Objective To study the effects of hypotensive resuscitation and larger volume fluid resuscitation on uncontrolled hemorrhagic shock and survival in rats with a standardized massive splenic injury model（MSI）.Methods ...Objective To study the effects of hypotensive resuscitation and larger volume fluid resuscitation on uncontrolled hemorrhagic shock and survival in rats with a standardized massive splenic injury model（MSI）.Methods Following the MSI model,fifty Wistar rats were randomly and equally divided into five groups,group 1:sham-operated group,group 2: shock untreated group,group 3:normal MAP resuscitation group（during acute resuscitation phase MAP was kept at 80 mm Hg）,group 4:Hypotensive resuscitation group（during acute resuscitation phase MAP was kept at（60±5） mm Hg）,and group 5:larger volume fluid resuscitation with hypotensive resuscitation group(during acute resuscitation phase MAP was kept at（60±5） mm Hg,simultaneously infused SNP at 5 μg·kg-1·min-1).Results The mean survival time in group 1～5 was 180 min,73.50 min±8.04 min,114.30 min±31.33 min,146.70 min±28.07 min and 171.60 min±15.74 min respectively.Statistic significances were seen in each group（P<0.05）,except between group 1 and group 5（P=0.0671）.The amount of bleeding in group 2～5（during acute resuscitation phase） was 3.79 ml/kg±1.39 ml/kg、17.41 ml/kg±8.88 ml/kg、8.67 ml/kg±4.59 ml/kg and 10.33 ml/kg±4.31 ml/kg respectively.The loss of blood in group 3 was significantly more than other groups（P<0.05）.Group 4 and 5 enhanced the blood loss significantly compared with group 2（P<0.05）.The histopathologic of liver and renal showed that histopathologic injury is severe in group 3 compared with group 4,and histopathologic injury is not in evidence in group 5.Conclusion Hypotensive resuscitation and adding SNP at proper dose additionally could improve tissue metabolism and prolong survival time during hypotensive resuscitation from uncontrolled hemorrhagic shock.It is a more ideal resuscitation method compared with normal blood pressure resuscitation.展开更多
目的观察早期应用Mdivi-1经维持低血压后复苏对非控制失血性休克大鼠肾脏的保护作用。方法 SD大鼠分成4组:假手术组(Sham组),非控制失血性休克组(Shock组),常规液体复苏组(Ct组),常规液体复苏联用Mdivi-1组(Mdivi-1组)。观察不同处理组...目的观察早期应用Mdivi-1经维持低血压后复苏对非控制失血性休克大鼠肾脏的保护作用。方法 SD大鼠分成4组:假手术组(Sham组),非控制失血性休克组(Shock组),常规液体复苏组(Ct组),常规液体复苏联用Mdivi-1组(Mdivi-1组)。观察不同处理组的存活率、存活时间、肾功能、肾血流量及其线粒体功能的变化。结果 (1)常规液体复苏组大鼠存活时间较休克组有所延长,与常规液体复苏组相比,Mdivi-1组治疗大鼠72 h存活率明显提高(0%vs 31.25%),存活时间明显延长(14.4 h vs 51.7 h,P<0.05);(2)肾血流量:与休克组相比,常规液体复苏可改善大鼠肾血流量(P<0.05),与常规液体复苏组相比,Mdivi-1改善肾血流量的作用更明显[(128.43±25.55)U/min vs(244.76±57.79)U/min,P<0.01];(3)肾功能:与休克组相比,Mdivi-1明显地改善肾功能肌酐(Crea)和尿素氮(Urea,P<0.01),与常规液体复苏组相比,Urea、Crea经Mdivi-1治疗后也明显得到改善(P<0.05);(4)线粒体呼吸控制率(respiratory control rate, RCR):Mdivi-1能显著改善肾线粒体呼吸控制率,与休克组和常规液体复苏组相比差异均有统计学意义(P<0.05);(5)氧化应激损伤指标:与休克组和常规液体复苏组相比,Mdivi-1组肾脏丙二醛(MDA)、活性氧(ROS)均明显下降(P<0.01),明显减轻非控失血性休克大鼠的氧化应激损伤。结论在非控制失血性休克确定性止血治疗前,进行常规液体复苏的同时给予Mdivi-1可有效地提高大鼠存活率,改善肾灌注和肾功能以及肾线粒体功能,减轻氧化应激损伤。展开更多
