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Zhi-yong Sheng - One of the best experts on this subject based on the ideXlab platform.

  • the effects of sodium pyruvate ringer solution on hemodynamic and organ functions during shock stage in dogs with a 50 total body surface area full thickness burn
    Chinese critical care medicine, 2014
    Co-Authors: Xiangxi Meng, Xiaodong Bai, Zhi-yong Sheng
    Abstract:

    OBJECTIVE To compare the effect of intravenous resuscitation with sodium pyruvate (Pyr) Ringer solution against lactated Ringer solution on hemodynamic and organ functions during shock stage in dogs with burn. METHODS 28 Beagle dogs were subjected to 50% total body surface area (TBSA) burn, and they were divided into three groups: burn injury without fluid resuscitation (NR, n=8), Ringer lactate solution (RL, n=10), and Pyr Ringer solution (RP, n=10). They were given intravenous fluid resuscitation according to Parkland Formula 30 minutes after burn. The hemodynamics, organ functions and mortality were observed in conscious state before burn injury, and 2, 6, 8, 12, 24 hours after burn injury. RESULTS Within 24 hours after burn, all the dogs in NR group died, and those in RL and RP groups were all alive. At 2 hours after burn, the mean arterial pressure (MAP), cardiac index (CI), dp/dt max of left ventricular contractility were significantly reduced in NR, RL and RP groups compared with those before injury (MAP: 45.33±7.78 mmHg vs. 141.67±5.98 mmHg, 91.33±10.25 mmHg vs. 142.33±6.16 mmHg, 98.67±9.54 mmHg vs. 142.83±5.47 mmHg; CI: 8.17±0.83 mL×s(-1)×m(-2) vs. 48.34±3.33 mL×s(-1)×m(-2), 16.84±2.17 mL×s(-1)×m(-2) vs. 47.34±1.67 mL×s(-1)×m(-2), 19.00±1.50 mL×s(-1)×m(-2) vs. 47.34±1.33 mL×s(-1)×m(-2); dp/dt max: 426.83±51.91 mmHg/s vs. 1 372.50±39.61 mmHg/s, 594.00±88.23 mmHg/s vs. 1 363.83±44.92 mmHg/s, 645.00±66.82 mmHg/s vs. 1 395.83±19.49 mmHg/s, all P<0.05), and the systemic vascular resistance (SVR) and alanine transaminase (ALT), creatinine (Cr), serum MB isoenzyme of creatine kinase (CK-MB), diamine oxidase (DAO) were significantly higher (SVR: 1 322.50±36.37 kPa×s×L(-1) vs. 281.45±8.84 kPa×s×L(-1), 777.50±41.84 kPa×s×L(-1) vs. 289.72±6.70 kPa×s×L(-1), 571.40±40.01 kPa×s×L(-1) vs. 286.27±8.66 kPa×s×L(-1); ALT: 89.50±4.11 U/L vs. 40.57±3.63 U/L, 89.25±4.88 U/L vs. 37.92±2.62 U/L, 86.30±5.61 U/L vs. 38.47±3.50 U/L; Cr: 75.62±4.61 μmol/L vs. 41.58±2.78 μmol/L, 77.00±5.92 μmol/L vs. 46.55±3.17 μmol/L, 74.13±2.56 μmol/L vs. 45.65±1.83 μmol/L; CK-MB: 13.122±0.282 kU/L vs. 1.557±0.009 kU/L, 8.885±0.272 kU/L vs. 1.497±0.009 kU/L, 8.692±0.180 kU/L vs. 1.490±0.005 kU/L; DAO: 2.26±0.14 kU/L vs. 0.25±0.02 kU/L, 1.50±0.07 kU/L vs. 0.25±0.01 kU/L, 1.37±0.07 kU/L vs. 0.25±0.02 kU/L, all P<0.05). All parameters in NR group kept on worsening till death, while hemodynamic and organ functions of two intravenous resuscitation groups were gradually improved, CI, SVR and DAO in RP group were significantly superior to those of RL group from 2 hours on after burn (all P<0.05), and dp/dt max and CK-MB in RP group were significantly better than those of RL group from 6 hours on after burn (dp/dt max: 1,082.33±63.59 mmHg/s vs. 1,018.60±47.36 mmHg/s, CK-MB: 7,898.70±255.74 U/L vs. 8,438.70±442.00 U/L, all P<0.05), and MAP was significantly better than that of RL group at 6 hours (124.67±9.39 mmHg vs. 114.33±9.16 mmHg, P<0.05), and Cr was significantly better than that of RL group from 24 hours on after burn (53.42±4.99 μmol/L vs. 60.77±3.11 μmol/L, P<0.05). CONCLUSIONS The Pyr Ringer solution was superior to the Ringer lactate solution in improving hemodynamic and organ functions for intravenous resuscitation in dogs with 50%TBSA full thickness burn.

