The Early Effect of Voluven, a Novel Hydroxyethyl Starch (130/0.4), on Cerebral Oxygen Supply and Consumption in Resuscitation of Rabbit With Acute Hemorrhagic Shock
The Early Effect of Voluven, a Novel Hydroxyethyl Starch (130/0.4), on Cerebral Oxygen Supply and Consumption in Resuscitation of Rabbit With Acute Hemorrhagic Shock
复制标题
新型羟乙基淀粉（130/0.4）Voluven 对急性失血性休克兔复苏时脑氧供应和消耗的早期影响。
DOI：
10.1097/ta.0b013e318173e7da
复制
发表时间：
2009-03-01
影响因子：
--
通讯作者：
Xiong, Lize
中科院分区：
文献类型：
--
作者：
Chen, Shaoyang;Zhu, Xiaoling;Xiong, Lize
背景资料：万汶（羟乙基淀粉[HES] 130/0.4）是新一代低分子量羟乙基淀粉产品，已广泛应用于创伤失血性休克的临床治疗。但在失血性休克复苏时是否影响脑氧供需平衡，目前尚无相关资料。本研究的目的是为了解决这个问题，在兔受到严重的出血性shock.Methods：在新西兰兔，急性失血性休克诱导抽取45%至50%的总血量从股静脉在10分钟时，平均动脉压降低到60%的基线水平。出血后30分钟，动物输注等量的万汶（V组）或三倍量的乳酸林格氏液（R组）。分别从股动脉和颈静脉球获得动脉（Sao（2））和静脉（SjvO（2））血样中的氧饱和度。结果：失血性休克后，脑组织中SjvO（2）、CjvO（2）水平降低，AVDO（2）、CERO 2升高;复苏后，V组SjvO（2）、AVDO（2）、CERO（2）迅速恢复至基础水平，而R组仍处于异常水平（p < 0.05）。复苏后30分钟，各组之间的SjvO（2）和CERO 2水平有显著差异。结论：在急性失血性休克复苏过程中，早期应用万汶有利于维持血流动力学的稳定和脑氧供需平衡。
Background: Voluven (hydroxyethyl starch [HES] 130/0.4), a new generation of HES product with low molecular weight, has been widely used for the treatment of traumatic and hemorrhagic shock in clinics. However, no data are available whether it affects the balance of cerebral oxygen supply and consumption when applied to resuscitate hemorrhagic shock. The purpose of this study was to address this question in rabbits subjected to a severe hemorrhagic shock.Methods: In New Zealand rabbits, an acute hemorrhagic shock was induced by withdrawing 45% to 50% of total blood volume from the femoral vein in 10 minutes when the mean arterial pressure was reduced to 60% of the baseline level. Thirty minutes after the hemorrhage, animals were infused with either an equal amount of Voluven (group V) or a tripled amount of lactated Ringer's solution (group R). The saturation of oxygen was obtained in arterial (Sao(2)) and venous (SjvO(2)) blood samples from the femoral artery and jugular bulb, respectively. Arterial oxygen content (Cao(2)), jugular oxygen content (CjvO(2)), arteriovenous oxygen difference (AVDO(2)), and cerebral oxygen extraction rate (CERO2) were calculated accordingly to evaluate the oxygenation state in the brain.Results: Levels of SjvO(2) and CjvO(2) were decreased after hemorrhagic shock, and there were increases in AVDO(2) and CERO2 values. After resuscitation, the SjvO(2), AVDO(2), and CERO2 levels in group V were quickly recovered to the basal levels, whereas the values in group R remained in the abnormal levels (p < 0.05). There were significant differences between the groups in their SjvO(2) and CERO2 levels at 30 minutes after resuscitation. In addition, the mean arterial pressure was restored to the basal levels in group V but not in group R after resuscitation (p < 0.05).Conclusion: We conclude that early infusion of Voluven is beneficial for maintenance of the hemodynamic stability and for the balance of cerebral oxygen supply and consumption during the resuscitation of acute hemorrhagic shock.