Hjelmqvist H, Gunnarsson U
Department of Physiology and Pharmacology, Karolinska Institutet, Stockholm, Sweden.
Shock. 1995 May;3(5):355-61.
Effects of treatment with systemic hypertonic (1.2M, 4 mL kg-1) NaCl (SHTNa) on tolerance to hemorrhage, accompanying systemic hemodynamics, and regional blood flow were investigated in conscious sheep. The results were compared with those obtained in animals subjected to hemorrhage during intracerebroventricular (ICV) administration of hypertonic (.5 M, .02 mL min -1) NaCl (CHTNa). Corresponding bleeding during ICV infusion of isotonic saline served as control. All treatments were started 30 min before commencement of a slow (.7 mL kg-1 min-1) hemorrhage, which was continued until the mean systemic arterial pressure (MSAP) suddenly dropped to about 50 mmHg. To reach the distinct fall in MSAP significantly more blood had to be withdrawn in the CHTNa (27.8 +/- 2.2 mL kg-1, p < .05) than in the SHTNa group (21.5 +/- 1.7 mL kg-1), which in turn showed a significantly higher tolerance to hemorrhage than the controls (15.1 +/- .7 mL kg-1, p < .01). The hemorrhage-induced reduction of cardiac output (CO) below basal level was less pronounced in the CHTNa group, where also the posthemorrhage CO recovery was most rapid. Spontaneous recovery of MSAP after bleeding was equally improved in both treatment groups with the central venous pressure being significantly higher in the SHTNa group. The hemorrhage-induced fall in renal blood flow (RBF) was more pronounced in the CHTNa group, which also had an impaired posthemorrhage recovery of RBF. In comparison to the SHTNa and control groups the renovascular resistance was significantly higher in the CHTNa group already during the prehemorrhage infusion period.(ABSTRACT TRUNCATED AT 250 WORDS)
在清醒绵羊中研究了全身高渗(1.2M,4 mL kg-1)氯化钠(SHTNa)治疗对出血耐受性、伴随的全身血流动力学和局部血流的影响。将结果与脑室内(ICV)给予高渗(0.5 M,0.02 mL min-1)氯化钠(CHTNa)期间出血的动物所获得的结果进行比较。ICV输注等渗盐水期间的相应出血作为对照。所有治疗均在缓慢(0.7 mL kg-1 min-1)出血开始前30分钟开始,持续出血直至平均体动脉压(MSAP)突然降至约50 mmHg。为了使MSAP明显下降,CHTNa组(27.8 +/- 2.2 mL kg-1,p < 0.05)比SHTNa组(21.5 +/- 1.7 mL kg-1)需要抽取更多的血液,而SHTNa组对出血的耐受性又明显高于对照组(15.1 +/- 0.7 mL kg-1,p < 0.01)。出血引起的心输出量(CO)低于基础水平的降低在CHTNa组中不太明显,该组出血后CO恢复也最快。两个治疗组出血后MSAP的自发恢复均得到同样改善,SHTNa组的中心静脉压明显更高。出血引起的肾血流量(RBF)下降在CHTNa组中更明显,该组出血后RBF的恢复也受损。与SHTNa组和对照组相比,CHTNa组在出血前输注期间肾血管阻力就明显更高。(摘要截短至250字)