ABSTRACT
Objective Gastrointestinal rehydration is a simple and effective method in treatment of burn shock during war-time, fire disaster and other harsh conditions , and practice has proved the exact curative effect of HCO 3 salt sugar liquid .This article was to investigate the effect of pyruvate-enriched oral rehydration solution ( Pyr-ORS ) on intestinal mucosal blood flow ( IMBF ) , activity of Na +-K+-ATPase and intestinal absorption rate during en-teral resuscitation of a 35% TBSA third-degree scald in rats . Methods 90 male rats were randomly divided into 5 groups: scald without fluid resuscitation ( S group ); sham scald resuscitated with HCO3 salt sugar liquid ( SS HCO3 group ); sham scald resuscitated with Pyr-ORS ( SS Pyr-ORS group ); scald resuscitated with HCO 3 salt sugar liquid (S HCO3 group); scald resuscitated with Pyr-ORS (S Pyr-ORS group) (n=18).Each group was divided into 2 subgroups of 1.5 and 4.5 h after scald injury.Intestinal absorption rate of water and Na +, IMBF and activity of Na +-K+-ATPase were detected on each group . Results Compared with shame scald groups , the intestinal absorption rates of water and Na +decreased ob-viously in scald groups with fluid resuscitation (P<0.05);at 1 h after scald injury, the intestinal absorption rates of water and Na +in S Pyr-ORS groups were both higher than those in S HCO 3 groups(P<0.05).Compared with shame scald groups , IMBF and activity of Na+-K+-ATPase at 1.5 and 4.5 h after scald injury decreased obviously in scald groups with fluid resuscitation (P<0.05); at 1.5 and 4.5 h after scald injury, IMBF in S Pyr-ORS groups (95.250 ±5.096/112.765 ±7.215) were greater than those in S HCO3 group (80.764 ±7.852/94.671 ±8.469), which was of statistical significance (P<0.05). Conclusion Pyr-ORS is a simple and effec-tive method in treatment of burn shock during wartime , fire disaster and other harsh conditions .
ABSTRACT
Enteral resuscitation is a new concept, but the treatment supplied has been already well known. Enteral resuscitation has been used widely for critical patients, which is benefit for their recovery. It is a safe and effective method for critical patients which could result in the amelioration of the hormonal stress response to promote the intestine function and improve outcome, and it is good in cost-effectiveness. Complications are minimal.
ABSTRACT
Objective To investigate the effect of carbachol on local gut inflammation during entetal resuscitation of rats with bum shock. Method Thirty-eight Wistar rats were subjected to 35%TBSA full thickness scald injury, and enteral fluid was infused into animal intestines via duodenal stomas 30 minutes post bum. The animals were randomly divided into four groups: no resuscitation (Control, n = 8), enteral resuscitation using either a glucose electrolyte solution (GES, n = 10) or GES plus carbachol (60 μg·kg-1,GES/CAR, n = 10), or carbachol alone (CAR, n = 10) .The volumeof GES infusion was based on the Parkland formula (4 ml· 1% TB-SA-1·Kg-1) - All animals were sacrificed 4 hours post bum, and specimens of jejunal tissue were collected to determine the levels of tumor necrosis factor (TNF)-α, nitric oxide (NO), nitric oxide synthase (NOS) and myeloperoxidase (MPO). Serum assays for plasma diamine oxidase (DAO) activities were also performed. Results There were no statistical differences in the intestinal levels of NOS, NO, TNF-α and MPO, and plasma OAO activities, between the GES group and the control group. Compared to the GES group, the GES/CAR group showed significantly lowered levels of intestinal NOS (1.276 ±0.391 vs. 1.818 ±0.436, P＜0.05), NO (0.925 ±0.402 vs. 1.561 ±0.190, P ＜ 0.05, TNF-α (0.87±0.13 vs. 1.94±0.47, P ＜0.01) and MPO (0.465 ±0.092 vs. 0.832±0.214, P＜0.05),and reduction in plasma DAO activites (0.732±0.192 vs. 1.381 ±0.564, P ＜0.05). The CAR group also showed significantly lowered levels of intestinal NOS, NO, TNF-α and MPO and reduced plasma DAO activites, compared to the GES group. Conclusions Theses results suggest that carbachol significantly inhibits the release of proinflammatory mediator and attenuates local inflammation in gut during enteral fluid resuscitation of rats in rats with bum shock. We postulate that carbachol may exert its and-inflammatory effects via the cholinergic anti-inflammatory pathway.
ABSTRACT
Objective To compare the effect of enteral administration and intravenous infusion of hypertonic electrolyte glucose solution (HEGS) in the resuscitation of burn shock. Methods Fifteen beagle dogs with 35% TBSA third degree burn were used in present study, and divided into three groups randomly: noresuscitation group, intravenous infusion resuscitation group and enteral administration resuscitation group. For the animals in the latter two groups, 1.8% HEGS was administrated intravenously or enterally for resuscitation 30 min after burn. The volume of fluid infusion in the first 8h was 1ml/(kg?1% TBSA), and the transfusion velocity was equilibrated. The mean arterial pressure (MAP), cardiac index (CI), plasma volume (PV), and sodium concentration in plasma were obtained to evaluate the effect of resuscitation used HEGS. Results The MAP, CI and PV were similar in both enteral and intravenous groups, which were higher than those in noresuscitation group. In both enteral and intravenous groups, MAP was raised after burn and then lowered after resuscitation, meanwhile CI and PV were raised and then lowered after resuscitation, but there were no differences between the two groups. The sodium concentration in plasma was stable in the noresuscitation group and increased in enteral and intravenous groups, and it was higher in intravenous groups than in enteral group. Conclusion In the resuscitation of early shock of 35% TBSA three degree burns, the effect of 1.8% HEGS administrated enterally on CI, PV, MAP and sodium concentration in plasma was similar to that of intravenous infused.