在创伤和出血性休克中复苏内皮质葡萄糖
Tanya Anand1, Angelica Alvarez Reyes2, Michael C Sjoquist2
1From the Department of Surgery, Division of Trauma, Critical Care, Burns, and Emergency Surgery, The University of Arizona, Tucson, AZ.
概括
内皮葡萄糖 (EG) 保护血管,但在出血性休克中受损,恶化结果. 有针对性的复苏策略可以保持EG完整性并改善患者的结果.
科学领域:
- 血管生物学 血管生物学
- 创伤病理生理学
- 复苏科学 复苏科学 复苏科学
背景情况:
- 内皮受内皮糖 (EG) 的保护,内皮糖是一种负电荷的屏障,对血管平衡至关重要.
- 脑电图的完整性对于机械传导,细胞信号传递,调节微血管透性和液体交换至关重要.
- 在创伤和出血性休克期间EG分解会导致炎症增加和患者的治疗结果差.
研究的目的:
- 为了描述内皮质葡萄糖 (EG).
- 审查EG流失在出血性休克中的影响.
- 引入有针对性的复苏的概念,以尽量减少EG脱落.
主要方法:
- 审查关于EG结构和功能的现有动物和人类研究.
- 分析EG流失严重程度与创伤/出血性休克患者的结果之间的关联.
- 评估复苏液策略及其对EG完整性的潜在影响.
主要成果:
- 脑电流失的严重程度与损伤的严重程度和较差的患者结果相关.
- 在出血性休克中优先考虑血,冷沉积物和全血而不是晶体质,可能会改善结果.
- 这些改善的结果可能与减少EG脱落和下游信号调制有关.
结论:
- 输血球流失是出血性休克病理生理学的重要因素.
- 针对性复苏,专注于EG保存和复制,是一种有前途的治疗方法.
- 在复苏过程中最大限度地减少EG脱落可能会导致患者在创伤和休克中获得更好的结果.
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