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高氧液复苏对高原失血性休克大鼠的复苏效果及抗休克机制。

Resuscitative effect of hyperoxia fluid on high-altitude hemorrhagic shock in rats and antishock mechanisms.

机构信息

Department of High Altitude Diseases, College of High Altitude Military Medicine, 3rd Military Medical University, Chongqing 400038, China.

出版信息

Cell Biochem Biophys. 2012 Mar;62(2):343-52. doi: 10.1007/s12013-011-9316-z.

Abstract

Pathophysiological characteristics of hemorrhagic shock at high altitude are different from that at plain which involve severe injury, high mortality, difficult treatment and compromised liquid tolerance. High-altitude pulmonary/cerebral edema and multiple-organ dysfunction render the conventional treatment ineffective. Herein, we evaluated the resuscitation effects of hyperoxia solution on high-altitude hemorrhagic shock in rats. For this purpose, a rat model of high-altitude (3,658 m) hemorrhagic shock was established on the plateau and hyperoxia solution (4 ml/kg) was infused through external jugular vein for resuscitation at 60 min post-hemorrhage. Blood pressure, blood gas, left and right ventricular pressure, lung and brain water content, survival time, survival rate at 2 h, levels of inflammatory cytokines and free oxygen radicals in blood and tissue were determined. After resuscitation with hyperoxia solution, blood pressure, arterial oxygen partial pressure, left and right ventricular systolic pressure, ±dp/dt max, survival time and rate were significantly increased. Lung and brain water content were unchanged, malondialdehyde activity in lung, brain and plasma and levels of TNF-α, IL-1, IL-6, and endothelin were significantly decreased. Besides, CGRP was elevated with reduced injury and improved lung and kidney functions. Concludingly, resuscitation with hyperoxia solution is feasible and more effective than other classical liquids, making it the first choice of treatment for high-altitude hemorrhagic shock.

摘要

高原环境下失血性休克的病理生理学特征与平原地区不同,高原环境下失血性休克往往伴随着严重的损伤、高死亡率、治疗困难和液体耐受性差等问题。高原肺水肿/脑水种和多器官功能障碍使得传统的治疗方法无效。在此,我们评估了高氧液对高原失血性休克大鼠的复苏效果。为此,在高原(3658 米)建立了失血性休克大鼠模型,并在出血后 60 分钟通过颈外静脉输注高氧液(4ml/kg)进行复苏。测定血压、血气、左、右心室压力、肺和脑含水量、生存时间、2 小时存活率、血液和组织中炎症细胞因子和游离氧自由基水平。高氧液复苏后,血压、动脉氧分压、左、右心室收缩压、±dp/dt max、生存时间和存活率明显升高。肺和脑含水量无变化,肺、脑和血浆中 MDA 活性以及 TNF-α、IL-1、IL-6 和内皮素水平明显降低。此外,CGRP 升高,损伤减轻,肺、肾功能改善。总之,高氧液复苏是可行的,比其他经典液体更有效,是高原失血性休克治疗的首选。

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