文摘Objective To study the effects of hypotensive resuscitation and larger volume fluid resuscitation on uncontrolled hemorrhagic shock and survival in rats with a standardized massive splenic injury model（MSI）.Methods Following the MSI model,fifty Wistar rats were randomly and equally divided into five groups,group 1:sham-operated group,group 2: shock untreated group,group 3:normal MAP resuscitation group（during acute resuscitation phase MAP was kept at 80 mm Hg）,group 4:Hypotensive resuscitation group（during acute resuscitation phase MAP was kept at（60±5） mm Hg）,and group 5:larger volume fluid resuscitation with hypotensive resuscitation group(during acute resuscitation phase MAP was kept at（60±5） mm Hg,simultaneously infused SNP at 5 μg·kg-1·min-1).Results The mean survival time in group 1～5 was 180 min,73.50 min±8.04 min,114.30 min±31.33 min,146.70 min±28.07 min and 171.60 min±15.74 min respectively.Statistic significances were seen in each group（P<0.05）,except between group 1 and group 5（P=0.0671）.The amount of bleeding in group 2～5（during acute resuscitation phase） was 3.79 ml/kg±1.39 ml/kg、17.41 ml/kg±8.88 ml/kg、8.67 ml/kg±4.59 ml/kg and 10.33 ml/kg±4.31 ml/kg respectively.The loss of blood in group 3 was significantly more than other groups（P<0.05）.Group 4 and 5 enhanced the blood loss significantly compared with group 2（P<0.05）.The histopathologic of liver and renal showed that histopathologic injury is severe in group 3 compared with group 4,and histopathologic injury is not in evidence in group 5.Conclusion Hypotensive resuscitation and adding SNP at proper dose additionally could improve tissue metabolism and prolong survival time during hypotensive resuscitation from uncontrolled hemorrhagic shock.It is a more ideal resuscitation method compared with normal blood pressure resuscitation.
文摘目的观察早期应用Mdivi-1经维持低血压后复苏对非控制失血性休克大鼠肾脏的保护作用。方法 SD大鼠分成4组:假手术组(Sham组),非控制失血性休克组(Shock组),常规液体复苏组(Ct组),常规液体复苏联用Mdivi-1组(Mdivi-1组)。观察不同处理组的存活率、存活时间、肾功能、肾血流量及其线粒体功能的变化。结果 (1)常规液体复苏组大鼠存活时间较休克组有所延长,与常规液体复苏组相比,Mdivi-1组治疗大鼠72 h存活率明显提高(0%vs 31.25%),存活时间明显延长(14.4 h vs 51.7 h,P<0.05);(2)肾血流量:与休克组相比,常规液体复苏可改善大鼠肾血流量(P<0.05),与常规液体复苏组相比,Mdivi-1改善肾血流量的作用更明显[(128.43±25.55)U/min vs(244.76±57.79)U/min,P<0.01];(3)肾功能:与休克组相比,Mdivi-1明显地改善肾功能肌酐(Crea)和尿素氮(Urea,P<0.01),与常规液体复苏组相比,Urea、Crea经Mdivi-1治疗后也明显得到改善(P<0.05);(4)线粒体呼吸控制率(respiratory control rate, RCR):Mdivi-1能显著改善肾线粒体呼吸控制率,与休克组和常规液体复苏组相比差异均有统计学意义(P<0.05);(5)氧化应激损伤指标:与休克组和常规液体复苏组相比,Mdivi-1组肾脏丙二醛(MDA)、活性氧(ROS)均明显下降(P<0.01),明显减轻非控失血性休克大鼠的氧化应激损伤。结论在非控制失血性休克确定性止血治疗前,进行常规液体复苏的同时给予Mdivi-1可有效地提高大鼠存活率,改善肾灌注和肾功能以及肾线粒体功能,减轻氧化应激损伤。
