EFFECT OF HYDRATION STATUS ON CEREBRAL BLOOD-FLOW AND CEREBROSPINAL-FLUID LACTIC-ACIDOSIS IN RABBITS WITH EXPERIMENTAL MENINGITIS
EFFECT OF HYDRATION STATUS ON CEREBRAL BLOOD-FLOW AND CEREBROSPINAL-FLUID LACTIC-ACIDOSIS IN RABBITS WITH EXPERIMENTAL MENINGITIS
复制标题
DOI：
10.1172/jci115676
复制
发表时间：
1992-03-01
影响因子：
15.9
通讯作者：
SANDE, MA
中科院分区：
文献类型：
--
作者：
TUREEN, JH;TAUBER, MG;SANDE, MA
在患有实验性肺炎球菌脑膜炎的兔子中评估了水合状态对脑血流量（CBF）和脑脊液（CSF）乳酸性酸中毒发展的影响。 由于先前已在该模型中证明脑血管自动调节功能丧失，因此我们推断血管内容量的降低可能会严重影响脑灌注。 此外，由于抗生素治疗后观察到蛛网膜下腔炎症反应急性加剧，因此不仅在脑膜炎发生时对动物进行研究，而且在抗生素治疗后4-6小时也对动物进行研究，以确定是否也会对CBF产生影响。 为了产生不同水平的水合，动物每 24 小时给予 50 毫升/公斤的生理盐水（“低液体”）或每 24 小时 150 毫升/公斤（“高液体”）。 感染 16 小时后，与接受较高液体方案的兔子相比，接受较低液体方案的兔子平均动脉血压 (MABP) 较低、CBF 较低、脑脊液乳酸较高。 在抗生素给药后的前4-6小时内，与高液体兔子相比，低液体兔子的MABP和CBF显着降低，并且脑脊液乳酸浓度的增加显着更大。 这项研究表明，血管内容量状态可能是决定 CBF 以及脑膜炎脑缺血程度的关键变量。
The effects of hydration status on cerebral blood flow (CBF) and development of cerebrospinal fluid (CSF) lactic acidosis were evaluated in rabbits with experimental pneumococcal meningitis. As loss of cerebrovascular autoregulation has been previously demonstrated in this model, we reasoned that compromise of intravascular volume might severely affect cerebral perfusion. Furthermore, as acute exacerbation of the inflammatory response in the subarachnoid space has been observed after antibiotic therapy, animals were studied not only while meningitis evolved, but also 4-6 h after treatment with antibiotics to determine whether there would also be an effect on CBF. To produce different levels of hydration, animals were given either 50 ml/kg per 24 h of normal saline ("low fluid") or 150 ml/kg 24 h ("high fluid"). After 16 h of infection, rabbits that were given the lower fluid regimen had lower mean arterial blood pressure (MABP), lower CBF, and higher CSF lactate compared with animals that received the higher fluid regimen. In the first 4-6 h after antibiotic administration, low fluid rabbits had a significant decrease in MABP and CBF compared with, and a significantly greater increase in CSF lactate concentration than, high fluid rabbits. This study suggests that intravascular volume status may be a critical variable in determining CBF and therefore the degree of cerebral ischemia in meningitis.