Source de financement / Nombre de biologie moléculaire de choc hémorragique GM053789

<ol>
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L., Uchida, T., Kramer, G. C. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Fluid+compartment+in+hemorrhaged+rats+after+hyperosmotic+crystalloid+and+hyperoncotic+crystalloid+resuscitation.">Fluid compartment in hemorrhaged rats after hyperosmotic crystalloid and hyperoncotic crystalloid resuscitation.</a> Am J Physiol. 270, F1-F8 (1996).</li><li>Perel, P., Roberts, I. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Colloids+vs+crystalloids+for+fluid+resuscitation+in+critically+ill+patients.">Colloids vs crystalloids for fluid resuscitation in critically ill patients.</a> Cochrane Database System Rev. 4, CD000567-CD000567 (2007).</li></ol>

Expériences sur les animaux ont été supervisés et effectués en conformité avec les directives et les règlements énoncés par le soin des animaux et du Comité institutionnel utilisation et la conduite de la recherche et le Bureau de conformité de l&#39;Université de Pittsburgh, une AALAS entièrement accrédité / institution AALAC. Sources animales comprennent Jackson Laboratories et Charles Rivers Laboratories. Tous les animaux subissent l&#39;assurance santé complets grâce à chaque fournisseur ainsi que l&#39;Université de Pittsburgh programmes internes de surveillance des animaux de la santé. Cette recherche est menée en conformité avec les principes du gouvernement américain pour l&#39;utilisation des animaux vertébrés. Le programme est enregistré avec l&#39;USDA, et a une lettre d&#39;assurance avec le Bureau des services de santé publique du bien-être des animaux de laboratoire.

