SENSITIVITY TO ENDOTOXIN IN RABBITS IS INCREASED AFTER HEMORRHAGIC-SHOCK
SENSITIVITY TO ENDOTOXIN IN RABBITS IS INCREASED AFTER HEMORRHAGIC-SHOCK
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DOI：
10.1152/jappl.1992.73.3.1146
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发表时间：
1992-09-01
影响因子：
3.3
通讯作者：
RICE, CL
中科院分区：
文献类型：
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作者：
MILESKI, WJ;WINN, RK;RICE, CL
创伤和出血后的免疫炎症反应可能导致脓毒症和多器官衰竭综合征的发生。测定心输出量（CO）、动脉压、动脉PO 2和肺通透性指数。本实验观察了失血性休克家兔对内毒素（LPS）的敏感性。通过将CO降低至基线的40%持续90分钟，然后用流出的血液复苏，然后用乳酸林格氏液维持CO接近基线来产生休克。将动物分为三组：1）仅失血性休克，2）仅LPS，和3）失血性休克+ LPS。第1组和第3组在第1天进行失血性休克。在第2天，将大肠杆菌LPS输注（1.0 μ g/kg iv）到组2和组3中。继续使用乳酸林格氏液进行液体复苏，以将CO维持在基线水平。注射LPS后5 h，静脉注射I-125-白蛋白，1h后处死动物，测定肺通透性指数。休克后LPS输注（第3组）导致CO、动脉压和PO 2显著降低，肺通透性增加。在第1组和第2组中未观察到这些变化。我们的结论是，失血性休克和复苏的结果在一个促炎症状态，导致随后暴露于LPS的敏感性增加。
The immunoinflammatory response following trauma and hemorrhage may predispose to the development of sepsis and multiple-organ failure syndrome. Cardiac output (CO), arterial pressure, arterial PO2, and pulmonary permeability index were measured. We examined the sensitivity of rabbits to infusions of lipopolysaccharide (LPS) after hemorrhagic shock. Shock was produced by reducing CO to 40% of baseline for 90 min, followed by resuscitation with shed blood and then with lactated Ringer solution to maintain CO near baseline. Animals were assigned to three groups: 1) hemorrhagic shock only, 2) LPS only, and 3) hemorrhagic shock + LPS. Groups 1 and 3 were subjected to hemorrhagic shock on day 1. Escherichia coli LPS was infused (1.0 mug/kg iv) into groups 2 and 3 on day 2. Fluid resuscitation with lactated Ringer solution was continued in an effort to maintain CO at baseline. Five hours after LPS infusion, I-125-albumin was injected intravenously, and rabbits were killed 1 h later for measurement of pulmonary permeability index. LPS infusion after shock (group 3) caused significant decreases in CO, arterial pressure, and PO2 and an increase in pulmonary permeability. These changes were not seen in the groups 1 and 2. We conclude that hemorrhagic shock and resuscitation result in a proinflammatory state, leading to increased sensitivity to subsequent exposure to LPS.