Wang Ying, Feng Jianhua, You Guoxing, Kan Xuemei, Qiu Longxiang, Chen Gan, Gao Dawei, Guo Wei, Zhao Lian, Zhou Hong
Institute of Transfusion Medicine, Academy of Military Medical Sciences, Beijing, China.
J Trauma. 2011 Dec;71(6):1915-9. doi: 10.1097/TA.0b013e31823bbfe3.
Hypothermia is common during hemorrhagic shock. To warm the victims or not has been controversial. This study aims to investigate the effect of warming during the initial time of hemorrhage on body temperature, blood pressure, and survival in rat hemorrhagic shock models.
Forty anesthetized rats were divided into control group (n = 20) and warming group (n = 20). The rats of control group were placed on a wooden pad without heating, and the rats of warming group were placed on a heating pad maintained at 37°C ± 0.1°C. Blood withdrawal reached 40% of the total blood volume within 60 minutes. Numbers of survival rats, rectal temperature, and mean arterial pressure (MAP) were recorded when blood loss reached 0 (T0), 20% (T20), 30% (T30), and 40% (T40) of the total blood volume, respectively.
Rectal temperature and MAP decrease gradually in both groups during hemorrhage. Warming continuously makes the rectal temperature of the warming group (36.68°C ± 0.63°C) slightly higher than that of the control group (36.17°C ± 0.69°C) at T0. The rectal temperature and MAP of the warming group are higher than that of the control group at T20, T30, and T40 (p < 0.05). Survival rates of the warming group are higher than that of the control group (p < 0.01).
Warming during hemorrhage may prevent exacerbation of hypothermia and hypotension and therefore improve survival.
低温在失血性休克期间很常见。是否对患者进行升温一直存在争议。本研究旨在探讨在出血初始阶段进行升温对大鼠失血性休克模型的体温、血压和存活率的影响。
将40只麻醉大鼠分为对照组（n = 20）和升温组（n = 20）。对照组大鼠置于未加热的木板上，升温组大鼠置于温度维持在37°C ± 0.1°C的加热垫上。在60分钟内采血至总血量的40%。分别在失血达到总血量的0（T0）、20%（T20）、30%（T30）和40%（T40）时记录存活大鼠数量、直肠温度和平均动脉压（MAP）。
两组在出血期间直肠温度和MAP均逐渐下降。持续升温使升温组在T0时的直肠温度（36.68°C ± 0.63°C）略高于对照组（36.17°C ± 0.69°C）。升温组在T20、T30和T40时的直肠温度和MAP均高于对照组（p < 0.05）。升温组的存活率高于对照组（p < 0.01）。
出血期间升温可能预防体温过低和低血压的加重，从而提高存活率。
