Melatonin improves survival and functional impairment including hemolysis, thrombocytopenia, and hypotension when administered in a prophylactic manner or early after initiation of sepsis or endotoxemia. In the present study, melatonin was given not before first symptoms of systemic inflammation became manifest. Lipopolysaccharide was infused at a rate of 0.5 mg/kg × h to induce systemic inflammation in male Wistar rats. Melatonin (single dose 3 mg/kg × 15 min) was intravenously administered 180 and 270 min after starting of the lipopolysaccharide infusion. Systemic and vital parameters (e.g., systemic blood pressure and breathing rate) as well as blood and plasma parameters (acid-base parameters; electrolytes; parameters of tissue injury such as glucose concentration, lactate concentration, hemolysis, and aminotransferase activities; parameters of thromboelastometry; and platelet count) were determined in regular intervals. Infusion of lipopolysaccharide led to characteristic symptoms of severe systemic inflammation including hypotension, metabolic acidosis and hypoglycemia, electrolyte and hemostatic disturbances, thrombocytopenia, and hemolysis. Melatonin neither decreased mortality nor reduced lipopolysaccharide-dependent changes to vital, blood, and plasma parameters. Even though melatonin may have a beneficial effect in early stages of systemic inflammation, it can hardly be an option in therapy of manifest sepsis or endotoxemia in an intensive care unit.

译文

当以预防性方式或在脓毒症或内毒素血症开始后早期给药时,褪黑素可改善生存和功能障碍,包括溶血,血小板减少症和低血压。在本研究中,褪黑激素不是在全身炎症的最初症状出现之前就给予的。以0.5 mg/kg × h的速率输注脂多糖以诱导雄性Wistar大鼠全身炎症。在开始脂多糖输注后180和270分钟静脉内施用褪黑素 (单剂量3 mg/kg × 15分钟)。全身和生命参数 (例如,全身血压和呼吸频率) 以及血液和血浆参数 (酸碱参数; 电解质; 组织损伤参数,例如葡萄糖浓度,乳酸浓度,溶血和氨基转移酶活性; 血栓弹性测定参数; 和血小板计数) 定期确定。输注脂多糖会导致严重全身性炎症的特征性症状,包括低血压,代谢性酸中毒和低血糖,电解质和止血障碍,血小板减少症和溶血。褪黑素既不能降低死亡率,也不能降低脂多糖依赖性的生命,血液和血浆参数变化。尽管褪黑激素在全身性炎症的早期阶段可能具有有益的作用,但在重症监护病房中,褪黑激素很难成为明显败血症或内毒素血症的治疗选择。

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