School of Medicine, Department of Emergency Medicine, Dokuz Eylul University, Izmir, Turkey.
Am J Emerg Med. 2012 Sep;30(7):1176-82. doi: 10.1016/j.ajem.2011.09.007. Epub 2011 Nov 17.
Animal experiments and clinical studies have shown that vasopressin infusion in cases of uncontrolled hemorrhagic shock is a promising treatment. However, there are only a few studies regarding the application of terlipressin in hemorrhagic cases. This study was designed to evaluate the effects of terlipressin vs controlled fluid resuscitation on hemodynamic variables and abdominal bleeding in a rat model of uncontrolled hemorrhage via liver injury.
A total of 21 average weight 250 ± 30 g Wistar rats were used. A midline celiotomy was performed, and approximately 65% of the median and left lateral lobes were removed with sharp dissection. After creation of the liver injury, rats were randomized into 1 of 3 resuscitation groups, the control group, Lactated Ringer's (LR) group, and terlipressin group, with 7 rats in each group. Blood samples were taken from rats for arterial blood gas analysis. At the end of the experiments, free intraperitoneal blood was collected on preweighed pieces of cotton, and the amount of free blood was determined by the difference in wet and dry weights.
In response to resuscitation, the terlipressin group demonstrated a significant elevation in mean arterial pressure (MAP). Blood loss was greater in the LR group compared with the control group (12.8 ± 1.9 mL vs 8.2 ± 0.7 mL, P < .05). At the end of the experiments, 5 rats in the control group, 5 in the LR group, and 2 in the terlipressin group died. The average survival rates were 28.6%, 28.6%, and 71.4%, respectively.
Compared with the control group, intravenous terlipressin bolus after liver injury contributed to an increase in MAP and survival rates without increasing abdominal bleeding.
动物实验和临床研究表明，在不受控制的失血性休克的情况下，血管加压素输注是一种有前途的治疗方法。然而，关于特利加压素在出血病例中的应用仅有少数研究。本研究旨在评估特利加压素与控制性液体复苏对通过肝损伤导致的不受控制的出血模型中血流动力学变量和腹部出血的影响。
总共使用了 21 只平均体重 250±30 g 的 Wistar 大鼠。进行中线剖腹术，并通过锐性解剖切除大约 65%的中肝叶和左外叶。创建肝损伤后，将大鼠随机分为 3 个复苏组中的 1 个，即对照组、乳酸林格氏液（LR）组和特利加压素组，每组 7 只大鼠。从大鼠中采集血样进行动脉血气分析。在实验结束时，将预称重的棉片上收集自由腹腔血，并通过湿重和干重的差值来确定自由血的量。
在复苏过程中，特利加压素组的平均动脉压（MAP）显著升高。LR 组的失血量明显大于对照组（12.8±1.9 mL 比 8.2±0.7 mL，P<0.05）。在实验结束时，对照组中有 5 只大鼠、LR 组中有 5 只大鼠和特利加压素组中有 2 只大鼠死亡。平均存活率分别为 28.6%、28.6%和 71.4%。
与对照组相比，肝损伤后静脉内给予特利加压素弹丸可增加 MAP 和存活率，而不会增加腹部出血。
