Effect of Peritoneal lavage with oxygenated perfluorochemicals on critical conditions

目的：本研究旨在探讨失血性休克时肠道的损伤及含氧全氟化合物（PFC）腹腔灌洗对失血性休克大鼠的保护作用。将大鼠随机分为4组（失血性休克组、O2 PFC组、N2 PFC组和假手术组），并进行失血性休克（血压为30-35 mm Hg，持续120分钟），然后复苏。在失血性休克和复苏期间，用含氧或含氮PFC进行腹腔灌洗。结果：大鼠失血性休克复苏后腹腔灌流含氧PFC组存活率较好。O2 PFC组失血性休克时及休克后体循环改善，代谢性酸中毒减轻。复苏后肠血流量明显增加，肠粘膜结构得到保护。O2 PFC组复苏后血浆肿瘤坏死因子-α（TNF-α）和白细胞介素-6（IL-6）水平的升高被抑制。结论：这些数据表明，含氧PFC腹腔灌洗维持失血性休克期间的有氧代谢，并改善复苏后肠系膜微循环，从而减轻全身炎症反应，可能是通过防止肠道诱导的远端器官衰竭。

Objective : This study was performed to assess the intestinal damage during hemorrhagic shock and elucidate the protective effect of peritoneal lavage with oxygenated perfluorochemicals (PFC) on hemorrhagic shock in rats.Methods : Rats were randomly divided into four groups (a hemorrhagic shock group, an O2PFC group, an N2PFC group, and a sham operated group), and were subjected to hemorrhagic shock (a blood pressure of 30-35 mm Hg for 120 minutes) followed by resuscitation. Peritoneal lavage with oxygenated or nitrogenated PFC was performed during hemorrhagic shock and resuscitation. Results : Rats undergoing peritoneal lavage with oxygenated PFC showed better survival after hemorrhagic shock and resuscitation. The systemic circulation during and after hemorrhagic shock was improved in the O2PFC group, and metabolic acidosis was also alleviated. Intestinal blood flow after resuscitation was significantly increased in this group and intestinal mucosal architecture was preserved. Finally, the increase of plasma tumor necrosis factor-α (TNF-α) and interleukin-6(IL-6) levels after resuscitation was suppressed in the O2PFC group. Conclusion : These data suggest that peritoneal lavage with oxygenated PFC maintains the aerobic metabolism during hemorrhagic shock and improves the mesenteric microcirculation after resuscitation, resulting in alleviating systemic inflammatory response, possibly by preventing gut-induced remote organ failure.