| Objective:To observe the effect of sodium pyruvate intraperitoneal rehydration salt on the survival rate and abdominal organs of animals with severe scalding combined with seawater immersion injury delayed intravenous rehydration.Methods:Male SD rats,252,were randomly divided into model control group(MC group),intraperitoneal saline rehydration group(IS group),and intraperitoneal sodium pyruvate rehydration group(IP group),84 per group.Severe scalding combined with seawater immersion model: The rats were scalded on the neck,back and buttocks with hot water at 100℃ for 15 s,resulting in 35% TBSA Ⅲ° scalding,and immediately immersed in artificial seawater(23.0±1.0℃)for 30 min after scalding.Intraperitoneal fluid injection:0h after completion of seawater immersion IS and IP groups were injected intraperitoneally with saline and sodium pyruvate injection,MC group was not treated.Delayed 2h intravenous fluid resuscitation: after the rats were retrieved from seawater,shock resuscitation was delayed for 2 hours by intravenous injection of sodium lactate Ringer’s solution.Each group of rats was divided into three batches,the first batch: the mean arterial pressure(MAP),heart rate(HR),respiration(RR)and rectal temperature(RT)were recorded before scalding,0h,2h,5h and 24 h after immersion using a Power Lab multi-channel physiological recorder and anal thermometer;the survival status of the rats was recorded for 24 hours and the survival time and 24 h survival rate were calculated.The second batch: Blood flow to the liver,kidney and small intestine mucosa of rats was recorded using laser Doppler flowmetry at four time points before scalding and 0h,2h and 5h after immersion.The third batch:Blood samples and histopathological samples were collected at five time points before scalding,0h,2h,5h and 24 h after immersion.Lactic acid(Lac)levels were measured using a blood gas analyser,alanine transaminase(ALT),serum creatinine(CR)and diamine oxidase(DAO)levels were measured using an AU5800 biochemical analyser,liver,kidney and small intestine tissue specimens were retained,formaldehyde was fixed,HE stained,histopathological changes were observed under a microscope and photographs were taken.Results:1.The mean survival time of the rats in the model control group was(969.55±556.0)min,which was significantly lower than that of the saline group(1273.3±343.22)min and the pyruvate group(1350.7±273.87)min(P<0.05).The survival rates of the model control group,saline group and pyruvate group were 50%,65% and 80%,respectively,and the survival rate of the pyruvate group was significantly higher than that of the model control group(P<0.05).2.MAP,HR and RR were significantly higher in the pyruvate group than in the saline group at 2h and 5h after seawater immersion(P < 0.05);MAP,HR and RR were significantly higher in the saline group than in the model control group at 2h and 5h after seawater immersion(P < 0.05).3.Lac in the pyruvate group was significantly lower than that in the model control and saline groups at 2 h after seawater immersion(P<0.05).RT was significantly higher in the 2h post-seawater immersion intraperitoneal infusion group than in the model control group(P<0.05);RT was significantly higher in the 5h post-seawater immersion pyruvate group than in the model control and saline groups(P < 0.05).4.The liver,kidney and small intestine mucosal blood flow in the 2h post-seawater immersion intraperitoneal rehydration group was significantly higher than that in the model control group(P <0.05);the liver,kidney and small intestine mucosal blood flow in the 2h and 5h post-seawater immersion pyruvate group was significantly higher than that in the model control and saline groups(P < 0.05).5.ALT was significantly lower in both peritoneal rehydration groups at 2h and 5h after seawater immersion compared to the model control group(P <0.05);ALT was significantly lower in the pyruvate group at 5h and 24 h after seawater immersion compared to the model control and saline groups(P<0.05).The CR of the pyruvate group was significantly lower than that of the model control group and saline group at 2h,5h and 24 h after seawater immersion(P < 0.05).The DAO of the pyruvate group was significantly lower than that of the model control group at 2h and 5h after seawater immersion(P< 0.05);the DAO of the pyruvate group was significantly lower than that of the saline group in the comparison of peritoneal rehydration groups at 2h after seawater immersion(P < 0.05).6.Under light microscopy(×400),the morphological structures of the liver,kidney and small intestine mucosa were clear and intact in all groups of rats before scalding and 0h after immersion,and no obvious and obvious damage was seen.After 2h of seawater immersion,all groups of tissue specimens showed different degrees of swelling,widening of cell gaps and infiltration of inflammatory cells.At 2h,5h and 24 h after seawater immersion the pyruvate group was significantly less damaged than the saline group and the model control group.Conclusion:In the rat model of delayed intravenous rehydration after 35% TBSA III°scald injury combined with seawater immersion injury,the intraperitoneal administration of sodium pyruvate rehydration salt after seawater immersion injury significantly increased the mean arterial pressure and rectal temperature,reduced the blood lactate level,effectively improved the blood flow,organ function and pathological damage of liver,kidney and small intestine mucosa tissues in the peritoneal cavity,significantly increased the survival rate and prolonged the survival time of rats within 24 hours. |
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