Zink B J, Syverud S A, Dronen S C, Barsan W G, Van Ligten P, Timerding B L
Department of Emergency Medicine, University of Cincinnati Medical Center, Ohio 45267.
Ann Emerg Med. 1988 Jan;17(1):15-9. doi: 10.1016/s0196-0644(88)80496-7.
Controversy exists as to whether ethanol intoxication causes exaggerated hypotension or increased mortality during hemorrhagic shock. Previous studies have used anesthetized animals. This limits data interpretation as anesthetic agents, particularly pentobarbital, have well-documented effects on hemodynamics and the response to hemorrhage. We studied the effects of moderate ethanol intoxication on blood pressure and survival time during fatal hemorrhagic shock in unanesthetized swine. Immature female swine weighing 15 to 20 kg were splenectomized and instrumented with chronic indwelling aortic catheters, right atrial catheters, and gastrostomy tubes. Four to seven days later the unanesthetized animals underwent hemorrhagic shock. Thirty minutes prior to the start of hemorrhage, the experimental group (n = 8) received 3 mL/kg of 100% ethanol mixed as a 1:3 solution with water through a gastrostomy tube. The control group (n = 8) received an equal amount of water. The distal aortic catheter was connected to a roller pump and blood was removed at a rate of 1 mL/kg/min until the animal died. Arterial pressure, heart rate, lactate ethanol and glucose levels, hematocrit, and arterial blood gases were measured in both groups at baseline and every 15 minutes thereafter. A mean ethanol level of 1,500 to 1,700 micrograms/mL was produced in the experimental group from baseline through 60 minutes. Data were analyzed using Student's two-tailed t test, and analysis of variance for repeated measures. There was no significant difference in survival time between the control (63.1 +/- 2.8 min) and ethanol (59.9 +/- 5.9 min) groups. Systolic blood pressure was significantly lower in the ethanol group after 15 minutes of hemorrhage (81 +/- 22 to 59 +/- 14 mm Hg, P less than .05).(ABSTRACT TRUNCATED AT 250 WORDS)
关于乙醇中毒是否会在失血性休克期间导致血压过度降低或死亡率增加，目前存在争议。以往的研究使用的是麻醉动物。这限制了数据的解读，因为麻醉剂，尤其是戊巴比妥，对血流动力学和出血反应有着充分记载的影响。我们研究了中度乙醇中毒对未麻醉猪致命性失血性休克期间血压和存活时间的影响。体重15至20千克的未成年雌性猪接受脾切除术，并植入慢性留置主动脉导管、右心房导管和胃造瘘管。四至七天后，未麻醉的动物经历失血性休克。在出血开始前30分钟，实验组（n = 8）通过胃造瘘管接受3毫升/千克的100%乙醇，与水按1:3的比例混合。对照组（n = 8）接受等量的水。将远端主动脉导管连接到滚轴泵，以1毫升/千克/分钟的速度抽血，直到动物死亡。在基线时以及此后每隔15分钟，测量两组动物的动脉压、心率、乳酸、乙醇和葡萄糖水平、血细胞比容以及动脉血气。从基线到60分钟，实验组的平均乙醇水平为1500至1700微克/毫升。使用学生双尾t检验和重复测量方差分析对数据进行分析。对照组（63.1±2.8分钟）和乙醇组（59.9±5.9分钟）的存活时间没有显著差异。出血15分钟后，乙醇组的收缩压显著降低（从81±22降至59±14毫米汞柱，P<0.05）。（摘要截短至250字）
