{"id":2475,"date":"2020-03-03T11:40:41","date_gmt":"2020-03-03T03:40:41","guid":{"rendered":"https:\/\/www.cosmomed.com.tw\/?p=2475"},"modified":"2023-09-19T13:34:21","modified_gmt":"2023-09-19T05:34:21","slug":"intraosseous-blood-infusion-with-rapid-infuser","status":"publish","type":"post","link":"https:\/\/www.cosmomed.com.tw\/en\/intraosseous-blood-infusion-with-rapid-infuser\/","title":{"rendered":"Is Intraosseous infusion compatible with Rapid infuser?"},"content":{"rendered":"\n
\"\"<\/figure>\n\n\n\n

\u9aa8\u5167\u91dd(Intraosseous Infusion, IO)\u662f\u975c\u8108\u6ce8\u5c04(Intravenous Infusion, IV)\u4e0d\u53ef\u884c\u6642\u70ba\u60a3\u8005\u5efa\u7acb\u8f38\u6db2\u901a\u8def\u9032\u884c\u7d66\u85e5\u6216\u8f38\u6db2\u7684\u66ff\u4ee3\u65b9\u6848\u3002\u9aa8\u5167\u6ce8\u5c04\u7684\u512a\u9ede\u662f\u4e0d\u6703\u584c\u9677\u4f46\u662f\u76f8\u5c0d\u786c\u8cea\u7684\u8cea\u5730\u53ca\u66f2\u6298\u8840\u7ba1\u7d50\u69cb\u6703\u589e\u52a0\u8f38\u6db2\u963b\u529b\u3001\u4e0d\u5229\u6db2\u9ad4\u6d41\u52d5\uff0c\u5c24\u5176\u8f38\u6ce8\u8840\u6db2\u6642\u53ef\u80fd\u5c0d\u7d30\u80de\u819c\u7522\u751f\u8f03\u5927\u7684\u526a\u61c9\u529b(shear stress)\u5c0e\u81f4\u6eb6\u8840\u6216\u662f\u5ef6\u9577\u8f38\u6ce8\u6642\u9593\uff0c\u56e0\u6b64\u6709\u5fc5\u8981\u66b8\u89e3\u4f7f\u7528\u9aa8\u5167\u91dd\u8f38\u8840<\/strong>\u7684\u9069\u5207\u6027\u3002<\/p>\n\n\n\n

\u4ee5\u5931\u8840\u6027\u4f11\u514b\u8c6c\u96bb\u8a55\u4f30\u9aa8\u5167\u52a0\u58d3\u8f38\u8840\u7684\u5b89\u5168\u6027<\/strong>
\u8fd1\u671f\uff0c\u7f8e\u570b\u6734\u8328\u8305\u65af\u6d77\u8ecd\u91ab\u5b78\u4e2d\u5fc3(Naval Medical Center Portsmouth)\u91dd\u5c0d\u9aa8\u5167\u91dd\u642d\u914d\u4e09\u7a2e\u8f38\u8840\u6a5f\u5236\uff1a\u63a8\u62c9\u6280\u8853(push-pull)\u3001\u52a0\u58d3\u888b(pressure bag)\u3001\u5feb\u901f\u8f38\u6db2\u7cfb\u7d71FMS2000\u5728\u5931\u8840\u6027\u4f11\u514b\u7684\u8c6c\u96bb\u8eab\u4e0a\u5be6\u9a57\u6709\u6548\u6d41\u901f\u8207\u5b89\u5168\u6027\uff0c\u7814\u7a76\u7d50\u679c\u986f\u793a\u63a8\u62c9\u6280\u8853\u7684\u6d41\u901f\u53ef\u905496.5 mL\/min\uff0c\u63a5\u8457\u662f\u52a0\u58d3\u888b72.6 mL\/min\uff0c\u6700\u5f8c\u662f\u5feb\u901f\u8f38\u6db2\u7cfb\u7d7160 mL\/min\u3002<\/p>\n\n\n

