Efficacy of saline solutions of different osmotic pressures for hemorrhagic shock rats exposure to seawater immersion

Yu ZHU; Yu WU; Kunlun TIAN; Peidong JIANG; Mingying XUE; Liangming LIU; Tao LI

doi:10.16016/j.1000-5404.202005248

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Efficacy of saline solutions of different osmotic pressures for hemorrhagic shock rats exposure to seawater immersion

Basic Medicine | 更新时间：2026-01-09

- Efficacy of saline solutions of different osmotic pressures for hemorrhagic shock rats exposure to seawater immersion
- Journal of Third Military Medical University Vol. 42, Issue 21, Pages: 2100-2106(2020)
- 作者机构：
  
  400042 重庆，陆军军医大学(第三军医大学)野战外科研究所战伤休克与输血研究室，创伤、烧伤与复合伤国家重点实验室
- 作者简介：
- 基金信息：
  
  the Key Logistic Scientific Project of the "Thirteenth Five-year Plan" of Medical Research of PLA(AWS16J032)
- DOI：10.16016/j.1000-5404.202005248
  CLC： R605.971;R654.1;R853.3
- Received：27 May 2020，
  
  Revised：2020-08-27，
  
  Published：15 November 2020
- 稿件说明：
移动端阅览
Yu ZHU, Yu WU, Kunlun TIAN, et al. Efficacy of saline solutions of different osmotic pressures for hemorrhagic shock rats exposure to seawater immersion[J]. Journal of Third Military Medical University, 2020, 42(21): 2100-2106.
DOI：

Yu ZHU, Yu WU, Kunlun TIAN, et al. Efficacy of saline solutions of different osmotic pressures for hemorrhagic shock rats exposure to seawater immersion[J]. Journal of Third Military Medical University, 2020, 42(21): 2100-2106. DOI： 10.16016/j.1000-5404.202005248.

摘要

目的

观察不同渗透压盐水对低温海水浸泡合并失血性休克大鼠的致死三联征、肝脏和肾脏功能、存活的影响。

方法

大鼠置于15 ℃海水中浸泡，同时复制失血性休克模型，制作低温海水浸泡合并失血性休克模型。浸泡2 h后，放置于温控箱中进行复温，同时用不同渗透压的液体(乳酸林格氏液LR、0.3%盐水、0.6%盐水、0.9%生理盐水)进行复苏治疗，抽血测pH、凝血功能及肝脏和肾脏功能的变化，记录体温和血压，并观察大鼠72 h的存活情况。

结果

海水合并失血性休克后大鼠的平均动脉压(mean arterial pressure，MAP)显著降低，不同渗透压的液体复苏可显著升高平均动脉压，0.6%盐水组在输液完能维持MAP在60~70 mmHg。海水浸泡合并失血性休克后，大鼠发生致死三联征，体温和pH显著降低，凝血功能障碍；液体复苏治疗后，致死三联征有所缓解，体温和pH有不同程度升高，凝血功能得到改善，0.6%盐水组可明显改善大鼠的pH和纤维蛋白原(FIB)，降低大鼠的凝血酶原时间(PT)、活化部分凝血酶原时间(APTT)和国际标准化比值(INR)，与LR治疗组比较，差异有统计学意义(

＜0.05)。器官功能结果显示，0.6%盐水组可以显著降低血中AST、ALT、BUN和Crea水平，保护海水浸泡合并失血休克大鼠的肝脏和肾脏功能，与LR对照组比较，0.6%盐水组的AST、ALT、BUN和Crea分别降低了32.5%、29.9%、22.5%和19.6%，差异均有统计学意义(

＜0.05)。同时0.6%盐水组可提高大鼠的存活率，延长存活时间，其72 h存活率为7/16，存活时间为(35.4±34.0)h，LR对照组的存活率为3/16，存活时间为(29.4±29.1)h。

结论

海水浸泡合并失血性休克后，适当低渗液体复苏可以减轻酸中毒和凝血功能障碍，保护器官功能，延长动物的存活时间，提高存活率。

Abstract

Objective

To investigate the effect of saline solutions of different osmotic pressures on the lethal triad

liver and kidney functions

and survival in hemorrhagic shock rats combined with seawater immersion.