<table border="1"><tbody><tr><th> Instrument </th><th> Fabricant </th><th> Numéro de catalogue </th></tr><tr><td> Dumont (SS/45 ° d&#39;angle 0.2x0.12mm pointe, longueur 13.5cm) </td><td> Outils Fine Science </td><td> 11203-25 </td></tr><tr><td> Ciseaux chirurgicaux (droite-12cm) </td><td> Outils Fine Science </td><td> 14068-12 </td></tr><tr><td> Hémostatiques (courbes-12.5cm) </td><td> Outils Fine Science </td><td> 13009-12 </td></tr><tr><td> Microciseaux (printemps ciseaux droite 8cm) </td><td> Outils Fine Science </td><td> 15000-00 </td></tr><tr><td> Pince (0,8 mm à pointe, courbées-10cm) </td><td> Outils Fine Science </td><td> 11050-10 </td></tr><tr><td> enrouleur de suture 6-0 </td><td> Outils Fine Science </td><td> 18020-60 </td></tr><tr><td> sutures 4-0 PDSII </td><td> Vet Penn </td><td> ETHZ304H </td></tr><tr><td> gaze 4x4 </td><td> peuvent être achetés par n&#39;importe quel fournisseur mondial </td><td></td></tr><tr><td> coton-embout applicateur </td><td> peuvent être achetés par n&#39;importe quel fournisseur mondial </td><td></td></tr><tr><td> Aiguille 30G </td><td> peuvent être achetés par n&#39;importe quel fournisseur mondial </td><td></td></tr><tr><td> Aiguille 23G </td><td> peuvent être achetés par n&#39;importe quel fournisseur mondial </td><td></td></tr><tr><td> Seringue 3cc </td><td> peuvent être achetés par n&#39;importe quel fournisseur mondial </td><td></td></tr><tr><td> Seringue 5cc </td><td> peuvent être achetés par n&#39;importe quel fournisseur mondial </td><td></td></tr><tr><td> Seringue 10cc </td><td> peuvent être achetés par n&#39;importe quel fournisseur mondial </td><td></td></tr><tr><td> 50cc tube conique </td><td> peuvent être achetés par n&#39;importe quel fournisseur mondial </td><td></td></tr><tr><td> 1cc seringue w / 25G aiguille </td><td> Fisher Scientific </td><td> 14-826-88 </td></tr><tr><td> Polyéthylène 10 tubes de 100 `(PE-10) </td><td> Fisher Scientific </td><td> 14 à 170-12P </td></tr><tr><td> Polyéthylène 50 tubes de 100 `(PE-50) </td><td> Fisher Scientific </td><td> 14 à 170-12B </td></tr><tr><td> Robinet 3 voies </td><td> Fisher Scientific </td><td> NC9779127 </td></tr><tr><td> chirurgicale tampon bleu </td><td> Fisher Scientific </td><td> 50-7105 </td></tr><tr><td> Pansements champ stérile </td><td> Fisher Scientific </td><td> NC9517505 </td></tr><tr><td> bande de rouleaux 1 &quot; </td><td> Corporate Express </td><td> MMM26001 </td></tr><tr><td> droites pots côté large bouche (utilisé comme plafond pour cône de nez) </td><td> VWR </td><td> 159000-058 </td></tr><tr><td> plateau en acier inoxydable 8 &quot;x 11&quot; </td><td> VWR </td><td> 62687-049 </td></tr><tr><td> mâle-mâle de verrouillage Leur 3-way </td><td> VWR </td><td> 20068-909 </td></tr><tr><td> poche de stérilisation 3 &quot;x8&quot; </td><td> VWR </td><td> 24008 </td></tr><tr><td> poche de stérilisation 5 &quot;x10&quot; </td><td> VWR </td><td> 24010 </td></tr><tr><td> Sauvage microscope M650 W / flèche se </td><td> Leica </td><td></td></tr><tr><td> Leica IC D appareil photo numérique / image en direct </td><td> Leica </td><td></td></tr><tr><td> Digi-Med BPA-400 &amp; analyseur intégrateur de systèmes </td><td> Micro-Med </td><td> SYS-400 </td></tr><tr><td> TXD-310 (Digi-Med transducteur) </td><td> Micro-Med </td><td> TXD-300 </td></tr><tr><td> Ordinateur </td><td> Dell </td><td></td></tr><tr><td> Stérilisateur à chaud instrument de perles </td><td> VWR </td><td> 18000-45 </td></tr><tr><td> Oster A5 tondeuse W. taille 40 lames </td><td> VWR </td><td> 10749-020 </td></tr><tr><td> circulant heating pad 18x26 </td><td> Harvard </td><td> py872-5272 </td></tr><tr><td> thermomètre rectal </td><td> Kent scientifique </td><td> RET-3 </td></tr></tbody></table><table border="1"><tbody><tr><th> Réactifs </th><th> Concentration </th><th> Fabricant </th><th> Numéro de catalogue </th></tr><tr><td> Pentobarbital sodique (solution de sodium Nembutol) </td><td> 70mg/kg </td><td> Ovation </td><td></td></tr><tr><td> Buprénorphine HCl </td><td> 0.1mg/kg </td><td> Bedford Laboratories </td><td></td></tr><tr><td> Ringer lactate injectable IV 250cc sac </td><td> Baxter </td><td></td><td></td></tr><tr><td> Aerrane (isoflurane) </td><td> 99,9% </td><td> Santé Animale NLS </td><td> 105996 </td></tr><tr><td> Héparine sodique </td><td> 1000U </td><td> Abraxis </td><td></td></tr><tr><td> Chlorure de sodium bactériostatique </td><td> 0,9% </td><td> Hospira </td><td></td></tr><tr><td> Alcool éthylique </td><td> 70% </td><td> Pharmaco-AAPER </td><td></td></tr><tr><td> Triadine povidone iodée (Bétadine) </td><td></td><td> Jetables Triade </td><td></td></tr></tbody></table>

