Poole G V, Johnson J C, Prough D S, Stump D A, Stullken E H
Crit Care Med. 1986 Jul;14(7):629-33. doi: 10.1097/00003246-198607000-00009.
Cerebral blood flow (CBF), cerebral oxygen delivery, and intracranial pressure were measured in 12 dogs subjected to hemorrhagic shock and then resuscitated with lactated Ringer's solution or 6% hetastarch. Hemorrhagic shock was produced by the rapid removal of blood to achieve a mean arterial pressure (MAP) of 40 mm Hg with BP maintained at that level for 30 min. Six animals were resuscitated with lactated Ringer's solution, 60 ml/kg iv, and six with 6% hetastarch, 20 ml/kg iv. Both solutions effectively restored systemic hemodynamic stability, increasing cardiac output and MAP. Intracranial pressure was significantly (p less than .05) lower after resuscitation in the hetastarch group, but CBF, which had decreased during shock, was not normalized by either fluid, and cerebral oxygen transport fell further with resuscitation secondary to a hemodilutional reduction of hemoglobin. Although 6% hetastarch may improve systemic hemodynamics and maintain a low intracranial pressure during resuscitation, it fails, as does lactated Ringer's solution, to restore cerebral oxygen transport to prehemorrhagic shock levels.
对12只遭受失血性休克后用乳酸林格氏液或6%羟乙基淀粉复苏的犬，测量其脑血流量（CBF）、脑氧输送量及颅内压。通过快速放血使平均动脉压（MAP）达到40 mmHg并维持30分钟来制造失血性休克。6只动物用60 ml/kg静脉注射乳酸林格氏液复苏，6只动物用20 ml/kg静脉注射6%羟乙基淀粉复苏。两种溶液均有效恢复了全身血流动力学稳定性，增加了心输出量和MAP。羟乙基淀粉组复苏后颅内压显著降低（p<0.05），但休克期间降低的CBF未被任何一种液体恢复至正常，且复苏后由于血红蛋白的血液稀释性降低，脑氧输送进一步下降。尽管6%羟乙基淀粉在复苏期间可能改善全身血流动力学并维持低颅内压，但它与乳酸林格氏液一样，未能将脑氧输送恢复至出血性休克前的水平。