  • oral hypertonic electrolyte glucose mosapride complex solution for resuscitation of burn shock in dogs
    Journal of Burn Care & Research, 2012
    Co-Authors: Jiake Chai, Guoyong Zhou, Zhi-yong Sheng
    Abstract:

    The objective of this study is to investigate the effect of oral feeding of an electrolyte glucose mosapride solution for resuscitation in dogs with shock after a 35% TBSA full-thickness burn and the effect of mosapride on gastric emptying time. Eighteen male Beagle dogs were randomly divided into intravenous isotonic solution group, intragastric hypertonic solution group, and mosapride group after they were subjected to a 35% TBSA full-thickness flame injury. In intravenous isotonic solution group (I group), isotonic electrolyte glucose solution was given through vein with adoption of the Parkland Formula. The resuscitation fluid in intragastric hypertonic solution group (H group) and mosapride group (M group) consisted of 1.8% NaCl and 5% glucose, the total fluid volume was one half of that for I group, and it was given in divided amount every 2 hours. Mosapride was added to the resuscitation fluid in mosapride group. Fluid replacement was begun 30 minutes after the injury in all the groups. Mean arterial pressure (MAP), cardiac output index (CI), intrathoracic blood volume index (ITBI), blood volume (BV), serum sodium concentration, intestinal mucosal blood flow (IMBF), gastric emptying, and serum motilin levels were determined at different time points. The urinary output of all animals was measured immediately after burn upto 360 minutes postburn. CI, ITBI, BV, and IMBF were all decreased obviously after burn. In I group and M group, CI, ITBI, BV, and IMBF were increased gradually after resuscitation, and they were significantly higher than that of H group (P .05), and it was higher than that in H group (P < .05). Serum sodium level in H group and M group increased in varying degrees and were markedly higher compared with the I group (P < .05). Postburn gastric emptying in H group was much more delayed (P < .05), but in M group it was much faster. Motilin level in the latter group also increased gradually postburn and was markedly higher than that of the other two groups (P < .05). At the early stage of 35% TBSA third-degree burns, gavage of 1.8% hypertonic electrolytes glucose ends in slow gastric emptying, resulting in delayed recovery from shock. When a prokinetic drug mosapride was added to the solution, gastric emptying could be accelerated and a resuscitation effect similar to that of intravenous isotonic fluid resuscitation can be achieved, while total fluid volume can be decreased by half.

  • the effect of valproic acid in alleviating early death in burn shock
    Burns, 2012
    Co-Authors: Jingyuan Hou, Haibin Wang, Mingxing Yang, Zhi-yong Sheng
    Abstract:

    Abstract The aim of this study was to examine whether administration of valproic acid (VPA) improves blood circulation and survival after lethal burn shock. Forty adult male Beagle dogs underwent a 50% TBSA full-thickness flame injury. In the first 24h after burn, animals were randomly divided into four groups: NR group received no treatment. VPA group and 2M2P(2-methyl-2-pentenoic acid) group received either VPA or 2M2P (100mg of the either drug in 20mL of normal saline) intravenously. VR group received intravenous infusion of lactated Ringer's solution according to Parkland Formula. In the second 24h after burn the animals of all groups received delayed IV fluid resuscitation. Hemodynamic variables and biochemical parameters were determined with animals in the conscious and cooperative state. From 4h after burn on, the levels of mean arterial pressure, cardiac index, plasma volume and intestinal mucosal blood perfusion in VPA group were significantly higher, and the levels of parameters of organ function and serum tumor necrosis factor-α were lower than those in NR group and 2M2P group (all P VPA (60%)>2M2P (30%)>NR (10%). Our results showed that histone deacetylace inhibitor (HDACI) valproic acid significantly improved hemodynamics, intestinal perfusion, and the survival rate after lethal burn shock. The mechanism may be attributable partly to the lowering of the level of proinflammatory factors, ameriolation of vasopermeability-induced visceral edema, reduction of blood volume loss, and protection of vital organs through inhibition of histone deacetylase activity of cell of vital organs.

  • carbachol promotes gastrointestinal function during oral resuscitation of burn shock
    World Journal of Gastroenterology, 2011
    Co-Authors: Jinwei Che, Yijun Tian, Zhi-yong Sheng
    Abstract:

    AIM: To investigate the effect of carbachol on gastrointestinal function in a dog model of oral resuscitation for burn shock. METHODS: Twenty Beagle dogs with intubation of the carotid artery, jugular vein and jejunum for 24 h were subjected to 35% total body surface area full-thickness burns, and were divided into three groups: no fluid resuscitation (NR, n = 10), in which animals did not receive fluid by any means in the first 24 h post-burn; oral fluid resuscitation (OR, n = 8), in which dogs were gavaged with glucose-electrolyte solution (GES) with volume and rate consistent with the Parkland Formula; and oral fluid with carbachol group (OR/CAR, n = 8), in which dogs were gavaged with GES containing carbachol (20 μg/kg), with the same volume and rate as the OR group. Twenty-four hours after burns, all animals were given intravenous fluid replacement, and 72 h after injury, they received nutritional support. Hemodynamic and gastrointestinal parameters were measured serially with animals in conscious and cooperative state. RESULTS: The mean arterial pressure, cardiac output and plasma volume dropped markedly, and gastrointestinal tissue perfusion was reduced obviously after the burn injury in all the three groups. Hemodynamic parameters and gastrointestinal tissue perfusion in the OR and OR/CAR groups were promoted to pre-injury level at 48 and 72 h, respectively, while hemodynamic parameters in the NR group did not return to pre-injury level till 72 h, and gastrointestinal tissue perfusion remained lower than pre-injury level until 120 h post-burn. CO2 of the gastric mucosa and intestinal mucosa blood flow of OR/CAR groups were 56.4 ± 4.7 mmHg and157.7 ± 17.7 blood perfusion units (BPU) at 24 h post-burn, respectively, which were significantly superior to those in the OR group (65.8 ± 5.8 mmHg and 127.7 ± 11.9 BPU, respectively, all P < 0.05). Gastric emptying and intestinal absorption rates of GES were significantly reduced to the lowest level (52.8% and 23.7% of pre-injury levels) in the OR group at about 2 and 4 h post-burn, and did not return to 80% of pre-injury level until 24 h. In the first 24 h post-burn, the rate of gastric emptying and intestinal water absorption were elevated by a mean 15.7% and 11.5%, respectively, in the OR/CAR group compared with the OR group. At 5 days, the mortality in the NR group was 30% (3/10), 12.5% in the OR group (1/8), and none in the OR/CAR group. CONCLUSION: Carbachol had a beneficial effect on oral resuscitation of burn shock by promoting gastric emptying and intestinal absorption in our canine model.

