Pulmonary microvascular response to hemorrhagic shock, resuscitation, and recovery.
Pulmonary microvascular response to hemorrhagic shock, resuscitation, and recovery.
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肺微血管对失血性休克、复苏和恢复的反应。
DOI：
10.1152/jappl.1979.46.3.498
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发表时间：
1979
期刊：
影响因子：
--
通讯作者：
J. Will
中科院分区：
文献类型：
--
作者：
R. Demling;G. Niehaus;J. Will
我们研究了失血性休克、复苏和恢复对肺微循环的影响。我们使用肺淋巴流量（QL）和淋巴细胞与血浆蛋白的比值作为经血管液体滤过率和蛋白渗透性的敏感指标。我们测量了肺血管压力，心输出量，血气，淋巴流量，淋巴和血浆蛋白之前和期间2小时的休克期，3小时的复苏期，72小时的恢复期，在9个未麻醉的羊慢性肺淋巴瘘。我们发现，在休克早期，当动物被流血的到含有醋酸柠檬酸盐葡萄糖溶液的袋中，直到主动脉压为50 Torr时，QL降低30%。在休克后期，由于肺血管阻力增加了250%，9只动物中有5只的QL逐渐增加到或超过基线。在3小时复苏期间，平均QL增加了110%，淋巴细胞与血浆蛋白的比值显著降低，表明没有蛋白渗透性变化。在9项研究中的5项中，淋巴液变得可见血腥。QL和淋巴RBC增加被认为是继发于微血管压力升高。在恢复期间，压力和QL恢复至基线。
We studied the effect of hemorrhagic shock, resuscitation, and recovery on the pulmonary microcirculation. We used lung lymph flow (QL) and lymph-to-plasma protein ratio as sensitive indices of transvascular fluid filtration rate and protein permeability. We measured pulmonary vascular pressures, cardiac output, blood gases, lymph flow, and lymph and plasma proteins before and during a 2-h period of shock, a 3-h period of resuscitation, and a 72-h period of recovery, in nine unanesthetized sheep with chronic lung lymph fistula. We found a 30% decrease in QL during early shock as animals were bled into bags containing an acetate citrate dextrose solution until aortic pressure was 50 Torr. QL gradually increased to or exceeded base line in five of nine animals during late shock as pulmonary vascula resistance increased by 250%. During the 3-h resuscitation period, mean QL increased by 110%, with the lymph-to-plasma protein ratio being significantly decreased, indicating no protein permeability change. In five of nine studies, lymph became visible bloody. The increased QL and lymph RBCs were felt to be secondary to an elevation in microvascular pressure. During the recovery period, pressures and QL returned to base line.