犬心肺复苏中浅低温闭胸心肺转流对脑的保护作用

目的观察闭胸浅低温心肺转流（CPB）对犬心肺复苏中脑损伤的保护作用。方法制作犬心搏骤停模型,停搏15min后行浅低温（32-34℃）（A组,n=6）和正常体温非开胸CPB复苏（B组,n=6）。于停搏前、停搏后15min,CPB开始后l、3h抽血,于3h取大脑皮层,测定血清和脑组织S100β蛋白浓度。结果停搏15min和CPB开始后1、3h,A、B两组犬血浆S100β含量均明显高于停搏前（P〈0．01）;A组于CPB1、3h时的S100β含量明显低于B组,差异有统计学意义（P〈0．01）,CPB后3h,A组大脑皮层中S100β含量为（2．051±0．923）pg／（mg·prot）,明显低于B组（4．068±1．462）pg／（mg·prot）（P〈0．05）。结论犬心脏停搏15min后行浅低温闭胸CPB复苏对大脑皮层的损伤较轻,有一定保护作用。     

Investigation of biomarkers for impending fluid overload in a feline acute haemorrhage-resuscitation model

ObjectiveTo determine biomarkers for impending fluid overload during intravenous fluid administration in a feline haemorrhage-resuscitation model.Study designRandomized crossover study.AnimalsA group of six domestic cats (mean age and weight: 21 months; 4.9 kg, respectively).MethodsThe cats underwent three treatments, 2 months apart. They were anaesthetized and instrumented to measure a range of physiological, blood gas, haematological and biochemical variables over time. Samples were taken during a health check, before haemorrhage, after haemorrhage and then at 30 minute intervals during fluid resuscitation and 24 hours later. The three treatments were: 1) control, sham haemorrhage and resuscitation; 2) lactated Ringer’s solution (LRS); and 3) 6% tetrastarch 130/0.4 (Vol) where the cats underwent a controlled haemorrhage then resuscitation by administering LRS and Vol at 60 and 20 mL kg^–1 hour^–1, respectively, for 120 minutes. Fluid overload was identified by nasal discharge and radiographic evidence. Biomarkers were variables that exceeded the reference interval for cats during treatment. Potential biomarkers were analysed using receiver operating characteristic curves (p < 0.05).ResultsMean ± standard deviation total blood loss was 10.2 ± 2.3, 29.3 ± 9.0 and 29.1 ± 6.3 mL kg^–1 for control, LRS and Vol, respectively. The total volume of LRS and Vol administered was 120 and 40 mL kg^–1, respectively. Haematocrit, albumin, magnesium, chloride-to-sodium ratio and sodium-chloride difference were identified as potential biomarkers. These variables exceeded the reference intervals from 30 minutes of resuscitation onwards. A chloride-to-sodium ratio > 0.84 was the most sensitive (90%) and specific (75%) of all potential biomarkers.Conclusions and clinical relevanceChanges in physiological variables, haematocrit and albumin were poor biomarkers of impending fluid overload compared with electrolytes. Finding the ideal biomarker to identify impending fluid overload of commonly used intravenous fluids should improve the safety of their administration in cats.     

Effects of early liquid resuscitation combined with hydrogen inhalation on lung injury in septic shock rats induced by lipopolysaccharides

AIM：To study the effects of fluid resuscitation combined with 2% hydrogen inhalation on lung injury in septic shock rats induced by lipopolysaccharides (LPS). METHODS：Sixty male Wistar rats were randomized to 4 groups： normal control group, septic shock control group, fluid resuscitation group and fluid resuscitation plus hydrogen inhalation group. Liquid resuscitation was applied to the rats in fluid resuscitation group and fluid resuscitation plus hydrogen inhalation group. The rats in fluid resuscitation plus hydrogen inhalation group also received 2% hydrogen inhalation and the rats in other groups inhaled air for control. The pathological changes of the lung were observed under light microscope. The levels of inflammatory mediators in bronchoalveolar lavage fluid (BALF) were measured by ELISA. The expression of Fas and Bcl-2 was detected by Western blotting. RESULTS：Compared with fluid resuscitation group, the levels of inflammatory mediators in BALF and the expression of Fas in lung tissues were decreased, and the expression of Bcl-2 in lung tissue was increased in fluid resuscitation plus hydrogen inhalation group. CONCLUSION：Fluid resuscitation with 2% hydrogen inhalation exhibits a protective effect on lung injury induced by LPS.