HEMODYNAMIC EFFECT OF INFUSION SOLUTION OF SORBITOL AND SODIUM LACTATE IN PATIENTS WITH SEVERE CHRONIC OBSTRUCTIVE PULMONARY DISEASE

V.K. Gavrysyuk, N.I. Gumenyuk, Ya.A. Dzyublik, N.D. Morskaya

Institute of phthisiology and pulmonology named after. F.G. Yanovskiy

10, M. Amosova str., 03680, Kiev, Ukraine

Background.
Polycytemia and associated elevation of hematocrit (Ht) is one of the causes of microcirculation impairment in patients with severe chronic obstructive pulmonary disease (COPD). The aim of the study was to evaluate the influence of the infusion preparation, containing 6 % sorbitol and 1,9 % sodium lactate solutions in patients with severe COPD.

Methods.
We examined 17 patients with severe course of disease in phase of remission (FEV1=38,1±2,6 $; FEV1/FC=47,1±2,9 %). We measured Ht (%), blood viscosity indices (using the method of viscosimetry), partial pressures of oxygen (PaO2, mm Hg) and carbon dioxide (PaCO2, mm Hg) in capillary blood. All tests were performed before and 2 hours after the intravenous infusion of 200 ml of sorbitol/sodium lactate preparation. Analogous trial was conducted with the infusion of 5 % glucose solution in order to do a comparison in the same cohort of patients.

Results.
The preparation caused hemodynamic effect (the level of Ht decreased on 2,8±0,4 %; P<0,001) and blood viscosity indices were improved. At the same time there was observed an increase of PaO2 (51,5±2,1 at baseline, 59,8±2,3 after the infusion; p<0,01) whereas PaCO2 was unchanged. After the glucose solution infusion there was a trend towards decease of Ht level and increase of PaO2, but the change of this indices was not statistically significant.

Conclusion.
Infusion solution of sorbitol and sodium lactate in patients with severe COPD caused significant hemodilution, decreased blood viscosity and decreased a degree of hypoxemia. Hemodilution effect is explained not only by simple dilution of blood, but mainly by active tissue dehydration due to hyperosmolarity of the solution.

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