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缺血及缺血再灌注对细菌移位、脂质过氧化和肠道组织学的影响:猪失血性休克的研究

The effects of ischemia and ischemia-reperfusion on bacterial translocation, lipid peroxidation, and gut histology: studies on hemorrhagic shock in pigs.

作者信息

Morales J, Kibsey P, Thomas P D, Poznansky M J, Hamilton S M

机构信息

Department of Surgery, University of Alberta, Edmonton, Canada.

出版信息

J Trauma. 1992 Aug;33(2):221-6; discussion 226-7. doi: 10.1097/00005373-199208000-00010.

Abstract

The bacterial translocation hypothesis was tested in two studies (acute and subacute) in a porcine model of hemorrhagic shock. Male pigs (30-40 kg each) under general anesthesia had their femoral vein, femoral artery, and portal vein catheterized. After stabilization (1 hour) they were bled (40% of blood volume) over 30 minutes, then maintained in the hypotensive state (MAP = 30-40 mm Hg) for 2 hours, following which, according to randomization, they entered the control group or were resuscitated with whole blood (WB group) or with lactated Ringer's solution (LR group). In the acute study, the mesenteric efferent lymphatic was also cannulated, the control group was not resuscitated, and the animals remained under general anesthesia to the end of the experiment (8.5 hours), when gut tissue was obtained for histologic study and measurement of lipid peroxidation. In the subacute study, the control group was not bled, the animals were awakened at 6.5 hours, and the portal vein catheter remained in situ until 48 hours. In both studies, samples of portal blood were obtained for culture at regular intervals and on completion, samples from mesenteric lymph nodes (MLNs) for culture were taken in the acute study, and in the subacute study samples from MLNs, spleen, and liver were obtained. In the acute study significant bacterial translocation to the MLNs and portal blood did not occur among the controls (n = 3), the LR group (n = 5), and the WB group (n = 6). Significant evidence of lipid peroxidation was found in both the LR and WB groups. Histologic assessment showed no difference among the groups.(ABSTRACT TRUNCATED AT 250 WORDS)

摘要

在一项针对失血性休克猪模型的两项研究(急性和亚急性)中,对细菌移位假说进行了验证。雄性猪(每头30 - 40千克)在全身麻醉下,将股静脉、股动脉和门静脉进行插管。稳定1小时后,在30分钟内放血(放血量为血容量的40%),然后维持低血压状态(平均动脉压 = 30 - 40毫米汞柱)2小时,之后根据随机分组,它们进入对照组,或接受全血复苏(全血组)或乳酸林格氏液复苏(乳酸林格氏液组)。在急性研究中,还对肠系膜传出淋巴管进行插管,对照组不进行复苏,动物一直处于全身麻醉状态直至实验结束(8.5小时),此时获取肠道组织用于组织学研究和脂质过氧化测量。在亚急性研究中,对照组不放血,动物在6.5小时时苏醒,门静脉导管保留原位直至48小时。在两项研究中,定期采集门静脉血样本进行培养,实验结束时,急性研究中采集肠系膜淋巴结样本进行培养,亚急性研究中采集肠系膜淋巴结、脾脏和肝脏样本。在急性研究中,对照组(n = 3)、乳酸林格氏液组(n = 5)和全血组(n = 6)均未出现向肠系膜淋巴结和门静脉血的显著细菌移位。在乳酸林格氏液组和全血组中均发现了脂质过氧化的显著证据。组织学评估显示各组之间无差异。(摘要截断于250字)

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