Endotoxin increases both protein and fluid microvascular permeability in cat skeletal muscle
Endotoxin increases both protein and fluid microvascular permeability in cat skeletal muscle
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DOI：
10.1097/01.ccm.0000048620.88344.70
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发表时间：
2003-02-01
影响因子：
8.8
通讯作者：
Grände, PO
中科院分区：
文献类型：
--
作者：
Holbeck, S;Grände, PO
目标：评价内毒素对整个器官骨骼肌蛋白质和液体渗透性的影响。设计：对照，前瞻性实验室研究。设定：大学研究实验室。主题：11只成年公猫。干预措施：该研究是在放置在充满液体的体积描记器中的猫后肢的自动灌注和去神经小腿肌肉上进行的。内毒素诱导的白蛋白渗透反射系数的变化被用作微血管壁蛋白质渗透性改变的量度，同时毛细血管滤过系数的变化被用作液体渗透性改变的量度。内毒素作为一个团注（1毫克/公斤静脉注射）给予6只猫，和另外5只猫只给予车辆（氯化钠）作为controls. Measures和主要结果：动脉血流量，动脉和静脉血压，总血管阻力，和组织体积的变化进行了连续测量。根据Starling液体平衡方程计算两种情况下（内毒素输注前和输注后约1.5小时）白蛋白渗透反射系数之间的比值。通过静脉推注20%人血白蛋白（0.6 g/kg）测量等容状态下的最大吸收速率和毛细血管过滤系数进行测定。在白蛋白输注前后测量白蛋白浓度，以校正血浆容量差异对诱导的胶体渗透压升高的影响。我们发现，白蛋白的渗透反射系数降低了30%（p <0.05），毛细血管滤过系数增加了31%（p <0.05）。结论：内毒素引起微血管壁蛋白质和液体通透性的显著增加。这些效应可能解释了在脓毒症和全身炎症反应综合征的危重患者中经常看到的血浆显著渗漏到氚中。
Objective: To evaluate effects of lipopolysaccharide (endotoxin) on protein and fluid permeability in a whole organ skeletal muscle preparation.Design: Controlled, prospective laboratory study. Setting: University research laboratory.Subjects: Eleven adult male cats.Interventions: The study was performed on the autoperfused and denervated calf muscles of the cat hindlimb placed in a fluid-filled plethysmograph. The endotoxin-induced change in the osmotic reflection coefficient for albumin was used as a measure of alteration in protein permeability of the microvascular wall, and the simultaneous change in capillary filtration coefficient was used as a measure of alteration in fluid permeability. Endotoxin as a bolus infusion (1 mg/kg iv) was given to six cats, and another five cats given only the vehicle (NaCl) were used as control.Measurements and Main Results: Arterial blood flow, arterial and venous blood pressures, total vascular resistance, and tissue volume changes were measured continuously. The ratio between the osmotic reflection coefficients for albumin on two occasions (before and about 1.5 hr after endotoxin infusion) was calculated from the Starling fluid equilibrium equation. This was performed by measurement of the maximum absorption rate from an iso-volumetric state by an intravenous bolus infusion of 20% human albumin (0.6 g/kg) and the capillary filtration coefficient. Albumin concentrations were measured before and after the albumin infusion to correct for effects of difference in plasma volume on the induced increase in colloid osmotic pressure. We found that the osmotic reflection coefficient for albumin was reduced by 30% (p < .05), and the capillary filtration coefficient was increased by 31% (p < .05) by endotoxin. No changes were seen in the vehicle experiments.Conclusion: Endotoxin causes a significant increase in both protein and fluid microvascular wall permeability. These effects may explain the marked leakage of plasma to the interstitium that is often seen in critically ill patients with sepsis and systemic inflammatory response syndrome.