Effect Of Transfusion Of The Different Ratios Of Crystalloid And Colliod On Brain Oxygen Supply-demand Balance Of Patients With Craniocerebral Operations

Objective:To probe into the effect of fluid administration of different ratios of crystalloid and colliod on brain oxygen supply-demand balance,cerebral energy metabolism in patients undergoing selective craniocerebral operations.Methods:Forty eight ASAâ… -â…¡patients under general anesthesia were randomized to four groups(n=12),group A only crystalloid,group B crystalloid:colliod=2:1,group C crystalloid:colliod= 1:1,group D crystalloid:colliod=1:2.Drowed blood synchronously from sigmoid sinus and dorsal artery of foot after intubation of internal jugular vein(T₁),afer skin incision(T₂),afer resection of tumor(T₃) and at the end of operation(T₄),then detected blood gas analysis,lactate content,blood sugar content,plasma electrolytic,to calculate cerebral arteriovenous difference of oxygen(D_a-vO₂),cerebral extraction of oxygen (CEO₂),venous-arterial lactate difference(VADLac),venous-arterial PCO₂ difference(VAPCO₂).Results:â‘ oxygen supply-demand balance: compaired with T₁,S_vO₂ increased,CEO₂ and D_a-vO₂ reduced at the time points of T₂,T₃,T₄,there was a statistically significant difference between the time(P<0.01).â‘¡cerebral energy metabolism:compaired with T₁,VADLac increased,VAPCO₂ reduced at the time point of T₂,T₃,T₄ in group AB,while group CD was opposite.There was a statistically significant difference between the time point(P<0.01).â‘¢intracranial pressure:There was no statistical difference in the value of SBP between groups.â‘£plasma electrolyte and acid-base balance:There was no statistical difference in the value of E₄A and pH between groups. Conclusion:â‘ The ratio of 1:1 crystalloid and colliod was beneficial to maintain encephalic oxygen supply-demand balance;Both only crystalloid and the ratio of 2:lof crystalloid and colliod occurred anaerobic metabolism while the ratio of 1:2 of crystalloid and colliod did not.â‘¡The ratios of 1:1 and 1:2 of crystalloid and colliod increased aerobic metabolism and decreased anaerobic metabolism of brain,which were better than the ratios of 1:0 and 2:1.