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Ann Transl Med. 2017 Nov;5(22):452. doi: 10.21037/atm.2017.11.35.
2
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本文引用的文献

1
International ERS/ESICM/ESCMID/ALAT guidelines for the management of hospital-acquired pneumonia and ventilator-associated pneumonia: Guidelines for the management of hospital-acquired pneumonia (HAP)/ventilator-associated pneumonia (VAP) of the European Respiratory Society (ERS), European Society of Intensive Care Medicine (ESICM), European Society of Clinical Microbiology and Infectious Diseases (ESCMID) and Asociación Latinoamericana del Tórax (ALAT).国际 ERS/ESICM/ESCMID/ALAT 医院获得性肺炎和呼吸机相关性肺炎管理指南:欧洲呼吸学会 (ERS)、欧洲重症监护医学学会 (ESICM)、欧洲临床微生物学和传染病学会 (ESCMID) 和拉丁美洲胸科协会 (ALAT) 医院获得性肺炎 (HAP)/呼吸机相关性肺炎 (VAP) 管理指南。
Eur Respir J. 2017 Sep 10;50(3). doi: 10.1183/13993003.00582-2017. Print 2017 Sep.
2
Changing Definitions of Sepsis.脓毒症定义的变化
Turk J Anaesthesiol Reanim. 2017 Jun;45(3):129-138. doi: 10.5152/TJAR.2017.93753. Epub 2017 Feb 1.
3
Severe Pneumococcal Pneumonia Causes Acute Cardiac Toxicity and Subsequent Cardiac Remodeling.重症肺炎球菌肺炎可导致急性心脏毒性及随后的心脏重塑。
Am J Respir Crit Care Med. 2017 Sep 1;196(5):609-620. doi: 10.1164/rccm.201701-0104OC.
4
Oral decontamination techniques and ventilator-associated pneumonia.口腔去污技术与呼吸机相关性肺炎
Br J Nurs. 2017 Jun 8;26(11):594-599. doi: 10.12968/bjon.2017.26.11.594.
5
Surviving Sepsis Campaign: International Guidelines for Management of Sepsis and Septic Shock: 2016.拯救脓毒症运动:脓毒症和脓毒性休克管理国际指南:2016 年版。
Intensive Care Med. 2017 Mar;43(3):304-377. doi: 10.1007/s00134-017-4683-6. Epub 2017 Jan 18.
6
Management of Adults With Hospital-acquired and Ventilator-associated Pneumonia: 2016 Clinical Practice Guidelines by the Infectious Diseases Society of America and the American Thoracic Society.成人医院获得性肺炎和呼吸机相关性肺炎的管理:美国感染病学会和美国胸科学会2016年临床实践指南
Clin Infect Dis. 2016 Sep 1;63(5):e61-e111. doi: 10.1093/cid/ciw353. Epub 2016 Jul 14.
7
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.
8
Endotracheal tube biofilm translocation in the lateral Trendelenburg position.气管内导管生物膜在侧卧位头低脚高位时的移位
Crit Care. 2015 Feb 27;19(1):59. doi: 10.1186/s13054-015-0785-0.
9
Hospital deaths in patients with sepsis from 2 independent cohorts.来自2个独立队列的脓毒症患者的医院死亡情况。
JAMA. 2014 Jul 2;312(1):90-2. doi: 10.1001/jama.2014.5804.
10
A more clinically relevant model of ventilator-associated pneumonia?一种更具临床相关性的呼吸机相关性肺炎模型?
Anesthesiology. 2014 May;120(5):1075-7. doi: 10.1097/ALN.0000000000000223.

呼吸机相关性肺炎的动物模型是否反映了人类脓毒症机制的病理生理学?

Does animal model on ventilator-associated pneumonia reflect physiopathology of sepsis mechanisms in humans?

作者信息

Pulido Laura, Burgos Diego, García Morato Joaquín, Luna Carlos M

机构信息

Department of Pulmonary Medicine, Experimental Surgery University Center, Hospital de Clínicas José de San Martín, Universidad de Buenos Aires, Buenos Aires, Argentina.

Thoracic Surgery Division, Department of Surgery, Experimental Surgery University Center, Hospital de Clínicas José de San Martín, Universidad de Buenos Aires, Buenos Aires, Argentina.

出版信息

Ann Transl Med. 2017 Nov;5(22):452. doi: 10.21037/atm.2017.11.35.

DOI:10.21037/atm.2017.11.35
PMID:29264369
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC5721223/
Abstract

Ventilator-associated pneumonia (VAP) is the leading cause of death in critically ill patients in intensive care units. In the last 20 years, different animal models have been a valuable tool for the study of pathophysiology and phenotypic characteristics of different lung infections observed in humans, becoming an essential link between '''' testing and clinical studies. Different animal models have been used to study the mechanism of a deregulated inflammatory response and host tissue damage of sepsis in VAP, as well as different infection parameters such as clinical, physiological, microbiological and pathological facts in several large and small mammals. In addition, the dosage of inflammatory modulators and their consequences in local and systemic inflammation, or even the administration of antibiotics, have been evaluated with very interesting results. Although some bronchial inoculation ways do not resemble the common pathophysiologic mechanisms, the experimental model of VAP induced by the inoculation of high concentrations of pathogens in mechanically ventilated animals is useful for studying the local and systemic responses of sepsis in VAP and it reproduces biological mechanisms such as acute lung injury, distress response, cardiac events and immune modulation comparable with clinical studies.

摘要

呼吸机相关性肺炎(VAP)是重症监护病房危重症患者的主要死因。在过去20年中,不同的动物模型一直是研究人类中观察到的不同肺部感染的病理生理学和表型特征的宝贵工具,成为测试和临床研究之间的重要纽带。不同的动物模型已被用于研究VAP中脓毒症炎症反应失调和宿主组织损伤的机制,以及几种大小哺乳动物的不同感染参数,如临床、生理、微生物学和病理学方面。此外,还评估了炎症调节剂的剂量及其在局部和全身炎症中的后果,甚至抗生素的给药情况,结果非常有趣。尽管一些支气管接种方式与常见的病理生理机制不同,但在机械通气动物中接种高浓度病原体诱导的VAP实验模型对于研究VAP中脓毒症的局部和全身反应很有用,并且它再现了与临床研究相当的生物机制,如急性肺损伤、应激反应、心脏事件和免疫调节。