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在通过控制性出血诱导出血性休克的犬中,自体输血结果与乳酸林格液输注的比较。

Blood autotransfusion outcomes compared with Ringer lactate infusion in dogs with hemorrhagic shock induced by controlled bleeding.

作者信息

Safaei Mansour, Takami Hassan Mousavi

机构信息

Associate Professor, Department of General Surgery, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran.

出版信息

J Res Med Sci. 2011 Oct;16(10):1332-9.

Abstract

BACKGROUND

The most common cause of shock in the surgical or trauma patient is hemorrhage. Crystalloid solutions and blood transfusion are the mainstays of treatment of hemorrhagic shock. Considering the disadvantages of allogeneic blood transfusion, such as risk of transmission of infectious diseases, and access and maintenance limitations, treatment of shock with autologous blood seems to be a decent solution. Autologous blood accumulated in body cavities in traumatic bleeding (such hemothorax), and bloodshed in operation field during open heart or vascular surgeries, and similar situations, can be utilized again. In this study, autotransfusion effects compared with crystalloid fluid in the treatment of hemorrhagic shock was investigated.

METHODS

After induction of hemorrhagic shock in dogs by Wiggers type controlled bleeding, treating them in a group with autologous blood and another group with Ringer lactate were performed, and the results of treatment were studied.

RESULTS

There was no mortality in both treatment approaches. Immediately after treatment, crystalloid positive effects such as renormalized vital signs and appropriate consciousness were more noticeable than autotransfusion, while twenty-four hours after, the desired effects of autologous blood were more pronounced like decreased metabolic acidosis and improvement of diuresis.

CONCLUSIONS

Crystalloid during the first hours after treatment of hemorrhagic shock may be better than autologous blood as preferred treatment, while autotransfusion showed its benefits some hours after. This finding can be used to develop better strategies for treatment of hemorrhagic shock.

摘要

背景

外科手术或创伤患者休克最常见的原因是出血。晶体溶液和输血是失血性休克治疗的主要手段。考虑到异体输血的缺点,如传染病传播风险以及获取和维持的局限性,自体血治疗休克似乎是一个不错的解决方案。外伤性出血(如血胸)时积聚在体腔中的自体血、心脏直视手术或血管手术期间手术野中的失血以及类似情况,都可以再次利用。在本研究中,研究了自体输血与晶体液在治疗失血性休克中的效果比较。

方法

通过维格斯型控制性出血诱导犬失血性休克后,一组用自体血治疗,另一组用乳酸林格液治疗,并研究治疗结果。

结果

两种治疗方法均无死亡。治疗后即刻,晶体液的积极效果如生命体征恢复正常和意识适宜比自体输血更明显,而24小时后,自体血的预期效果更显著,如代谢性酸中毒减轻和利尿改善。

结论

失血性休克治疗后的最初几个小时,晶体液作为首选治疗可能比自体血更好,而自体输血在数小时后显示出其益处。这一发现可用于制定更好的失血性休克治疗策略。

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本文引用的文献

6
Initial resuscitation of hemorrhagic shock.失血性休克的初步复苏。
World J Emerg Surg. 2006 Apr 27;1:14. doi: 10.1186/1749-7922-1-14.

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