[Effect of carbachol on gastric emptying and gastric mucosa partial pressure of carbon dioxide in oral resuscitation of burn shock with a glucose-electrolyte solution in dogs].
OBJECTIVE
To investigate the effect of carbachol (CAR) on gastric emptying and gastric mucosa partial pressure of carbon dioxide (PgCO2) in the resuscitation of burn shock with oral administration of glucose-electrolyte solution (GES) in dogs.


METHODS
Twenty-four adult male Beagle dogs were randomly divided into 4 groups: 35% total body surface area (TBSA) III degree burn resuscitated with oral GES (35% TBSA GES, n=6), 35% TBSA III degree burn with oral GES containing 20 microg/kg of CAR (35% TBSA GES/CAR, n=6), 50% TBSA III degree burn with oral GES (50% TBSA GES, n=6) and 50% TBSA III degree burn with oral GES containing 20 microg/kg of CAR (50% TBSA GES/CAR, n=6). Dogs were subjected to 35% TBSA or 50% TBSA full-thickness flame injury respectively. Thirty minutes after burn, dogs were given GES or GES containing CAR according to Parkland formula (1/2 of 4 mlxkg(-1)x1% TBSA(-1) within 8 hours post burn, and the remaining 1/2 within next 16 hours post burn) by gavage. The gastric emptying rate, PgCO2 and intolerance symptoms were determined at 2, 4, 8 and 24 hours post burn.


RESULTS
The gastric emptying rate was significantly decreased in all groups after the burn (P<0.05), and it was 51.5% at 2 hours after burn in 35% TBSA GES group and 39.2% at 4 hours after burn in 50% TBSA GES group. It was gradually ameliorated, but still much lower than pre-injury levels (both P<0.05). The gastric emptying rate in GES/CAR group were significantly higher at all time points after injury than those in 35% GES group (P<0.05), and it was higher than that in 50% GES group at 8 hours and 24 hours (both P<0.05). The gastric emptying rate restored to pre-injury levels (P>0.05) in 35% GES/CAR group, and it was still lower than pre-injury level in 50% GES/CAR group (P<0.05). The PgCO2 were significantly elevated in all groups post burn (all P<0.05), and could not return to pre-injury levels. The PgCO2 in GES/CAR group were significantly higher at all time points after injury than those in 35% GES group (P<0.05), and it was higher than that in 50% GES group at 4 hours and 24 hours (P<0.05). The degree of gastric intolerance symptoms could be ranked as follows: 50%TBSA GES group (83.3%, 5/6)>50% TBSA GES/CAR group (50.0%, 3/6)>35%TBSA GES group (16.7%, 1/6)>35%TBSA GES/CAR group (0, 0/6).


CONCLUSIONS
The results indicate that CAR has a significant effect in improving gastric emptying and gastric ischemia during oral resuscitation of burn shock with a glucose electrolyte solution.
Tian
Yi-jun
YJ
Laboratory of Shock and Organ Dysfunction, Burns Institute, First Affiliated Hospital of PLA General Hospital, Beijing 100037, China.
Hu
Sen
S
Du
Ying
Y
Che
Jin-wei
JW
Geng
Shi-jia
SJ
Wu
Jing
J
Sheng
Zhi-yong
ZY
D000284:Administration, Oral; D000818:Animals; D002056:Burns / Q000503:physiopathology* / Q000628:therapy; D002217:Carbachol / Q000494:pharmacology*; D002245:Carbon Dioxide / Q000378:metabolism*; D004195:Disease Models, Animal; D004285:Dogs; D004573:Electrolytes / Q000627:therapeutic use; D005440:Fluid Therapy; D005746:Gastric Emptying / Q000187:drug effects*; D005753:Gastric Mucosa / Q000187:drug effects / Q000378:metabolism; D005947:Glucose / Q000627:therapeutic use; D008297:Male; D010313:Partial Pressure; D011897:Random Allocation; D012151:Resuscitation / Q000379:methods*
D004573:Electrolytes; D002245:Carbon Dioxide; D002217:Carbachol; D005947:Glucose