Variation in the circulation of mesenteric lymph fluid during uncontrolled hemorrhagic shock / 中华急诊医学杂志

ABSTRACT

Objective To identify the changes of mesenteric lymph fluid in cases of uncontrolled hemor-rhagic shock (UHS), which is most often occurred in modem trauma and battle injury. The lymph of gut plays an important role during shock and MODS. The objective of this experiment is to identify the change of mesenteric lymph fluid in UHS. Method Thirty-eight SD rats were canulated with PE 50 catheters separately into right carotid artery,left femoral artery and femoral vein. A serf-made steel catheter was inserted into main mesenteric lymph duct and the mesenteric lymph fluid was collected. The rots were divided into three groups control group (n=10), controlled hemorrhagic shock (CHS) group (n=10) and UHS group (n=10). After the mean blood pressure was dropped to 40 mmHg by exsanguination, hemorrhage was made by amputation of 75% tail in length and let the stump keep open to bleed. The volume of mesenteric lymph fluid was recorded, and the protein and endotoxin in it were examined, too. Data were analyzed using ANOVA and Chi-square test. Results The mesenteric lymph fluid was decreasing remarkably during shock until it was below 1/4 of normal. After hemorrhage was controlled, the mesentefic lymph fluid increased slowly. However, it kept decreasing persistently in cases of UHS. So did the protein content. The eudotoxin in lymph fluid increased 2 hours after CHS and one hour after UHS. There was significant difference in endotoxin between CHS and UHS 2 hours after shock (P<0.05). Con-dusions The volume and protein content of mesenteric lymph fluid decreased mare significantly in UHS than that in CHS. And contrarily, the endotoxin in lymph fluid increased more significantly in UHS than that in CHS. The change of the mesenteric lymph fluid may be an important cause of MODS after UHS.