BACKGROUND:Mortality of hemorrhagic shock primarily depends on whether or not the patients can endure the loss of circulating volume until radical treatment is applied. We investigated whether hydrogen (H2) gas inhalation would influence the tolerance to hemorrhagic shock and improve survival. METHODS:Hemorrhagic shock was achieved by withdrawing blood until the mean arterial blood pressure reached 30-35 mm Hg. After 60 minutes of shock, the rats were resuscitated with a volume of normal saline equal to four times the volume of shed blood. The rats were assigned to either the H2 gas (1.3% H2, 26% O2, 72.7% N2)-treated group or the control gas (26% O2, 74% N2)-treated group. Inhalation of the specified gas mixture began at the initiation of blood withdrawal and continued for 2 hours after fluid resuscitation. RESULTS:The survival rate at 6 hours after fluid resuscitation was 80% in H2 gas-treated rats and 30% in control gas-treated rats (p < 0.05). The volume of blood that was removed through a catheter to induce shock was significantly larger in the H2 gas-treated rats than in the control rats. Despite losing more blood, the increase in serum potassium levels was suppressed in the H2 gas-treated rats after 60 minutes of shock. Fluid resuscitation completely restored blood pressure in the H2 gas-treated rats, whereas it failed to fully restore the blood pressure in the control gas-treated rats. At 2 hours after fluid resuscitation, blood pressure remained in the normal range and metabolic acidosis was well compensated in the H2 gas-treated rats, whereas we observed decreased blood pressure and uncompensated metabolic acidosis and hyperkalemia in the surviving control gas-treated rats. CONCLUSIONS:H2 gas inhalation delays the progression to irreversible shock. Clinically, H2 gas inhalation is expected to stabilize the subject until curative treatment can be performed, thereby increasing the probability of survival after hemorrhagic shock.

译文

背景:失血性休克的死亡率主要取决于患者是否可以忍受循环量的损失,直到应用根治性治疗。我们调查了吸入氢气(H2)是否会影响对出血性休克的耐受性并提高生存率。
方法:通过抽血直至平均动脉血压达到30-35 mm Hg来实现失血性休克。休克60分钟后,用相当于生理盐水四倍体积的生理盐水使大鼠复苏。将大鼠分为H2气体(1.3%H2、26%O2、72.7%N2)治疗组或对照组气体(26%O2、74%N2)治疗组。在抽血开始时开始吸入指定的气体混合物,并在进行液体复苏后继续吸入2小时。
结果:液体复苏后6小时的存活率在H2气体处理的大鼠中为80%,在对照气体处理的大鼠中为30%(p <0.05)。通过H 2气处理的大鼠,通过导管抽出的血液引起的休克量显着大于对照大鼠。尽管失去了更多的血液,但经过60分钟的电击后,H2气处理的大鼠的血清钾水平却被抑制。液体复苏完全恢复了H2气处理的大鼠的血压,而未能完全恢复对照气处理的大鼠的血压。液体复苏后2小时,H2气处理的大鼠的血压保持在正常范围内,代谢性酸中毒得到了很好的补偿,而存活的对照气处理的大鼠中血压降低,代谢性酸中毒和高钾血症没有得到补偿。
结论:吸入H2气体延迟了不可逆性休克的进展。临床上,预计吸入H2气体可使受试者稳定,直到可以进行治愈性治疗为止,从而增加失血性休克后存活的可能性。

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