Intraperitoneal, but not enteric, adenosine administration improves survival after volume-controlled hemorrhagic shock in rats
Intraperitoneal, but not enteric, adenosine administration improves survival after volume-controlled hemorrhagic shock in rats
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腹膜内而非肠内给予腺苷可改善大鼠容量控制性失血性休克后的存活率
作者：
Xianren Wu;R. Kentner;J. Stezoski;P. Kochanek;E. Jackson;T. Carlos;J. Carcillo;W. Behringer;P. Safar;S. Tisherman
目的为了避免腺苷潜在的不良全身副作用，本研究探讨腹膜内或肠内腺苷对容量控制性失血性休克后生存和炎症反应的潜在益处。设计前瞻性、随机性和盲法。使用三相容量控制失血性休克模型：失血性休克阶段（120 分钟）、复苏阶段（60 分钟）和观察阶段（72 小时）。比较三组：对照组、腹膜内腺苷和肠内腺苷。设置动物研究设施。受试者雄性斯普拉格-道利大鼠。干预措施从失血性休克20分钟开始并持续到复苏阶段，所有三组均接受腹腔灌洗和向回肠重复推注媒介物（生理盐水）或腺苷。腹腔内腺苷组（n = 10）使用腺苷溶液（0.1 mM）进行腹腔灌洗。在肠腺苷组（n = 10）中，将腺苷（1.0 mM）注射到回肠中。使用相同的失血性休克模型，在复苏时间为 1 小时或 4 小时时，对 12 只单独的大鼠（对照和腹膜内腺苷，每只 n = 6）研究了血液细胞因子浓度和肺和肝脏中的白细胞浸润。测量和主要结果失血性休克和复苏期间三组的平均动脉压和心率相似。与对照组相比，腹膜内和肠内腺苷组的钾、乳酸和血尿素氮浓度较低，动脉 pH 值较高（均 p < .05）。腹膜内腺苷组的 72 小时生存时间比对照组更长 (p < .05)。血浆白细胞介素-1&bgr;、白细胞介素-6、白细胞介素-10 和肿瘤坏死因子-&agr; 均不存在。对照组和腹膜内腺苷组之间肺和肝脏中的浓度和白细胞浸润均不同。结论通过腹膜内途径给予腺苷可延长大鼠严重容量控制性失血性休克后的生存时间，且不会加重低血压或心动过缓。这种有益作用可能不能归因于腺苷对炎症反应的影响。
ObjectiveTo circumvent the potential adverse systemic side effects of adenosine, this study explored the potential benefit of intraperitoneal or enteric adenosine on survival and inflammatory responses after volume-controlled hemorrhagic shock. DesignProspective, randomized, and blinded. A three-phase, volume-controlled hemorrhagic shock model was used: hemorrhagic shock phase (120 mins), resuscitation phase (60 mins), and observation phase (72 hrs). Three groups were compared: controls, intraperitoneal adenosine, and enteric adenosine. SettingAnimal research facility. SubjectsMale Sprague-Dawley rats. InterventionsStarting at 20 mins of hemorrhagic shock and continuing through the resuscitation phase, all three groups received both intraperitoneal lavage and repeated bolus injections into the ileum of vehicle (normal saline) or adenosine. In the intraperitoneal adenosine group (n = 10), adenosine solution (0.1 mM) was used for intraperitoneal lavage. In the enteric adenosine group (n = 10), adenosine (1.0 mM) was injected into the ileum. Blood cytokine concentrations and leukocyte infiltration in lungs and liver were studied in 12 separate rats (control and intraperitoneal adenosine, n = 6 each) with the same hemorrhagic shock model at resuscitation time 1 hr or 4 hrs. Measurements and Main Results Mean arterial pressure and heart rate were similar between the three groups during hemorrhagic shock and resuscitation. Potassium, lactate, and blood urea nitrogen concentrations were lower and arterial pH was higher in the intraperitoneal and enteric adenosine groups compared with the control group (both p < .05). Survival time to 72 hrs was longer in the intraperitoneal adenosine group than in the control group (p < .05). Neither plasma interleukin-1&bgr;, interleukin-6, interleukin-10, and tumor necrosis factor-&agr; concentrations nor leukocyte infiltration in the lungs and liver was different between the control and intraperitoneal adenosine groups. ConclusionsThe administration of adenosine via the intraperitoneal route improves survival time after severe volume-controlled hemorrhagic shock in rats without worsening hypotension or bradycardia. This beneficial effect may not be attributable to effects of adenosine on the inflammatory response.
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影响因子：
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作者：
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DOI：
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发表时间：
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期刊：
Journal of applied physiology (Bethesda, Md. : 1985)
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DOI：
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发表时间：
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影响因子：
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