ABSTRACT
Objective To study the effect of different mechanical ventilation modes and parameters on intragastric pressure and digestive function. Methods Forty patients suffered respiratory failure were selected in the study. In different modes and parameters of mechanical ventilation, a multi-channel physiological signal recording device was used to monitor the intra-trachea pressure (ITP), intra-gastric pressure (IGP) synchronously, and the emptying time of stomach, pH value and total bile acid (TBA) concentration in gastric fluid of patients. Results (1) For three types of ventilation mode(PSV,SIMV and CMV), ITP was the lowest in group PSV, the highest was in group CMV and the middle was in group SIMV. With the in-crease in ITP, IGP was also increased. CMV was the most influencing factor for the IGP (P＜0.01). In different PEEP values, the greater the PEEP, the higher the ITP. (2) Under mechanical ventilation support, when ITP increased, the emptying time of stomach decreased (P＜0.01), the concentration of TBA increased (P＜0.05). However, there was no significant change in pH value of gastric fluid (P>0.05). Conclusion Various mechanical ventilation modes and parameter settings induced differ-ent ITP, thereby affecting the IGP and gastric emptying. The digestive function can be promoted by choosing the appropriate mechanical ventilation mode and parameters.
ABSTRACT
Objective To investigate the expression changes of hepatic gelsolin (GSN) and the potential effect of traditional Chinese medicine Xuebijing injection in septic rats. Methods A total of 104 male Wistar rats were randomly divided into four groups, ie, normal control group (n = 8), sham operation group (n = 32), cecal ligation and puncture group (CLP group, n = 32) and Xuebijing treatment group (n = 32). The sepsis animal models in the last two groups were developed by CLP. In Xuebijing treatment group, animals were treated intravenously with Xuebijing injection (4 ml/kg) at 2, 12, 24,36, 48 and 60 hours after operation, respectively. Animals were sacrificed respectively at 6, 12, 24, and 72 hours after operation to harvest blood and hepatic tissue samples. Markers of liver function, contents of GSN and Gc globulin and expression of GSN mRNA in the liver tissues were detected. Results Compared with normal control group and sham operation group, hepatic GSN content was decreased significantly at various intervals in CLP group (P ＜ 0. 05), which reached the lowest value of (1.42 ±0.50) ng/mg at 12 hours. Meanwhile, expression of GSN mRNA in the liver was markedly enhanced at six hours after CLP and remained a high value until 72 hours, compared with the sham operation group (1.203±0.053 vs 1.030 ±0.084, P ＜0.05). Similarly, the hepatic Gc globulin contents was increased in the CLP group compared with the normal control group and sham operation group (P ＜ 0.05).After treatment with Xuebijing injection, the hepatic GSN contents at 6-72 hours was increased gradually while serum ALT and AST levels at 6, 12 and 24 hours were reduced significantly in comparison to the CLP group (P ＜ 0.05). Nevertheless, treatment with Xuebijing injection showed no marked effect on hepatic GSN mRNA expression and Gc globulin release (P ＞ 0.05). Conclusions Hepatic GSN contents are persistently reduced in the development of sepsis and treatment with Xuebijing injection can markedly attenuate acute liver injury through increasing GSN contents in severe sepsis.