PDF(Pubmed)
Abstract：
Large-volume therapeutic phlebotomy is the mainstay of hemochromatosis treatment and offers an opportunity to investigate the hemodynamic changes during acute hypovolemia. An otherwise healthy 64-year-old male with hemochromatosis participated. On nine separate visits, 1000 mL therapeutic phlebotomy was performed. On one occasion, pre- and post-phlebotomy orthostatic challenge with 27° reverse Trendelenburg position was administered. Mean arterial pressure, heart rate, and stroke volume were measured continuously during the procedures. The patient\'s tolerance to the interventions was continuously evaluated. The procedures were well tolerated by the patient. Mean arterial pressure was maintained during hemorrhage and following phlebotomy in both supine and reverse Trendelenburg positions, primarily through an increase in heart rate and systemic vascular resistance. The present study found that 1000 mL therapeutic phlebotomy in a patient with hemochromatosis may be acceptably and safely used to model hemorrhage. The approach demonstrates high clinical applicability and ethically robustness in comparison with volunteer studies.
摘要：
大容量治疗性静脉切开术是血色素沉着症治疗的主要方法，并提供了研究急性低血容量期间血液动力学变化的机会。一名健康的64岁男性血色素沉着症患者参与其中。在九次单独的访问中，进行1000mL治疗性静脉切开术。有一次,给予具有27°反向Trendelenburg位置的静脉切开术前后的体位攻击。平均动脉压,心率,在手术过程中连续测量每搏量。连续评估患者对干预措施的耐受性。患者对手术的耐受性良好。在出血期间和放血后，仰卧位和反向Trendelenburg位置均保持平均动脉压。主要是通过增加心率和全身血管阻力。本研究发现，血色素沉着症患者的1000mL治疗性静脉切开术可能是可接受且安全地用于模拟出血。与志愿者研究相比，该方法具有很高的临床适用性和道德稳健性。
