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盲肠结扎穿孔所致脓毒症幸存者的认知障碍

Cognitive impairment in sepsis survivors from cecal ligation and perforation.

作者信息

Barichello Tatiana, Martins Márcio R, Reinke Adalisa, Feier Gustavo, Ritter Cristiane, Quevedo João, Dal-Pizzol Felipe

机构信息

Laboratório de Fisiopatologia Experimental, Universidade do Extremo Sul Catarinense, Criciúma, Brazil.

出版信息

Crit Care Med. 2005 Jan;33(1):221-3; discussion 262-3. doi: 10.1097/01.ccm.0000150741.12906.bd.

Abstract

OBJECTIVE

Critical illness survivors present long-term cognitive impairment, including problems with memory and learning. We evaluated cognitive performance in rats that survived from sepsis induced by cecal ligation and puncture (CLP).

DESIGN

Prospective, controlled experiment.

SETTING

Animal basic science laboratory.

SUBJECTS

Male Wistar rats, weighing 300-350 g.

INTERVENTIONS

The rats underwent CLP (sepsis group) with "basic support" (saline at 50 mL/kg immediately and 12 hrs after CLP plus ceftriaxone at 30 mg/kg and clindamycin at 25 mg/kg 6, 12, and 18 hrs after CLP) or sham-operated (control group).

MEASUREMENTS AND MAIN RESULTS

Ten days after surgery, the animals underwent three behavioral tasks: a) inhibitory avoidance task; b) habituation to an open field; and c) continuous multiple-trials step-down inhibitory avoidance task (CMSIA). In the habituation to an open-field task, there were no differences in the number of crossings and rearings. The sepsis group showed significantly decreased performance in latency retention compared with the sham group in inhibitory avoidance. Furthermore, when tested by the habituation to an open-field task, the sepsis group did not show any difference between training and test, indicating memory impairment. In the CMSIA, the sepsis group showed a significant increase in the number of training trials required to reach the acquisition criterion.

CONCLUSION

Our data provide the first experimental demonstration that survivors from CLP show learning and memory impairment after complete physical recovery from sepsis.

摘要

目的

危重症幸存者存在长期认知障碍,包括记忆和学习问题。我们评估了经盲肠结扎和穿刺(CLP)诱导脓毒症后存活的大鼠的认知表现。

设计

前瞻性对照实验。

设置

动物基础科学实验室。

对象

体重300 - 350克的雄性Wistar大鼠。

干预措施

大鼠接受CLP(脓毒症组)并给予“基本支持”(CLP后立即及12小时给予50 mL/kg生理盐水,CLP后6、12和18小时给予30 mg/kg头孢曲松和25 mg/kg克林霉素)或假手术(对照组)。

测量指标及主要结果

手术后10天,动物接受三项行为任务:a)抑制性回避任务;b)旷场适应;c)连续多次递减式抑制性回避任务(CMSIA)。在旷场适应任务中,穿越次数和直立次数没有差异。在抑制性回避任务中,脓毒症组与假手术组相比,潜伏期保持表现显著下降。此外,在旷场适应任务测试中,脓毒症组在训练和测试之间没有显示出任何差异,表明存在记忆障碍。在CMSIA中,脓毒症组达到习得标准所需的训练次数显著增加。

结论

我们的数据首次通过实验证明,CLP幸存者在从脓毒症完全身体恢复后表现出学习和记忆障碍。

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