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首页> 外文期刊>Shock: Molecular, cellular, and systemic pathobiological aspects and therapeutic approaches = The official journal of the Shock Society, the European Shock Society, the Brazilian Shock Society, the International Federation of Shock Societies >Fluid resuscitation in severe sepsis and septic shock: albumin, hydroxyethyl starch, gelatin or ringer's lactate-does it really make a difference?
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Fluid resuscitation in severe sepsis and septic shock: albumin, hydroxyethyl starch, gelatin or ringer's lactate-does it really make a difference?

机译：液体复苏在严重脓毒症和脓毒性冲击:清蛋白、羟乙基淀粉、明胶或林格氏lactate-does真的做一个不同吗?

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The aim of this study was to investigate whether the type of i.v. fluid administered has an impact on outcome in an animal model of septic shock. The study included 28 anesthetized, invasively monitored, mechanically ventilated female sheep (29.5 +/- 4.0 kg), which received 0.5 g/kg body weight of feces into the abdominal cavity to induce peritonitis. During the surgical operation and 4 h after feces spillage, only Ringer's lactate (RL) was administered in all animals. Thereafter, animals were randomized to receive continuous infusions of RL (n = 7) alone or combined with either 20% albumin (n = 7, volume ratio to RL 1:10) or 6% hydroxyethyl starch (HES) (n = 7, volume ratio to RL 1:1), or gelatin alone (n= 7, no volume limitation). Fluid resuscitation was titrated to maintain pulmonary artery occlusion pressure at baseline levels throughout the experiment. No antibiotics or vasoactive drugs were administered, and animals were monitored until their spontaneous death. Hemodynamic variables were better with HES and albumin than with the other fluids, as reflected by higher stroke volume, cardiac index, and oxygen delivery (all P < 0.05). Hydroxyethyl-starch-treated animals also had lower arterial lactate concentrations (P < 0.01). However, times to develop hypotension and oliguria were similar in all groups. Blood interleukin (IL) 6 concentrations were significantly increased in all groups. The mean survival time was similar in all groups. In this clinically relevant model of prolonged septic shock, albumin and HES solution resulted in higher cardiac output, oxygen delivery, and lower blood lactate levels than gelatin and RL; however, the choice of i.v. fluid did not affect outcome.
机译：本研究的目的是调查是否静脉输液液体管理有影响的类型结果在感染性休克的动物模型。这项研究包括28麻醉,创性监测,机械通风女羊(29.5 + / - 4.0公斤)0.5克/公斤的身体粪便进入腹腔引起腹膜炎。和4 h后粪便溢出,只有林格氏在所有的动物乳酸(RL)管理。此后,动物被随机分配接受不断注入RL (n = 7)单独或加上20%的白蛋白(n = 7,体积比率RL 1:10)或6%羟乙基淀粉(HES)RL (n = 7,体积比1:1),或独自明胶(n = 7,没有数量限制)。滴定是保持肺动脉阻塞压力在基线水平这个实验。药物管理和动物监控,直到他们的自然死亡。好他和血流动力学变量白蛋白比与其他液体,如反映较高的中风,心脏指数氧气交付(P < 0.05)。Hydroxyethyl-starch-treated动物也有降低动脉乳酸浓度(P < 0.01)。然而,时代发展低血压和在所有组少尿是相似的。白介素6 (IL)浓度在所有组显著增加。在所有组生存时间是相似的。临床相关模型,长时间的感染性导致休克、白蛋白和他的解决方案更高的心输出量,氧气交付,和更低的血乳酸水平比明胶和RL;然而,并不影响静脉输液液体的选择结果。

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