The effect of fluid resuscitation with early use of norepinephrine on lung of septic shock rat induced by LPS / 中华急诊医学杂志

ABSTRACT

Objective To explore the efficacy of different modes of fluid resuscitation (early or delayed use of norepinephrine) on lung injury of septic shock rat induced by LPS.Methods A total of 60 male Wistar rats were randomly (random number) divided into 4 groupsthe normal control group (group A,n =15),septic shock control group (group B,n =15),conventional fluid resuscitation group (group C,n =15),fluid resuscitation with early using of norepinephrine group (group D,n =15).All rats were mechanically ventilated with the same parameters.In the group C,norepinephrine was used 30 min after fluid resuscitation.In the group D,norepinephrine was used at the beginning of fluid resuscitation.Vital signs,volume of fluid infused and dosage of norepinephrine were recorded.Rats were sacrificed 2 h later and blood samples were collected for blood gas analysis.The lung tissues and BALF were collected.Pathological changes of the lung tissues were observed under light microscope.The levels of MPO,SOD and MDA were detected.The levels of IL-6,IL-8 and TNF-α in BALF and in serum were detected by using ELISA.Results Compared with group C,the mean volume of fluid infusion to achieve target blood pressure was decreased,oxygenation index was improved and the level of blood lactic acid were decreased in group D (P ＜ 0.05).HE staining indicated that inflammatory cells were decreased,pulmonary edema and alveolar walls hyperemia were alleviated in group D in comparison with group C.Inflammatory cytokines (IL-6,IL-8 and TNF-α) in BALF and in serum were significantly decreased in group D compared with group C (P ＜0.05).Levels of MPO were decreased in group D compared with group B and group C.However,early using of norepinephrine had limited effect on the levels of SOD and MDA.Conclusions The current study demonstrated that fluid resuscitation with early use of norepinephrine exhibited a protective effect on lung injuries induced by LPS.