Busund R, Lindsetmo R O, Balteskard L, Rekvig O P, Revhaug A
Department of Surgery, Tromsø University Hospital, Norway.
Circ Shock. 1993 Aug;40(4):268-75.
Plasma therapy in severe septicemia, either as part of plasma exchange or alone, was evaluated in a model of lethal septic shock induced with live Escherichia coli in pigs. The following groups were studied: group I, septic animals treated with repeated plasma exchanges, n = 8; group II, nontreated septic controls, n = 8; group III, septic animals treated with repeated plasma infusions, n = 14; and group IV, nonseptic animals treated with repeated plasma infusions, n = 7. In the septic animals treated with plasma (groups I and III), a rapid fatal response was observed between 2 and 5 min after the start of plasma therapy, while the septic controls (group II) showed a progressively longer lasting septic shock. The nonseptic animals (group IV) were unaffected by the plasma infusions. Plasma levels of endotoxin above 2 ng/ml were associated with rapid death during plasma therapy. Ionized Ca2+ fell abruptly in this situation. This study indicates that commonly used plasma therapies (exchanges or transfusions) in septic animals may have acute deleterious effects. These effects may be explained by depletion of ionized calcium.
在猪的致死性大肠杆菌诱导的感染性休克模型中，对严重败血症中的血浆疗法进行了评估，该疗法可作为血浆置换的一部分，也可单独使用。研究了以下几组：第一组，接受重复血浆置换治疗的败血症动物，n = 8；第二组，未治疗的败血症对照组，n = 8；第三组，接受重复血浆输注治疗的败血症动物，n = 14；第四组，接受重复血浆输注治疗的非败血症动物，n = 7。在用血浆治疗的败血症动物（第一组和第三组）中，在血浆治疗开始后2至5分钟内观察到快速致命反应，而败血症对照组（第二组）则表现出持续时间逐渐延长的感染性休克。非败血症动物（第四组）不受血浆输注的影响。血浆内毒素水平高于2 ng/ml与血浆治疗期间的快速死亡有关。在这种情况下，离子钙水平会突然下降。这项研究表明，败血症动物中常用的血浆疗法（置换或输血）可能具有急性有害作用。这些作用可能是由离子钙的消耗所解释的。