\n
\"\"<\/figure>\n<\/div>\n\n\n

\u503c\u5f97\u6ce8\u610f\u7684\u662f\uff0c\u96d6\u7136\u63a8\u62c9\u6280\u8853\u6d41\u901f\u6700\u5feb\u4f46\u7522\u751f\u7684\u5e73\u5747\u58d3\u529b\u5cf0\u503c\u70ba3058 mmHg\uff0c\u8840\u6f3f\u6e38\u96e2\u8840\u7d05\u7d20\u6aa2\u6e2c(Plasma-free hemoglobin)\u9054173.3 mg\/dl\u5df2\u7d93\u8d85\u904e\u9ad4\u5916\u7dad\u751f\u6a5f\u69cb(Extracorporeal Life Support Organization, ELSO)\u5efa\u8b70\u768450 mg\/dl\uff1b\u52a0\u58d3\u888b\u3001\u5feb\u901f\u8f38\u6db2\u7cfb\u7d71\u7684\u5e73\u5747\u58d3\u529b\u5cf0\u503c\u5247\u5206\u5225\u662f360 mmHg\u8207301 mmHg\uff0c\u5169\u8005\u8840\u6f3f\u6e38\u96e2\u8840\u7d05\u7d20\u5747\u70ba12 mg\/dl\u3002<\/p>\n\n\n\n

\u4f5c\u8005\u8a8d\u70ba\u58d3\u529b\u888b\u5728\u58d3\u529b\u5cf0\u503c\u8207\u6d41\u901f\u4e4b\u9593\u80fd\u53d6\u5f97\u8f03\u4f73\u5e73\u8861\u3001\u7522\u51fa\u6eb6\u8840\u91cf\u5c11\uff0c\u662f\u4e09\u8005\u4e2d\u6700\u9069\u5408\u5728\u7dca\u6025\u5fa9\u7526\u74b0\u5883\u4e2d\u642d\u914d\u9aa8\u5167\u91dd\u4f7f\u7528\u7684\u52a0\u58d3\u8f38\u8840\u65b9\u5f0f\u3002\u800c\u5feb\u901f\u8f38\u6db2\u7cfb\u7d71FMS2000\u5118\u7ba1\u5be6\u9a57\u6578\u64da\u8207\u52a0\u58d3\u888b\u76f8\u4f3c\uff0c\u4f46\u53d7\u9650\u65bc\u7cfb\u7d71\u5b89\u5168\u63aa\u65bd\u4e00\u4f46\u8f38\u6db2\u58d3\u529b\u8d85\u904e\u4e0a\u9650\u503c\u5373\u4e2d\u65b7\u8f38\u6db2\uff0c\u56e0\u6b64\u7528\u5728\u9aa8\u5167\u8f38\u8840\u7684\u53ef\u9760\u6027\u6709\u5f85\u5546\u69b7\u3002<\/p>\n\n\n\n

\u5b89\u5168\u81f3\u4e0a Think Safety First<\/strong>
\u904e\u53bb\u7814\u7a76\u66fe\u986f\u793a\u8840\u888b\u52a0\u58d3\u8d85\u904e300 mmHg\u5c31\u53ef\u80fd\u5c0e\u81f4\u8840\u6f3f\u6e38\u96e2\u8840\u7d05\u7d20\u589e\u591a\uff0c\u56e0\u6b64\u5e02\u552e\u7684\u5feb\u901f\u8f38\u6db2\u7cfb\u7d71\u6700\u5927\u58d3\u529b\u5747\u4ee5\u6b64\u70ba\u9650\u53c8\u6db2\u9ad4\u6d41\u901f\u8207\u52a0\u58d3\u5927\u5c0f\u6210\u6b63\u6bd4\uff0c\u6240\u4ee5\u4e0d\u96e3\u7406\u89e3\u5feb\u901f\u8f38\u6db2\u7cfb\u7d71\u5728\u9019\u88e1\u7684\u6d41\u901f\u8868\u73fe\u3002\u5118\u7ba1\u5728\u9019\u4efd\u6734\u8328\u8305\u65af\u6d77\u8ecd\u91ab\u5b78\u4e2d\u5fc3\u7684\u7814\u7a76\u5831\u544a\u88e1\u986f\u793a\u8840\u888b\u88ab\u52a0\u58d3\u81f3360 mmHg\u4e5f\u672a\u7522\u751f\u904e\u591a\u7684\u8840\u6f3f\u6e38\u96e2\u8840\u7d05\u7d20\uff0c\u4f46\u57fa\u65bc\u6700\u5927\u5c64\u5ea6\u7684\u8f38\u8840\u5b89\u5168\u8003\u91cf\uff0c\u5feb\u901f\u8f38\u6db2\u7cfb\u7d71\u8a2d\u8a08\u8981\u5728\u6027\u80fd\u8207\u5b89\u5168\u6027\u4e4b\u9593\u6b0a\u8861\u512a\u5148\u4fdd\u969c\u60a3\u8005\u5b89\u5168\u3002<\/strong>\u5c31\u8c9d\u723e\u66fc\u7279\u7684FMS2000\u6216\u8f03\u65b0\u6a5f\u578bRI-2<\/a>\u4f86\u8aaa\uff0c\u7576\u8f38\u6ce8\u58d3\u529b\u903c\u8fd1300 mmHg\u6642\u6703\u81ea\u52d5\u6e1b\u901f\u964d\u58d3\u4e26\u767c\u51fa\u8b66\u793a\u901a\u77e5\u4f7f\u7528\u8005\uff0c\u4e00\u4f46\u58d3\u529b\u8d85\u904e\u4e0a\u9650\u6642\u5373\u66ab\u505c\u8f38\u6db2\u907f\u514d\u4e0d\u7576\u8f38\u6ce8\u3002<\/p>\n\n\n\n

