Michell Michael W, Oliveira Hermes M, Kinsky Michael P, Vaid Sumreen U, Herndon David N, Kramer George C
Resuscitation Research Laboratory, Department of Anesthesiology, University of Texas Medical Branch, Galveston, Texas 77555-0801, USA.
J Burn Care Res. 2006 Nov-Dec;27(6):819-25. doi: 10.1097/01.BCR.0000245422.33787.18.
Enteral resuscitation could provide a means to resuscitate burn shock when intravenous (IV) therapy is unavailable, such as in mass disasters. We evaluated the extent of intestinal absorption and resuscitative effects of World Health Organization Oral Rehydration Solution after a 40% TBSA burn in anesthetized swine compared with the IV infusion of lactated Ringer's infused by Parkland formula. Plasma volume (PV) was measured using indocyanine green dye dilution. Intestinal absorption was assessed using phenol red as a nonabsorbable marker. Changes in hematocrit, hemodynamics, and measured PV showed equivalent resuscitative effects of enteral and IV resuscitation. The duodenal fluid absorption rate started at 77 +/- 32 ml/hr per meter of intestine during the first hour and increased to 296 +/- 40 ml/hr during the fourth hour of resuscitation, with a total of 93 +/- 2% of World Health Organization Oral Rehydration Solution infused into the intestine being absorbed. Intestinal absorption rates after burn injury are sufficient to resuscitate a 40% TBSA burn.
当无法进行静脉输液治疗时，如在大规模灾难中，肠内复苏可为烧伤休克的复苏提供一种手段。我们评估了在麻醉猪身上40%体表面积烧伤后，与按照帕克兰公式静脉输注乳酸林格氏液相比，世界卫生组织口服补液盐的肠道吸收程度和复苏效果。使用吲哚菁绿染料稀释法测量血浆容量（PV）。使用酚红作为不可吸收标记物评估肠道吸收情况。血细胞比容、血流动力学和测量的PV变化显示肠内复苏和静脉复苏具有同等的复苏效果。复苏第1小时，十二指肠液体吸收速率开始为每米肠77±32毫升/小时，在复苏第4小时增加至296±40毫升/小时，注入肠道的世界卫生组织口服补液盐总量的93±2%被吸收。烧伤后肠道吸收速率足以复苏40%体表面积烧伤。