fixed volume or fixed pressure: a murine model of hemorrhagic shock

Il est de notoriété publique que la perte de sang et de blessures traumatiques graves peuvent conduire à une cascade d&#39;événements de signalisation préjudiciables résultant souvent de la mortalité. 1, 2, 3, 4, 5 Ces événements de signalisation peuvent également conduire à une septicémie et / ou un dysfonctionnement de plusieurs organes (MOD .) 6, 7, 8, 9 Il est essentiel alors de rechercher les causes de la fonction immunitaire supprimée et préjudiciables cascades de signalisation afin de développer des moyens plus efficaces pour aider les patients qui souffrent de blessures traumatiques. 10 ce choc hémorragique fixes pression (SH) procédure, bien que techniquement difficile, est une excellente ressource pour les enquêtes sur ces conditions physiopathologiques. 11, 12, 13 Progrès dans l&#39;évaluation des systèmes biologiques, à savoir les systèmes de biologie ont permis à la communauté scientifique à mieux comprendre les réseaux complexes physiologiques et les modes de communication cellulaire. 14 choc hémorragique s&#39;est avérée être un outil vital pour le dévoilement de ces modes de communication cellulaire comme ils se rapportent à la fonction immunitaire. 15, 16, 17, 18 Cette procédure peut être maîtrisé! Cette procédure peut également être utilisé comme un volume fixe ou une approche de pression fixe. Nous avons adapté cette technique dans le modèle murin d&#39;améliorer la recherche dans la fonction immunitaire innée et adaptative. 19, 20, 21 En raison de leur petite taille HS chez la souris présente des défis uniques. Cependant en raison de nombreuses souches de souris disponibles, cette espèce constitue une ressource incomparable pour l&#39;étude des réponses biologiques. Le modèle SH est un modèle important pour étudier les habitudes de communication cellulaire et les réponses des systèmes tels que les systèmes de médiateur hormonal et inflammatoire, et les signaux de danger, soit humide et que la régulation positive PAMP qu&#39;il suscite des réponses distinctes qui diffèrent des autres formes de choc. 22, 23 , 24, 25 Le développement de souches transgéniques murines et l&#39;induction d&#39;agents biologiques pour inhiber la signalisation spécifiques ont présenté des occasions précieuses pour élucider davantage notre compréhension de la monter et descendre la régulation de la transduction du signal après une perte de sang grave, à savoir SH et les traumatismes 26, 27 , 28, 29, 30. Il ya de nombreuses méthodes de réanimation (R) en association avec le HS et les traumatismes. 31, 32, 33, 34 Une méthode de réanimation volume fixe de solution de Ringer lactate seul (LR), égal à trois fois le volume du sang versé, est utilisée dans ce modèle d&#39;étudier les mécanismes endogènes tels que les blessures d&#39;organes à distance et de l&#39;inflammation systémique. méthode de 35, 36, 38 Ce de la réanimation est avérée efficace pour évaluer les effets des traumatismes HS et 38, 39.

Watch this Scientific Journal Video about Fixed Volume or Fixed Pressure: A Murine Model of Hemorrhagic Shock at JoVE.com

Fixed Volume or Fixed Pressure: A Murine Model of Hemorrhagic Shock

Le modèle du choc hémorragique a été une ressource fiable et reproductible facilitant l&#39;identification et la compréhension des cascades de signalisation associées à l&#39;inflammation et des lésions des organes cibles après un traumatisme. Cet article fournit une description étape par étape des aspects chirurgicaux et mécaniques associées à la procédure expérimentale choc hémorragique chez la souris.

Volume fixe ou pression fixe: un modèle murin de choc hémorragique

It is common knowledge that severe blood loss and traumatic injury can lead to a cascade of detrimental signaling events often resulting in mortality. 1, ...

fixed-volume-or-fixed-pressure-a-murine-model-of-hemorrhagic-shock

Research

JoVE Journal

Medicine

24.5K vues.  University of Pittsburgh. Le modèle du choc hémorragique a été une ressource fiable et reproductible facilitant l'identification et la compréhension des cascades de signalisation associées à l'inflammation et des lésions des organes cibles après un traumatisme. Cet article fournit une description étape par étape des aspects chirurgicaux et mécaniques associées à la procédure expérimentale choc hémorragique chez la souris.

