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急性乙醇中毒在绵羊腹膜炎模型中的作用

Effects of acute ethanol intoxication in an ovine peritonitis model.

作者信息

Hosokawa Koji, Su Fuhong, Taccone Fabio Silvio, Post Emiel Hendrik, Creteur Jacques, Vincent Jean-Louis

机构信息

Department of Intensive Care, Erasme University Hospital, Université Libre de Bruxelles, Brussels, Belgium.

出版信息

BMC Anesthesiol. 2018 Jun 19;18(1):70. doi: 10.1186/s12871-018-0537-1.

Abstract

BACKGROUND

Acute ethanol intoxication has been shown to have contrasting effects on outcomes in sepsis. The aim of this study was to explore the effects of acute ethanol intoxication on hemodynamics, renal function, brain perfusion and lactate/pyruvate in an ovine sepsis model.

METHODS

Anesthetized, mechanically ventilated female sheep were randomized to an ethanol group (n = 7), which received 1 g/kg ethanol diluted in intravenous (i.v.) saline infusion or a control group (n = 7), which received the same volume of i.v. saline. Both groups received the treatment for a period of 2 h prior to induction of sepsis by intraperitoneal injection of feces. Other treatment included fluid resuscitation but no vasopressors or antibiotics. Global hemodynamics, renal blood flow, brain cortex laser Doppler flowmetry and microdialysis analyses were recorded hourly.

RESULTS

In the ethanol group, blood ethanol concentrations were 137 ± 29 mg/dL at the time of feces injection and decreased to become undetectable by 12 h. Arterial hypotension occurred earlier in the ethanol than in the control group (8 [7-12] vs. 14 [11-20] hours, p = 0.03). Lactate levels increased to > 2 mmol/L earlier in the ethanol group. Renal dysfunction (9 [6-13] vs. 13 [12-15] hours, p = 0.05) and oliguria (urine output < 0.5 mL/kg/h; 10 [7-12] vs. 13 [12, 13] hours, p = 0.01) developed earlier in the ethanol than in the control group. Brain blood flow and lactate/pyruvate were unaffected. There was no significant difference in survival time.

CONCLUSIONS

Acute ethanol intoxication in this model of peritonitis resulted in earlier development of shock and renal dysfunction but did not alter brain perfusion and metabolism or short-term survival.

摘要

背景

急性乙醇中毒已被证明对脓毒症的预后有不同影响。本研究的目的是在绵羊脓毒症模型中探讨急性乙醇中毒对血流动力学、肾功能、脑灌注以及乳酸/丙酮酸的影响。

方法

将麻醉状态下、机械通气的雌性绵羊随机分为乙醇组(n = 7),该组通过静脉输注生理盐水稀释的1 g/kg乙醇,或对照组(n = 7),该组接受相同体积的静脉生理盐水。两组在腹腔注射粪便诱导脓毒症前均接受2小时的治疗。其他治疗包括液体复苏,但不使用血管升压药或抗生素。每小时记录整体血流动力学、肾血流量、脑皮质激光多普勒血流测定和微透析分析结果。

结果

在乙醇组中,粪便注射时血液乙醇浓度为137±29 mg/dL,并在12小时时降至无法检测到的水平。乙醇组比对照组更早出现动脉低血压(8 [7 - 12] 小时对14 [11 - 20] 小时,p = 0.03)。乙醇组中乳酸水平更早升高至>2 mmol/L。乙醇组比对照组更早出现肾功能障碍(9 [6 - 13] 小时对13 [12 - 15] 小时,p = 0.05)和少尿(尿量<0.5 mL/kg/h;10 [7 - 12] 小时对13 [12, 13] 小时,p = 0.01)。脑血流量和乳酸/丙酮酸未受影响。生存时间无显著差异。

结论

在该腹膜炎模型中,急性乙醇中毒导致休克和肾功能障碍更早出现,但未改变脑灌注和代谢或短期生存情况。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e354/6009814/beac7de96e07/12871_2018_537_Fig1_HTML.jpg

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