Postgraduate Study Program (MSc) "Cardiopulmonary Resuscitation", Medical School, National and Kapodistrian University of Athens, Athens, Greece.
Department of Anesthesiology, Medical School, Aretaieio Hospital, National and Kapodistrian University of Athens, Athens, Greece.
Eur J Trauma Emerg Surg. 2019 Dec;45(6):1077-1085. doi: 10.1007/s00068-018-0980-1. Epub 2018 Jul 13.
To investigate the effects of the combination of centhaquin and 6% hydroxyethyl starch 130/0.4 (HES 130/0.4) in a swine model of hemorrhagic shock.
Twenty Landrace-Large White pigs were instrumented and subjected to hemorrhagic shock. The animals were randomly allocated in two experimental groups, the control (group CO, n = 10) and the centhaquin groups (0.015 mg/kg, n = 10, group CH). Acute hemorrhage was induced by stepwise blood withdrawal (18 mL/min) from the internal jugular vein until MAP decreased to 40-45 mmHg, whereas anesthesia remained constant. All animals received HES 130/0.4 solution in the resuscitation phase until their mean arterial pressure (MAP) reached 90% of the baseline. The animals were observed for 60 min, during which no further resuscitation was attempted.
The total amount of blood and the bleeding time did not differ significantly between group CO and group CH (120 ± 13 vs. 120 ± 14 mL, p = 0.6; 20 ± 2 vs. 20 ± 1 min, p = 0.62, respectively). During the hemorrhagic phase, only a difference in heart rate (97.6 ± 4.4 vs. 128.4 ± 3.6 beats/min, p = 0.038) was observed between the two groups. The time required to reach the target MAP was significantly shorter in the centhaquin group compared to controls (13.7 ± 0.4 vs. 19.6 ± 0.84 min, p = 0.012). During the resuscitation phase, a statistical significant difference was observed in MAP (75.2 ± 1.6 vs. 89.8 ± 2.1 mmHg, p = 0.02) between group CO and group CH. During the observation phase, a statistical significant difference was observed in SVR (1109 ± 32.65 vs. 774.6 ± 21.82 dyn s/cm, p = 0.039) and cardiac output (5.82 ± 0.31 vs. 6.9 ± 0.78 L/min, p = 0.027) between the two groups. Two animals of group CO and seven animals of group CH survived for 24 h (p = 0.008). We observed a marked increase in microvascular capillary permeability in group CO compared to group CH, with the wet/dry weight ratio being significantly higher in group CO compared to group CH (4.8 ± 1.6 vs. 3.08 ± 0.6, p < 0.001).
The combination of centhaquin 0.015 mg/kg and HES 130/0.4 resulted in shorter time to target MAP, lower wet-to-dry ratio, and better survival rates after resuscitation from hemorrhagic shock.
研究 centhaquin 与 6%羟乙基淀粉 130/0.4（HES 130/0.4）联合应用于失血性休克猪模型的效果。
20 头长白-大白猪接受了创伤手术并经历了失血性休克。动物被随机分配到两个实验组，对照组（CO 组，n=10）和 centhaquin 组（0.015mg/kg，n=10，CH 组）。通过从颈内静脉逐渐采血（18mL/min）将 MAP 降低至 40-45mmHg 来诱导急性出血，而麻醉保持不变。所有动物在复苏阶段均接受 HES 130/0.4 溶液，直至其平均动脉压（MAP）达到基线的 90%。观察动物 60min，期间不再进行进一步复苏。
CO 组和 CH 组的总出血量和出血时间无显著差异（120±13 vs. 120±14mL，p=0.6；20±2 vs. 20±1min，p=0.62）。在出血阶段，两组间仅心率存在差异（97.6±4.4 次/分 vs. 128.4±3.6 次/分，p=0.038）。CH 组达到目标 MAP 的时间明显短于 CO 组（13.7±0.4 分钟 vs. 19.6±0.84 分钟，p=0.012）。在复苏阶段，CO 组和 CH 组的 MAP（75.2±1.6mmHg vs. 89.8±2.1mmHg，p=0.02）存在显著差异。在观察阶段，两组间 SVR（1109±32.65 dyn s/cm vs. 774.6±21.82 dyn s/cm，p=0.039）和心输出量（5.82±0.31 L/min vs. 6.9±0.78 L/min，p=0.027）存在显著差异。CO 组有 2 只动物和 CH 组有 7 只动物存活 24 小时（p=0.008）。与 CH 组相比，CO 组的微血管毛细血管通透性明显增加，湿/干重比显著更高（4.8±1.6 vs. 3.08±0.6，p<0.001）。
在失血性休克复苏中，centhaquin 0.015mg/kg 与 HES 130/0.4 的联合应用可缩短达到目标 MAP 的时间，降低湿/干重比，提高存活率。