Vidéo: Fixed Volume or Fixed Pressure: A Murine Model of Hemorrhagic Shock

Measurement of the Pressure-volume Curve in Mouse Lungs

In recent decades the mouse has become the primary animal model of a variety of lung diseases. In models of emphysema or fibrosis, the essential phenotypic changes are best assessed by measurement of the changes in lung elasticity. To best understand specific mechanisms underlying such pathologies in mice, it is essential to make functional measurements that can reflect the developing pathology. Although there are many ways to measure elasticity, the classical method is that of the total lung pressure-volume (PV) curve done over the whole range of lung volumes. This measurement has been made on adult lungs from nearly all mammalian species dating back almost 100 years, and such PV curves also played a major role in the discovery and understanding of the function of pulmonary surfactant in fetal lung development. Unfortunately, such total PV curves have not been widely reported in the mouse, despite the fact that they can provide useful information on the macroscopic effects of structural changes in the lung. Although partial PV curves measuring just the changes in lung volume are sometimes reported, without a measure of absolute volume, the nonlinear nature of the total PV curve makes these partial ones very difficult to interpret. In the present study, we describe a standardized way to measure the total PV curve. We have then tested the ability of these curves to detect changes in mouse lung structure in two common lung pathologies, emphysema and fibrosis. Results showed significant changes in several variables consistent with expected structural changes with these pathologies. This measurement of the lung PV curve in mice thus provides a straightforward means to monitor the progression of the pathophysiologic changes over time and the potential effect of therapeutic procedures.

Here we present a protocol to simply and reliably measure the lung pressure-volume curve in mice, showing that it is sufficiently sensitive to detect phenotypic parenchymal changes in two common lung pathologies, pulmonary fibrosis and emphysema. This metric provides a means to quantify the lung&#8217;s structural changes with developing pathology.

La mesure de la courbe pression-volume dans les poumons de souris

In recent decades the mouse has become the primary animal model of a variety of lung diseases. In models of emphysema or fibrosis, the essential ...

Recherche

Médecine

Scleral Cross-linking Using Riboflavin and Ultraviolet-A Radiation for Prevention of Axial Myopia in a Rabbit Model

Myopic individuals, especially those with severe myopia, are at higher-than-normal risk of cataract, glaucoma, retinal detachment and chorioretinal abnormalities. In addition, pathological myopia is a common irreversible cause of visual impairment and blindness1-3. Our study demonstrates the effect of scleral crosslinking using riboflavin and ultraviolet-A radiation on the development of axial myopia in a rabbit model. The axial length of the eyeball was measured by A-scan ultrasound in New Zealand white rabbits aged 13 days (male and female). The eye then underwent 360&#176; conjunctival peritomy with scleral crosslinking, followed by tarsorrhaphy. Axial elongation was induced in 13 day-old New Zealand rabbits by suturing their right eye eyelids (tarsorrhaphy). The eyes were divided into quadrants, and every quadrant had two scleral irradiation zones, each with an area of 0.2 cm&#178; and a radius of 4 mm. Crosslinking was performed by dropping 0.1% dextran-free riboflavin-5-phosphate onto the irradiation zones 20 sec before ultraviolet-A irradiation and every 20 sec during the 200 sec irradiation time. UVA radiation (370 nm) was applied perpendicular to the sclera at 57 mW/cm&#178; (total UVA light dose, 57 J/cm&#178;). Tarsorrhaphies were removed on day 55, followed by repeated axial length measurements. This study demonstrates that scleral crosslinking with riboflavin and ultraviolet-A radiation effectively prevents occlusion-induced axial elongation in a rabbit model.

We demonstrate the effect of scleral crosslinking with riboflavin and UVA on an axial elongation rabbit eye. Axial elongation was induced in 13 day-old New Zealand rabbits (male and female) by suturing their right eye eyelids (tarsorrhaphy).

Scléral Cross-linking Utilisation de la riboflavine et Ultraviolet-A rayonnement pour la prévention des Axial Myopie dans un modèle de lapin

Myopic individuals, especially those with severe myopia, are at higher-than-normal risk of cataract, glaucoma, retinal detachment and chorioretinal ...

Uncontrolled Hemorrhagic Shock Modeled via Liver Laceration in Mice with Real Time Hemodynamic Monitoring

Uncontrolled hemorrhage is an important cause of preventable deaths among trauma patients. We have developed a murine model of uncontrolled hemorrhage via a liver laceration that results in consistent blood loss, hemodynamic alterations, and survival.
Mice undergo a standardized resection of the left-middle lobe of the liver. They are allowed to bleed without mechanical intervention. Hemostatic agents can be administered as pre-treatment or rescue therapy depending on the interest of the investigator. During the time of hemorrhage, real-time hemodynamic monitoring via a left femoral arterial line is performed. Mice are then sacrificed, blood loss is quantified, blood is collected for further analysis, and organs are harvested for analysis of injury. Experimental design is described to allow for simultaneous testing of multiple animals.
Liver hemorrhage as a model of uncontrolled hemorrhage exists in the literature, primarily in rat and porcine models. Some of these models utilize hemodynamic monitoring or quantify blood loss but lack consistency. The present model incorporates quantification of blood loss, real-time hemodynamic monitoring in a murine model that offers the advantage of using transgenic lines and a high-throughput mechanism to further investigate the pathophysiologic mechanisms in uncontrolled hemorrhage.

