Flynn W J, Cryer H G, Garrison R N
Department of Surgery, University of Louisville 40292.
Surgery. 1991 Aug;110(2):350-6.
We studied the intestinal microvascular blood flow responses to hemorrhage and resuscitation with pentoxifylline by in vivo video microscopy. Male Sprague-Dawley rats were hemorrhaged to 50% of baseline mean arterial pressure for 45 minutes and then blindly randomized to receive pentoxifylline (25 mg/kg bolus + 0.2 mg/kg/minute) or an equivalent volume of saline plus return of shed blood and an additional bled volume of Ringer's lactate solution. Hemorrhage caused intestinal microvascular blood flow to decrease to 10% to 15% of baseline values. In the control group, resuscitation restored cardiac output and mean arterial pressure to baseline values, but intestinal microvascular blood flow remained at 30% of baseline values. In contrast, addition of pentoxifylline to the resuscitation regimen resulted in an immediate hyperemic response with an increase in intestinal microvascular blood flow to significantly greater than baseline values followed by return to baseline. Arteriolar dilation was not responsible for the improvement in flow implicating improved flow dynamics between erythrocytes, granulocytes, and vascular endothelia within the microcirculation. We conclude that addition of pentoxifylline to resuscitation from hemorrhagic shock restores intestinal microvascular blood flow.
我们通过体内视频显微镜研究了出血及用己酮可可碱复苏时肠道微血管血流反应。将雄性Sprague-Dawley大鼠出血至基线平均动脉压的50%并持续45分钟，然后随机分为两组，一组接受己酮可可碱（25mg/kg推注 + 0.2mg/kg/分钟），另一组接受等量生理盐水加回输 shed blood 及额外失血体积的乳酸林格液。出血导致肠道微血管血流降至基线值的10%至15%。对照组中，复苏使心输出量和平均动脉压恢复至基线值，但肠道微血管血流仍维持在基线值的30%。相比之下，在复苏方案中加入己酮可可碱会引发即刻充血反应，肠道微血管血流增加至显著高于基线值，随后恢复至基线。小动脉扩张并非血流改善的原因，提示微循环中红细胞、粒细胞和血管内皮之间的血流动力学得到改善。我们得出结论，在失血性休克复苏中加入己酮可可碱可恢复肠道微血管血流。
