一个临床前随机的控制剂量优化大剂量甲酸,用于逆转格拉姆阴性败血症引起的心血管,大脑和功能障碍
Connie Pei Chen Ow1, Rachel M Peiris1, Anton Trask-Marino1
1Translational Cardiovascular and Renal Research Group and Preclinical Critical Care Unit, Florey Institute of Neuroscience and Mental Health, University of Melbourne, 30 Royal Parade, Parkville, 3052, Melbourne, VIC, Australia.
高剂量的酸 (3.0 g/kg) 有效地逆转了羊的败血症引起的心血管和功能障碍. 这一剂量达到~10 mmol/L的血度,这对于格兰阴性败血症的多器官保护至关重要.
科学领域:
- 关键护理医学 关键护理医学
- 药理学 药理学是指药理学的学科.
- 脏生理学 脏生理学
背景情况:
- 用于研究败血症病理生理学的Ovine Gram-negative败血症模型.
- 亚酸在治疗败血症引起的器官功能障碍方面显示出有前途.
- 以前的研究表明,较低的剂量改善了人类败血性休克的结果.
研究的目的:
- 确定在羊中因败血症引起的心血管和功能障碍的最低治疗剂量.
- 研究酸对败血症标志物的剂量依赖性影响.
- 确定甲酸盐治疗作用的血度值.
主要方法:
- 仪器健康的绵羊与动脉流动和脏探针.
- 诱导性败血症使用活体大肠杆菌输液超过31小时.
- 给药液体复苏并随机给静脉注射酸 (1.0,2.0或3.0克/公斤) 或载体,与北上腺素定位保持平均动脉压力.
主要成果:
- 败血症导致低血压,急性损伤和髓缺氧.
- 酸在3.0g/kg的水平恢复了平均动脉压,并减少了对北上腺素的需求 (P=0.007).
- 观察到脏氧化和尿液流量的剂量依赖性改善;3.0g/kg抑制了脏炎症信号和恢复了内皮氧化活性.
结论:
- 需要至少3.0g/kg的甲酸盐剂量来逆转羊中败血症引起的心血管和功能障碍.
- 达到~10 mmol/L的血亚酸盐度对于多器官保护至关重要.
- 这些发现强调了酸在败血症治疗中的剂量依赖的治疗值.
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