去甲肾上腺素用于进行性失血性休克大鼠可提高复苏生存率

Improved Survival after Resuscitation with Norepinephrine in a Murine Model of Uncontrolled Hemorrhagic Shock.
去甲肾上腺素用于进行性失血性休克大鼠可提高复苏生存率
Laboratory Investigations

Anesthesiology. 107(4):591-596, October 2007.

Poloujadoff, Marie-Pierre M.D., M.Sc. *; Borron, Stephen W. M.D., M.Sc. +; Amathieu, Roland M.D., M.Sc. *; Favret, Fabrice Ph.D. ++; Camara, Mamadou S. M.S. [S]; Lapostolle, Frederic M.D. *; Vicaut, Eric M.D., Ph.D. [//]; Adnet, Frederic M.D., Ph.D. #

Abstract:
摘要：
Background: Recent studies have challenged current guidelines on fluid resuscitation. However, studies on resuscitation using norepinephrine in uncontrolled hemorrhagic shock are lacking. The authors examined the effects of norepinephrine in combination with saline infusion in uncontrolled hemorrhage in rats.
背景：近期的研究对当前液体复苏指南提出了挑战。去甲肾上腺素用于进行性失血性休克治疗方面的研究甚少。因此，作者对去甲肾上腺素的复苏效果进行观察。
Methods: Rats subjected to a 15-min controlled hemorrhage (withdrawal of 3 ml blood/100 g body mass) followed by a 60-min uncontrolled hemorrhage (75% tail amputation) were randomly assigned to one of several treatment groups (10 rats/group) receiving different doses of norepinephrine (0 [NE0], 5 [NE5], 50 [NE50], or 500 [NE500] [mu]g [middle dot] 100 g-1 [middle dot] h-1). In the four hypotensive resuscitation groups (n = 40), mean arterial pressure was not allowed to fall below 40 mmHg by titrated infusion of normal saline. In the four normotensive resuscitation groups (n = 40), it was not allowed to fall below 80 mmHg. The endpoint was survival at 210 min.
方法：将实验大鼠尾巴的75%切断，在60min进行性出血后，再在15min内抽取3ml/100g血液。根据接受去甲肾上腺素剂量的不同进行随机分组，10只/组，分为0 [NE0]、5 [NE5]、50 [NE50]、500 [NE500] [mu]g/100 g/h。低血压治疗的四组（n = 40）血压不能低于40mmHg，否则输注生理盐水进行复苏。血压正常的四组（n = 40），血压不低于80mmHg。实验在大鼠存活210min时终止。
Results: There was a significant difference (P < 0.05) in survival rate among groups. Among the hypotensive rats, 6 (60%) survived in the NE0 and NE5 dose groups, 9 (90%) survived in the NE50 dose group, and none survived in the NE500 dose group. Among the normotensive rats, none survived in the NE0 group, 4 (40%) survived in the NE5 dose group, all 10 (100%) survived in the NE50 group, and none survived in the NE500 group.
结果：组间大鼠存活率存在显著差异（P < 0.05）。低血压组大鼠， NE0和NE5治疗组有6（60%）只存活，NE50治疗组则有9（90%）只存活，而NE500治疗组则无一存活。正常血压组大鼠，NE0组无一存活，NE5治疗组4（40%）只存活，NE50治疗组全部存活，而NE500治疗组则无一存活。
Conclusions: The early use of norepinephrine in uncontrolled hemorrhagic shock in rats significantly improved survival when infused at a rate of 50 [mu]g [middle dot] 100 g-1 [middle dot] h-1 in normotensive and hypotensive resuscitation strategies.
结论：使血压正常和保持低血压情况下，早期使用50 [mu]g/100 g/h的去甲肾上腺素用于大鼠进行性失血性休克的治疗，可显著提高生存率。


去甲肾上腺素用于进行性失血性休克大鼠可提高复苏生存率

摘要：

背景：近期的研究对当前液体复苏指南提出了挑战。去甲肾上腺素用于进行性失血性休克治疗方面的研究甚少。因此，作者对去甲肾上腺素的复苏效果进行观察。

方法：将实验大鼠尾巴的75%切断，在60min进行性出血后，再在15min内抽取3ml/100g血液。根据接受去甲肾上腺素剂量的不同进行随机分组，10只/组，分为0 [NE0]、5 [NE5]、50 [NE50]、500 [NE500] [mu]g/100 g/h。低血压治疗的四组（n = 40）血压不能低于40mmHg，否则输注生理盐水进行复苏。血压正常的四组（n = 40），血压不低于80mmHg。实验在大鼠存活210min时终止。

结果：组间大鼠存活率存在显著差异（P < 0.05）。低血压组大鼠， NE0和NE5治疗组有6（60%）只存活，NE50治疗组则有9（90%）只存活，而NE500治疗组则无一存活。正常血压组大鼠，NE0组无一存活，NE5治疗组4（40%）只存活，NE50治疗组全部存活，而NE500治疗组则无一存活。

结论：使血压正常和保持低血压情况下，早期使用50 [mu]g/100 g/h的去甲肾上腺素用于大鼠进行性失血性休克的治疗，可显著提高生存率。