Raffa J, Trunkey D D
J Trauma. 1978 Feb;18(2):90-3. doi: 10.1097/00005373-197802000-00002.
Previous studies have shown myocardial depression to occur secondary to toxic extracts of burned mouse and human skin and secondary to toxins present in acute human burn serum. The present report describes myocardial depression in an arterially perfused rabbit interventricular septum as a result of toxins present in acute burn plasma. New Zealand white rabbits subjected to a 25% BSA full-thickness burn were heparinized and exsanguinated 2 hours postinjury. Cellular elements and plasma were separated and the plasma frozen. Rabbit myocardial septa were then perfused with normal or burn plasma. Rabbit red cells were added to restore hematocrit to 20 degrees, and the plasma-red cell mixtures were equilibrated with 98% O2 plus 2% CO2. Temperature (28 degrees C), pH (7.40), and flow rate (1 ml/min) were constant for all trials. All normal plasma preparations showed an improvement in developed tension (DT) during the 30-60 minute perfusion period with mean % change equal to + 10.5. A corresponding increase in dP/dt was also noted for all normals (mean % change equal to + 14.3); all septa perfused with acute burn plasma showed a decline in myocardial performance during a similar perfusion period. Mean % change in DT for burn plasma preparations was - 57.5, and in dP/dt for these septa was - 59.5. Significant myocardial depression occurs in arterially perfused rabbit septa when acute burn shock plasma is used as the perfusate.
先前的研究表明，心肌抑制继发于烧伤小鼠和人类皮肤的毒性提取物以及急性人类烧伤血清中的毒素。本报告描述了急性烧伤血浆中的毒素导致动脉灌注兔室间隔出现心肌抑制。对新西兰白兔进行25%体表面积的全层烧伤，伤后2小时给予肝素化并放血。分离细胞成分和血浆，将血浆冷冻。然后用正常血浆或烧伤血浆灌注兔心肌间隔。加入兔红细胞使血细胞比容恢复到20%，血浆-红细胞混合物用98% O₂加2% CO₂平衡。所有试验的温度（28℃）、pH（7.40）和流速（1 ml/min）均保持恒定。所有正常血浆制剂在30 - 60分钟的灌注期内舒张期张力（DT）均有所改善，平均变化百分比为 + 10.5。所有正常制剂的dP/dt也相应增加（平均变化百分比为 + 14.3）；所有用急性烧伤血浆灌注的间隔在相似的灌注期内心肌功能均下降。烧伤血浆制剂的DT平均变化百分比为 - 57.5，这些间隔的dP/dt平均变化百分比为 - 59.5。当使用急性烧伤休克血浆作为灌注液时，动脉灌注的兔间隔会出现明显的心肌抑制。
