Weeren F R, Tobias T A, Schertel E R, Allen D A, Brourman J D
Division of Thoracic and Cardiovascular Surgery, Ohio State University, Columbus, Ohio, USA.
Shock. 1994 Mar;1(3):159-65. doi: 10.1097/00024382-199403000-00001.
We compared the effects of 7% NaCl in 6% dextran 70 (HSD) and 0.9% NaCl (IS) resuscitation of endotoxic dogs on hemodynamic and cardiorespiratory parameters and the oxygen consumption-delivery relationship. Escherichia coli endotoxin (3 mg.kg-1, intravenously) was infused over 5 min into 13 paralyzed, chloralose-anesthetized, splenectomized dogs. Six additional dogs received a sham endotoxin infusion (saline) and served as controls. After 30 min, the endotoxic animals were resuscitated to 150% of their baseline cardiac output (CO) and maintained at this CO for 30 min using 7% NaCl in 6% dextran 70 (HSD at 1 ml.kg-1.min-1; n = 7) or 0.9% NaCl (IS at 4 ml.kg-1.min-1; n = 6). Oxygen consumption (VO2), measured by indirect calorimetry, hemodynamic parameters, and oxygen delivery (DO2), improved in similar temporal patterns in both groups during resuscitation and VO2 reached steady-state values. Oxygen delivery, VO2, mean arterial pressure, and cardiac output did not significantly differ between groups at the end of resuscitation, but VO2 increased significantly from baseline values only in the HSD group. The total volume of HSD administered averaged 10.0 +/- 0.2 ml.kg-1 which was significantly less than the volume of IS, which averaged 67.2 +/- 9.3 ml.kg-1. Incremental hemorrhages (2-5 ml.kg-1) were then performed in all dogs to determine the oxygen consumption-delivery relationship and the critical level of oxygen delivery (DO2Crit). The average DO2Crit values of the HSD, IS, and control groups were 9.42, 9.15, and 6.82 ml.min-1.kg-1, respectively.(ABSTRACT TRUNCATED AT 250 WORDS)
我们比较了7%氯化钠与6%右旋糖酐70(高渗盐右旋糖酐溶液,HSD)和0.9%氯化钠(等渗盐水,IS)对感染内毒素犬进行复苏时,对血流动力学和心肺参数以及氧消耗-输送关系的影响。将大肠杆菌内毒素(3毫克/千克,静脉注射)在5分钟内注入13只瘫痪、氯醛糖麻醉、脾切除的犬体内。另外6只犬接受假内毒素输注(生理盐水)并作为对照。30分钟后,对感染内毒素的动物进行复苏,使其心输出量(CO)达到基线的150%,并使用7%氯化钠与6%右旋糖酐70(HSD,1毫升/千克·分钟;n = 7)或0.9%氯化钠(IS,4毫升/千克·分钟;n = 6)维持此心输出量30分钟。通过间接测热法测量的氧消耗(VO₂)、血流动力学参数和氧输送(DO₂)在复苏期间两组呈现相似的时间模式,且VO₂达到稳态值。复苏结束时,两组的氧输送、VO₂、平均动脉压和心输出量无显著差异,但仅HSD组的VO₂较基线值显著增加。HSD的平均给药总量为10.0±0.2毫升/千克,显著低于IS的平均给药量,IS平均为67.2±9.3毫升/千克。然后对所有犬进行递增性出血(2 - 5毫升/千克),以确定氧消耗-输送关系和氧输送临界水平(DO₂Crit)。HSD组、IS组和对照组的平均DO₂Crit值分别为9.42、9.15和6.82毫升/分钟·千克。(摘要截选至250字)