Zieleskiewicz Laurent, Claret Pierre-Géraud, Muller Laurent, de La Coussaye Jean Emmanuel, Lefrant Jean Yves, Schuster Iris, Roger Claire, Bobbia Xavier
Department of Anesthesiology and Intensive Care, North Hospital, APHM, Aix Marseille Univ., INSERM, INRA, C2VN, Marseille, France.
Department of Anesthesiology, Critical Care, Montpellier University, Pain and Emergency Medicine, Nîmes University Hospital, Nîmes, France.
Turk J Emerg Med. 2020 Jul 18;20(3):97-104. doi: 10.4103/2452-2473.290066. eCollection 2020 Jul-Sep.
Global longitudinal strain (GLS) appears sensitive and reproducible to identify left ventricular systolic dysfunction. The main objective was to analyze the GLS changes in an anesthetized-piglet model of controlled hemorrhagic shock (HS). The secondary objective was to evaluate if GLS changes was different depending on the expansion fluid treatment with or without norepinephrine.
Eighteen anesthetized and ventilated piglets were bled until the mean arterial pressure reached 40 mmHg. Controlled hemorrhage was maintained for 30 min before randomizing the piglets to three resuscitation groups: control group, LR group (resuscitated with lactated ringer), and NA group (resuscitated with lactated ringer and norepinephrine).
There was no difference in the baseline hemodynamic, biological, and ultrasound data among the three groups. During the hemorrhagic phase, the GLS increased significantly from 25 mL/kg of depletion. During the resuscitation phase, the GLS decreased significantly from 20 mL/kg of fluid administration. There was no difference in GLS variation among the groups during the hemorrhagic, maintenance, and resuscitation phases.
In our HS model, GLS increased with hemorrhage and decreased during resuscitation, showing its preload dependence.
整体纵向应变（GLS）在识别左心室收缩功能障碍方面似乎具有敏感性和可重复性。主要目的是分析在控制性失血性休克（HS）麻醉仔猪模型中GLS的变化。次要目的是评估GLS变化是否因使用或不使用去甲肾上腺素的扩容液体治疗而有所不同。
18只麻醉并通气的仔猪放血直至平均动脉压达到40 mmHg。在将仔猪随机分为三个复苏组之前，维持控制性出血30分钟：对照组、乳酸林格液组（用乳酸林格液复苏）和去甲肾上腺素组（用乳酸林格液和去甲肾上腺素复苏）。
三组之间的基线血流动力学、生物学和超声数据无差异。在出血期，从失血25 mL/kg开始，GLS显著增加。在复苏期，从给予液体20 mL/kg开始，GLS显著降低。在出血、维持和复苏期，各组之间的GLS变化无差异。
在我们的HS模型中，GLS随出血增加而升高，在复苏期间降低，显示出其对前负荷的依赖性。
