Special Pathogens, National Microbiology Laboratory, Public Health Agency of Canada, Winnipeg, Manitoba, Canada.
Department of Medical Microbiology and Infectious Diseases, College of Medicine, Faculty of Health Sciences, University of Manitoba, Winnipeg, Manitoba, Canada.
Sci Rep. 2017 Apr 26;7(1):1204. doi: 10.1038/s41598-017-01107-6.
Critical care needs have been rising in recent decades as populations age and comorbidities increase. Sepsis-related admissions to critical care contribute up to 50% of volume and septic shock carries a 35-54% fatality rate. Improvements in sepsis-related care and mortality would have a significant impact of a resource-intensive area of health care delivery. Unfortunately, research has been hampered by the lack of an animal model that replicates the complex care provided to humans in an intensive care unit (ICU). We developed a protocol to provide full ICU type supportive care to Rhesus macaques. This included mechanical ventilation, continuous sedation, fluid and electrolyte management and vasopressor support in response to Ebolavirus-induced septic shock. The animals accurately recapitulated human responses to a full range of ICU interventions (e.g. fluid resuscitation). This model can overcome current animal model limitations by accurately emulating the complexity of ICU care and thereby provide a platform for testing new interventions in critical care and sepsis without placing patients at risk.
近几十年来,随着人口老龄化和合并症的增加,重症监护的需求不断增加。与脓毒症相关的重症监护入院占总量的 50%,而感染性休克的死亡率为 35-54%。改善与脓毒症相关的护理和死亡率将对医疗保健提供的资源密集型领域产生重大影响。不幸的是,由于缺乏能够复制重症监护病房(ICU)中为人类提供的复杂护理的动物模型,研究受到了阻碍。我们制定了一项方案,为恒河猴提供全面的 ICU 类型支持性护理。这包括机械通气、持续镇静、液体和电解质管理以及血管加压素支持,以应对埃博拉病毒引起的感染性休克。这些动物准确地再现了人类对各种 ICU 干预措施的反应(例如,液体复苏)。该模型可以通过准确模拟 ICU 护理的复杂性来克服当前动物模型的局限性,从而为在不使患者面临风险的情况下在重症监护和脓毒症中测试新干预措施提供平台。