  • the curative effect of 1 8 hypertonic electrolyte glucose solution in enteral resuscitation of burn shock
    Chinese journal of surgery, 2009
    Co-Authors: Jiake Chai, Jinwei Che, Xiaopeng Shen, Zhi-yong Sheng
    Abstract:

    OBJECTIVE To study the resuscitative effect of hypertonic electrolyte glucose solution (HEGS) in enteral resuscitation of burn shock. METHODS Eighteen Beagle dogs with 35% TBSA full-thickness flame injury were used in this study. They were randomized to a control group (no-fluid resuscitation, N group), a HEGS resuscitation group (H group) or an isotonic electrolyte glucose solution (IEGS) resuscitation group (I group). The solution enterally was given for resuscitation from half an hour after burn. The volumes and rates of fluid infusion in the H group were basically in accordance with 2 ml/(kg x 1%TBSA), those in the I group were basically in accordance with Parkland Formula [4 ml/(kg x 1%TBSA)]. The haemodynamic parameters, global end-diastolic volume index, plasma volume, osmotic pressure of plasma, intestinal absorptive rates of water and Na(+), and intestine mucosa blood flow were continuously assessed. RESULTS The cardiac output index, global end-diastolic volume index, plasma volume and intestine blood mucosa flow reduced markedly after burn in the three groups, and then gradually returned from 2 h after burn in two resuscitation groups, which were higher than that in the N group (P < 0.05). The activities of diamine oxidase in plasma in the two resuscitation groups were higher than that in N group (P < 0.05). The intestinal absorption rates of water and Na(+) reduced markedly after burn in two resuscitation groups with the lowest levels, and then returned from 6 h after burn. The rates of water in H group were lower than that in I group (P < 0.05); the rates of Na(+) in H group were higher than in I group (P < 0.05). CONCLUSION The results indicated that 35%TBSA III degrees burn-injury dogs be resuscitated effectively with 1.8% hypertonic electrolyte-glucose solution by enteral, which 1/2 volume of an isotonic electrolyte glucose solution.

Jinwei Che - One of the best experts on this subject based on the ideXlab platform.

  • carbachol promotes gastrointestinal function during oral resuscitation of burn shock
    World Journal of Gastroenterology, 2011
    Co-Authors: Jinwei Che, Yijun Tian, Zhi-yong Sheng
    Abstract:

    AIM: To investigate the effect of carbachol on gastrointestinal function in a dog model of oral resuscitation for burn shock. METHODS: Twenty Beagle dogs with intubation of the carotid artery, jugular vein and jejunum for 24 h were subjected to 35% total body surface area full-thickness burns, and were divided into three groups: no fluid resuscitation (NR, n = 10), in which animals did not receive fluid by any means in the first 24 h post-burn; oral fluid resuscitation (OR, n = 8), in which dogs were gavaged with glucose-electrolyte solution (GES) with volume and rate consistent with the Parkland Formula; and oral fluid with carbachol group (OR/CAR, n = 8), in which dogs were gavaged with GES containing carbachol (20 μg/kg), with the same volume and rate as the OR group. Twenty-four hours after burns, all animals were given intravenous fluid replacement, and 72 h after injury, they received nutritional support. Hemodynamic and gastrointestinal parameters were measured serially with animals in conscious and cooperative state. RESULTS: The mean arterial pressure, cardiac output and plasma volume dropped markedly, and gastrointestinal tissue perfusion was reduced obviously after the burn injury in all the three groups. Hemodynamic parameters and gastrointestinal tissue perfusion in the OR and OR/CAR groups were promoted to pre-injury level at 48 and 72 h, respectively, while hemodynamic parameters in the NR group did not return to pre-injury level till 72 h, and gastrointestinal tissue perfusion remained lower than pre-injury level until 120 h post-burn. CO2 of the gastric mucosa and intestinal mucosa blood flow of OR/CAR groups were 56.4 ± 4.7 mmHg and157.7 ± 17.7 blood perfusion units (BPU) at 24 h post-burn, respectively, which were significantly superior to those in the OR group (65.8 ± 5.8 mmHg and 127.7 ± 11.9 BPU, respectively, all P < 0.05). Gastric emptying and intestinal absorption rates of GES were significantly reduced to the lowest level (52.8% and 23.7% of pre-injury levels) in the OR group at about 2 and 4 h post-burn, and did not return to 80% of pre-injury level until 24 h. In the first 24 h post-burn, the rate of gastric emptying and intestinal water absorption were elevated by a mean 15.7% and 11.5%, respectively, in the OR/CAR group compared with the OR group. At 5 days, the mortality in the NR group was 30% (3/10), 12.5% in the OR group (1/8), and none in the OR/CAR group. CONCLUSION: Carbachol had a beneficial effect on oral resuscitation of burn shock by promoting gastric emptying and intestinal absorption in our canine model.

