Crowley J P, Metzger J, Pivacek L, Dennis R C, Valeri C R
Department of Medicine, Brown University, Providence, Rhode Island.
Circ Shock. 1988 Nov;26(3):287-95.
We studied the effect of an infusion of citrated plasma on the hemodynamic response and bacterial clearance of acutely septic dogs rendered severely neutropenic with cyclophosphamide. Two hours after a 5 X 10(9)/kg intravenous injection of E. coli, neutropenic control dogs infused with 20 ml/kg of normal saline became hypotensive and remained so for the next 2 hr. In contrast, the infusion of 20 ml/kg of citrated plasma after the initiation of bacteremia was followed by a significant (P less than .01) improvement in the mean arterial pressure (MAP), compared to saline-treated animals. The effect of citrated plasma administration on MAP was unrelated to bacterial clearance or to improvement in cardiac output but was associated with an increase in total peripheral resistance that was sustained for 2 hr after plasma infusion. The infusion of hyperimmune plasma from dogs previously immunized to core glycolipid antigen appeared to have no important advantage over normal plasma. At the doses of plasma that were given, a relatively higher arterial pH was the only observed significant difference (P less than .05) when immune plasma was compared to normal plasma. Resuscitation of septic neutropenic dogs with large volumes of plasma deserves further study with respect to the specific mechanisms responsible for its beneficial effect.
我们研究了输注枸橼酸盐血浆对经环磷酰胺处理导致严重中性粒细胞减少的急性脓毒症犬血流动力学反应和细菌清除的影响。在静脉注射5×10⁹/kg大肠杆菌两小时后，输注20ml/kg生理盐水的中性粒细胞减少对照犬出现低血压，并在接下来的两小时内持续低血压状态。相比之下，在菌血症开始后输注20ml/kg枸橼酸盐血浆，与生理盐水处理的动物相比，平均动脉压（MAP）有显著（P＜0.01）改善。输注枸橼酸盐血浆对MAP的影响与细菌清除或心输出量改善无关，但与血浆输注后持续两小时的总外周阻力增加有关。输注先前免疫核心糖脂抗原的犬的超免疫血浆似乎与正常血浆相比没有重要优势。在给予的血浆剂量下，与正常血浆相比，免疫血浆唯一观察到的显著差异（P＜0.05）是动脉pH相对较高。关于大量血浆对脓毒症中性粒细胞减少犬复苏有益作用的具体机制，值得进一步研究。
