Inoue S, Lukes S, Alexander J W, Trocki O, Silberstein E B
Shriners Burns Institute, Cincinnati, Ohio 45219.
J Burn Care Rehabil. 1989 Jul-Aug;10(4):300-8. doi: 10.1097/00004630-198907000-00003.
The hemodynamic responses to early enteral feeding were assessed with fluid-resuscitated, 30% total body surface area-burned guinea pigs fed by means of tube gastrostomies. Regional blood flow and cardiac output were determined by a reference sample method, injecting 15 microns radiolabeled microspheres. During the initial 24 hours after burn injury, animals were given the same volume by continuous infusion of either lactated Ringer's solution (LR group) or a liquid diet (20% protein, 12% lipid, and 68% carbohydrate; 175 kcal/kg/24 hr) (diet group). Although cardiac outputs in the LR and diet groups were not different from each other at 24 hours and no less than that in unburned control animals, the diet group showed higher blood flow to the jejunum (+55.7%) and cecum (+98.7%) than did the LR group. Burn injury caused little change of blood flow to tissues other than the intestine. In addition, early feeding after burn injury suppressed excessive cortisol response to burn shock. The increase in gut blood flow associated with enteral feeding could have an impact on mucosal barrier function.
通过对经液体复苏、全身30%体表面积烧伤的豚鼠进行胃造瘘管饲,评估早期肠内喂养的血流动力学反应。采用参考样本法,通过注射15微米放射性标记微球来测定局部血流量和心输出量。在烧伤后的最初24小时内,通过持续输注乳酸林格氏液(LR组)或流质饮食(20%蛋白质、12%脂质和68%碳水化合物;175千卡/千克/24小时)(饮食组)给予动物相同体积的液体。尽管LR组和饮食组在24小时时的心输出量彼此无差异且不少于未烧伤对照动物的心输出量,但饮食组空肠血流量(增加55.7%)和盲肠血流量(增加98.7%)高于LR组。烧伤对肠道以外组织的血流量影响不大。此外,烧伤后早期喂养可抑制烧伤休克引起的皮质醇过度反应。肠内喂养引起的肠道血流量增加可能会对黏膜屏障功能产生影响。