Effects of sodium pyruvate Ringer’s solution on the lactic acidosis and plasma volume during intravenous resuscitation in dogs with 50%TBSA degree Ⅲ full thickness burn injury
GAO Mingjuan1, LI Juan1, WANG Xiaona1, HU Sen2, SHENG Zhiyong2, ZHANG Huiping2, and BAI Xiaodong1
1. Burns and Plastic Surgery Department,The General Hospital of Chinese People’s Armed Police Forces, Beijing 100039, China; 2. Key Research Laboratory of Tissue Repair and Regeneration of PLA, and Beijing Key Research Laboratory of Skin Injury and Repair Regeneration, First Hospital Affiliated to the Chinese PLA General Hospital, Beijing 100048, China
Abstract：Objective To study the effects of sodium pyruvate Ringer’s solution on lactic acidosis and plasma volume during intravenous resuscitation in dogs with 50% TBSA degree Ⅲ full thickness burn injury. Methods Beagle dogs with intubation of the carotid artery and jugular vein for 24 h were subjected to a 50% TBSA degree Ⅲ burns, and were divided into three groups: burn injury without fluid resuscitation (NR, n=8), burn injury with fluid Lac-Ringer (VL, n=10), and with fluid Pry-Ringer (VP,n=10). The two intravenous fluid resuscitation began at 30 minutes after burn with volume and rate consistent with the Parkland Formula. The arterial and venous blood were sampled at different time points after injury,and then mean arterial pressure, circulating plasma volume, artery blood gas analysis and lactic acid were measured at conscious state. Results Two hours after burn, the mean arterial pressures in NR,VL and VP groups were(45.3±7.8)mmHg,(91.3±10.2)mmHg and(98.7±9.5)mmHg, respectively, which were significantly reduced(all P<0.05)compared with those before injury(41.7±6.0) mmHg,(142.3±6.1) mmHg and (142.8±5.5)mmHg,the change in plasma volume,pH value,PaO2 had the same trend as the mean arterial pressure, blood lactate level significantly reduced(P<0.05). All measurements in NR group kept worsening, and all died within 24 h after burn; while those of two intravenous resuscitation groups improved gradually,VP group was significantly superior to VL group at 6 hour after rususcitation(all P<0.05). Conclusions The Pyr-Ringer may be superior to the standard Lac-Ringer in the improvement of lactic acidosis and plasma volume during intravenous resuscitation in dogs with 50%TBSA full thickness burn injury.
高明娟，李娟，王晓娜，胡森，盛志勇，张慧萍，白晓东. 50%TBSA Ⅲ度烧伤犬静脉补液时丙酮酸钠林格液对循环血容量和血乳酸水平的影响[J]. 武警医学, 2016, 27(1): 51-54.
GAO Mingjuan, LI Juan, WANG Xiaona, HU Sen, SHENG Zhiyong, ZHANG Huiping, and BAI Xiaodong. Effects of sodium pyruvate Ringer’s solution on the lactic acidosis and plasma volume during intravenous resuscitation in dogs with 50%TBSA degree Ⅲ full thickness burn injury. Med. J. Chin. Peop. Armed Poli. Forc., 2016, 27(1): 51-54.
Flaherty D C, Hoxha B, Sun J, et al. Pyruvate-fortified fluid resuscitation improves hemodynamic stability while suppressing systemic inflammation and myocardial oxidative stress after hemorrhagic shock[J]. Mil Med, 2010, 175(3): 166-172.
[5]
Zager R A, Johnson A C, Becker K. Renal cortical pyruvate depletion during AKI [J]. J Am Soc Nephrol, 2014, 25(5): 998-1012.
[6]
Mallet R T, Sun J, Knott E M, et al. Metabolic cardio protection by pyruvate: recent progress[J]. Exp Biol Med (Mayweed), 2005, 23(7): 435-443.
Cotton B A,Guy J S,Morris J A Jr, et al. The cellular,metabolic,and systemic consequences of aggressive fluid resuscitation strategies[J].Shock,2006,26(2):115-121.
[10]
Santry H P,Alam H B.Fluid resuscitation:past,present,and the future[J]. Shock,2010,33(3):229-241.
[11]
Su Fuhong, Wang Zhen, CaiYing, et al. Beneficial effects of ethyl pyruvate in septic shock from peritonitis[J]. Arch Surg, 2007, 142: 166-171.
[12]
Schillinger W, Hunlich M, Sossalla S, et al. Intracoronary pyruvate in cardiogenic shock as an adjunctive therapy to catecholamines and intra-aortic balloon pump shows beneficial effects on hemodynamics [J]. Clin Res Cardiol, 2011,100(5):433-438.
[13]
Ojha S, Goyal S, Kumari S, et al. Pyruvate attenuates cardiac dysfunction and oxidative stress in isoproterenol-induced cardiotoxicity[J]. Exp Toxicol Pathol, 2012, 64(4): 393-399.
[14]
Olivencia-Yurvati A H, Blair J L, Baig M, et al. Pyruvate-enhanced cardio protection during surgery with cardiopulmonary bypass [J]. Cardiothoracic Vasc Anesth, 2003,17(6): 715-720.
[15]
Yi J S, Kim T Y, Kim D K, et al. Systemic pyruvate administration markedly reduces infarcts and motor deficits in rat models of transient and permanent focal cerebral ischemia[J]. Neurobiol Dis, 2007, 26(1): 94-104.
[16]
Capacchione J, Fontana J L, West S, et al. Pyruvate improves cerebral metabolism during hemorrhagic shock[J]. Am J Physiol, 2001, 281: H854-H864.
[17]
Mongan P D, Capacchione J, West S, et al. Pyruvate improves redox status and decreases indicators of hepatic apoptosis during hemorrhagic shock in swine[J]. Am J Physiol, 2002, 283: H1634-H1644.
[18]
Ochiai K, Zhang J, Gong G, et al. Effects of augmented delivery of pyruvate on my ocardial high-energy phosphate metabolism at high work state[J]. Am J Physiol Heart Circ Physiol, 2004, 286 (10) : 2237.
[19]
Cai B L, Deitch E A, Grande D, et al. Anti-inflammatory resuscitation improves survival in hemorrhage with trauma[J]. J Trauma, 2009, 66(6): 1632-1640.
[20]
Gou D M, Tan H J, Cai H J, et al. Pyruvate effects on red blood cells during in vitro cardiopulmonary bypass with dogs’ blood [J]. Artif Organs, 2012, 36(11) : 988-991.
[21]
Sharma A B, Knott E M, Jian B, et al. Pyruvate improves cardiac electromechanical and metabolic recovery from cardiopulmonary arrest and resuscitation [J]. Resuscitation, 2005, 66: 71-81.
[22]
Hu S, Bai X D, Liu X Q, et al. Pyruvate Ringer’s solution corrects lactic acidosis and prolongs survival during hemorrhagic shock in rats[J]. J Emerg Med, 2013, 45(6): 885-893.
2016, Vol. 27 
