Sielaff T D, Sugerman H J, Tatum J L, Kellum J M, Blocher C R
Department of Surgery, Medical College of Virginia, Virginia Commonwealth University, Richmond 23298-0519.
J Trauma. 1987 Dec;27(12):1313-22. doi: 10.1097/00005373-198712000-00001.
A combination drug therapy (Poly-5: ibuprofen 12.5 mg/kg, methylprednisolone 30 mg/kg, cimetidine 150 mg, diphenhydramine 10 mg/kg, and ketanserin 0.2 mg/kg) given at 20 and 120 minutes after starting continuous intravenous Pseudomonas (Ps, 5 X 10(8) CFU/20 kg/min) was studied in three groups of swine: saline control (C, n = 9), Ps alone (Ps, n = 8), and Ps plus Poly-5 (n = 5). PaO2, systemic (SAP) and pulmonary arterial (PAP) pressures, cardiac index (CI), thermal-cardiogreen extravascular lung water (EVLW), pulmonary albumin flux (slope index, SI), and arterial blood serotonin levels (5-HT) were measured. Ps produced significant (p less than 0.05) increases in PAP, EVLW, and SI with decreases in PaO2, CI, and SAP. 5-HT fell significantly compared to baseline. Poly-5 prevented (p less than 0.05) the rise in EVLW and SI and the fall in PaO2 and CI compared to Ps. PAP and SI were maintained at C until 90 and 150 minutes, respectively. SAP fell significantly from C at 30, 60, and 180 minutes. 5-HT was significantly lower than Ps throughout, and significantly lower than baseline at 180 minutes. Combined blockade of arachidonic acid metabolites, histamine, and serotonin receptors prevented hypoxemia, increased pulmonary capillary permeability, and cardiovascular deterioration in this porcine septic ARDS model.
在三组猪中研究了联合药物疗法（Poly - 5：布洛芬12.5毫克/千克、甲泼尼龙30毫克/千克、西咪替丁150毫克、苯海拉明10毫克/千克和酮色林0.2毫克/千克），在开始持续静脉输注铜绿假单胞菌（Ps，5×10⁸CFU/20千克/分钟）后20分钟和120分钟给药：生理盐水对照组（C，n = 9）、单独使用Ps组（Ps，n = 8）和Ps加Poly - 5组（n = 5）。测量了动脉血氧分压（PaO₂）、体循环（SAP）和肺动脉（PAP）压力、心脏指数（CI）、热稀释 - 心绿血管外肺水（EVLW）、肺白蛋白通量（斜率指数，SI）以及动脉血血清素水平（5 - HT）。Ps导致PAP、EVLW和SI显著升高（p < 0.05），同时PaO₂、CI和SAP降低。与基线相比，5 - HT显著下降。与Ps组相比，Poly - 5可预防（p < 0.05）EVLW和SI的升高以及PaO₂和CI的下降。PAP和SI分别在90分钟和150分钟前维持在对照组水平。在30分钟、60分钟和180分钟时，SAP较对照组显著下降。5 - HT在整个过程中均显著低于Ps组，在180分钟时显著低于基线。在该猪脓毒症急性呼吸窘迫综合征模型中，联合阻断花生四烯酸代谢产物、组胺和血清素受体可预防低氧血症、增加肺毛细血管通透性并防止心血管功能恶化。
