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本文引用的文献

1
Toward Smarter Lumping and Smarter Splitting: Rethinking Strategies for Sepsis and Acute Respiratory Distress Syndrome Clinical Trial Design.迈向更明智的合并与更明智的拆分:重新思考脓毒症和急性呼吸窘迫综合征临床试验设计策略
Am J Respir Crit Care Med. 2016 Jul 15;194(2):147-55. doi: 10.1164/rccm.201512-2544CP.
2
Therapeutic Targets in Sepsis: Past, Present, and Future.脓毒症治疗靶点:过去、现在和未来。
Clin Chest Med. 2016 Jun;37(2):181-9. doi: 10.1016/j.ccm.2016.01.015. Epub 2016 Mar 18.
3
Sepsis: in search of cure.脓毒症:寻找治愈方法。
Inflamm Res. 2016 Aug;65(8):587-602. doi: 10.1007/s00011-016-0937-y. Epub 2016 Mar 19.
4
The Third International Consensus Definitions for Sepsis and Septic Shock (Sepsis-3).《脓毒症及脓毒性休克第三次国际共识定义(脓毒症-3)》
JAMA. 2016 Feb 23;315(8):801-10. doi: 10.1001/jama.2016.0287.
5
Criteria for initiation of invasive ventilation in septic shock: An international survey.脓毒性休克有创通气启动标准:一项国际调查。
J Crit Care. 2016 Feb;31(1):54-7. doi: 10.1016/j.jcrc.2015.09.032. Epub 2015 Oct 23.
6
Sleep Loss and Circadian Rhythm Disruption in the Intensive Care Unit.重症监护病房中的睡眠剥夺与昼夜节律紊乱
Clin Chest Med. 2015 Sep;36(3):419-29. doi: 10.1016/j.ccm.2015.05.008. Epub 2015 Jun 29.
7
The Economic and Humanistic Burden of Severe Sepsis.严重脓毒症的经济与人文负担
Pharmacoeconomics. 2015 Sep;33(9):925-37. doi: 10.1007/s40273-015-0282-y.
8
Trial of early, goal-directed resuscitation for septic shock.早期目标导向性复苏治疗脓毒性休克的试验。
N Engl J Med. 2015 Apr 2;372(14):1301-11. doi: 10.1056/NEJMoa1500896. Epub 2015 Mar 17.
9
Goal-directed resuscitation for patients with early septic shock.目标导向性复苏治疗早期感染性休克患者。
N Engl J Med. 2014 Oct 16;371(16):1496-506. doi: 10.1056/NEJMoa1404380. Epub 2014 Oct 1.
10
A randomized trial of protocol-based care for early septic shock.一项基于方案的早期脓毒性休克护理的随机试验。
N Engl J Med. 2014 May 1;370(18):1683-93. doi: 10.1056/NEJMoa1401602. Epub 2014 Mar 18.

为非人类灵长类动物提供长期强化护理:危重病的高保真动物模型。

Delivering Prolonged Intensive Care to a Non-human Primate: A High Fidelity Animal Model of Critical Illness.

机构信息

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.

出版信息

Sci Rep. 2017 Apr 26;7(1):1204. doi: 10.1038/s41598-017-01107-6.

DOI:10.1038/s41598-017-01107-6
PMID:28446775
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC5430740/
Abstract

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.

摘要

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。