Bark Björn P, Grände Per-Olof
Department of Anaesthesia and Intensive Care, Lund University and Lund University Hospital, SE-221 85, Lund, Sweden,
Intensive Care Med Exp. 2014 Dec;2(1):11. doi: 10.1186/2197-425X-2-11. Epub 2014 Mar 6.
Previous experimental studies have shown that vitamin C has several beneficial effects in sepsis and burns, such as decreased tissue oedema, improved endothelial barrier function and decreased transcapillary leakage of plasma markers. It has still not been investigated, though, if vitamin C has any impact specifically on plasma volume. The present study aims at testing the hypothesis that vitamin C decreases plasma volume loss in sepsis.
Anaesthetized male adult Sprague-Dawley rats were used in this prospective randomized study. All experiments were carried out at a university hospital laboratory. Sepsis was induced by caecal ligation and incision. After 3 h, vitamin C was given either as a bolus dose (66 mg/kg) followed by a continuous infusion (33 mg/kg/h) (n = 9), or as a single bolus dose (200 mg/kg) (n = 9). A sham group (n = 9) underwent the same surgical procedure, but no vitamin C was given. Plasma volume was measured ((125)I-dilution technique) at baseline, at 3 h after end of initiation of sepsis and at the end of the experiment 3 h later. Arterial blood samples for analyses of electrolytes, blood gases, haematocrit and lactate were taken at the same time points.
There were no significant differences in plasma volumes or the physiological parameters analysed between any of the three groups at any time point. There was a significantly larger urine production in the single bolus dose group (200 mg/kg) compared to the sham group.
Vitamin C treatment did not decrease the loss of plasma volume in the septic rat. The diuretic effect of vitamin C was in accordance with previous studies.
先前的实验研究表明,维生素C在脓毒症和烧伤中有多种有益作用,如减轻组织水肿、改善内皮屏障功能以及减少血浆标志物的跨毛细血管渗漏。然而,维生素C是否对血浆容量有特定影响仍未得到研究。本研究旨在验证维生素C可减少脓毒症时血浆容量丢失这一假设。
本前瞻性随机研究使用了麻醉的成年雄性Sprague-Dawley大鼠。所有实验均在大学医院实验室进行。通过盲肠结扎和切开诱导脓毒症。3小时后,一组给予大剂量推注(66毫克/千克),随后持续输注(33毫克/千克/小时)(n = 9),另一组给予单次大剂量推注(200毫克/千克)(n = 9)。假手术组(n = 9)接受相同的手术操作,但不给予维生素C。在基线、脓毒症诱导开始后3小时以及3小时后的实验结束时,使用(125)I稀释技术测量血浆容量。在相同时间点采集动脉血样本分析电解质、血气、血细胞比容和乳酸。
在任何时间点,三组之间的血浆容量或所分析的生理参数均无显著差异。与假手术组相比,单次大剂量推注组(200毫克/千克)的尿量明显更多。
维生素C治疗并未减少脓毒症大鼠的血浆容量丢失。维生素C的利尿作用与先前的研究一致。