A new salutary resuscitative fluid: liposome encapsulated hemoglobin/hypertonic saline solution.
A new salutary resuscitative fluid: liposome encapsulated hemoglobin/hypertonic saline solution.
复制标题
一种新的有益复苏液：脂质体封装的血红蛋白/高渗盐水溶液。
DOI：
10.1097/00005373-199207000-00076
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发表时间：
1992
期刊：
影响因子：
--
通讯作者：
Giora Z. Feuerstein
中科院分区：
文献类型：
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作者：
Reuven Rahinovici;Alan S. Rudolph;Jerome Vernick;Giora Z. Feuerstein
低容量高渗（7.5%）生理盐水（HTS）复苏是失血性休克患者的一种不断发展的治疗方式。在控制失血性休克模型和一些临床试验中，该溶液已显示出发挥保护性血流动力学作用。然而，HTS没有携氧能力，因此不能直接改善氧的输送。开发含氧复苏液的主要策略之一是将血红蛋白包封在磷脂囊泡（LEH）内。该制剂的优点是无血型和抗原，易于适应大规模生产，并且非常稳定，保质期长。因此，我们验证了一个假设，即用HTS重组的冻干LEH可以改善暴露于致命的控制性失血性休克的大鼠的组织氧合和存活率。取70%血容量，15分钟后开始用HTS （5ml /kg）、LEH （5ml /kg）、乳酸林格氏液（vol:vol = 1:3）、LEH-HTS （5ml /kg）或氧气（100%）治疗（n = 10-16）引起休克。LEH-HTS改善了使用薄膜室氧传感器直接测量的骨骼肌氧张力（PO2 87 +/- 13 mm Hg与其他组40-50 mm Hg相比，p < 0.05）。这与血压改善、酸中毒减少和24小时生存率增加相关（75% vs.其他组6%-25%，p < 0.05）。综上所述，本研究表明HTS重组LEH作为血液替代品对失血性休克的治疗具有显著的有益作用。
Low-volume resuscitation with hypertonic (7.5%) saline (HTS) is an evolving therapeutic modality for patients with hemorrhagic shock. This solution has been shown to exert protective hemodynamic effects in models of controlled hemorrhagic shock and in several clinical trials. However, HTS has no oxygen-carrying capacity and therefore does not improve oxygen delivery directly. One of the leading strategies in developing an oxygen-carrying resuscitative fluid is the encapsulation of hemoglobin within phospholipid vesicles (LEH). This preparation has the advantage of being blood type and antigen free, easily adaptable to scale-up production, and remarkably stable with a long shelf life. We therefore tested the hypothesis that lyophilized LEH reconstituted with HTS will improve tissue oxygenation and survival in rats exposed to a lethal controlled hemorrhagic shock. Shock was induced by withdrawal of 70% of blood volume and therapy (n = 10-16) with HTS (5 mL/kg), LEH (5 mL/kg), lactated Ringer's solution (vol:vol = 1:3), LEH-HTS (5 mL/kg), or oxygen (100%) was initiated 15 minutes later. The LEH-HTS improved skeletal muscle oxygen tension directly measured using a thin-film chamber oxygen sensor (PO2 87 +/- 13 mm Hg vs. 40-50 mm Hg in other groups, p < 0.05). This was associated with improved blood pressure, reduced acidosis, and increased survival at 24 hours (75% vs. 6%-25% in other groups, p < 0.05). In conclusion, the study demonstrates a remarkably salutary effect of LEH reconstituted with HTS as a blood substitute in the treatment of hemorrhagic shock.