Uncontrolled hemorrhage, an important cause of mortality among trauma patients, can be modeled using a standard liver laceration in a murine model. This model results in consistent blood loss, survival, and allows for testing hemostatic agents. This article provides the step-by-step process to perform this valuable model.

Choc hémorrhagique incontrôlable modélisé par la lacération du foie chez les souris avec une surveillance hémodynamique en temps réel

Uncontrolled hemorrhage is an important cause of preventable deaths among trauma patients. We have developed a murine model of uncontrolled hemorrhage via ...

Surgical Training for the Implantation of Neocortical Microelectrode Arrays Using a Formaldehyde-fixed Human Cadaver Model

This protocol describes a procedure to assist surgeons in training for the implantation of microelectrode arrays into the neocortex of the human brain. Recent technological progress has enabled the fabrication of microelectrode arrays that allow recording the activity of multiple individual neurons in the neocortex of the human brain. These arrays have the potential to bring unique insight onto the neuronal correlates of cerebral function in health and disease. Furthermore, the identification and decoding of volitional neuronal activity opens the possibility to establish brain-computer interfaces, and thus might help restore lost neurological functions. The implantation of neocortical microelectrode arrays is an invasive procedure requiring a supra-centimetric craniotomy and the exposure of the cortical surface; thus, the procedure must be performed by an adequately trained neurosurgeon. In order to provide an opportunity for surgical training, we designed a procedure based on a human cadaver model. The use of a formaldehyde-fixed human cadaver bypasses the practical, ethical and financial difficulties of surgical practice on animals (especially non-human primates) while preserving the macroscopic structure of the head, skull, meninges and cerebral surface and allowing realistic, operating room-like positioning and instrumentation. Furthermore, the use of a human cadaver is closer to clinical daily practice than any non-human model. The major drawbacks of the cadaveric simulation are the absence of cerebral pulsation and of blood and cerebrospinal fluid circulation. We suggest that a formaldehyde-fixed human cadaver model is an adequate, practical and cost-effective approach to ensure proper surgical training before implanting microelectrode arrays in the living human neocortex.

We designed a procedure in which a formaldehyde-fixed human cadaver is used to assist neurosurgeons in training for the implantation of microelectrode arrays into the neocortex of the human brain.

Formation en chirurgie pour l’Implantation de la microélectrode néocorticales tableaux en utilisant un modèle de cadavre humain formaldéhyde-corrigé

This protocol describes a procedure to assist surgeons in training for the implantation of microelectrode arrays into the neocortex of the human brain. ...

Complete and Partial Aortic Occlusion for the Treatment of Hemorrhagic Shock in Swine

Hemorrhage remains the leading cause of preventable deaths in trauma. Endovascular management of non-compressible torso hemorrhage has been at the forefront of trauma care in recent years. Since complete aortic occlusion presents serious concerns, the concept of partial aortic occlusion has gained a growing attention. Here, we present a large animal model of hemorrhagic shock to investigate the effects of a novel partial aortic balloon occlusion catheter and compare it with a catheter that works on the principles of complete aortic occlusion. Swine are anesthetized and instrumented in order to conduct controlled fixed-volume hemorrhage, and hemodynamic and physiological parameters are monitored. Following hemorrhage, aortic balloon occlusion catheters are inserted and inflated in the supraceliac aorta for 60 min, during which the animals receive whole-blood resuscitation as 20% of the total blood volume (TBV). Following balloon deflation, the animals are monitored in a critical care setting for 4 h, during which they receive fluid resuscitation and vasopressors as needed. The partial aortic balloon occlusion demonstrated improved distal mean arterial pressures (MAPs) during the balloon inflation, decreased markers of ischemia, and decreased fluid resuscitation and vasopressor use. As swine physiology and homeostatic responses following hemorrhage have been well-documented and are like those in humans, a swine hemorrhagic shock model can be used to test various treatment strategies. In addition to treating hemorrhage, aortic balloon occlusion catheters have become popular for their role in cardiac arrest, cardiac and vascular surgery, and other high-risk elective surgical procedures.

