医学
内毒素休克
血管活性
内科学
休克(循环)
感染性休克
药理学
内分泌学
血流动力学
去甲肾上腺素
作者
Guoping Lu,Yan Wang,Zhu-jin Lu,Lin-en Zhang,Niranjan Kissoon
出处
期刊:Pediatric Critical Care Medicine
[Ovid Technologies (Wolters Kluwer)]
日期:2012-11-01
卷期号:13 (6)
被引量:2
标识
DOI:10.1097/pcc.0b013e31825b84ce
摘要
Objective To evaluate the effect of continuous blood purification on cardiac function and plasma vasoactive substances in endotoxic shock in piglets. Design This was a randomized controlled trial in an animal laboratory in a tertiary care pediatric center. Materials and methods Twenty-three healthy Shanghai white piglets weighing 8-14 kg were randomly assigned to one of the four groups: control group (n = 5), continuous blood purification without lipopolysaccharide infusion group (continuous blood purification, n = 6), lipopolysaccharide-induced endotoxin shock without continuous blood purification group (lipopolysaccharide, n = 6), and lipopolysaccharide-induced endotoxin shock with continuous blood purification group (continuous blood purification/lipopolysaccharide, n = 6). Interventions The lipopolysaccharide and continuous blood purification/lipopolysaccharide groups were injected intravenously with Escherichia coli endotoxin to induce septic shock. The continuous blood purification and continuous blood purification/lipopolysaccharide groups received continuous venovenous hemodiafiltration right after model establishment. At baseline state (T0), following the injection of lipopolysaccharide (T), 1 hr later (T1), 3 hrs later (T3), and 5 hrs later (T5) after model establishment, clinical systemic inflammatory response syndrome parameters, hemodynamic indexes, and plasma concentration of vasoactive substances were obtained. Plasma concentration of dopamine was measured by enzyme-linked immunosorbent assay (DSL Company) and endothelin-1 by enzyme-linked immunosorbent assay (R&D Company). Nitric oxide synthase activity was measured by chromatometry (Nanjing Jiancheng Bioengineering Institute, China). Measurements and main results In continuous blood purification/lipopolysaccharide group, after treatment with CPB, heart rate decreased significantly (p .9, p Conclusions The adverse cardiovascular effects of lipopolysaccharide-induced endotoxin shock can be improved by continuous blood purification. Improvement is correlated with increases in the concentration of plasma vasoactive substances (endothelin and dopamine) and decreases in nitric oxide synthase activity.
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