Wu T T
Nihon Geka Gakkai Zasshi. 1985 Apr;86(4):381-93.
It is well established that septic shock is caused by Gram-negative endotoxemia, and is characterized by hyperdynamic state being observed in the early stage of shock. This study is designed to elucidate the hemodynamic and metabolic changes induced by continuous infusion of small amount of endotoxin in the dog, with special reference to the existence of hyperdynamic state. Seven mongrel dogs were continuously infused with 10 micrograms/kg/day of E.coli endotoxin for 4 days under fasted, awake condition. All animals revealed mild hypodynamic state with severe catabolic responses in protein-energy metabolism. In contrast, 11 dogs infused with 36kcal/kg/day of glucose and 10 micrograms/kg/day of endotoxin showed marked increase (+30%) in cardiac index, and decrease in mean arterial pressure as well as total peripheral resistance, indicating the presence of hyperdynamic state. Metabolic studies indicate mild catabolic response. Administration of fat emulsion instead of isocaloric glucose has resulted transient hyperdynamic state, but failed to maintain this condition. In conclusion, it is possible to produce hyperdynamic state similar to that seen in septic shock by continuous administration of small amount of endotoxin in the dog, provided proper amount of glucose is supplied.
败血症性休克由革兰氏阴性菌内毒素血症引起,且在休克早期表现为高动力状态,这一点已得到充分证实。本研究旨在阐明持续小剂量输注内毒素对犬血流动力学和代谢的影响,特别关注高动力状态的存在情况。7只杂种犬在禁食、清醒状态下连续4天输注10微克/千克/天的大肠杆菌内毒素。所有动物均表现出轻度低动力状态,且在蛋白质-能量代谢方面有严重的分解代谢反应。相比之下,11只输注36千卡/千克/天葡萄糖和10微克/千克/天内毒素的犬,心脏指数显著增加(+30%),平均动脉压和总外周阻力降低,表明存在高动力状态。代谢研究显示有轻度分解代谢反应。给予脂肪乳剂而非等热量葡萄糖会导致短暂的高动力状态,但无法维持这一状态。总之,在犬中持续给予小剂量内毒素,同时提供适量葡萄糖,有可能产生类似于败血症性休克所见的高动力状态。