Traber D L, Adair T H, Adams T
Circ Shock. 1981;8(5):551-61.
Sheep which have been previously prepared for cardiopulmonary studies and collection of lung lymph were given 0.75 micrograms/kg of E coli endotoxin iv. This induced sepsis produced a triphasic response. Phase 1 occurs during the first hour after endotoxin administration and is characterized by a decreased cardiac output, lymph to plasma protein ratio, neutrophil count, and an increased hematocrit, total plasma protein concentration, lymph flow, and pulmonary artery pressure. During phase 2 these variables tend to return toward their baseline values. Phase 3 begins 2.5 hr after the administration of endotoxin and shows many of the same changes that were observed in phase 1. Also during the late phase, the plasma protein concentration and lymphocyte count were reduced and the lymph to plasa protein ratio was increased. It is concluded that (1) An early fall in cardiac output occurs as a consequence of hypovolemia. The decreased volume is the result of fluid movement from the vascular compartment to the interstitial space consequent to a microvascular pressure increase. Since the changes occur coincidentally with a drop in neutrophil count, these cells may bear some causal relationship to the response. (2) The late fall in cardiac output in phase 3, also the result of a diminished vascular volume, occurs secondarily to extravasular fluid movement as a consequence of both an elevated microvascular pressure and an increased permeability to protein. The latter may be causally related to a fall in lymphocytes.
先前已为心肺研究和肺淋巴液采集做好准备的绵羊，静脉注射0.75微克/千克的大肠杆菌内毒素。这种诱导的脓毒症产生了三相反应。第一阶段发生在内毒素给药后的第一小时内，其特征是心输出量、淋巴与血浆蛋白比率、中性粒细胞计数降低，而血细胞比容、总血浆蛋白浓度、淋巴流量和肺动脉压升高。在第二阶段，这些变量趋于恢复到基线值。第三阶段在内毒素给药后2.5小时开始，表现出许多与第一阶段相同的变化。在后期，血浆蛋白浓度和淋巴细胞计数降低，淋巴与血浆蛋白比率升高。得出以下结论：(1) 心输出量早期下降是血容量不足的结果。血容量减少是由于微血管压力升高导致液体从血管腔转移到间质间隙。由于这些变化与中性粒细胞计数下降同时发生，这些细胞可能与该反应存在某种因果关系。(2) 第三阶段心输出量后期下降也是血管容量减少的结果，是微血管压力升高和蛋白质通透性增加导致血管外液体移动的继发结果。后者可能与淋巴细胞减少存在因果关系。
