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心肺复苏后致毛细血管渗漏综合征大鼠模型的建立。

Establishment of a Rat Model of Capillary Leakage Syndrome Induced by Cardiopulmonary Resuscitation After Cardiac Arrest.

机构信息

Department of Pediatric Emergency Medicine and Critical Care Medicine, Children's Hospital of Fudan University, Shanghai, 201102, China.

Department of Pediatric Critical Care Medicine, Children's Hospital of Chongqing Medical University, Chongqing, 400014, China.

出版信息

Curr Med Sci. 2023 Aug;43(4):708-715. doi: 10.1007/s11596-023-2695-8. Epub 2023 Jul 5.

Abstract

OBJECTIVE

Cardiopulmonary resuscitation (CPR) after cardiac arrest (CA) is one of the main causes of capillary leakage syndrome (CLS). This study aimed to establish a stable CLS model following the CA and cardiopulmonary resuscitation (CA-CPR) model in Sprague-Dawley (SD) rats.

METHODS

We conducted a prospective, randomized, animal model study. All adult male SD rats were randomly divided into a normal group (group N), a sham operation group (group S), and a cardiopulmonary resuscitation group (group T). The SD rats of the three groups were all inserted with 24-G needles through their left femoral arteries and right femoral veins. In group S and group T, the endotracheal tube was intubated. In group T, CA induced by asphyxia (AACA) was caused by vecuronium bromide with the endotracheal tube obstructed for 8 min, and the rats were resuscitated with manual chest compression and mechanical ventilation. Preresuscitation and postresuscitation measurements, including basic vital signs (BVS), blood gas analysis (BG), routine complete blood count (CBC), wet-to-dry ratio of tissues (W/D), and the HE staining results after 6 h were evaluated.

RESULTS

In group T, the success rate of the CA-CPR model was 60% (18/30), and CLS occurred in 26.6% (8/30) of the rats. There were no significant differences in the baseline characteristics, including BVS, BG, and CBC, among the three groups (P>0.05). Compared with pre-asphyxia, there were significant differences in BVS, CBC, and BG, including temperature, oxygen saturation (SpO), mean arterial pressure (MAP), central venous pressure (CVP), white blood cell count (WBC), hemoglobin, hematocrit, pH, pCO, pO, SO, lactate (Lac), base excess (BE), and Na (P<0.05) after the return of spontaneous circulation (ROSC) in group T. At 6 h after ROSC in group T and at 6 h after surgery in groups N and S, there were significant differences in temperature, heart rate (HR), respiratory rate (RR), SpO, MAP, CVP, WBC, pH, pCO, Na, and K among the three groups (P<0.05). Compared with the other two groups, the rats in group T showed a significantly increased W/D weight ratio (P<0.05). The HE-stained sections showed consistent severe lesions in the lung, small intestine, and brain tissues of the rats at 6 h after ROSC following AACA.

CONCLUSION

The CA-CPR model in SD rats induced by asphyxia could reproduce CLS with good stability and reproducibility.

摘要

目的

心脏骤停(CA)后的心肺复苏(CPR)是毛细血管渗漏综合征(CLS)的主要原因之一。本研究旨在建立一种稳定的 CLS 模型,即在 Sprague-Dawley(SD)大鼠中建立 CA-CPR 模型。

方法

前瞻性、随机、动物模型研究。所有成年雄性 SD 大鼠随机分为正常组(N 组)、假手术组(S 组)和心肺复苏组(T 组)。三组 SD 大鼠均通过左股动脉和右股静脉插入 24-G 针。在 S 组和 T 组中,通过气管内插管。在 T 组中,用维库溴铵(vecuronium bromide)阻塞气管内插管 8 分钟,引起窒息性 CA(AACA),并用手动胸外按压和机械通气进行复苏。评估复苏前和复苏后的基本生命体征(BVS)、血气分析(BG)、常规全血细胞计数(CBC)、组织干湿比(W/D)和 6 小时后的 HE 染色结果。

结果

T 组 CA-CPR 模型的成功率为 60%(18/30),26.6%(8/30)的大鼠发生 CLS。三组间基础生命体征(BVS)、BG 和 CBC 等基线特征无显著性差异(P>0.05)。与窒息前相比,T 组 BVS、CBC 和 BG 有显著差异,包括体温、氧饱和度(SpO)、平均动脉压(MAP)、中心静脉压(CVP)、白细胞计数(WBC)、血红蛋白、血细胞比容、pH 值、pCO、pO、SO、乳酸(Lac)、碱剩余(BE)和 Na(P<0.05)。T 组 ROSC 后 6 小时和 N 组和 S 组手术后 6 小时,三组间体温、心率(HR)、呼吸率(RR)、SpO、MAP、CVP、WBC、pH 值、pCO、Na 和 K 有显著差异(P<0.05)。与其他两组相比,T 组大鼠的 W/D 重量比明显增加(P<0.05)。HE 染色切片显示,在 AACA 后 ROSC 6 小时时,大鼠肺、小肠和脑组织均出现严重病变。

结论

窒息诱导的 SD 大鼠 CA-CPR 模型可再现 CLS,具有良好的稳定性和可重复性。

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