新式復甦溶液於白豬體外循環及大鼠疾病模式下之比較

Abstract

復甦溶液廣泛被認為是急重症治療的黃金準則，而依成分的不同又可區分為晶體溶液跟膠體溶液兩種，但是何者為最適合的復甦溶液在現今依舊爭議不斷，仍取決於各區性的差異、臨床醫師的經驗以及醫療機構的偏好。在本研究中，我們期望能透過白豬的體外循環模型以及大鼠的敗血性和出血性模型來探討三羥甲基胺基甲烷均衡溶液（TBS）的應用，運用檢測血液生化學、離子以及血氣的變化來評估TBS的效用。研究結果顯示TBS與其他復甦溶液在不同模型下並無顯著差異，但是在減緩代謝性酸血症的預後上以及減緩體外循環的心肌傷害上有顯著差異。總結來說，TBS在本研究的體外循環模型、大鼠敗血性以及出血性模型中提供了安全並且可行的另一種治療策略。

A resuscitation solution is widely considered as the cornerstone of treatment for critically ill patients. Resuscitation solutions can contain crystalloids and colloids. Nevertheless, determining the ideal resuscitation solution is based on regional variations, clinician experiences, and institute preferences; thus, this topic has been a matter of debate. In this study, we aimed to explore the application of trometamol-balanced solution (TBS) that were identified by white pig cardiopulmonary bypass (CPB) model and rat diseased models. The biochemical parameters, electrolytes, and blood gas parameters were performed using an Abbott i-STAT analyzer to investigate the effect of using TBS on hemodynamic parameters. The biochemical parameters, electrolytes, and blood gas parameters implied similar trends and the majority of data showed no considerable changes between TBS and the other resuscitation solutions. However, TBS might be more effective in metabolic acidosis and myocardial damage alleviation. In summary, TBS is safe and feasible in this study and may offer advantages in hemorrhagic shock, septic shock and as priming solution in CPB.