  • the curative effect of 1 8 hypertonic electrolyte glucose solution in enteral resuscitation of burn shock
    Chinese journal of surgery, 2009
    Co-Authors: Jiake Chai, Jinwei Che, Xiaopeng Shen, Zhi-yong Sheng
    Abstract:

    OBJECTIVE To study the resuscitative effect of hypertonic electrolyte glucose solution (HEGS) in enteral resuscitation of burn shock. METHODS Eighteen Beagle dogs with 35% TBSA full-thickness flame injury were used in this study. They were randomized to a control group (no-fluid resuscitation, N group), a HEGS resuscitation group (H group) or an isotonic electrolyte glucose solution (IEGS) resuscitation group (I group). The solution enterally was given for resuscitation from half an hour after burn. The volumes and rates of fluid infusion in the H group were basically in accordance with 2 ml/(kg x 1%TBSA), those in the I group were basically in accordance with Parkland Formula [4 ml/(kg x 1%TBSA)]. The haemodynamic parameters, global end-diastolic volume index, plasma volume, osmotic pressure of plasma, intestinal absorptive rates of water and Na(+), and intestine mucosa blood flow were continuously assessed. RESULTS The cardiac output index, global end-diastolic volume index, plasma volume and intestine blood mucosa flow reduced markedly after burn in the three groups, and then gradually returned from 2 h after burn in two resuscitation groups, which were higher than that in the N group (P < 0.05). The activities of diamine oxidase in plasma in the two resuscitation groups were higher than that in N group (P < 0.05). The intestinal absorption rates of water and Na(+) reduced markedly after burn in two resuscitation groups with the lowest levels, and then returned from 6 h after burn. The rates of water in H group were lower than that in I group (P < 0.05); the rates of Na(+) in H group were higher than in I group (P < 0.05). CONCLUSION The results indicated that 35%TBSA III degrees burn-injury dogs be resuscitated effectively with 1.8% hypertonic electrolyte-glucose solution by enteral, which 1/2 volume of an isotonic electrolyte glucose solution.

  • effect of oral fluid resuscitation on pulmonary vascular permeability and lung water content in burn dogs in shock stage
    Chinese journal of burns, 2009
    Co-Authors: Jinwei Che, Yijun Tian
    Abstract:

    OBJECTIVE: To investigate the effect of oral fluid resuscitation on pulmonary vascular permeability and lung water content in burn dogs during shock stage. METHODS: Eighteen male Beagle dogs with catheterization of carotid artery and jugular vein for 24 hours were subjected to 50% TBSA full-thickness burn, then they were divided into non-fluid resuscitation (NR), oral fluid resuscitation (OR), intravenous fluid resuscitation (IR) groups, with 6 dogs in each group. Dogs in OR and IR groups were given glucose-electrolyte solution (GES) by gastric tube or intravenous infusion according to Parkland Formula within 24 hours after burn, while those in NR group were not given any treatment. Dogs in each group were then given intravenous fluid for further resuscitation after 24 post burn hours (PBH). Deaths were recorded within 72 hours after burn. Mean arterial pressure (MAP), respiratory rate (RR), PaO2, extravascular lung water index (ELWI) and pulmonary vascular permeability index (PVPI) were determined before burn and at 30 mins and 4, 8, 24, 48, 72 PBH with the aid of PICCO. Dogs were sacrificed to collect lung tissue for determination of water content at 72 PBH or just before death. RESULTS: All dogs died during 9-22 PBH in NR group, 3 dogs died during 25-47 PBH in OR group, and all dogs survived within 72 PBH in IR groups. Compared with those before burn, RR (44.0 +/- 5.0) times/min, ELWI (10.3 +/- 0.6) mL/kg and PVPI (6.6 +/- 0.6) were markedly increased in NR group at 8 PBH, but PaO2 and MAP were obviously decreased (P 0.05), which were lower than that in NR group (P < 0.05). CONCLUSIONS: Although the protective effect of oral fluid resuscitation with GES on the lung of burn dog at shock stage was inferior to intravenous fluid, it still can decrease pulmonary vascular permeability, alleviate pulmonary edema, and reduce pulmonary complication compared with no resuscitation with fluids.

Xiangxi Meng - One of the best experts on this subject based on the ideXlab platform.