Here, we present a protocol demonstrating a hemorrhagic shock model in swine that uses aortic occlusion as a bridge to definitive care in trauma. This model has application in testing a wide range of surgical and pharmacological therapeutic strategies.

Occlusion aortique complète ou partielle pour le traitement du choc hémorragique chez le porc

Hemorrhage remains the leading cause of preventable deaths in trauma. Endovascular management of non-compressible torso hemorrhage has been at the ...

Standardized Hemorrhagic Shock Induction Guided by Cerebral Oximetry and Extended Hemodynamic Monitoring in Pigs

Hemorrhagic shock ranks among the main reasons for severe injury-related death. The loss of circulatory volume and oxygen carriers can lead to an insufficient oxygen supply and irreversible organ failure. The brain exerts only limited compensation capacities and is particularly at high risk of severe hypoxic damage.This article demonstrates the reproducible induction of life-threatening hemorrhagic shock in a porcine model by means of calculated blood withdrawal. We titrate shock induction guided by near-infrared spectroscopy&#160;and extended hemodynamic monitoring to display systemic circulatory failure, as well as cerebral microcirculatory oxygen depletion. In comparison to similar models that primarily focus on predefined removal volumes for shock induction, this approach highlights a titration by means of the resulting failure of macro- and microcirculation.

Hemorrhagic shock is a severe complication in seriously injured patients, which leads to life-threatening oxygen undersupply. We present a standardized method to induce hemorrhagic shock via blood withdrawal in pigs that is guided by hemodynamics and microcirculatory cerebral oxygenation.

Induction de choc hémorragique normalisée guidée par l'oxymétrie cérébrale et la surveillance hémodynamique prolongée chez les porcs

Hemorrhagic shock ranks among the main reasons for severe injury-related death. The loss of circulatory volume and oxygen carriers can lead to an ...

Closed Chest Biventricular Pressure-Volume Loop Recordings with Admittance Catheters in a Porcine Model

Pressure-volume (PV) loop recording enables the state-of-the-art investigation of load-independent variables of ventricular performance. Uni-ventricular evaluation is often performed in preclinical research. However, the right and left ventricles exert functional interdependence due to their parallel and serial connections, encouraging simultaneous evaluation of both ventricles. Furthermore, various pharmacological interventions may affect the ventricles and their preloads and afterloads differently. 
We describe our closed chest approach to admittance-based bi-ventricular PV loop recordings in a porcine model of acute right ventricular (RV) overload. We utilize minimally invasive techniques with all vascular accesses guided by ultrasound. PV catheters are positioned, under fluoroscopic guidance, to avoid thoracotomy in animals, as the closed chest approach maintains the relevant cardiopulmonary physiology. The admittance technology provides real-time PV loop recordings without the need for post-hoc processing. Furthermore, we explain some essential troubleshooting steps during critical timepoints of the presented procedure. 
The presented protocol is a reproducible and physiologically relevant approach to obtain a bi-ventricular cardiac PV loop recording in a large animal model. This can be applied to a large variety of cardiovascular animal research.

Here we present a closed chest approach to admittance-based bi-ventricular pressure-volume loop recordings in pigs with acute right ventricular dysfunction.

Enregistrements en boucle pression-volume biventriculaire thoracique fermé avec cathéters d’admission dans un modèle porcin

Pressure-volume (PV) loop recording enables the state-of-the-art investigation of load-independent variables of ventricular performance. Uni-ventricular ...