Methods

The rats were immersed in 15 ℃ seawater

and inflicted to establish the model of hemorrhagic shock (40 mmHg for 2 h). After being immersed for 2 h

they were placed into the temperature control box for rewarming and treated with Lactate Ringer's (LR) solutions of different osmotic pressures (containing 0.3%

0.6%

and 0.9% saline

respectively) for resuscitation. Then their blood samples were collected to measure the pH value and evaluate the coagulation

liver and kidney functions. Meanwhile

the body temperature and blood pressure were recorded

and the survival was observed within 72 h.

Results

The mean arterial pressure (MAP) was significantly decreased after seawater immersion combined with hemorrhagic shock. All the fluids of different osmotic pressures obviously increased the MAP. The pressure could be maintained at 60~70 mmHg with 0.6% saline solution. Seawater immersion co

mbined with hemorrhagic shock induced the rats to develop lethal triad

with notable decreases in body temperature

pH value

and coagulation dysfunction. While

fluid resuscitation treatment alleviated lethal triad

elevated the body temperature and pH value to different degrees

and improve the coagulation function. The treatment of 0.6% saline solution significantly improved the pH value and fibrinogen level

reduced the prothrombin time (PT)

activated partial thromboplastin time (APTT) and international normalized ration (INR)

with significant differences when compared with simple LR solution (

0.05). The results of organ functions showed that 0.6% saline solution significantly reduced the levels of aspartate aminotransferase (AST)

alanine aminotransferase (ALT)

blood urea nitrogen (BUN) and creatinine (Crea)

which were decreased by 32.5%

29.9%

22.5% and 19.6%

respectively when compared with simple LR solution (

0.05). What's more

0.6% saline solution also improved the survival rate and prolonged the survival time

with a 72-hour survival rate of 7/16 and a survival time of 35.4±34.0 h

and the survival rate was only 3/16 and the time was merely 29.4±29.1 h after simple LR solution treatment.

Conclusion

Appropriate hypo-osmotic fluid resuscitation can attenuate acidosis and coagulation dysfunction

protect organ functions

prolong the survival time

and improve the survival rate after seawater immersion combined with hemorrhagic shock.

关键词

Keywords

references

张鸿祺, 周国泰, 张愈.灾难医学[M].北京:北京医科大学、中国协和医科大学联合出版社, 1993:717-747.

ZHANG H Q, ZHOU G T, ZHANG Y. Disaster medicine [M]. Beijing: Joint Publishing House of Beijing Medical College and Beijing Union Medical University, 1993: 717-747.

陈强, 赖西南, 葛衡江.海水浸泡对犬弹烧复合伤伤情特点的影响[J].中华航海医学与高气压医学杂志, 2004, 11(4): 193-197. DOI:10.3760/cma.j.issn.1009-6906.2004.04.001.

CHEN Q, LAI X N, GE H J. Influence of seawater immersion on the characteristics of projectile-burn combined wound in dogs with seawater immersion[J]. Chin J Naut Med Hyperb Med, 2004, 11(4): 193-197. DOI:10.3760/cma.j.issn.1009-6906. 2004.04.001.

刘建仓, 陆松敏, 贾后军.低温海水浸泡失血性休克大鼠血液动力学变化[J].创伤外科杂志, 2000, 2(2): 93. DOI:10.3969/j.issn.1009-4237.2000. 02.010.

LIU J C, LU S M, JIA H J. The hemodynamic changes of hemorrhagic shock in rats with cold seawater immersion [J]. J Traum Surg, 2000, 2(2): 93. DOI:10.3969/j.issn.1009-4237.2000.02.010.

[刘良明.战创伤休克早期救治研究进展[J ] .创伤外科杂志, 2013, 15(2): 100-103. DOI: CNKI:SUN:CXWK.0.2013-02-003 http://dx.doi.org/CNKI:SUN:CXWK.0.2013-02-003 .

[LIU L M. Research progress of early care and treatment in war wound and traumatic shock[J ] . J Traum Surg, 2013, 15(2): 100-103. DOI: CNKI:SUN:CXWK.0.2013-02-003 http://dx.doi.org/CNKI:SUN:CXWK.0.2013-02-003 .

程浩, 奂剑波, 陈丽娜, 等.长时程海水浸泡体温过低大鼠的病理学和血液学观察[J].中华航海医学与高气压医学杂志, 2018, 25(5): 281-288. DOI:10.3760/cma.j.issn.1009-6906.2018.05.002.

CHENG H, HUAN J B, CHEN L N, et al . Observation on the pathological and hematological parameters of the rats with hypothermia induced by prolonged seawater immersion[J ] . Chin J Naut Med Hyperb Med, 2018, 25(5): 281-288. DOI:10.3760/cma.j.issn.1009-6906.2018.05.002.

