Effect of distal ischemic postconditioning on fluid resuscitation guided by PICCO and its effect on proinflammatory and anti-inflammatory balance in patients with traumatic hemorrhagic shock
LIN Aihua
XU Ke
DING Tingting
CHEN Xiangkun
Abstract：Objective To observe the effect of distal ischemic postconditioning ( RIPC) on fluid resuscitation under the guidance of PICCO in patients with traumatic hemorrhagic shock (THS) and the effect of proinflammatory and anti-inflam-matory balance in the body. Methods One hundred and fourteen THS patients were enrolled in this study from May 2013 to Sep 2017. All the patients were randomly and equally divided into two group,RIPC group (n=57) and control group (n=57). The protocol of fluid resuscitation was based on PICCO guidance. Three proinflammation factors (TNF-α, IL-1β and IL-6) and three anti-inflammation factors (TGF-β,IL-4 and IL-10) were selected for anti-inflammation system evaluation. Re-sults The dosage of both crystalloid [(2 135. 21 ± 442. 35) ml vs. (2 563. 92 ± 610. 52) ml, t=4. 293, P＜0. 001] and colloidal solution [(645. 23 ± 221. 23) ml vs. (783. 76 ± 98. 83) ml, t=4. 316, P＜0. 001] in RIPC group were lower than those in control group. The levels of LCR in RIPC group were higher than those in control group [(13. 54 ± 2. 88)% vs. (7. 25 ± 3. 14)% , t=11. 14, P＜0. 001]. On T1 stage, it could be found the increase of MAP (tRIPC=3. 359, P=0. 001;tcontrol=2. 373, P=0. 012) and GEDVI (tRIPC=7. 354, P＜0. 001; tControl=2. 690, P=0. 005) in both of two group. The levels of SVRI (t=8. 601, P＜0. 001) in RIPC group were decreased, while the EVIWI (t=3. 391, P＜0. 001) in control group were increased on T1 stage. The levels of proinflammation factors (TNF-α, IL-1β and IL-6) in RIPC group were lower than those in control group (t=6. 227, t=14. 856, t=16. 506, P＜0. 001), while the levels of anti-inflammation factors (TGF-β, IL-4 and IL-10) in RIPC group were higher than those in control group (t=20. 280, t=6. 307,t=18. 877, P＜ 0. 001). Correlation analysis suggested that△IL-1β(r=0. 633) and△IL-10(r=0. 661) were related factors to RIPC. Con-clusion RIPC intervention can help improve the clinical effect of fluid resuscitation guided by PICCO in THS patients, and further improve the proinflammatory and anti-inflammatory balance in THS patients.
Keywords：Remote ischemia post conditioningTraumatic hemorrhagic shockAnt-inflammation and proinflamma-tion balance
Publication Date：2018-01-01
Online Publishing Date：2025-08-15(First online date of this platform, not the publication date of the document)
Pages：5( 702-705,709 )