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失血性休克对肺超声诱导的肺毛细血管出血的影响。

The Impact of Hemorrhagic Shock on Lung Ultrasound-Induced Pulmonary Capillary Hemorrhage.

作者信息

Miller Douglas L, Dou Chunyan, Raghavendran Krishnan, Dong Zhihong

机构信息

Department of Radiology, University of Michigan Health System, Ann Arbor, Michigan, USA.

Department of Surgery, University of Michigan Health System, Ann Arbor, Michigan, USA.

出版信息

J Ultrasound Med. 2021 Apr;40(4):787-794. doi: 10.1002/jum.15463. Epub 2020 Aug 28.

Abstract

OBJECTIVES

Lung ultrasound (LUS) exposure can induce pulmonary capillary hemorrhage (PCH), depending on biological and physical exposure parameters. This study was designed to investigate the variation in the LUS induction of PCH due to hemorrhagic shock, which itself can engender pulmonary injury.

METHODS

Male rats were anesthetized with isoflurane in air. Shock was induced by withdrawal of 40% of the blood volume and assessed by the blood pressure detected by a femoral artery catheter and by blood glucose tests. B-mode ultrasound was delivered at 7.3 MHz with a low output (-20 dB) for aiming and with the maximal output (0 dB) for exposure. Pulmonary capillary hemorrhage was quantified by an assessment of comet tail artifacts in the LUS images and by measurement of PCH areas on the surface of fresh lung samples.

RESULTS

Tests without shock or catheterization surgery gave results for PCH similar to those of previous studies using different methods. Exposure before hemorrhagic shock gave a mean PCH area ± SE of 24.8 ± 9.2 mm on the ultrasound scan plane, whereas exposure after shock gave 0 PCH (P < .001; n = 7).

CONCLUSIONS

The presence of hemorrhagic shock significantly reduces the occurrence of LUS-induced PCH.

摘要

目的

肺超声(LUS)暴露可导致肺毛细血管出血(PCH),这取决于生物学和物理暴露参数。本研究旨在调查失血性休克导致的LUS诱发PCH的变化,失血性休克本身可导致肺损伤。

方法

雄性大鼠在空气中用异氟醚麻醉。通过抽取40%血容量诱导休克,并通过股动脉导管检测的血压和血糖测试进行评估。B型超声以7.3MHz的频率发射,低输出(-20dB)用于定位,最大输出(0dB)用于暴露。通过评估LUS图像中的彗尾伪像和测量新鲜肺样本表面的PCH面积来量化肺毛细血管出血。

结果

无休克或导管插入术的测试得出的PCH结果与先前使用不同方法的研究结果相似。失血性休克前暴露在超声扫描平面上的平均PCH面积±标准误为24.8±9.2mm,而休克后暴露的PCH面积为0(P<.001;n=7)。

结论

失血性休克的存在显著降低了LUS诱发PCH的发生率。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0f87/7914277/583d5f9da949/nihms-1629568-f0001.jpg

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