Pulido Laura, Burgos Diego, García Morato Joaquín, Luna Carlos M
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.
Ann Transl Med. 2017 Nov;5(22):452. doi: 10.21037/atm.2017.11.35.
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.
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。