\u8c48\u6b62\u65bc\u5feb<\/strong>
\u96d6\u7136\u58d3\u529b\u7ba1\u7406\u6a5f\u5236\u8f03\u70ba\u4fdd\u5b88\uff0c\u4f46\u4f7f\u7528\u5feb\u901f\u8f38\u6db2\u7cfb\u7d71<\/a>\u4ecd\u6709\u8a31\u591a\u512a\u52e2\u503c\u5f97\u4e00\u63d0\uff0c\u4f8b\u5982\u8f38\u6ce8\u540c\u6642\u52a0\u6eab\u6db2\u9ad4\u81f3\u4eba\u9ad4\u6eab\u5ea6\u907f\u514d\u4f4e\u6eab\u75c7\u4ee5\u53ca\u81ea\u52d5\u6392\u6c23\u907f\u514d\u7a7a\u6c23\u6813\u585e\uff0c\u9019\u4e9b\u529f\u80fd\u5728\u5927\u91cf\u5feb\u901f\u8f38\u8840\u6642\u70ba\u60a3\u8005\u63d0\u4f9b\u66f4\u597d\u7684\u8f38\u6ce8\u5b89\u5168\u3002<\/p>\n\n\n\n

\"\"
RI-2\u6709\u8457Push-Pull\u3001\u52a0\u58d3\u888b\u4e0d\u53ef\u53d6\u4ee3\u7684\u512a\u9ede\u50cf\u662f\u52a0\u6eab\u3001\u6392\u6c23<\/figcaption><\/figure>\n\n\n\n

\u53c3\u8003\u8cc7\u6599\uff1a<\/strong>
[1]. Auten, Jonathan & McEvoy, Christian & Roszko, Paul & Polk, Travis & Kachur, Ryan & Kemp, Jean & Natarajan, Ramesh & Zarow, Greg. (2019). Safety of Pressurized Intraosseous Blood Infusion Strategies in a Swine Model of Hemorrhagic Shock. The Journal of surgical research. 246. 190-199. 10.1016\/j.jss.2019.09.005. <\/a>
[2].Extracorporeal Life Support Organization (ELSO) Guidelines for Adult Respiratory Failure August, 2017<\/a>.
[3].Eurenius S, Smith RM.\u00a0Hemolysis\u00a0in\u00a0blood\u00a0infused under\u00a0pressure. Anesthesiology 1973;39:650\u20131.<\/a>
[4].Choi YJ, Huh H, Bae GE, et al. Effect of varying external pneumatic pressure on hemolysis and red blood cell elongation index in fresh and aged blood: Randomized laboratory research.\u00a0Medicine (Baltimore)<\/em>. 2018;97(28):e11460. doi:10.1097\/MD.0000000000011460<\/a><\/p>\n","protected":false},"excerpt":{"rendered":"

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