Department of Nursing, Tzu Chi University, Hualien, Taiwan.
Cytokine. 2012 Oct;60(1):68-75. doi: 10.1016/j.cyto.2012.06.009. Epub 2012 Jun 27.
Hypothermia frequently occurs during fluid resuscitation of trauma victims, especially in patients with a major blood loss. Recent studies have suggested that mild hypothermia may ameliorate hemorrhagic shock (HS) induced splanchnic damage.
The aim of the present study is to compare the status of body temperature and splanchnic injury under different resuscitation speeds for HS in conscious rats.
Experimental study in an animal model of HS. Twenty-four male Wistar-Kyoto rats were used in the study. To mimic HS, 40% of the total blood volume was withdrawn. Fluid resuscitation was given 30 min after blood withdrawal. The rats were randomly divided into three groups; the control group, the 10-min rapid group, and the 12-h slow group.
Levels of blood biochemical parameters, including aspartate transferase (GOT), and alanine transferase (GPT), were measured. Levels of serum tumor necrosis factor α (TNF-α) and interleukin 6 (IL-6) were measured and levels of bronchoalveolar lavage fluid (BALF) TNF-α and nitric oxide (NO) were measured by ELISA. The lung, liver and small intestine were examined for pathological changes 48 h after HS.
Initially slow rate resuscitation with limited-volume significantly decreased body temperature, serum GOT, GPT, TNF-α, and IL-6 levels, levels of TNF-α, and NO in BALF. Moreover, the slow group had lower injury scores in the lung, liver and small intestine than the rapid group after HS. This finding suggests that mild hypothermia induced by a slow fluid resuscitation rate with limited-volume ameliorates HS-induced splanchnic damage in conscious rats.
在创伤患者的液体复苏过程中，尤其是在大量失血的患者中，经常会发生低体温。最近的研究表明，轻度低体温可能会改善出血性休克（HS）引起的内脏损伤。
本研究旨在比较不同复苏速度对清醒大鼠 HS 时体温和内脏损伤的影响。
HS 动物模型的实验研究。本研究使用 24 只雄性 Wistar-Kyoto 大鼠。为了模拟 HS，抽取 40%的总血容量。在抽血后 30 分钟进行液体复苏。大鼠随机分为三组；对照组、10 分钟快速组和 12 小时缓慢组。
测量了血液生化参数（包括天冬氨酸转移酶（GOT）和丙氨酸转移酶（GPT））的水平。通过 ELISA 测量了血清肿瘤坏死因子-α（TNF-α）和白细胞介素 6（IL-6）的水平，并测量了支气管肺泡灌洗液（BALF）TNF-α和一氧化氮（NO）的水平。在 HS 后 48 小时检查了肺、肝和小肠的病理变化。
最初以有限容量的较慢速度复苏会显著降低体温、血清 GOT、GPT、TNF-α 和 IL-6 水平、BALF 中的 TNF-α 和 NO 水平。此外，与快速组相比，缓慢组在 HS 后肺、肝和小肠的损伤评分较低。这一发现表明，通过较慢的液体复苏速度和有限的容量诱导轻度低体温可改善清醒大鼠 HS 引起的内脏损伤。
