The Journal of surgical research
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Comparative Study
Short-term effects of hydroxyethylstarch resuscitation on systemic and regional hemodynamics and metabolism in a brain-dead canine model.
Hydroxyethylstarch (HES) is a synthetic polymer of glucose that has been suggested for therapeutic use in long-term plasma expansion. The aim of this study was to test the hypothesis that the infusion of a small volume of HES may provide benefits in systemic and regional hemodynamics and metabolism in a brain-dead canine model compared with large volume crystalloid resuscitation. ⋯ Small volumes of 6% HES 450/0.7 improved cardiovascular performance and provided the same regional hemodynamic and metabolic benefits of large volumes of isotonic crystalloid solutions.
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Limited fluid resuscitation has been proven to have a good effect on uncontrolled hemorrhagic shock. Arginine vasopressin (AVP) and norepinephrine (NE) were used to treat vasodilatory or septic shock, and were used to reduce the fluid requirement for uncontrolled hemorrhagic shock. Based on their pressor and hemodynamic stabilization effects, it is speculated that AVP and NE may be a good treatment for uncontrolled hemorrhagic shock at early stage after hemostasis. ⋯ AVP+NE is a good treatment for uncontrolled hemorrhagic shock at the early stage after hemostasis if blood is unavailable. Whole blood transfusion can potentiate this beneficial effect of AVP+NE.
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The rat sepsis model in the present study was used to understand the role of sustained hyperglycemia and ovariectomy, either separately or together, on the response of pro-inflammatory mediators and oxidative response. ⋯ Hyperglycemia and ovariectomy (postmenopausal period) severely increased serum cytokines and oxidant levels with the stages of our sepsis model. The lung tissue was most affected by diabetes and ovariectomy under sepsis conditions. Ovariectomy leading to estrogen deficiency results in general changes in metabolism, which are seen in the liver, lungs, and heart with diabetes under sepsis conditions.
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Prolonged sedation with propofol at high doses may lead to fatal multi-organ dysfunction, know as propofol infusion syndrome. We tested the hypothesis that propofol plus remifentanil co-administration attenuates propofol tolerance to its sedative effect and assessed if such an effect has an impact on propofol toxicity in rabbits under prolonged mechanical ventilation. ⋯ Although propofol tolerance is attenuated in propofol plus remifentanil receiving rabbits under prolonged mechanical ventilation, fatal multi-organ injury occurs resembling human propofol infusion syndrome.
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Obstetric hemorrhage remains a leading cause of maternal death internationally. Polydatin is an effective drug in ameliorating microcirculatory insufficiency and increasing survival rate in non-pregnant animal model of controlled hemorrhagic shock. In the present study, we investigated the effects of hypotensive resuscitation combined with Polydatin administration on microcirculation and survival rate in a clinically relevant model of uncontrolled hemorrhagic shock in pregnancy. ⋯ On the basis of hypotensive resuscitation, Polydatin administration improved microcirculation and prolonged survival time in pregnant rabbit model of uncontrolled hemorrhagic shock.