Zhao Jingxiang, You Guoxing, Wang Bo, Sun Zhenwei, Wang Zhen, Xia Sha, Zhao Lian, Zhou Hong
Beijing Institute of Transfusion Medicine, Beijing Key Laboratory of Blood Safety and Supply Technologies, Beijing, P. R. China.
Shock. 2017 Aug;48(2):196-200. doi: 10.1097/SHK.0000000000000827.
To compare the efficacy of hypotensive resuscitation with hypertonic saline dextran 70 (HSD) and lactated Ringer (LR) solutions in a rat model of hemorrhagic shock at a simulated altitude of 4,000 m.
Anesthetized rats were bled to maintain their mean arterial pressure (MAP) at 45 mm Hg for 1 h. The distal quarter of the tail was then amputated to allow free blood loss; rats were simultaneously resuscitated with 4 mL kg HSD (HSD group, n = 10) or 4 mL kg LR (LR group, n = 10), followed by hypotensive resuscitation with LR to maintain MAP at 55 to 60 mm Hg for 1 h. A control group received no resuscitation (n = 10). Afterward, the cut end of the tail was ligated. The MAP, acid-base balance, blood loss, volume of fluid infused, and survival were recorded.
Compared with controls, HSD resuscitation improved MAP (without increasing uncontrolled blood loss), increased arterial pH and oxygen saturation (SaO2), decreased arterial lactate concentration at the end of resuscitation, and resulted in higher survival rate (P < 0.05). Hypotensive resuscitation with LR also maintained higher MAP, pH, and SaO2 than the control group, but was associated with increased blood loss and inferior survival (P > 0.05).
For hemorrhagic shock at simulated high altitude, resuscitation of rats with a bolus of HSD was associated with reduced blood loss and serum lactate concentration, and superior SaO2, hemoglobin concentration and survival rate, compared with LR solution.
在海拔4000米的模拟环境下，比较高渗盐水右旋糖酐70（HSD）和乳酸林格氏液（LR）用于大鼠失血性休克模型的降压复苏效果。
将麻醉后的大鼠放血，使平均动脉压（MAP）维持在45 mmHg 1小时。然后截断鼠尾远端四分之一，任其自由失血；同时分别用4 mL/kg HSD（HSD组，n = 10）或4 mL/kg LR（LR组，n = 10）对大鼠进行复苏，随后用LR进行降压复苏，使MAP维持在55至60 mmHg 1小时。对照组不进行复苏（n = 10）。之后，结扎鼠尾断端。记录MAP、酸碱平衡、失血量、输液量和存活率。
与对照组相比，HSD复苏可提高MAP（且不增加失控性失血），提高动脉pH值和氧饱和度（SaO2），降低复苏结束时的动脉乳酸浓度，并提高存活率（P < 0.05）。LR降压复苏也使MAP、pH值和SaO2高于对照组，但与失血量增加和存活率较低有关（P > 0.05）。
对于模拟高海拔环境下的失血性休克，与LR溶液相比，用大剂量HSD对大鼠进行复苏可减少失血量和血清乳酸浓度，提高SaO2、血红蛋白浓度和存活率。
