganese oxides adsorbed and immobilised these elements.
