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感染对实验性热损伤中氧消耗和核心体温的影响。

Effects of infection on oxygen consumption and core temperature in experimental thermal injury.

作者信息

Aulick L H, McManus A T, Mason A D, Pruitt B A

出版信息

Ann Surg. 1986 Jul;204(1):48-52. doi: 10.1097/00000658-198607000-00006.

Abstract

Oxygen consumption (VO2) and colonic temperature (Tc) were measured in groups of rats before and after 30% total body surface, full thickness burns. Some wounds were seeded with Pseudomonas aeruginosa or Staphylococcus epidermidis, and some seeded wounds were treated with Sulfamylon or Silvadene. Three groups became bacteremic (B) during the 2-3 week period of observation. At an ambient temperature (Ta) of 32 C, VO2 of the B group rose from 0.83 +/- 0.01 to 1.20 +/- 0.01 ml/hr/g (mean +/- S.E., p less than 0.001) versus 0.81 +/- 0.01 to 0.99 +/- 0.02 for nine nonbacteremic (NB) groups (p less than 0.001). Tc increased only in the B groups--from 36.8 +/- 0.1 to 37.7 +/- 0.1 C (p less than 0.001). In the second or third week postinjury, VO2 of the NB rats was reduced when Ta was increased to 34 C; Tc followed changes in Ta. Sulfamylon lowered VO2 of P. aeruginosa seeded, NB rats. The metabolic cost of wound contamination appeared to vary with bacterial strain. The metabolic effects of infection appear to be a continuum, beginning with a modest rise in VO2 and progressing to greater increases in VO2 and Tc with wound invasion and systemic infection.

摘要

在大鼠全身30%体表面积的全层烧伤前后,对几组大鼠进行了耗氧量(VO2)和结肠温度(Tc)的测量。部分伤口接种铜绿假单胞菌或表皮葡萄球菌,部分接种伤口用磺胺米隆或磺胺嘧啶银处理。在2至3周的观察期内,有三组大鼠发生了菌血症(B)。在环境温度(Ta)为32℃时,菌血症组的VO2从0.83±0.01上升至1.20±0.01毫升/小时/克(平均值±标准误,p<0.001),而九组非菌血症(NB)大鼠的VO2则从0.81±0.01上升至0.99±0.02(p<0.001)。Tc仅在菌血症组中升高,从36.8±0.1℃升至37.7±0.1℃(p<0.001)。在受伤后的第二或第三周,当Ta升至34℃时,非菌血症大鼠的VO2降低;Tc随Ta的变化而变化。磺胺米隆降低了接种铜绿假单胞菌的非菌血症大鼠的VO2。伤口污染的代谢成本似乎因细菌菌株而异。感染的代谢效应似乎是一个连续过程,始于VO2的适度升高,随着伤口侵袭和全身感染,VO2和Tc进一步升高。

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