不同限制性复苏血压水平对出血未控制性休克家兔动脉血气的影响
Effects of different blood pressure levels on the arterial blood gas of rabbit with uncontrolled hemorrhagic shock during restrictive resuscitation
-
摘要: 目的:观察不同限制性复苏血压水平对出血未控制性休克家兔动脉血气的影响,探讨出血未控制性休克复苏时应维持的理想血压水平。方法:采用Wigger改良法制作出血未控制性休克模型,24只家兔随机分为4组(n=6)。NR组:不复苏组;N50组:复苏维持平均动脉压(mean arterial pressure,MAP)在50mmHg水平;N60组:复苏维持MAP在60mmHg水平;N70组:复苏维持MAP在70mmHg水平;在休克前、休克后0、60、120、150、180、240min检测动脉血气分析,包括血乳酸、剩余碱、氧分压、二氧化碳分压、pH值等指标。结果:N60组氧分压、二氧化碳分压、乳酸、pH值在各个时间点均优于其他组(P0.05)。结论:失血性休克家兔在出血未控制前行限制性液体复苏时,维持MAP在60mmHg对动脉血气的影响较小,提示60mmHg可能是限制性液体复苏比较理想的MAP水平。Abstract: Objective:To observe effects of different blood pressure levels on the arterial blood gas of rabbit with uncontrolled hemorrhagic shock during restrictive resuscitation and explore the ideal blood pressure levels for uncontrolling hemorrhagic shock.Methods:Model with uncontrolled hemorrhagic shock was established according to modifed Wigger's describtion.Twenty-four rabbits in the model were randomly divided into 4 groups(6 in each group),noresuscitation(NR) group as control,N50,N60 and N70 groups with maintaining mean arterial pressure(MAP) at 50,60 and 70 mmHg respectively.The arterial blood gas analysis(ABGA) including lactic acid,base excess,arterial oxygen tension,arterial carbon dioxide tension and potential of hydrogen were detected before shock and at 0,60,120,150,180 and 240 minutes after shock.Results:The data of ABGA of N60 group were better than those of other groups at all time-points.Conclusions:During restrictive resuscitation of the rabbits with unconrntrolled hemorrhagic shock,maintaining MAP at 60mmHg has little effect on their ABGA.The results suggest that MAP at 60 mmHg is suitable level for the restrictive resuscitation.
-
Key words:
- shock /
- restrictive resuscitatio /
- blood gas analysis /
- mean arterial pressure
-
[2] Wang MT,Mei B,He J,et al.Effect of traumatic preoperative limited fluid resuscitation to the patients with shock[J].JMC PLA,2007,22(4):226-229. [2] Kirkpatrick AW,Ball CG,D'Amours SK,et al.Acute resuscitation of the unstable adult trauma patient:bedside diagnosis and therapy[J].Can J Surg,2008,51(1):57-69. [3] 王振杰,郑士友,王飞,等.活动性出血休克家兔行限制性液体复苏的研究[J].中华急诊医学杂志,2009,18(2):154-157. [4] Eken C.Acidosis is a life-threatening condition regardless of the underlying condition[J].Am J Emerg Med,2008,26(6):721. [5] 郑军,洪波,张世范,等.一种新型失血性休克动物模型和初级生命救护装置的联合实验和评价[J].西北国防医学杂志,2010,31(2):86-88. [6] 杨振.外科休克[M]//吴在德,吴肇汉.外科学.7版.北京:人民卫生出版社,2008:34-41. [7] 刘大为,严静,邱海波,等.低血容量休克复苏指南:2007[J].中国实用全科医学杂志,2007,27(8):581-587. [8] Rossaint R,Bouillon B,Cerny V,et al.Management of bleeding following major trauma:an updated European guideline[J].Critical Care,2010,14(2):R52. [9] Lu YQ,Cai XJ,Gu LH,et al.Experimental study of controlled fluid resuscitation in the treatment of severe and uncontrolled hemorrhagic shock[J].J Trauma,2007,63(4):798-804. [10] Antonelli M,Levy M,Andrews PJ,et al.Hemodynamic monitoring in shock and implications for management.International Consensus Conference,Paris,France,27-28,April,2006[J].Intensive Care Med,2007,33(4):575-590. [11] Abramson D,Scalea TM,Hitchcock R,et al.Lactate clearance and survival following injury[J].J Trauma,1993,35(4):584-589. [12] Hobbs TR,O'Malley JP,Khouangsathiene S,et al.Comparison of lactate,base excess,bicarbonate and pH as predictors of mortality after severe trauma in rhesus macaques(Macaca mulatta)[J].Comp Med,2010,60(3):233-239. [13] Rixen D,Siegel JH.Bench-to-bedside review:oxygen debt and its metabolic correlates as quantifiers of the severity of hemorrhagic and post-traumatic shock[J].2005,9(5):441-453. [14] Kaplan LJ,Kellum JA.Comparison of acid-base models for prediction of hospital mortality after trauma[J].Shock,2008,29(6):662-666. -
点击查看大图
计量
- 文章访问数: 2549
- HTML全文浏览量: 258
- PDF下载量: 156
- 被引次数: 0
下载:
