Abstract:
Background With the increased use of improvised explosive devices (IEDs) in modern warfare, burn-hemorrhagic shock combined injury has become one of the important forms of combat injury. The value of the application of restrictive resuscitation in resource-limited first-line treatment is worth exploring.
Objective To explore the application value of restrictive resuscitation on burn combined hemorrhagic shock by establishing a novel burn-hemorrhagic shock combined injury pig model and to observe the effect of restrictive resuscitation on macrocirculation and microcirculation in this model within 6 h.
Methods Twenty 4-month-old healthy landrace pigs were randomly divided into two groups: control (CON) group and restricted resuscitation (RIN) group. A burn-hemorrhagic shock combined injury pig model was established by solid gasoline flame and slow blood loss from femoral artery. After modeling, pulse indicated continuous cardiac output (PICCO), side stream dark field (SDF) and blood gas analysis were used to compare the macrocirculation and microcirculatory parameters and organ wet to dry ratio of the two groups at the timepoints before and at 30 min, 1 h, 2 h, 4 h and 6 h after the injury.
Results Restrictive resuscitation can restore sublingual microcirculation in the experimental pigs at the end of the experiment, with a significant increase in microvascular flow index (MFI) scores compared to the CON group (P < 0.05), and can partially restored mesenteric circulation. Compared with the CON group, HR, ITBVI, Lac, and BE could be significantly improved in the RIN group (P < 0.05), along with the wet to dry ratio of lung, intestinal, and renal tissues (P < 0.05), However, there was no statistically significant difference in wet dry weight between heart, liver and brain tissues (P>0.05), indicating that capillary permeability of lung, intestinal and renal tissues increased significantly after injury.
Conclusion Restrictive resuscitation can effectively restore perfusion of the sublingual microcirculation within 6 h after injury in pigs with burn-hemorrhagic shock combined injury, and can improve ischemia and hypoxia, and can stabilize the macrocirculation and microcirculation in pigs with combined injury. The persistent elevation of vascular permeability after burn-hemorrhagic shock combined injury is a prominent situation, which may be an important breakthrough point to improve the early treatment effect of this combined injury in the future.
下载: