Dyess D L, Powell R W, Roberts W S, Tacchi E J, Swafford A N, Ferrara J J, Ardell J L
Department of Surgery, University of South Alabama College of Medicine, Mobile 36617, USA.
J Surg Res. 1995 Jul;59(1):29-34. doi: 10.1006/jsre.1995.1128.
Acute hemorrhage in premature infants occurs as the result of obstetrical complications, birth trauma, or operative procedures. This study evaluates the response of the preterm piglet to acute hemorrhage and resuscitation. Piglets delivered by Caesarean section 7-14 days preterm underwent acute arterial/venous hemorrhage (20 cc/kg). At 0, 15, and 60 min after hemorrhage, hemodynamic parameters and regional blood flows (reference organ technique) were measured. Animals were then resuscitated with shed blood (20 cc/kg), crystalloid (60 cc/kg), or colloid (dextran 40, 20 cc/kg) with study parameters obtained 30 min later (statistical analysis by ANOVA). Significant decreases in blood pressure (BP) and cardiac output (CO) occurred after hemorrhage. BP and CO were reestablished to near control levels following resuscitation with blood and crystalloid. Dextran failed to return BP to baseline; however, it resulted in CO 1.7 x control. Heart and CNS blood flow were not significantly influenced by hemorrhage; however, dextran increased flows to these organs significantly above control levels. In the kidney and small bowel, flows decreased significantly following hemorrhage; blood and crystalloid restored flows to near baseline, while dextran resulted in flows significantly greater. In summary, the preterm piglet responds to hemorrhage with maintenance of blood flow to the heart and brain and significantly decreased flows to the kidney and small intestine. Flows following resuscitation with blood and crystalloid are comparable to those in control. Dextran resuscitation resulted in flows significantly greater than baseline; this response might be detrimental with ongoing hemorrhage and/or prolonged ischemia.
早产儿急性出血是由产科并发症、出生创伤或手术操作引起的。本研究评估早产仔猪对急性出血和复苏的反应。剖宫产分娩的早产7 - 14天的仔猪经历急性动静脉出血（20 cc/kg）。在出血后0、15和60分钟，测量血流动力学参数和局部血流量（参考器官技术）。然后用自体血（20 cc/kg）、晶体液（60 cc/kg）或胶体液（右旋糖酐40，20 cc/kg）对动物进行复苏，30分钟后获得研究参数（通过方差分析进行统计分析）。出血后血压（BP）和心输出量（CO）显著下降。用血液和晶体液复苏后，BP和CO恢复到接近对照水平。右旋糖酐未能使BP恢复到基线水平；然而，它使CO达到对照值的1.7倍。出血对心脏和中枢神经系统血流量没有显著影响；然而，右旋糖酐使这些器官的血流量显著高于对照水平。在肾脏和小肠，出血后血流量显著下降；血液和晶体液使血流量恢复到接近基线水平，而右旋糖酐使血流量显著增加。总之，早产仔猪对出血的反应是维持心脏和大脑的血流量，同时肾脏和小肠的血流量显著减少。用血液和晶体液复苏后的血流量与对照相当。右旋糖酐复苏导致血流量显著高于基线水平；这种反应在持续出血和/或长时间缺血的情况下可能是有害的。
