Tokyay R, Zeigler S T, Kramer G C, Rogers C S, Heggers J P, Traber D L, Herndon D N
Department of Surgery, University of Texas Medical Branch, Galveston.
J Trauma. 1992 Jun;32(6):704-12; discussion 712-3. doi: 10.1097/00005373-199206000-00006.
We compared the effects of lactated Ringer's (LR) and hypertonic saline dextran (HSD) on postburn cardiovascular function, O2 consumption, lipid peroxidation, and bacterial translocation. Miniature pigs with 40% total body surface area (TBSA), third-degree burns received, 30 minutes postburn, either Parkland resuscitation (LR group, n = 8) or HSD, 10 mL/kg/30 minutes, followed by LR, 4 mL/kg/%burn over the next 23 hours (HSD group, n = 8). The HSD prevented the early decrease in cardiac index (CI); the early increase in the resistance of the systemic, mesenteric, celiac, and renal vascular beds; and the decrease in mesenteric O2 consumption seen after burns when LR alone is used for resuscitation. The HSD also moderated the systemic and mesenteric lipid peroxidation. Bacterial translocation was less in the HSD group (3 of 8 animals) compared with the LR group (5 of 8 animals), but was not statistically different. Hypertonic saline dextran may be beneficial in improving the postburn microcirculation and attenuating postburn oxidant-induced lipid peroxidation in the systemic tissues and the gut.
我们比较了乳酸林格氏液（LR）和高渗盐右旋糖酐（HSD）对烧伤后心血管功能、氧消耗、脂质过氧化和细菌移位的影响。对全身表面积（TBSA）达40%的Ⅲ度烧伤小型猪，于烧伤后30分钟给予帕克兰复苏方案（LR组，n = 8），或给予HSD 10 mL/kg/30分钟，随后在接下来的23小时内给予LR 4 mL/kg/%烧伤面积（HSD组，n = 8）。HSD可防止心脏指数（CI）早期下降；防止全身、肠系膜、腹腔和肾血管床阻力早期增加；以及防止单独使用LR进行复苏时烧伤后出现的肠系膜氧消耗减少。HSD还减轻了全身和肠系膜脂质过氧化。与LR组（8只动物中有5只）相比，HSD组细菌移位较少（8只动物中有3只），但差异无统计学意义。高渗盐右旋糖酐可能有助于改善烧伤后的微循环，并减轻全身组织和肠道中烧伤后氧化剂诱导的脂质过氧化。
