脓毒血症 败血症..pdf

Hydroxyethyl Starch, but Not Modi?ed Fluid Gelatin, Affects In?ammatory Response in a Rat Model of Polymicrobial Sepsis with Capillary Leakage Xiaomei Feng, MD, PhD BACKGROUND: Intravascular volume therapy is crucial in septic patients to improve tissue perfusion and maintain stable hemodynamics. Modified fluid gelatins (MFG) Jian Liu, PhD and medium weight hydroxyethyl starches (HES) are the most widely used synthetic colloids. Our aim in this study, performed in septic rats challenged by Min Yu, PhD cecal ligation and puncture (CLP), was to investigate the effects of HES and MFG on pulmonary capillary leakage and to determine whether an antiinflammatory mechanism was involved. Sihai Zhu, MD METHODS: Animals were randomly allocated to eight groups: saline control; CLP and saline; CLP and HES (7.5, 15, and 30 mL/kg); CLP and MFG (7.5, 15, and 30 Jianguo Xu, MD, PhD mL/kg). Each group had 20 rats, 10 of which were used for pulmonary capillary leakage and 10 for other measurements. Four hours after CLP, the specified doses of HES or MFG were infused. Six hours after surgery, pulmonary capillary leakage, levels of tumor necrosis factor-?, interleukin-1?, and macrophage inflammatory protein-2, intercellular adhesion molecule-1 mRNA expression, myeloperoxidase activity, lung histological changes, and nuclear factor-?B activation were measured. RESULTS: HES and MFG significantly attenuated the increase in capillary leakage in a dose-dependent manner. In addition, HE