Department of Emergency Surgery, The First Affiliated Hospital of Bengbu Medical College.
Department of Emergency Surgery, The First Affiliated Hospital of Bengbu Medical College.
J Surg Res. 2021 Apr;260:259-266. doi: 10.1016/j.jss.2020.11.014. Epub 2020 Dec 23.
Fluid resuscitation is widely used for treating traumatic hemorrhagic shock. We focused on the efficacies of different fluid resuscitation methods on improving coagulation function of traumatic hemorrhagic shock (THS) rats.
Sprague-Dawley rats (n = 100) were randomly divided into 5 groups, namely, Sham group, THS group, acetic acid Ringer's fluid (AR) group, hydroxyethyl starch solution (HES) group, and AR + HES group. A THS rat model was established by left femoral bleeding. The effects of different fluid resuscitation methods on conventional coagulation function parameters, Rotational thromboelastometry parameters, platelet-derived microparticles and endothelial cell-derived microparticles content of the THS rats were detected by ACL TOP system, rotation thromboelastometry, and flow cytometry, respectively.
Using AR and HES alone had no significant effect on the coagulation function of THS rats, but the two in combination reduced the increases of thrombin time, prothrombin time, activated part thrombin time, international normalized ratio, fibrin degradation products, D-dimer and the decreases of platelet count and fibrinogen concentration induced by THS. The CT and CFT were significantly reduced, whereas α and MCF were increased in the THS rats in AR + HES group. The combination of AR and HES reversed the effect of THS on elevating platelet-derived microparticles and endothelial cell-derived microparticle levels. In addition, the coagulation was relatively the optimal in the AR, HES, and AR + HES groups when the mice were resuscitated to a mean arterial pressure of 60 mmHg.
AR combined with HES has a significant protective effect on coagulation function of THS rats when the mean arterial pressure reaches 60 mmHg.
液体复苏广泛用于治疗创伤性失血性休克。我们专注于不同液体复苏方法对改善创伤性失血性休克(THS)大鼠凝血功能的疗效。
Sprague-Dawley 大鼠(n=100)随机分为 5 组,即假手术组、THS 组、醋酸林格氏液(AR)组、羟乙基淀粉溶液(HES)组和 AR+HES 组。通过左股动脉出血建立 THS 大鼠模型。通过 ACL TOP 系统、旋转血栓弹性描记术和流式细胞术分别检测不同液体复苏方法对 THS 大鼠常规凝血功能参数、旋转血栓弹性描记术参数、血小板衍生微粒和内皮细胞衍生微粒含量的影响。
单独使用 AR 和 HES 对 THS 大鼠的凝血功能没有显著影响,但两者联合使用可降低 THS 引起的凝血酶时间、凝血酶原时间、活化部分凝血活酶时间、国际标准化比值、纤维蛋白降解产物、D-二聚体增加以及血小板计数和纤维蛋白原浓度降低。AR+HES 组 CT 和 CFT 明显降低,α和 MCF 升高。AR 和 HES 的联合使用逆转了 THS 对血小板衍生微粒和内皮细胞衍生微粒水平升高的影响。此外,当平均动脉压达到 60mmHg 时,AR、HES 和 AR+HES 组的凝血功能相对最佳。
当平均动脉压达到 60mmHg 时,AR 联合 HES 对 THS 大鼠的凝血功能具有显著的保护作用。