刘艳丽, 田昆仑, 朱娱, 等.低温海水浸泡合并失血休克对大鼠致死三联征及器官功能的影响[J].第三军医大学学报, 2020, 42(8):752-757. DOI:10.16016/j.1000-5404.201912181.

LIU Y L, TIAN K L, ZHU Y, et al .Lethal triad and multi-organ dysfunction in rats following cold seawater bath and hemorrhagic shock[J ] .J Third Mil Med Univ, 2020, 42(8):752-757. DOI:10.16016/j. 1000-5404.201912181.

BLUMBERG N, CHOLETTE J M, PIETROPAOLI A P, et al . 0.9% NaCl (normal saline)—Perhaps not so normal after all?[J ] . Transfus Apher Sci, 2018, 57(1): 127-13 1. DOI:10.1016/j.transci.2018.02.021.

VAN REGENMORTEL N, DE WEERDT T, VAN CRAENENBROECK A H, et al . Effect of isotonic versus hypotonic maintenance fluid therapy on urine output, fluid balance, and electrolyte homeostasis: a crossover study in fasting adult volunteers[J ] . Br J Anaesth, 2017, 118(6): 892-900. DOI:10.1093/bja/aex118.

SHIOZAKI A, ICHIKAWA D, TAKEMOTO K, et al . Efficacy of a hypotonic treatment for peritoneal dissemination from gastric cancer cells: an in vivo evaluation[J ] . Biomed Res Int, 2014, 2014: 707089. DOI:10.1155/2014/707089.

RAE L, FIDLER P, GIBRAN N. The physiologic basis of burn shock and the need for aggressive fluid resuscitation[J]. Crit Care Clin, 2016, 32(4): 491-505. DOI:10.1016/j.ccc.2016.06.001.

海霖, 余姣.失血性休克致死性三联征的筛查及救治[J].中国急救医学, 2019, 39(7): 700-703. DOI:10.3969/j.issn.1002-1949.2019.07.018.

HAI L, YU J. Screening and treatment for hemorrhagic shock lethal triad of death[J]. Chin J Crit Care Med, 2019, 39(7): 700-703. DOI:10.3969/j.issn.1002-1949.2019.07.018.

庄永敬, 谢培增, 陈大军, 等.海上环境下海战伤救治的实验研究[J].华南国防医学杂志, 2010, 24(2): 141-144, 153. DOI:10.13730/j.1009 -2595.2010.02.024.

ZHUANG Y J, XIE P Z, CHEN D J, et al . Experimental study of treatment on sea warfare wound in marine environment[J ] . Mil Med J South China, 2010, 24(2): 141-144, 153. DOI:10.13730/j.1009 -2595.2010.02.024.

李辉, 鹿尔驯, 虞积耀, 等.快速输注低张液体在治疗胸外伤后海水浸泡致高渗血症中的作用[J].中国危重病急救医学, 2001, 13(7): 433-435. DOI:10.3760/j.issn:1003-0603.2001.07.015.

LI H, LU E X, YU J Y, et al . Preliminary study of fluid therapy in the management of plasma hyperosmolarity due to seawater immersion after open chest injury[J ] . Chin Crit Care Med, 2001, 13(7): 433-435. DOI:10.3760/j.issn:1003-0603. 2001.07.015.

李燕华, 孙善全.低渗液对星形胶质细胞水通道蛋白-4表达的影响[J].中华医学杂志, 2004, 84(6): 496-501. DOI:10.3760/j:issn:0376-2491. 2004.06.018.

LI Y H, SUN S Q. Effect of hypotonic medium on expression of aquaporin-4 in astrocytes[J]. Natl Med J China, 2004, 84(6): 496-501. DOI:10.3760/j:issn:0376-2491.2004.06.018.

奂剑波, 陈丽娜, 韩志海, 等.大鼠海水浸泡体温过低症水浴复温的实验研究[J].第二军医大学学报, 2018, 39(4): 443-449. DOI:10.16781/j.0258- 879x.2018.04.0443.

HUAN J B, CHEN L N, HAN Z H, et al . Experimental study on water bath rewarming in rats with hypothermia by seawater immersion[J ] . Acad J Second Mil Univ , 2018, 39(4): 443-449. DOI:10.16781/j.0258-879x.2018.04.0443.

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