Wang D, Zhu S, Liu S
Department of Burns, First Municipal People's Hospital, Lianyungang 222002, Jiang Su Province, P. R. China.
Zhonghua Shao Shang Za Zhi. 2001 Oct;17(5):269-71.
To explore the effects of delayed resuscitation on burn shock with ringer's solution.
Twelve mongrel dogs were randomly divided into control (S, n = 6) and treatment (LR, n = 6) groups. The dogs in LR group were inflicted by 35% TBSA III degree burn and were resuscitated with Lactate Ringer's solution. Urine output in amount of 1 ml.kg-1.h-1, and cardiac output at level of 70% approximately 80% of pre-burn level were referred for the modulation of the speed and amount of fluid infusion. The postburn changes of volumetric load, mean arterial pressure (MAP), LVSP +/- dp/dtmax, CI, DO2 and VO2 during the first 24 hours of resuscitation were observed.
The infusion amount of LR solution was 8.87 +/- 1.02 ml/kg per 1% TBSA during the first 24 hours of resuscitation, which was 1.2 times more than that with Parkland formula. Furthermore, the infusion fluid amount within the first 4 hours of resuscitation was (3.63 +/- 0.99) ml.kg(-1).1% TBSA-1, which was 41% of total amount within the first 24 hours. MAP, LVSP, +/- dp/dtmax, CI, DO2 and VO2 reached or approached the levels in S group within 2 hours of resuscitation.
The infusion amount of Lactate Ringer's solution needed in delayed resuscitation was larger than that in early resuscitation. And the indices of hemodynamics and myocardial mechanics were improved obviously within 2 hours of resuscitation.
探讨延迟复苏对烧伤休克林格液复苏效果的影响。
将12只杂种犬随机分为对照组(S组,n = 6)和治疗组(乳酸林格液组,LR组,n = 6)。LR组犬给予35%总体表面积Ⅲ度烧伤,并采用乳酸林格液进行复苏。以尿量1 ml·kg-1·h-1及心输出量达到烧伤前水平的70%~80%作为调节输液速度和输液量的指标。观察复苏后24小时内容量负荷、平均动脉压(MAP)、左室收缩压±dp/dtmax、心脏指数(CI)、氧输送(DO2)及氧耗(VO2)的变化。
复苏后24小时内LR液输入量为每1%总体表面积8.87±1.02 ml/kg,比Parkland公式计算量多1.2倍。复苏开始4小时内输入量为(3.63±0.99)ml·kg-1·1%总体表面积-1,占24小时总量的41%。复苏后2小时内MAP, LVSP,±dp/dtmax, CI, DO2及VO2达到或接近S组水平。
延迟复苏所需乳酸林格液输入量大于早期复苏,且复苏后2小时内血流动力学及心肌力学指标明显改善。