Complete and Partial Resuscitative Endovascular Balloon Occlusion of the Aorta for Hemorrhagic Shock

Resuscitative endovascular balloon occlusion of the aorta (REBOA) devices grew out of a military-civilian partnership to develop new capabilities for hemorrhage control. With the advent of purpose-built devices, REBOA has become increasingly common in civilian trauma and acute care settings. Currently available REBOA catheters were designed as complete aortic occlusion devices. However, the therapeutic window for complete aortic occlusion is time-limited due to ischemia-reperfusion injury. The partial procedure allows blood flow past the level of occlusion while maintaining targeted proximal pressure, which has been shown to reduce distal ischemia and adjunctive resuscitation requirements in preclinical studies with prolonged occlusion times as compared to traditional complete occlusion.
pREBOA-PRO is the first catheter designed to enable partial and complete aortic occlusion and is currently in limited market release at seven Level I trauma centers in North America. This paper will focus on procedural considerations for REBOA, including patient selection criteria and a comparison of complete and partial aortic occlusion in a simulator, along with highlighting critical steps to improve clinical outcomes. Additionally, this paper reviews a contrast-enhanced CT scan from a trauma patient that shows distal perfusion after 2 h of partial aortic occlusion using this newly designed catheter and discusses representative results from the limited market release to highlight the profound effect of technological innovation on outcomes in vascular emergencies.

A commercial catheter was designed to facilitate true partial resuscitative endovascular balloon occlusion of the aorta (REBOA) and address the complications associated with complete aortic occlusion. Initial clinical reports indicate that partial REBOA improves transition to reperfusion, reduction of distal ischemia, and extension of safe occlusion time compared to complete occlusion.

Occlusion endovasculaire complète et partielle par ballonnet réanimé de l’aorte pour choc hémorragique

Resuscitative endovascular balloon occlusion of the aorta (REBOA) devices grew out of a military-civilian partnership to develop new capabilities for ...

Description of a Swine Infant Model of Volume-Controlled Hemorrhagic Shock

Hemorrhagic shock is a leading cause of morbidity and mortality in pediatric patients. Interpretation of the clinical indicators validated in adults to guide resuscitation and comparison between different therapies is difficult in children due to the inherent heterogeneity of this population. As a result, compared to adults, appropriate management of pediatric hemorrhagic shock is still not well established. In addition, the scarcity of pediatric patients with hemorrhagic shock precludes the development of clinically relevant studies. For this reason, an experimental pediatric animal model is necessary to study the effects of hemorrhage in children as well as their response to different therapies. We present an infant animal model of volume-controlled hemorrhagic shock in anesthetized young pigs. Hemorrhage is induced by withdrawing a previously calculated blood volume, and the pig is subsequently monitored and resuscitated with different therapies. Here, we describe a precise and highly reproducible model of hemorrhagic shock in immature swine. The model yields hemodynamic data that characterizes compensatory mechanisms that are activated in response to severe hemorrhage.

This article aims to provide researchers with a detailed and accessible guide to set up an infant porcine model of hemorrhagic shock.

Description d’un modèle porcin de choc hémorragique à volume contrôlé

Hemorrhagic shock is a leading cause of morbidity and mortality in pediatric patients. Interpretation of the clinical indicators validated in adults to ...

Induction de l’endotoxémie dépendante du dosage chez le porc par perfusion de LPS

Lipopolysaccharide Infusion as a Porcine Endotoxemic Shock Model

Sepsis and septic shock are frequently encountered in patients treated in intensive care units (ICUs) and are among the leading causes of death in these patients. It is caused by a dysregulated immune response to an infection. Even with optimized treatment, mortality rates remain high, which makes further insights into the pathophysiology and new treatment options necessary. Lipopolysaccharide (LPS) is a component of the cell membrane of gram-negative bacteria, which are often responsible for infections causing sepsis and septic shock. 
The severity and high mortality of sepsis and septic shock make standardized experimental studies in humans impossible. Thus, an animal model is needed for further studies. The pig is especially well suited for this purpose as it closely resembles humans in anatomy, physiology, and size. 
This protocol provides an experimental model for endotoxemic shock in pigs by LPS infusion. We were able to reliably induce changes frequently observed in septic shock patients, including hemodynamic instability, respiratory failure, and acidosis. This will allow researchers to gain valuable insight into this highly relevant condition and evaluate new therapeutic approaches in an experimental setting.

Pleins feux sur l’auteur : Induction d’un choc endotoxémique expérimental chez le porc pour l’étude de l’insuffisance hémodynamique et respiratoire

We provide a protocol for an experimental endotoxemic shock model in pigs by infusion of lipopolysaccharide.

Perfusion de lipopolysaccharides comme modèle de choc endotoxémique porcin

Sepsis and septic shock are frequently encountered in patients treated in intensive care units (ICUs) and are among the leading causes of death in these ...