Krausz M M, David M, Amstislavsky T
Department of Surgery B, Carmel Medical Center, Technion Faculty of Medicine, Haifa, Israel.
Shock. 1994 Oct;2(4):267-70. doi: 10.1097/00024382-199410000-00006.
Hypertonic saline solution (HTS) treatment of uncontrolled hemorrhagic shock (UCHS) in anesthetized animals leads to increased bleeding, fall in mean arterial pressure (MAP), and increased mortality. To rule out the effect of anesthetic drugs on this response, HTS infusion in UCHS was studied in awake rats. 24 h prior to the experiment, the animals were cannulated under neurolidal-ketalar anesthesia and two major branches of the ileo-colic artery were encircled with a silk suture. On the next day the awake animals were randomly divided into two groups: in group 1 (n = 16) controlled hemorrhagic shock (CHS) was induced by arterial bleeding of 20 mL/kg; in group 2 (n = 16) UCHS was induced by transcutaneous tear of two branches of the ileo-colic artery. The animals in each group were then divided into two subgroups: group A was untreated and group B was treated with 5 mL/kg 7.5% NaCl (HTS) after 10 min. Arterial bleeding in group 1A was followed by a fall in MAP to 63 +/- 2 mmHg (p < .001), and the hematocrit decreased to 37 +/- 3% (p < .01) in 10 min. Injury to two branches of the ileo-coli artery was followed by intra-abdominal bleeding, fall in MAP to 87 +/- 6 mmHg (p < .01), and a decrease in hematocrit to 32 +/- 2% (p < .01) in 10 min. Infusion of HTS in group 1B was followed by an increase in MAP to 84 +/- 4 mmHg (p < .01) and a fall in hematocrit to 22 +/- 2% (p < .01) after 60 min, while in the untreated group 1A, the MAP was 65 +/- 4 mmHg (p < .05).(ABSTRACT TRUNCATED AT 250 WORDS)
在麻醉动物中,用高渗盐溶液(HTS)治疗失血性休克(UCHS)会导致出血增加、平均动脉压(MAP)下降以及死亡率上升。为排除麻醉药物对这种反应的影响,在清醒大鼠中研究了高渗盐溶液在失血性休克中的输注情况。实验前24小时,在神经安定-氯胺酮麻醉下对动物进行插管,并在回结肠动脉的两个主要分支用丝线环绕。第二天,将清醒动物随机分为两组:第1组(n = 16)通过20 mL/kg动脉出血诱导控制性失血性休克(CHS);第2组(n = 16)通过经皮撕裂回结肠动脉的两个分支诱导非控制性失血性休克(UCHS)。然后将每组动物再分为两个亚组:A组不治疗,B组在10分钟后用5 mL/kg 7.5%氯化钠(HTS)治疗。第1A组动脉出血后,MAP在10分钟内降至63±2 mmHg(p <.001),血细胞比容降至37±3%(p <.01)。回结肠动脉两个分支损伤后,腹腔内出血,MAP在10分钟内降至87±6 mmHg(p <.01),血细胞比容降至32±2%(p <.01)。第1B组输注HTS后,60分钟后MAP升至84±4 mmHg(p <.01),血细胞比容降至22±2%(p <.01),而未治疗的第1A组MAP为65±4 mmHg(p <.05)。(摘要截断于250字)