Effects of colloid resuscitation on peripheral microcirculation, hemodynamics, and colloidal osmotic pressure during acute severe hemorrhage in rabbits
Effects of colloid resuscitation on peripheral microcirculation, hemodynamics, and colloidal osmotic pressure during acute severe hemorrhage in rabbits
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DOI：
10.1097/01.shk.0000159555.87662.93
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发表时间：
2005-04-01
期刊：
影响因子：
3.1
通讯作者：
Ozaki, M
中科院分区：
文献类型：
--
作者：
Komori, M;Takada, K;Ozaki, M
本文观察了羟乙基淀粉（HES）对失血性休克家兔微循环、血流动力学和胶体渗透压的影响。共40只家兔用戊巴比妥和异氟烷麻醉，并机械通气。制备耳室，通过活体显微镜检查血管。通过去除近一半的循环血量诱导休克。20只家兔放血后立即静脉输注20 mL羟乙基淀粉。然后静脉给予额外的HES，总体积为100 mL。另外20只家兔（对照组）静脉注射40 mL乳酸林格氏液（LR），然后在与HES相同的条件下再注射LR至总体积为200 mL。放血后，HES和LR组的小动脉直径降低相似（HES，基线值的40.5% +/- 14.8% vs LR，43.3% +/- 13.1%）。输注完成后，HES组的小动脉直径显著恢复至基线值的90.8% ± 10.2%，而LR组仅为62.6% ± 10.7%（P < 0.005）。羟乙基淀粉组动脉血流速度和血流量恢复也明显优于LR组（P < 0.005）。输注完成后，HES组的平均小动脉压、中心静脉压和血浆胶体渗透压显著高于LR组（P < 0.005）。我们的结论是，静脉输注羟乙基淀粉有效地维持微循环，血流动力学和胶体渗透压在兔模型的急性严重出血。
We examined the effects of hydroxyethyl starch (HES) on the microcirculation, hemodynamics, and colloidal osmotic pressure in a rabbit model of hemorrhagic shock. A total of 40 rabbits was anesthetized with pentobarbital and isoflurane, and they were mechanically ventilated. An ear chamber was prepared to examine blood vessels by intravital microscopy. Shock was induced by removing nearly half of the circulating blood volume. Twenty rabbits received 20 mL of HES by intravenous infusion immediately after blood letting. Additional HES was then administered intravenously to a total volume of 100 mL. The other 20 rabbits (control) were intravenously given 40 mL of lactated Ringer's solution (LR), followed by additional LR to a total volume of 200 mL, administered under the same conditions as HES. After blood letting, arteriolar diameter decreased similarly in the the HES and LR groups (HES, 40.5% +/- 14.8% of the baseline value versus LR, 43.3% +/- 13.1%). After the completion of infusion, arteriolar diameter significantly recovered to 90.8% +/- 10.2% of the baseline value in the HES group as compared with only 62.6% +/- 10.7% in the LR group (P < 0.005). Recovery of arterial blood flow velocity and blood flow rate was also significantly better in the HES group than in the LR group (P < 0.005). Mean arteriolar pressure, central venous pressure, and plasma colloid osmotic pressure after the completion of infusion were significantly greater in the HES group than in the LR group (P < 0.005). We conclude that intravenous infusion of HES effectively maintains the microcirculation, hemodynamics, and colloidal osmotic pressure in a rabbit model of acute severe hemorrhage.