Effect of Peritoneal lavage with oxygenated perfluorochemicals on critical conditions

目的：评价失血性休克对肠道的损伤，探讨含氧全氟化合物(PFC)腹腔灌洗对失血性休克大鼠的保护作用。方法：将大鼠随机分为失血性休克组、O2PFC组、N2PFC组和假手术组4组，给予失血性休克(血压30~35 mm Hg，120min)后复苏。失血性休克和复苏时分别用氧合或氮化的PFC进行腹腔灌洗。结果：给予氧合PFC腹腔灌洗的大鼠在失血性休克复苏后存活率较高。O2PFC组失血性休克时和失血性休克后的体循环得到改善，代谢性酸中毒也有所减轻。复苏后肠血流量明显增加，肠粘膜结构得到保护。O2PFC组复苏后血浆肿瘤坏死因子-α和白介素6(IL-6)水平的升高受到抑制。结论：氧合PFC腹腔灌洗可维持失血性休克时的有氧代谢，改善复苏后的肠系膜微循环，从而减轻全身炎症反应，其机制可能与预防肠源性远隔器官衰竭有关。

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.