Velasco I T, Rocha e Silva M, Oliveira M A, Oliveira M A, Silva R I
Research Division, Faculdade de Medicina, Universidade de São Paulo, Brazil.
Crit Care Med. 1989 Mar;17(3):261-4. doi: 10.1097/00003246-198903000-00012.
Single bolus injections of hypertonic (7.5%) NaCl (H), hyperoncotic (6%) dextran-70 (D), or of their combination (HD) were given to severely bled (54.2 +/- 1.3 ml/kg) anesthetized dogs. Two shock procedures (30 or 60 min at 35 mm Hg) were tested. Survival was highest (11/12) after HD, lower (9/12) after H, and lowest (7/12) after D; it was higher (15/18 vs. 12/18) after the shorter vs. longer shock procedure. Cardiac index (CI) was restored to 83%-104% of prehemorrhage levels immediately after HD or H; 3 h later it was down to 67%-71% of control; after D, CI was stable at 41% to 50% of control; no differences in the relative performances of the agents tested in the 30 or 60-min shock durations. Arterial pressure recovered to near control levels in all groups; consequently, systemic vascular resistance was reduced after H and HD, but increased after D. Plasma volume recovered to 95% of control after H, 105% of control after HD, but only to 80% after D; however, the response to H was transient. Metabolic acidosis was partially reverted by all solutions. Plasma Na+ was transiently raised by H and HD. Overall differences detected between H vs. HD tend to favor HD as a resuscitative solution.
对严重失血（54.2±1.3毫升/千克）的麻醉犬单次推注高渗（7.5%）氯化钠（H）、高渗胶体（6%）右旋糖酐-70（D）或它们的组合（HD）。测试了两种休克程序（在35毫米汞柱下持续30或60分钟）。HD治疗后的存活率最高（12只中有11只存活），H治疗后较低（12只中有9只存活），D治疗后最低（12只中有7只存活）；较短休克程序后的存活率高于较长休克程序（18只中有15只存活对18只中有12只存活）。HD或H注射后，心脏指数（CI）立即恢复到出血前水平的83%-104%；3小时后降至对照值的67%-71%；D注射后，CI稳定在对照值的41%至50%；在30分钟或60分钟休克持续时间内，所测试药物的相对性能没有差异。所有组的动脉压均恢复到接近对照水平；因此，H和HD治疗后全身血管阻力降低，而D治疗后全身血管阻力增加。H治疗后血浆容量恢复到对照值的95%，HD治疗后恢复到对照值的105%，但D治疗后仅恢复到对照值的80%；然而，对H的反应是短暂的。所有溶液都部分纠正了代谢性酸中毒。H和HD使血浆Na+短暂升高。H与HD之间检测到的总体差异倾向于支持HD作为复苏溶液。
