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首页> 外文期刊>The Journal of trauma >Evaluation of hyperviscous fluid resuscitation in a canine model of hemorrhagic shock: a randomized, controlled study.
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Evaluation of hyperviscous fluid resuscitation in a canine model of hemorrhagic shock: a randomized, controlled study.

机译：失血性休克犬模型中高粘液复苏的评估：一项随机对照研究。

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BACKGROUND: Enhancing plasma viscosity during fluid resuscitation results in vasodilation and improved microvascular perfusion in rodents subjected to hemorrhagic shock. We hypothesized that resuscitation with hyperviscous lactated Ringer's solution (hyperLRS) would result in improved tissue oxygenation and acid-base values in hemorrhaged dogs. METHODS: Twelve dogs were anesthetized and splenectomized. Vascular catheterization was performed, and tissue oxygen probes were placed in the jejunal serosa and skeletal muscle to assess macro- and microhemodynamic parameters. Baseline (BL) and posthemorrhage data were obtained. After 1 hour of hemorrhagic shock (mean arterial pressure [MAP] 30-40 mm Hg), treatment groups (n = 6) were administered bolus LRS or hyperLRS, and then received sufficient LRS to achieve and maintain an MAP between 60 mm Hg and 70 mm Hg. Data were obtained at 10, 30, 60, 120, and 180 minutes after fluid resuscitation. RESULTS: There were no significant differences between LRS or hyperLRS groups at BL or posthemorrhage. Blood and plasma viscosity were significantly increased by the administration of hyperLRS at all time points postresuscitation compared with LRS. Significantly more fluid was required to maintain MAP, and vascular hindrance was consistently lower in dogs administered hyperLRS versus LRS, suggesting viscosity-induced vasodilation. Central and mesenteric venous oxygen saturations were significantly decreased, whereas lactate and oxygen extraction ratios were significantly increased after hyperLRS administration compared with LRS. The tissue oxygen tension was similar in dogs administered hyperLRS or LRS. CONCLUSIONS: A hyperviscous balanced electrolyte solution did not improve hemodynamic parameters, tissue oxygen tension, or acid-base values despite evidence for viscosity-induced vasodilation.
机译：背景：在液体复苏过程中提高血浆粘度会导致失血性休克的啮齿类动物血管舒张并改善微血管灌注。我们假设用高粘度乳酸林格氏液（hyperLRS）进行复苏可以改善出血犬的组织氧合和酸碱值。方法：对十二只狗进行麻醉和脾切除术。进行了血管导管插入术，并将组织氧探头放置在空肠浆膜和骨骼肌中以评估宏观和微观血液动力学参数。获得基线（BL）和出血后数据。出血性休克1小时（平均动脉压[MAP] 30-40 mm Hg）后，向治疗组（n = 6）推注LRS或hyperLRS，然后接受足够的LRS以达到并维持MAP在60 mm Hg和200 mg Hg之间。 70毫米汞柱。在液体复苏后的10、30、60、120和180分钟获得数据。结果：在BL或出血后，LRS或hyperLRS组之间无显着差异。与LRS相比，在复苏后的所有时间点通过hyperLRS给药可显着增加血液和血浆粘度。与LRS相比，给予hyperLRS的狗需要更多的液体来维持MAP，并且血管障碍持续降低。这表明粘度引起的血管舒张。与LRS相比，hyperLRS给药后中枢和肠系膜静脉血氧饱和度显着降低，而乳​​酸和氧的提取率则明显升高。给予hyperLRS或LRS的狗的组织氧张力相似。结论：尽管有证据显示粘度引起的血管舒张，但高粘平衡电解质溶液并未改善血流动力学参数，组织氧张力或酸碱值。

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