  • the effects of sodium pyruvate ringer solution on hemodynamic and organ functions during shock stage in dogs with a 50 total body surface area full thickness burn
    Chinese critical care medicine, 2014
    Co-Authors: Xiangxi Meng, Xiaodong Bai, Zhi-yong Sheng
    Abstract:

    OBJECTIVE To compare the effect of intravenous resuscitation with sodium pyruvate (Pyr) Ringer solution against lactated Ringer solution on hemodynamic and organ functions during shock stage in dogs with burn. METHODS 28 Beagle dogs were subjected to 50% total body surface area (TBSA) burn, and they were divided into three groups: burn injury without fluid resuscitation (NR, n=8), Ringer lactate solution (RL, n=10), and Pyr Ringer solution (RP, n=10). They were given intravenous fluid resuscitation according to Parkland Formula 30 minutes after burn. The hemodynamics, organ functions and mortality were observed in conscious state before burn injury, and 2, 6, 8, 12, 24 hours after burn injury. RESULTS Within 24 hours after burn, all the dogs in NR group died, and those in RL and RP groups were all alive. At 2 hours after burn, the mean arterial pressure (MAP), cardiac index (CI), dp/dt max of left ventricular contractility were significantly reduced in NR, RL and RP groups compared with those before injury (MAP: 45.33±7.78 mmHg vs. 141.67±5.98 mmHg, 91.33±10.25 mmHg vs. 142.33±6.16 mmHg, 98.67±9.54 mmHg vs. 142.83±5.47 mmHg; CI: 8.17±0.83 mL×s(-1)×m(-2) vs. 48.34±3.33 mL×s(-1)×m(-2), 16.84±2.17 mL×s(-1)×m(-2) vs. 47.34±1.67 mL×s(-1)×m(-2), 19.00±1.50 mL×s(-1)×m(-2) vs. 47.34±1.33 mL×s(-1)×m(-2); dp/dt max: 426.83±51.91 mmHg/s vs. 1 372.50±39.61 mmHg/s, 594.00±88.23 mmHg/s vs. 1 363.83±44.92 mmHg/s, 645.00±66.82 mmHg/s vs. 1 395.83±19.49 mmHg/s, all P<0.05), and the systemic vascular resistance (SVR) and alanine transaminase (ALT), creatinine (Cr), serum MB isoenzyme of creatine kinase (CK-MB), diamine oxidase (DAO) were significantly higher (SVR: 1 322.50±36.37 kPa×s×L(-1) vs. 281.45±8.84 kPa×s×L(-1), 777.50±41.84 kPa×s×L(-1) vs. 289.72±6.70 kPa×s×L(-1), 571.40±40.01 kPa×s×L(-1) vs. 286.27±8.66 kPa×s×L(-1); ALT: 89.50±4.11 U/L vs. 40.57±3.63 U/L, 89.25±4.88 U/L vs. 37.92±2.62 U/L, 86.30±5.61 U/L vs. 38.47±3.50 U/L; Cr: 75.62±4.61 μmol/L vs. 41.58±2.78 μmol/L, 77.00±5.92 μmol/L vs. 46.55±3.17 μmol/L, 74.13±2.56 μmol/L vs. 45.65±1.83 μmol/L; CK-MB: 13.122±0.282 kU/L vs. 1.557±0.009 kU/L, 8.885±0.272 kU/L vs. 1.497±0.009 kU/L, 8.692±0.180 kU/L vs. 1.490±0.005 kU/L; DAO: 2.26±0.14 kU/L vs. 0.25±0.02 kU/L, 1.50±0.07 kU/L vs. 0.25±0.01 kU/L, 1.37±0.07 kU/L vs. 0.25±0.02 kU/L, all P<0.05). All parameters in NR group kept on worsening till death, while hemodynamic and organ functions of two intravenous resuscitation groups were gradually improved, CI, SVR and DAO in RP group were significantly superior to those of RL group from 2 hours on after burn (all P<0.05), and dp/dt max and CK-MB in RP group were significantly better than those of RL group from 6 hours on after burn (dp/dt max: 1,082.33±63.59 mmHg/s vs. 1,018.60±47.36 mmHg/s, CK-MB: 7,898.70±255.74 U/L vs. 8,438.70±442.00 U/L, all P<0.05), and MAP was significantly better than that of RL group at 6 hours (124.67±9.39 mmHg vs. 114.33±9.16 mmHg, P<0.05), and Cr was significantly better than that of RL group from 24 hours on after burn (53.42±4.99 μmol/L vs. 60.77±3.11 μmol/L, P<0.05). CONCLUSIONS The Pyr Ringer solution was superior to the Ringer lactate solution in improving hemodynamic and organ functions for intravenous resuscitation in dogs with 50%TBSA full thickness burn.

Xiaodong Bai - One of the best experts on this subject based on the ideXlab platform.

