Haemodynamic and metabolic effects of resuscitation with Ringer's ethyl pyruvate in the acute phase of porcine endotoxaemic shock
Haemodynamic and metabolic effects of resuscitation with Ringer's ethyl pyruvate in the acute phase of porcine endotoxaemic shock
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DOI：
10.1111/j.1399-6576.2006.01140.x
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发表时间：
2006-11-01
影响因子：
2.1
通讯作者：
Hjelmqvist, H.
中科院分区：
文献类型：
--
作者：
Andersson, A.;Fenhammar, J.;Hjelmqvist, H.
背景：丙酮酸乙酯具有抗炎和清除自由基的特性。然而，尚未详细研究丙酮酸乙酯的血液动力学效应。我们调查了复苏与林格氏丙酮酸乙酯溶液（REPS）与林格氏乙酸（RA）在猪内毒素血症shock.Methods的急性模型的全身，区域和微循环血液动力学和代谢的影响：14只麻醉猪接受了内毒素，逐步增加超过30分钟的速率为2.5 μ g/kg/h的输注。内毒素血症60分钟后，用丙酮酸乙酯40 mg/kg（以REPS形式给药）或等量RA复苏动物，给药时间超过10分钟。此后，开始输注丙酮酸乙酯40 mg/kg/h（以REPS形式给药）或等量RA，并减少维持液，使给予的液体总量保持恒定。实验结束后300分钟内毒素血症。结果：Enclotoxin输注导致低动力状态，液体复苏后60分钟逆转。进行性恶化，随后，300分钟后，所有动物再次低动力。在全身血液动力学、肾动脉或门静脉血流或肝脏、肾脏、回肠浆膜或粘膜中的微循环血流方面，未发现组间对治疗的反应存在差异。两组均出现代谢性酸中毒和动脉血乳酸增加，但REPS组从150分钟起碱过剩显着降低，150和210分钟阴离子间隙显着升高。结论：我们无法证明REPS和RA在急性猪血液中毒性休克模型中复苏方面有任何差异。
Background: Ethyl pyruvate has been shown to possess anti-inflammatory and free radical scavenging properties. However, the haemodynamic effects of ethyl pyruvate have not been studied in detail. We investigated the systemic, regional and microcirculatory haemodynamic and metabolic effects of resuscitation with Ringer's ethyl pyruvate solution (REPS) vs. Ringer's acetate (RA) in an acute model of porcine endotoxaemic shock.Methods: Fourteen anaesthetized pigs received an infusion of endotoxin that was increased stepwise over 30 min to a rate of 2.5 mu g/kg/h. After 60 min of endotoxaemia, the animals were resuscitated with either ethyl pyruvate 40 mg/kg, given as REPS, or the equivalent volume of RA, administered over 10 min. Thereafter, an infusion of either ethyl pyruvate 40 mg/kg/h, given as REPS, or the equivalent volume of RA, was started, and the maintenance fluid was reduced so that the total amount of fluid given was kept constant. The experiment was terminated after 300 min of endotoxaemia.Results: Enclotoxin infusion led to a hypodynamic state that was reversed by fluid resuscitation after 60 min. Progressive deterioration ensued and, after 300 min, all animals were again hypodynamic. No differences in response to treatment were found between the groups with regard to systemic haemodynamics, renal artery or portal vein flow or microcirculatory flow in the liver, kidney, ileal serosa or mucosa. Metabolic acidosis and increased arterial blood lactate developed in both groups, but, in the REPS group, the base excess was significantly lower from 150 min and the anion gap was significantly higher at 150 and 210 min.Conclusion: We could not demonstrate any difference between REPS and RA for resuscitation in this model of acute porcine enclotoxaemic shock.