为创伤性失血性休克研究和医学训练开发和描述一种战斗伤员护理猪模型。

IF 2.2
Venetia Cardona, Frédérique Dufour-Gaume, Florent Montespan, Audrey Bordone, Nicolas J Prat
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引用次数: 0

摘要

目的:尽管失血性休克合并多重创伤的死亡率很高,但很少有动物模型能代表这种联合攻击类型,因为大多数动物模型本质上是再现软组织损伤。为了提高创伤研究及其对战场情况的适用性,必须定义合适的模拟战场创伤护理的动物模型。由于麻醉本身会影响生理和血流动力学变量,我们研究了三种不同类型的麻醉,氯胺酮-咪达唑仑(KM)、异氟醚(ISO)和阿法索酮(ALFA),在猪战斗相关失血性休克损伤模型中。方法:19头猪随机分为KM组(n = 5)、ISO组(n = 6)和ALFA组(n = 8),采用双侧股骨骨折失血性休克和延迟复苏治疗。结果:创伤性损伤合并大出血导致严重休克的特征性表现。KM和ISO组是失血性休克血流动力学紊乱的代表,而ALFA组表现出低耐受性的迹象,即使在复苏后也有极端和持续的心动过速。结论:我们的结论是ALFA不是我们血液动力学受损模型最合适的麻醉剂,KM或ISO是研究猪创伤性失血性休克的两种相关麻醉方案。然而,在院前医疗护理或严峻环境下,KM与医疗实践的临床相关性最大。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Development and description of a porcine model of combat casualty care for traumatic-hemorrhagic shock research and medical training.

Purpose: Despite the high incidence of death among cases of hemorrhagic shock associated with polytrauma, few animal models are representative of this combined type of aggression, as most essentially reproduce soft tissue injury. To improve trauma research and its applicability to battlefield situations, appropriate animal models simulating battlefield trauma care must be defined. As anesthesia itself influences physiological and hemodynamic variables, we studied three different types of anesthesia, ketamine-midazolam (KM), isoflurane (ISO), and alfaxalone (ALFA), in a porcine model of combat-related hemorrhagic shock injury.

Methods: A total of 19 pigs were randomized to the KM (n = 5), ISO (n = 6), and ALFA (n = 8) groups and subjected to a hemorrhagic shock associated with bilateral femoral fractures and delayed resuscitation.

Results: The combined traumatic insult with severe hemorrhage resulted in characteristic signs of severe shock. The KM and ISO groups were representative of the hemodynamic perturbation of hemorrhagic shock, whereas the ALFA group showed signs of low tolerance, with extreme and persistent tachycardia even after resuscitation.

Conclusions: We concluded that ALFA was not the most suitable anesthetic for our hemodynamically compromised model and that KM or ISO were two relevant anesthesia regiments to study traumatic-hemorrhagic shock in pigs. However, KM was the most clinically relevant to medical practices in prehospital medical care or an austere environment.

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