不同年龄大鼠非控制性失血性休克的理想复苏压力

Ideal target resuscitation pressure for uncontrolled hemorrhagic shock in rats at different age stage

目的观察不同年龄(6周、14周和1年)大鼠在失血性休克时的理想复苏压力。方法通过横断脾实质和切断1根脾动脉分支复制非控制性出血性大鼠休克模型,用乳酸林格液(LR)和羟乙基淀粉(HS)(体积比2:1)进行复苏,将复苏血压分别维持在40、50、60、70和80mmHg 1h,彻底止血后用全血(由供血鼠提供)和乳酸林格氏液1:2进行复苏使平均动脉压维持在80～90mmHg 2h。观察不同年龄大鼠的出血量、输液量、血流动力学指标、血气分析、动物存活、组织血流量和器官功能。结果 6周龄大鼠,非控制性出血期间失血性休克复苏的允许性低血压是40～50mmHg。14周龄鼠和1年鼠在非控制性出血期间的允许性复苏血压力分别是50～60mmHg和70mmHg。6周和14周大鼠,雌性大鼠低压复苏比雄性大鼠有更好的效果,但是1年龄大鼠低压复苏影响无性别差异。结论不同年龄段失血性休克大鼠在活动性出血期间(非控出血期间)具有不同允许性低压复苏血压。6周、14周和1年龄大鼠允许性低血压分别为40～50mmHg,50～60mmHg和70mmHg。

Objective To investigate the ideal target resuscitation pressure for uncontrolled hemorrhagic shock in rats at different age stage. Methods Anesthetized SD rats were used to make models of uncontrolled hemorrhagic shock. The rats were resuscitated at different target MAPs （40,50,60,70 and 80 mmHg） for 1 hour with infusion of hydroxyethly starch ＋ lactated Ringer ＇ s solution at a ratio of 1 ： 2. After complete hemostasis was achieved by full ligation of the splenic artery, rats received whole blood and lactated Ringer＇ s solution at a ratio of 1 ： 2 to maintain the MAP at 80-90 mmHg for 2 hours. Blood losses, fluid requirements, hmodynamic parameters, blood gases, animal survival, tissue blood flow and organ function were observed. Results For 6 weeks of rats, 40-50 mmHg target resuscitation pressure is the ideal permissive hypotension to resuscitate the uncontrolled hemorrhagic shock, which was superior to other resuscitation pressures in improving hemodynamics, blood perfusion, blood gases, organ function and animal survival of uncontrolled hemorrhagic shock rats. 50-60 mmHg and 70 mmHg are the ideal permissive hypotension to resuscitate the uncontrolled hemorrhagic shock for 14-week rats and for one year old rats, respectively. In 6-week and 14-week rats, hypotensive resuscitation had better beneficial effects in female rats than in male rats. While in one-year old rats, there was no gender difference in resuscitation effects of permissive hypotension. Conclusion Different ages of hemorrhagic shock rats have different permission hypotension during the period of active hemorrhage. The ideal permission hypotension for 6 week, 14 week and one year old rats is 40-50 mmHg,50-60 mmHg and 70 mmHg,respectively.