Experimental Study On Gastro-infusion Of Glucose-Eletrolyte Solution Containing Carbachol For Resuscitation Of Vital Hemorrhagic Shock In Dogs

Objective Severe hemorrhagic shock animal model was established by depletion of40%whole blood volume to beagle dogs to evaluate the effect of gastro-infusion of glucose-eletrolyte solution on hemodynamic indexs, organ function and mortality. Furthermore, carbachol was added to such solution to investigate its effects and mechanism of gastric empting and intestinal absorption during oral resuscitation process to provide evidence for the clinical application of oral resuscitation for hemorrhagic shock.MethodsPart1:Forty beagle dogs with40%blood volume loss were adopted in the study, which were randomized to four groups(each n=10):(1) NR group: non-resuscitation;(2) VR group:triple volume of GES was given intravenously for resuscitation of hemorrhagic shock postinjury.(3) OR group:a same volume of GES was given orally for resuscitation.(4)OC group:carbachol was added to GES with20μg/kg body weight for oral resuscitation of shock. All animals were given delayed intravenous resuscitation24hours postinjury. Hemodynamics indexs were determined before injury and2,4,8,24,48,72hours postinjury by PICCO. IMBF was detected by PeriFlux System5000. Vein blood was harvested at each time point for the detection of organ function. PV was measured by ICG. Intestinal absorptive rates of water, Na+were assessed with phenol red. Meanwhile average survive time and mortality of72h were recorded.Result1.Survival time changes. Mortalities of72h postinjury differed notablely in four grous which showed that NR group>OR group>OC group>VR group. 2.Hemodynamics index: hemodynamics status of three resuscitation groups were all improved compared to that of NR group (P<0.01). In resuscitatoin groups, CI, SVI,MAP and EVIBF of two groups resuscitated orally were lower than that of VR groups in2-48h (P<0.01) and OC group higher than OR goup in8-24.3. Organ function index. The plasma content of ALT,CK-MB and Cr, BUN were significantly elevated postinjury compared to that before injury and inproved with time. Such indexs were much lower in VR group than oral suscitation groups in4-48h and much lower in OC group than those in OR group in8-24h4.gastric emptying rate and intestinal absorption:The gastric emptying rate and intestinal absorption rate of water and Na+were notably decreased after depletions which was higher in OC group than OR group4-24h postinjury (p<0.01).Conclusion1. Beagle dog animal model was successfully established to resuscitate hemorrhagic shock by gastric-infusion of GES.2.hemodanamic indexs were significantly deteriorated, organ function damaged and blood supply decreased after depletion of40%blood volume in beagle dogs. Early oral resuscitation of GES can notably improve such changes and reduce animal motality which shows less improvement than intravenous resuscitation.3. Gastrointestine blood supplies were significantly decreased after40%hemorrhagic shock which affect their function of emptying and absorption. Oral administration of GES can resuscitate effectively in the early stage while great volume of oral fluid somehow burdened the gastrointestinal functions which reduce the resuscitation effect.4.Addition of carbachol in GES can effectively improve the resuscitation process and enhance ogan functions by increased gastrointestinal blood supply and motivation.