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The effect of hypertonic-hyperoncotic fluid on interstinal microcirculation at prehospital situation

院前高渗高渗液对肠间微循环的影响

基本信息

批准号：
17592112
负责人：
OI Yoshiyuki
金额：
$ 2.24万
依托单位：
Nihon University
依托单位国家：
日本
项目类别：
Grant-in-Aid for Scientific Research (C)
财政年份：
2005
资助国家：
日本
起止时间：
2005 至 2006
项目状态：
已结题

来源：
https://kaken.nii.ac.jp/en/grant/KAKENHI-PROJECT-17592112/
关键词：
hydroxyethyl starch hypertonic saline hemorrhagic shock vitalscopy prehospital 微小循環

项目摘要

The present study was performed to evaluate the effects of various kinds of fluids on microcirculation in the intestine in the hemorrhagic shock, which was prepared for the prehospital scenario. Before the experiment, animals were randomly divided into the following experimental groups: sham group (surgical preparation with no hemorrhage); control group (hemorrhage with no resuscitation fluid); transfusion group, blood in a 1:1 relation to removed blood volume; HES group, 6% HES in normal saline (molecular weight, 175-220 kDa; degree of substitution, 0.45-0.55) in a 1:1 relation to removed blood volume; AR group, AR solution in a 3:1 relation to removed blood volume; HS group, hypertonic saline solution (4mL/kg); HHS group, 4ml/kg of 6% HES in 7.5% hypertonic saline.The main finding in this study is that although all groups that received fluids showed no significant difference in the blood flow and oxygenation in the villi at the time of arrival in hospital, HES solution equivalent to the volume of hemorrhage improved more effectively at the end of study than other solutions. Small volume of HHS also had a good effect on microcirculation in the intestine, but the effect continued for short time compared with HES solution equivalent to the hemorrhage.The main reason why small volume of HHS failed at improving the microcirculation in the intestine is considered to be that the extent of the hemorrhage was too severe to compensate for the volume loss compared with other studies. Further study as to how much volume of HHS should be infused is needed to establish the small volume solution therapy at prehospital scene.

本研究旨在探讨失血性休克时不同输液对肠道微循环的影响。实验前将动物随机分为以下实验组：假手术组（手术准备，无出血）;对照组（出血，无复苏液）;输血组，血液与取出的血量成1：1的比例; HES组，6% HES的生理盐水溶液（分子量175-220 kDa，取代度0.45-0.55），AR组，AR溶液，HS组，高渗盐溶液（4 mL/kg）; HHS组，4 ml/kg的6%HES溶于7.5%高渗盐水中，本研究的主要发现是，尽管所有接受液体的组在到达医院时的血流和绒毛中的氧合没有显著差异，但在研究结束时，与出血量相当的HES溶液比其他溶液更有效地改善。小体积HHS对肠道微循环也有良好的影响，但与出血量相当的HES溶液相比，这种影响持续的时间较短，小体积HHS未能改善肠道微循环的主要原因被认为是出血的程度太严重，与其他研究相比无法补偿体积损失。需要进一步研究应输注多少体积的HHS，以建立院前现场的小体积溶液治疗。