  • the effects of sodium pyruvate ringer solution on hemodynamic and organ functions during shock stage in dogs with a 50 total body surface area full thickness burn
    Chinese critical care medicine, 2014
    Co-Authors: Xiangxi Meng, Xiaodong Bai, Zhi-yong Sheng
    Abstract:

    OBJECTIVE To compare the effect of intravenous resuscitation with sodium pyruvate (Pyr) Ringer solution against lactated Ringer solution on hemodynamic and organ functions during shock stage in dogs with burn. METHODS 28 Beagle dogs were subjected to 50% total body surface area (TBSA) burn, and they were divided into three groups: burn injury without fluid resuscitation (NR, n=8), Ringer lactate solution (RL, n=10), and Pyr Ringer solution (RP, n=10). They were given intravenous fluid resuscitation according to Parkland Formula 30 minutes after burn. The hemodynamics, organ functions and mortality were observed in conscious state before burn injury, and 2, 6, 8, 12, 24 hours after burn injury. RESULTS Within 24 hours after burn, all the dogs in NR group died, and those in RL and RP groups were all alive. At 2 hours after burn, the mean arterial pressure (MAP), cardiac index (CI), dp/dt max of left ventricular contractility were significantly reduced in NR, RL and RP groups compared with those before injury (MAP: 45.33±7.78 mmHg vs. 141.67±5.98 mmHg, 91.33±10.25 mmHg vs. 142.33±6.16 mmHg, 98.67±9.54 mmHg vs. 142.83±5.47 mmHg; CI: 8.17±0.83 mL×s(-1)×m(-2) vs. 48.34±3.33 mL×s(-1)×m(-2), 16.84±2.17 mL×s(-1)×m(-2) vs. 47.34±1.67 mL×s(-1)×m(-2), 19.00±1.50 mL×s(-1)×m(-2) vs. 47.34±1.33 mL×s(-1)×m(-2); dp/dt max: 426.83±51.91 mmHg/s vs. 1 372.50±39.61 mmHg/s, 594.00±88.23 mmHg/s vs. 1 363.83±44.92 mmHg/s, 645.00±66.82 mmHg/s vs. 1 395.83±19.49 mmHg/s, all P<0.05), and the systemic vascular resistance (SVR) and alanine transaminase (ALT), creatinine (Cr), serum MB isoenzyme of creatine kinase (CK-MB), diamine oxidase (DAO) were significantly higher (SVR: 1 322.50±36.37 kPa×s×L(-1) vs. 281.45±8.84 kPa×s×L(-1), 777.50±41.84 kPa×s×L(-1) vs. 289.72±6.70 kPa×s×L(-1), 571.40±40.01 kPa×s×L(-1) vs. 286.27±8.66 kPa×s×L(-1); ALT: 89.50±4.11 U/L vs. 40.57±3.63 U/L, 89.25±4.88 U/L vs. 37.92±2.62 U/L, 86.30±5.61 U/L vs. 38.47±3.50 U/L; Cr: 75.62±4.61 μmol/L vs. 41.58±2.78 μmol/L, 77.00±5.92 μmol/L vs. 46.55±3.17 μmol/L, 74.13±2.56 μmol/L vs. 45.65±1.83 μmol/L; CK-MB: 13.122±0.282 kU/L vs. 1.557±0.009 kU/L, 8.885±0.272 kU/L vs. 1.497±0.009 kU/L, 8.692±0.180 kU/L vs. 1.490±0.005 kU/L; DAO: 2.26±0.14 kU/L vs. 0.25±0.02 kU/L, 1.50±0.07 kU/L vs. 0.25±0.01 kU/L, 1.37±0.07 kU/L vs. 0.25±0.02 kU/L, all P<0.05). All parameters in NR group kept on worsening till death, while hemodynamic and organ functions of two intravenous resuscitation groups were gradually improved, CI, SVR and DAO in RP group were significantly superior to those of RL group from 2 hours on after burn (all P<0.05), and dp/dt max and CK-MB in RP group were significantly better than those of RL group from 6 hours on after burn (dp/dt max: 1,082.33±63.59 mmHg/s vs. 1,018.60±47.36 mmHg/s, CK-MB: 7,898.70±255.74 U/L vs. 8,438.70±442.00 U/L, all P<0.05), and MAP was significantly better than that of RL group at 6 hours (124.67±9.39 mmHg vs. 114.33±9.16 mmHg, P<0.05), and Cr was significantly better than that of RL group from 24 hours on after burn (53.42±4.99 μmol/L vs. 60.77±3.11 μmol/L, P<0.05). CONCLUSIONS The Pyr Ringer solution was superior to the Ringer lactate solution in improving hemodynamic and organ functions for intravenous resuscitation in dogs with 50%TBSA full thickness burn.

Shuming Wang - One of the best experts on this subject based on the ideXlab platform.

  • effects of hypotonic sodium pyruvate oral rehydration salt on capillary permeability gastrointestinal and organs function in rats with a 50 total body surface area scald injury
    Chin J Injury Repair and Wound Healing(Electronic Edition), 2019
    Co-Authors: Shuming Wang, Rui Liu, Xuezhe Zhan
    Abstract:

