Nakamura Y, Wakabayashi A, Woolley T, Mullin P, Ito Y, Connolly J E
Arch Surg. 1976 Jul;111(7):783-6. doi: 10.1001/archsurg.1976.01360250059012.
In order to study the therapeutic effects of total body washout (TBW) in experimental endotoxin shock, we used the following procedure. Seventeen rabbits (controls) received Escherichia coli endotoxin (5 mg/kg) intravenously and were observed for 12 hours. Shock developed in 14 rabbits; they died in 5.2 +/- 1.0 (mean +/- SD) hours, with a survival rate of 18%. Seventeen rabbits were subjected to TBW only. Muscle temperature was lowered to 25 C with a pump oxygenator circuit and the animals were exsanguinated. After residual blood was flushed out with cold, lactated Ringer solution, the animals were rewarmed with another circuit that was primed with homologous blood. Fourteen animals survived (82%). Two hours after E. coli endotoxin was injected intravenously 17 animals were treated with TBW. The survival rate (53%) of this group was significantly higher than in the control group (18%) (P less than .005). Eight nonsurvivors showed hypotension and acidosis even after TBW treatment, thus indicating the irreversibility of their endotoxin shock. This study indicates that endotoxin shock may be reversed by TBW if it is instituted before irreversible cellular damage.
为研究全身冲洗（TBW）在实验性内毒素休克中的治疗效果，我们采用了以下步骤。17只兔子（对照组）静脉注射大肠杆菌内毒素（5毫克/千克），观察12小时。14只兔子发生休克，其中5只在5.2±1.0（平均值±标准差）小时内死亡，存活率为18%。17只兔子仅接受全身冲洗。通过泵氧合回路将肌肉温度降至25摄氏度，然后放血。用冷的乳酸林格液冲洗残留血液后，用另一个预充同源血液的回路使动物复温。14只动物存活（82%）。在静脉注射大肠杆菌内毒素2小时后，对17只动物进行全身冲洗治疗。该组的存活率（53%）显著高于对照组（18%）（P＜0.005）。8只未存活的动物即使在全身冲洗治疗后仍表现出低血压和酸中毒，这表明它们的内毒素休克已不可逆。本研究表明，如果在细胞发生不可逆损伤之前进行全身冲洗，内毒素休克可能被逆转。
