Department of Anesthesiology, Investigational Intensive Care Unit, The University of Texas Medical Branch, Shriners Burns Hospital for Children, 601 Harborside Drive, Galveston, TX 77555-1102, USA.
Burns. 2010 Nov;36(7):1050-8. doi: 10.1016/j.burns.2010.01.009. Epub 2010 Apr 14.
We modified our established and clinically relevant ARDS model of smoke inhalation injury and septic shock by administration of combined antibiotics (AB) such as piperacillin and ciprofloxacin, to more closely mimic the clinical intensive care setting. Twenty-three sheep were subjected to the injury, and allocated to four groups for a 96 h study period: sham (n=5 non-injured); control (n=6: injured); AB6h (n=6: injured, antibiotics started 6 h post-injury); AB12h (n=6: injured, antibiotics started 12 h post-injury). All sham animals survived 96 h. Control, AB6h, AB12h groups reached criteria of septic shock within 12 h post-injury. All controls died within 36 h. Eighty three percent of AB6h and fifty percent of AB12h survived 96 h. Median survival times were significantly improved in the treated groups compared with the control group: 24 h in control vs. 80.5 h in AB6h, and 65 h in AB12h animals. Combined ciprofloxacin and piperacillin therapy was effective, reduced nitric oxide production and mortality, and will allow future long-term studies in this model.
我们通过联合使用抗生素(如哌拉西林和环丙沙星)来改良已建立的、具有临床相关性的烟雾吸入性损伤和感染性休克 ARDS 模型,使其更接近临床重症监护环境。23 只绵羊接受了损伤,并分为四组进行 96 小时的研究:假手术组(n=5 只未受伤);对照组(n=6 只:受伤);AB6h 组(n=6 只:受伤,抗生素在损伤后 6 小时开始);AB12h 组(n=6 只:受伤,抗生素在损伤后 12 小时开始)。所有假手术动物均存活 96 小时。对照组、AB6h 组和 AB12h 组在损伤后 12 小时内达到感染性休克标准。所有对照组动物均在 36 小时内死亡。AB6h 组的 83%和 AB12h 组的 50%动物存活 96 小时。与对照组相比,治疗组的中位生存时间显著提高:对照组为 24 小时,AB6h 组为 80.5 小时,AB12h 组为 65 小时。联合使用环丙沙星和哌拉西林治疗有效,降低了一氧化氮的产生和死亡率,并将允许在该模型中进行未来的长期研究。