    Objective To investigate the effects of hypotonic sodium pyruvate oral rehydration salts on vascular permeability, gastrointestinal and organ function in severely burned rats. Methods Eighty male Sprague-Dawley(SD) rats were selected and 50% total body surface area (TBSA) full thickness scald model was established. Rats were divided into 4 groups according to the random number table: scalded non-rehydration group (NR group), hypotonic sodium pyruvate-oral rehydration solution group ( PR group), hypotonic sodium citrate-oral rehydration solution group (CR group) and false scald control group (SR group), 20 rats in each group. NR group, PR group and CR group using 96 ℃ water bath soaked rat back for 15 s, double lower limb for 15 s, abdomen for 8 s, resulting in 50% TBSA Ⅲ degree scald model (severe burns confirmed by pathological section); The SR group was immersed in a 37 ℃ water bath for the same time. The PR group and the CR group started oral rehydration by intragastric administration immediately after the injury. The volume and speed of rehydration were based on the Parkland Formula, that is, 4 mL/kg per 1% TBSA rehydration, one half of volume was infused during the first 8 hours, the rest during the following 16 hours after burns, all rats received the oral rehydration solution treatment through the gavage in every 0.5 h strictly according to the coculation. The SR group was treated with free drinking water and the NR group was not given oral rehydration. The changes of organ water content, organ function index and gastrointestinal function of rats in each group were observed at 8 h and 24 h after scald. Data were processed with one way analysis of variance, t test and chi-square test. Results (1) At 8 and 24 h after injury, the water content of organ tissues (heart, liver, lung, kidney and intestine) of the 4 groups were statistically significant (with P values below 0.05); compared with NR group, the water content of organ tissues in the other three groups decreased, and the difference was statistically significant (with P values below 0.05). At 8 h after injury, the tissue water contents of the heart, liver, lung, kidney and intestine of the PR group were (75.66±1.21)%, (72.83±1.12)%, (75.91±1.24)%, (77.67±1.17)% and (79.16±1.01)%, respectively, all lower than those of the CR group [(79.48±1.25)%, (74.16±1.12)%, (78.87±0.88)%, (79.39±1.19)%, (81.23±0.86)%], the differences were statistically significance (t=3.698, 4.368, 5.112, 5.287, 4.257; with P values below 0.05). At 24 h after injury, the tissue water contents of the heart, liver, lung, kidney and intestine of the PR group were (71.78±1.08)%, (66.89±1.11)%, (71.42±1.18)%, (71.64±1.17)%, (73.91±1.03)%, all lower than those of the CR group [(77.12±1.22)%, (71.13±1.09)%, (75.81±1.14)%, (76.78±1.15)%, (78.42±0.94)%], the differences were statistical significance (t=4.165, 4.572, 4.981, 4.653, 5.017; with P values below 0.05). (2) At 8 and 24 h after injury, the organ function indexes [creatine phosphokinase isoenzyme (CK-MB), alamine aminotransferase (ALT), creatinine] were significantly different in the 4 groups (with P values below 0.05); compared with the NR group, CK-MB, ALT and creatinine were significantly observed in the PR group and the CR group at 8 and 24 h after injury, the differences were statistically significant (with P values below 0.05); 8 h after injury, CK-MB, ALT and creatinine in the PR group were (2 575.6±165.1) U/L, (270.3±61.2) U/L, (46.1±6.4) μmol/L, all lower than those in the CR group [(3 949.4±165.5) U/L, (542.6±60.1) U/L, (66.7±6.8) μmol/L], the differences were statistically significant (t=2.396, 5.465, 5.146; with P values below 0.05); 24 h after injury, CK-MB, ALT and creatinine in the PR group were (1 652.8±167.8) U/L, (226.9±12.1) U/L, (38.2± 4.8) μmol/L, all lower than those in the CR group [(3247.2±121.2) U/L, (418.1±10.9) U/L, (51.1±5.4) μmol/L], the differences were statistically significant (t=2.382, 4.957, 4.060; with P values below 0.05). (3) At 8 and 24 h after injury, the gastric emptying rate of the PR group was (85.1±1.4)%, (91.2±1.8)%, which were higher than those of the CR group [(45.7±1.8)%, (66.1±1.4)%], the differences were statistically significant (χ2=37.327, 38.421; with P values below 0.05). (4) At 8 and 24 h after injury, the total intestinal absorption in the PR group [(20.07±0.78) , (44.07±2.54) mL] were higher than those in the CR group [(14.81±0.69), (31.53±1.62) mL], the differences were statistical significance (χ2=4.716, 5.217; with P values below 0.05). Conclusion Hypotonic sodium pyruvate oral rehydration salts can significantly improve vascular permeability, gastrointestinal and organ function in severely scalded rats, and may provide a certain therapeutic effect on the recovery of severely scalded rats. Key words: Pyruvic acid; Fluid therapy; Capillary permeability; Scald; Organ function

  • effect of hypotonic sodium pyruvate oral rehydration salt on the hemodynamics tissues blood perfusion and survival rate in rats after severe burns
    Chin J Injury Repair and Wound Healing(Electronic Edition), 2017
    Co-Authors: Rui Liu, Shuming Wang, Xiuhong Gan, Huiping Zhang
    Abstract:

