RINGERS ACETATE AND DEXTRAN-70 WITH OR WITHOUT HYPERTONIC SALINE IN ENDOTOXIN-INDUCED SHOCK IN PIGS
RINGERS ACETATE AND DEXTRAN-70 WITH OR WITHOUT HYPERTONIC SALINE IN ENDOTOXIN-INDUCED SHOCK IN PIGS
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DOI：
10.1097/00003246-199011000-00016
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发表时间：
1990-11-01
影响因子：
8.8
通讯作者：
MODIG, J
中科院分区：
文献类型：
--
作者：
KRISTENSEN, J;MODIG, J
本实验观察了醋酸林格氏液、6%右旋糖酐-70、7.5%NaCl以及7.5%NaCl与右旋糖酐-70联合应用对猪大肠杆菌内毒素休克的复苏效果。约3小时后，达到可再现的休克状态，开始治疗，由左心房压力控制。高渗溶液（7.5%NaCl和7.5%NaCl的右旋糖酐-70溶液）与等渗溶液（林格氏醋酸盐和右旋糖酐-70）相比，未显示出任何总体优势。仅观察到输注后持续< 30 min的短暂有益血流动力学效应。当施用葡聚糖-70时，心血管功能显著改善，并且与晶体组（林格氏乙酸盐和7.5%NaCl）相比，氧输送（≥ DO 2）和存活率显著更高。给予大量醋酸林格氏液导致肺功能立即恶化。左房压难以升高，甚至难以维持在基线水平，心脏指数仅一过性升高。总体结果是与右旋糖酐-70处理的猪相比，DO 2恶化并且存活率差。我们得出结论，右旋糖酐-70在猪内毒素休克复苏中上级醋酸林格氏液。此外，我们发现单独使用高渗盐水或与右旋糖酐联合使用在治疗这种类型的长期内毒素休克中没有作用。
The effects of Ringer''s acetate, 6% dextran-70, 7.5% NaCl, and the combination of 7.5% NaCl and dextran-70 were tested in resuscitation from endotoxin shock induced by continuous iv infusion of Escherichia coli endotoxin in pigs. After about 3 h, a reproducible shock state was achieved and treatment was started, governed by the left atrial pressure. The hypertonic solutions (7.5% NaCl and 7.5% NaCl in dextran-70) did not show any overall advantages over the isotonic solutions (Ringer''s acetate and dextran-70). Only transient beneficial hemodynamic effects lasting < 30 min after infusion were seen. When dextran-70 was administered, cardiovascular function was markedly improved and oxygen delivery (.ovrhdot.DO2) and survival were significantly higher compared with the crystalloid groups (Ringer''s acetate and 7.5% NaCl). Administration of large amounts of Ringer''s acetate resulted in an immediate deterioration of pulmonary function. It was difficult to elevate left atrial pressure or even to keep it at baseline level, and cardiac index was only transiently increased. The overall result was a deterioration of DO2 and poor survival compared with the dextran-70 treated pigs. We conclude that dextran-70 is superior to Ringer''s acetate in resuscitation from endotoxin-induced shock in pigs. Furthermore, we found no role for the use of hypertonic saline, alone or in combination with dextran, in the treatment of this type of prolonged endotoxin shock.