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Objective To investigate the effects of drag-reducing polymers on microcirculation in 40%total body surface area burn-injured rats. Methods SD rats were randomized into control group, drag-reducing polymer (DRPs) group and normal saline (NS) group (5 minutes after scald, drag-reducing polymer or saline was injected for fluid resuscitation). Wet dry weigh ratio of lung, histopathologic changes and arterial blood gas at 24 hour were respectively measured by wet dry weigh ratio method, hematoxylin-eosin (HE) staining and arterial blood gas analysis. The velocity of flow of red cell in oblique ridge and the survival time of burn-injured rats were observed. Results Compared with control group, rats in NS group exhibit significant lung injury characterized by a high W/D (P < 0.01), accumulation of a large number of neutrophils in HE stain, low partial pressure of oxygen (PO2) and high lactate (Lac) (P<0.05 or P<0.01) in arterial blood. Compared with the NS group, DRPs treatment rats exhibit significantly reduced lung injury characterized by W/D reducing (P < 0.05), the reduction of neutrophil infiltration, increased PO2, decreased Lac (P<0.05, P<0.01). In addition, DRPs treatment obviously increases the burn-induced low velocity of flow of red cell in oblique ridge (P<0.01). Moreover, the survival time of burned rats can be improved by DRPs treatment (P < 0.05). Conclusion DRPs ameliorates burn-induced acute lung injury, the mechanism may be through improving the burn-induced microcirculation disorders.
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Objective To explore a suitable plan for the delayed rapid fluid resuscitation in burn patients with shock. Methods 20 patients with total body surface area (TBSA) burned over 40% admitted 4～8h after postburn were enrolled in this study. The patients were randomly divided into plasma and gelofusin groups. Rapid fluid replacement was given immediately after admission under close hemodynamic monitoring. Hemodynamic (PAP, PAWP, CO, PVR, SVR) and hemorrheological parameters, tissue oxygenation (DO 2, VO 2, O 2ext , lactic acid, base deficit) as well as indices reflecting the main visceral functions and damage were investigated. Results The amount of rapid fluid infusion within 2h after admission accounted for 38 8?6 1% of the amount calculated with the formula for the first 24h. When the infusion amount of pre-hospitalization was added, the amount would be (48 3?5 0)% of the amount for the first 24h. The real amount of the infusion for the first 24h was (31 4?14 3)% more than that of the amount calculated with the Evans formula. The real infused fluid amount for the second 24h was almost equal to the amount calculated with the formula. After fast fluid replacement therapy, all the parameters determined were markedly improved. Conclusions It is proposed that the formula for the delayed rapid fluid resuscitation in burn patients with shock should be: the amount infused for the first 24h (ml) =TBSA (%)?body weight (kg)?2 6,the ratio of colloid to electrolytes is 1:1, water=2000ml. Half of the total amount should be infused in the first 2h after admission under close hemodynamic monitoring. The amount infused for the second 24h (ml)=TBSA (%)?body weight (kg)?1,the ratio of colloid to electrolytes is 1:1, water=2000m1.
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The antishock properties of Fu-tze "801" , an active fraction isolated from the root of Aconite,were studied on burned rats. The rats were given 65-70% TB'SA second degree scalds. All animals died in a short time postburn. Using this rat model, it was found that the marked spasmodic rhythmic constriction in arterioles occurred and the microierculatory flow state showed pronounced derangements in the me-senteric microcirculation, and platelet aggregate increased in circulating blood.After treatment with Fu-tze "801" , the survival and the mirocirculation were improved in the scalded rats, these findings suggest that Fu-tze "801" affords the antishock action on rats after a major scald burn.
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Cellular energy metabolism and intracellular pH of intact heart, kidney and liver of small animals were studied before and after burn with an effective technique of phosphorus-31 nuclear magnetic resonance (31P-NMR) spectroscopy. Advantages of this technique are that the measurement can be performed constantly without any complicated and destructive process, that it is possible to use this technique in clinical examination in the near future and that a lot of information can be obtained from only one spectrum.It was demonstrated that there were a short cellular energy source and a cellular acidosis in' heart, kidney and liver during burn shock. The high-energy phosphate compounds-lowered wavily but not straight, which could be divided into stress stage, compensation stage and decompensation stage. Intracellular pH decreased first in the heart, and then in the kidney and liver. In contrast to the results obtained by way of direct blood flow determination, the early and significant intracellular acidosis indicated the insufficiency of blood and oxygen supply in myocardium.
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The effects of thyrotrophin releasing hormone(TRH) given 0.5h after injury on survival and ?-endorphin release in scalded rats (about 30% TBSA, 20s in 100℃ water) were studied. The results showed tenfold increase of ?-endorphin-like immunoreactivity (ir-?-EP) in the plasma and the pituitary 2h after scald, while in the hypothalamus ir-?-EP did not rise above control until 6h after scald. 24h after scald, survival in rats given TRH was 46.7% and those given saline was 6.7% (P
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The serial changes in thromboxane (TXA2) prostacyclin(PGI2),circulatory platelet aggregate ratio (CPAR),platelet count,blood viscosity,myocardial enzyme spectrum,cortisol and epinephrine were determined in 42 severely burnt patients randomly divided into two groups.The findings demonstrated that in the control group,both TXA2 and TXA2/PGI2 ratio increased significantly during the early postburn stage.Myocardial enzyme spectrum,blood viscosity,cortisol and epinephrine also increased markedly.However,levels of the above parameters in the anisodamine-treated group were significantly lower than in the control following the infusion of anisodamine.On the contrary,CPAR and platelet count in the treated group increased and were significantly higher than those in the control.Moreover,TXA2 was closely correlated with CPAR,platelet count,blood viscosity and myocardial enzyme spectrum (P