压力记录分析法指导的目标导向液体治疗失血性休克兔的效果

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Abstract Objective To evaluate the therapeutic effect of the goal-directed fluid therapy guided by pressure recording analytical method(PRAM)against hemorrhagic shock rabbits.Methods Forty hemorrhagic shock rabbits were randomly divided into two groups:goal-directed fluid therapy group (group G) and the traditional fluid therapy group(group C),with 20 cases in each.The total fluid intake, crystal fluid intake, colloid fluid intake, autologous blood input, urine volume, vasoactive drug usage, and animal deaths during fluid therapy were recorded.The hemodynamic indexes and blood gas values were calculated beforemodeling (T₀), upon hemorrhagic shock (T₁), 30 minutes after liquid treatment (T₂), 60 minutes afterliquid treatment (T₃), and 90 minutes afterliquid treatment(T₄).Results Compared with group C, the total fluid intake, crystalloid intake and autologous blood input in group G decreased, while the colloidal fluid intake and urine output increased, with statistically significant difference (P<0.05).Two patients in group G and five patients in group Ctook vasoactive drugs.Compared to group C,MAP,PaO₂ and BE were significantly increased in groupGat T₂ and T₃,while HR,pH,PaCO₂ and Lac were significantly decreased.Inboth groups,MAP,HR,PaO₂,pH and BE were more significantly increased at T₂ to T₄ than at T₁,while MAP,PaO₂,pH and BE were more significantly decreased at T₂ and T₃ than at T₀, but HR,PaCO₂ and Lac were more significantly increased than at T₀ (P<0.05).Conclusions The goal-directed fluid therapy guided by pressure recording analysis method has advantages over traditional fluid therapies in that this approach can improve hemodynamic status, ameliorate metabolic acidosis, optimize the fluid input and fluid ratio, and reduce autologous blood inputs.

Key words： pressure recording analytical method goal-directed fluid therapy stroke volume variation hemorrhagic shock

Received: 10 May 2020

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	LIU Xiaomei
	MA Li
	DONG Lan

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LIU Xiaomei,MA Li,DONG Lan. Goal-directed fluid therapy in hemorrhagic shock rabbits guided by pressure recording analytical method[J]. Med. J. Chin. Peop. Armed Poli. Forc., 2020, 31(12): 1058-1062.

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http://journal08.magtechjournal.com/Jwk_wjyx/EN/ OR http://journal08.magtechjournal.com/Jwk_wjyx/EN/Y2020/V31/I12/1058

[1]	Shoemaker W C, Appel P L,Kram H B, et al.Prospective trial of supranormal values of survivors as therapeutic goals in high-risk surgical patients [J].Chest,1988,94(6):1176-1186.
[2]	Yates D R,Davies S J,Milner H E,et al.Crystalloid or colloid for goal-directerd fulid therapy in colorectal surgery[J].Br J Anaesth,2014,112(2):281-289.
[3]	Abbas S M,Hill A G .Systematic review of the literature for the use of oesophageal doppler monitor for fulid replacement in major abdominal surgery[J].Anaesthesia,2008,63:44-51.
[4]	Giglio M T,Marucci M,Testini M,et al.Goaldirected haemodynamic therapy and gastrointestinal complications in major surgery :a meta analysis of randomized controlled trails[J].Br J Anaesth,2009,103:637-646.
[5]	Kinberger O,Amberger M,Brandt S,et al.Goaldirected colloid administration improves the microcirculation of healthy and perianastomotic colon[J].Anesthesiology,2009,110:496-504.
[6]	Hilterbrand L B, Kinberger O,Amberger M,et al.Crystalloids versus colloids for goal-directed fluid therapy in major surgery[J].Crit Care,2009,13: 40.
[7]	Derichard A,Robin E,Tavernier B,et al.Automated pulse pressure and stroke volume variations from radial artery:evaluation during major abdominal surgery[J].Br J Anaesth,2009,103:678-684.
[8]	Marik P E,Baram M,Vahid B.Does central venous pressure predict fluid responsiveness?a systematic review of the literature and tale of seven mares [J].Chest,2008,134(1):172-178.
[9]	Kramer A, Zygun D, Hawes H, et al. Pulse pressure variation predicts fluid responsiveness following coronary artery bypass surgery [J]. Chest,2004,126: 1563-1568.
[10]	Biais M, Bernard O, Ha J C, et al .Abilities of pulse pressure variations and stroke volume variations to predict fluid responsiveness in prone position during scoliosis surgery[J].BrJAnaesth,2010,104(4):407-413.
[11]	Bendjelid K, Romand JA. Fluid responsiveness in mechanically ventilated patients: a review of indices used in intensive care [J]. Intensive Care Med, 2003,29: 352-360.
[12]	Marik P E,Baram M,Vahid B.Does central venous pressure predict fluid responsiveness? A syetematic review of the literature and the tale of seven mares[J].Chest,2008,134(1):172-178.
[13]	Zimmermann M,Feibicke T,Keyl C,et al.Accuracy of stroke volume variation compared with plethvariability index to predict fluid responsiveness in mechanically ventilated patients undergoing major surgery [J].Eur J Anaesthesiol,2010,27(6):555-561.
[14]	Benes J,Chytra I,Altmann P,et al.Intraoperative fluid optimization using stroke volume variation in high risk surgical patients:results of prospective randomized study [J].Crit Care,2010,14:118.
[15]	Gan TJ,Soppitt A,Maroof M,et al.Goal-directed intraoperative fluid administration reduces length of hospital stay after major surgery [J].Anesthesiology,2002,97(4):820-826.
[16]	翁立军,张野,胡宪文,等.目标容量填充对沙滩椅位下骨科肩关节镜手术患者血流动力学的影响[J].临床麻醉学杂志,2016,32(5):426-429.
[17]	Challand C,Struthers R,Sneyd J R,et al.Randomized controlled trail of intraoperative goal-directed fluid therapy in aerobically fit and unfit patient having major colorectal sugery [J].Br JAneasth,2012,108(1):53-62.
[18]	Pomano S M,Pistolesi M.Assessment of cardiac output from systemic arterial pressure in humans [J].Crit Care Med,2002,30(8):1834-1841.
[19]	Giomarelli P, Biagioli B,Scolletta S.Cardiac output monitoring by pressure recording analytical method in cardiac surgery [J].Eur J Cardiothorac Surg,2004,26(3):515-520.
[20]	Romagnoli S,Ricci Z,Romano S M,et al.Flotrac/vigileotm(third generation)and mostcare/pram versus echocardiography for cardiac output estimation in vascular surgery[J].J Cardiothorac Vasc Anesth,2013,27(6):1114-1121.
[21]	Forget P,Lois F, Kock M.Goal-directed fluid management based on the pulse oximeter-derived pleth variability index reduces lactate levels and improves fluid management [J]. Anesth Analg,2010,111:910-914.