van Rijen E A, Ward J J, Little R A
North Western Injury Research Centre, University of Manchester, United Kingdom.
Shock. 1997 Sep;8(3):219-24. doi: 10.1097/00024382-199709000-00011.
Although the efficacy of colloid resuscitation fluids in restoring cardiovascular status in hemorrhagic shock is accepted, the effect they have on the activity of the reticuloendothelial system (RES) is less clear. As interaction with the RES may be important in determining susceptibility to infections after resuscitation the effects of three such fluids, hydroxyethyl starch, Haemaccel, and fresh autologous blood on RES function after a 40% hemorrhage have been investigated in BALB/C mice. The mice, anesthetized with isoflurane, were bled over a 10 min period, left hypovolemic for 30 min, and then resuscitated with their shed blood or the same volume of asanguineous fluid. Normothermia was maintained throughout the experiments. Whole body phagocytic activity was assessed at 1, 6, 24, 48, and 72 h after the end of hemorrhage by measuring the clearance rate (K) of intravenously injected 51Cr-labeled sheep red blood cells. No significant change in K was found at any time in animals resuscitated with shed blood. However, significant increases in K were found 48 h after resuscitation with Haemaccel. Hepatic uptake of sheep red blood cells was significantly increased at 48 and 72 h in Haemaccel-resuscitated animals compared with hydroxyethyl starch or shed blood resuscitation, whereas spleen uptake decreased at 72 h. Lung uptake was not affected at any time with any fluid. The same volume of Haemaccel had no significant effect either on K or on organ uptake when given to normovolemic animals. The changes in organ uptake after hemorrhage and resuscitation with Haemaccel were partially prevented if animals were resuscitated with Haemaccel plus autologous red cells.
尽管胶体复苏液在失血性休克中恢复心血管状态的功效已得到认可，但其对网状内皮系统（RES）活性的影响尚不清楚。由于与RES的相互作用在确定复苏后感染易感性方面可能很重要，因此在BALB/C小鼠中研究了三种此类液体，即羟乙基淀粉、贺斯和新鲜自体血在40%失血后对RES功能的影响。用异氟烷麻醉的小鼠在10分钟内失血，使其处于低血容量状态30分钟，然后用其自身失血或相同体积的无血液体进行复苏。在整个实验过程中维持正常体温。在出血结束后1、6、24、48和72小时，通过测量静脉注射的51Cr标记绵羊红细胞的清除率（K）来评估全身吞噬活性。用自身失血复苏的动物在任何时候K均未发现显著变化。然而，用贺斯复苏后48小时发现K显著增加。与羟乙基淀粉或自身失血复苏相比，用贺斯复苏的动物在48和72小时时肝脏对绵羊红细胞的摄取显著增加，而在72小时时脾脏摄取减少。任何液体在任何时候对肺摄取均无影响。给血容量正常的动物注射相同体积的贺斯对K或器官摄取均无显著影响。如果用贺斯加自体红细胞对动物进行复苏，则出血和用贺斯复苏后器官摄取的变化会部分得到预防。