    Objective To explore the effect of hypotonic sodium pyruvate-oral rehydration salt on the hemodynamics, tissues blood perfusion and survival rate in rats after severe burns. Methods (1)Eighty male Sprague-Dawley (SD) rats were randomly divided into 4 groups (n=80): sham-scald group; burns with no rehydration group; burns with hypotonic sodium pyruvate-oral rehydration solution group and burns with hypotonic sodium citrate-oral rehydration solution group. Each group had 20 rats. The osmolarity of sodium pyruvate-oral rehydration solution and sodium citrate-oral rehydration solution were respectively about 247 mOsm/L and 245 mOsm/L. Except for the sham-scald group, the rats were subjected to 50% total body surface area(TBSA) third-degree burns by immersing the back of the backpart for 15 s, both lower extremities for 15 s and the abdomen for 8 s in 96 ℃ water. sham-scald rats were immersed in 37 ℃ water instead. Immediately after scalding, rehydrated animals received the oral rehydration solution treatment through the gavage. According to the Parkland Formula, the total amount of crystalloids was 4mL/ kg × 1% TBSA. One half of volume was infused during the first 8 hours, the rest during the following 16 hours after burns. All rats received the oral rehydration solution treatment through the gavage in every 0.5 h strictly according to the coculation. The rats in the sham-scald group were treated with free drinking water and rats in burns with no rehydration group were not given with oral rehydration solution. Hemodynamic parameters [mean arterial pressure(MAP), cardiac outcome (CO), dp/dtmax, systemic vascular resistance (SVR)] and liver, kidney and intestinal mucosal blood perfusion were observed at 8 h and 24 h after injury. (2)Another set of 80 male SD rats in identical experimental procedures without tests was randomly assigned to sham control group; burns with no rehydration group; burns with hypotonic sodium citrate-oral rehydration solution group and burns with hypotonic sodium pyruvate-oral rehydration solution group (n=20, each group) for analyzing the survival rate at 8 h and 24 h after burn. Data were processed with one-way ANOVA, t test and Chi-square test. Results (1)The hemodynamic parameters (MAP, CO, dp/dtmax, SVR) were significantly different at 8 h and 24 h after burn, there were significant differences (with P values below 0.05). Compared with that in burns with no rehydration solution group, the hemodynamic parameters (MAP, CO, dp/dtmax) of other 3 groups were higher, there were significant differences (with P values below 0.05). The hemodynamic parameters in burns with no rehydration solution group continued to decline until death.MAP, CO and dp/dtmax were higher in burns with hypotonic sodium pyruvate-oral rehydration solution group[(96.34±8.23) mmHg, (1.68±0.08) L/min and (720.46±61.37) mmHg/s] than that in burns with hypotonic sodium citrate-oral rehydration solution group [(75.35±7.63) mmHg, (0.97±0.05) L/min and (670.87±70.61) mmHg/s] at 8 h postburn; the differences were statistically significant (t=5.125, 2.375, 2.412, with P values below 0.05). MAP, CO and dp/dtmax were also higher in burns with hypotonic sodium pyruvate-oral rehydration solution group [(112.78±9.32) mmHg, (1.89±0.11) L/min and (953.42±74.18) mmHg/s] than that in burns with hypotonic sodium citrate-oral rehydration solution group [(93.12±10.22) mmHg, (1.13±0.09) L/min and (750.81± 65.72) mmHg/s] at 24 h postburn and the differences were statistically significant(t=5.127, 2.641, 2.981, with P values below 0.05). SVR was lower in burns with hypotonic sodium pyruvate-oral rehydration solution group [(4088.03±271.83), (3256.83±222.58) dyn·s·cm-5] than that in burns with hypotonic sodium citrate-oral rehydration solution group [(4643.17±263.72), (4305.15±230.17) dyn·s·cm-5] at 8 h and 24 h time points postburn and the differences were statistically significant (t=5.387, 4.213, with P values below 0.05). The levels of tissue blood flows (hepatic, renal and intestinal mucosa) in rats subjected to scald dropped sharply after burns, which grew to a higher level in burns with hypotonic sodium citrate-oral rehydration solution group and burns with hypotonic sodium pyruvate-oral rehydration solution group than that in the burns with no rehydration group at 8 h and 24 h postburn; the differences were statistically significant (with P values below 0.05). The levels of tissue blood flows (hepatic, renal and intestinal mucosa) were higher in burns with hypotonic sodium pyruvate-oral rehydration solution group [(225.4±28.6), (337±25.8), (68.7±10.7) BPU] than that in burns with hypotonic sodium citrate-oral rehydration solution group [(176.5±11.4), (179±19.7), (47.3±4.9) BPU] at 8 h postburn; the differences were statistically significant (t=0.168, 2.462, 2.432, with P values below 0.05). The levels of tissue blood flows (hepatic, renal and intestinal mucosa) in burns with hypotonic sodium pyruvate-oral rehydration solution group [(272.78±35.2), (319±20.1), (49.4±3.1) BPU] were higher than that in burns with hypotonic sodium citrate-oral rehydration solution group [(152.8±14.1), (128±12.7), (35.7±4.7) BPU] at 24 h postburn; the differences were statistically significant (t=3.163, 3.428, 2.314, with P values below 0.05). (2)The 24-hour survival rates of burns with hypotonic sodium pyruvate-oral rehydration solution group and burns with hypotonic sodium citrate-oral rehydration solution group were both significantly higher than the rate of the burns with no rehydration group (with P values below 0.05); the survival rate of burns with hypotonic sodium pyruvate-oral rehydration solution group (40.0%) was also significantly higher than that in the hypotonic sodium citrate-oral rehydration solution group (20.0%) and the difference was statistically significant (χ2=4.113, P=0.038). Conclusion Hypotonic sodium pyruvate-oral rehydration solution can significantly improve the systemic hemodynamics, tissues blood perfusion and survival in rats subjected with severe burn. Key words: Pyruvic acid; Fluid therapy; Burns; Hemodynamics; Survival rate