Meng Xiangxi, Li Juan, Bai Xiaodong, Hu Sen, Zhou Fangqiang
Laboratory of Shock and Organ Dysfunction, Burns Institute, the First Hospital Affiliated to the People's Liberation Army General Hospital, Beijing 100048, China.
Email:
Zhonghua Wai Ke Za Zhi. 2014 Jun;52(6):450-4.
To study the effect of oral fluid resuscitation with pyruvate sodium-glucose-electrolyte solution (PGES) on hemodynamics, organ functions and mortalities during shock stage in dogs with burn.
In comparison of oral pyruvate sodium-glucose-electrolyte solution (PGES) with NaHCO₃-glucose-electrolyte solution (HGES), beagle dogs with intubation of the carotid artery, jugular vein and jejunum for 24 hours were subjected to a 50% total body surface area (TBSA) burn, and were divided into three groups: pure burn without fluid resuscitation (NR, n = 8), and two oral fluid resuscitation (each n = 10), in which dogs were given with Pry-GES (OP) or NaHCO₃-GES (OH) according to Parkland formula. The hemodynamic and organ functions were measured serially before burn and 2, 6, 8, 12 and 24 hours after burn at no anaesthesia state A. Twenty-four hours mortality rate following burn was also recorded.
Two hours after burn, the mean arterial pressure of NR, OH and OP group was (45 ± 8), (57 ± 8) and (80 ± 9) mmHg (1 mmHg = 0.133 kPa) respectively, which were significantly reduced (t = 16.967, 14.595 and 10.100, all P < 0.05) compared with those before injury ((42 ± 6), (144 ± 6) and (142 ± 6) mmHg respectively), the change of cardiac output, dp/dtmax of left ventricular contractility and intestinal mucosal blood flow had the same trend as the mean arterial pressure. The systemic vascular resistance and organ parameters (Cr, CK-MB, ALT and DAO) in all groups increased obviously (t = -46.894--2.465, all P < 0.05). All measurements of NR group kept worsening, and all died within 24 hours after burn; while those of two oral resuscitation groups had improved gradually (F = 0.001-1.600, all P < 0.05), OP group was significantly superior to OH group (F = 0.013-0.466, P < 0.05). At 24 hours after burn, 6 (6/10) survived in OP group, 4 (4/10) in OH group and 0 (0/8) in NR group.
The Pyr-GES may be superior to the standard NaHCO₃-GES in the improvement of hemodynamics and organ functions during oral resuscitation in dogs with 50%TBSA full thickness burn.
研究口服丙酮酸钠 - 葡萄糖 - 电解质溶液（PGES）进行液体复苏对烧伤犬休克期血流动力学、器官功能及死亡率的影响。
将经颈动脉、颈静脉和空肠插管24小时的比格犬，50%总体表面积（TBSA）烧伤后，比较口服丙酮酸钠 - 葡萄糖 - 电解质溶液（PGES）与碳酸氢钠 - 葡萄糖 - 电解质溶液（HGES），分为三组：单纯烧伤未进行液体复苏（NR，n = 8），以及两个口服液体复苏组（每组n = 10），其中犬按Parkland公式给予Pry - GES（OP）或NaHCO₃ - GES（OH）。在未麻醉状态下，于烧伤前及烧伤后2、6、8、12和24小时连续测量血流动力学和器官功能。记录烧伤后24小时死亡率。
烧伤后2小时，NR组、OH组和OP组平均动脉压分别为（45 ± 8）、（57 ± 8）和（80 ± 9）mmHg（1 mmHg = 0.133 kPa），与伤前（分别为（42 ± 6）、（144 ± 6）和（142 ± 6）mmHg）相比显著降低（t = 16.967、14.595和10.100，均P < 0.05），心输出量、左心室收缩力dp/dtmax及肠黏膜血流量变化趋势与平均动脉压相同。所有组全身血管阻力及器官参数（Cr、CK - MB、ALT和DAO）明显升高（t = -46.894至 -2.465，均P < 0.05）。NR组各项指标持续恶化，烧伤后24小时内全部死亡；而两个口服复苏组指标逐渐改善（F = 0.001至1.600，均P < 0.05），OP组明显优于OH组（F = 0.013至0.466，P < 0.05）。烧伤后24小时，OP组存活6只（6/10），OH组存活4只（4/10），NR组存活0只（0/8）。
对于50%TBSA全层烧伤犬，口服复苏时Pyr - GES在改善血流动力学和器官功能方面可能优于标准的NaHCO₃ - GES。
