Name: lavage-induced surfactant depletion in pigs as a model of the acute respiratory distress syndrome (ards)
Uploaded: 2016-09-07T12:30:00
Description: Watch this Scientific Journal Video about Lavage-induced Surfactant Depletion in Pigs As a Model of the Acute Respiratory Distress Syndrome ARDS at JoVE.com

All authors disclose no financial or any other conflicts of interests.
GRANTS:
This study was supported by a grant from the Deutsche Forschungsgemeinschaft to P. Pickerodt and W. Boemke (Pi795/2-2).

实验在实验医学的Charité部进行 - Universitätsmedizin，柏林，德国（根据EN DIN ISO 9001 CERTI网络版：2000），并在柏林，德国前实验联邦当局对动物的研究获得批准。实验动物管理，这是在所有的实验中使用的原则，分别按照实验动物科学的欧洲和德国社会的准则。 1.动物福利和动物实验<ol><li>所有的实验都是在完全麻醉公猪进行（德国长×大）的3-4个月的年龄，体重30-60公斤。 </l...

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	<li>Rubenfeld, G. D., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Incidence+and+Outcomes+of+Acute+Lung+Injury.">Incidence and Outcomes of Acute Lung Injury.</a> N Engl J Med. 353 (16), 1685-1693 (2005).</li><li>Ballard-Croft, C., Wang, D., Sumpter, L. R., Zhou, X., Zwischenberger, J. B. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Large-animal+models+of+acute+respiratory+distress+syndrome.">Large-animal models of acute respiratory distress syndrome.</a> Ann Thorac Surg. 93 (4), 1331-1339 (2012).</li><li>Lachmann, B., Robertson, B., Vogel, J. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=In+vivo+lung+lavage+as+an+experimental+model+of+the+respiratory+distress+syndrome.">In vivo lung lavage as an experimental model of the respiratory distress syndrome.</a> Acta Anaesthesiol Scand. 24 (3), 231-236 (1980).</li><li>Donaubauer, B., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Low-dose+inhalation+of+an+endothelin-A+receptor+antagonist+in+experimental+acute+lung+injury:+ET-1+plasma+concentration+and+pulmonary+inflammation.">Low-dose inhalation of an endothelin-A receptor antagonist in experimental acute lung injury: ET-1 plasma concentration and pulmonary inflammation.</a> Exp Biol Med (Maywood). 231 (6), 960-969 (2006).</li><li>Theisen, M. M., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Ventral+recumbency+is+crucial+for+fast+and+safe+orotracheal+intubation+in+laboratory+swine.">Ventral recumbency is crucial for fast and safe orotracheal intubation in laboratory swine.</a> Lab Anim. 43 (1), 96-101 (2009).</li><li>Kelly, C. R., Rabbani, L. E. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Videos+in+clinical+medicine.+Pulmonary-artery+catheterization.">Videos in clinical medicine. Pulmonary-artery catheterization.</a> N Engl J Med. 369 (25), 35 (2013).</li><li>Forrester, J. S., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Thermodilution+cardiac+output+determination+with+a+single+flow-directed+catheter.">Thermodilution cardiac output determination with a single flow-directed catheter.</a> Am Heart J. 83 (3), 306-311 (1972).</li><li>Deja, M., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=The+inhaled+ET(A)+receptor+antagonist+LU-135252+acts+as+a+selective+pulmonary+vasodilator.">The inhaled ET(A) receptor antagonist LU-135252 acts as a selective pulmonary vasodilator.</a> Clin Sci (Lond). 103, 21-24 (2002).</li><li>Matute-Bello, G., Frevert, C. W., Martin, T. R. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Animal+models+of+acute+lung+injury.">Animal models of acute lung injury.</a> Am J Physiol Lung Cell Mol Physiol. 295 (3), 379-399 (2008).</li><li>Kloot, T. E., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Recruitment+maneuvers+in+three+experimental+models+of+acute+lung+injury.+Effect+on+lung+volume+and+gas+exchange.">Recruitment maneuvers in three experimental models of acute lung injury. Effect on lung volume and gas exchange.</a> Am J Respir Crit Care Med. 161 (5), 1485-1494 (2000).</li></ol>

本文介绍了一步步指令来诱导猪严重肺损伤，由于表面活性剂冲刷反复灌洗肺。这种特定的方法使肺功能和肺血管阻力可再现和可比较的恶化。当务之急是要灌洗，直到猪在P 一 O 2 / F I O 2比值下降低于100毫米汞柱，并保持低于100毫米汞柱为1小时。一次，这是取得的动物通常不会因为没有招募演习被进行4,8-从肺损伤至少4至8小时，只要恢复。遵守该协议有?...

尽管超过40年的深入研究人类急性呼吸窘迫综合征（ARDS）的死亡率仍然高，40和50％之间的1值。肺损伤动物模型研究中的复杂病机变化或新的治疗方法来降低死亡率和限制长期残疾发挥重大作用。 各种型号已经建立诱发肺损伤，模拟的或大（ 如猪）人ARDS或小动物（ 如啮齿动物）的各个方面。方法强烈不同，包括肺动脉灌注油酸的，静脉内（IV）的细菌的输注，和内毒素或盲肠结扎引起败血症引起的ARDS穿刺（CLP）的模型。此外，直接肺损伤由于大潮气量和高峰吸气压力（呼吸机相关性肺损伤; VILI），烟雾/烧伤或肺缺血/再灌注（I / R）模型经常使用2。CLP模型，以及与内毒素的工作模型的一个主要缺点，是阻碍所造成的单独肺损伤biotrauma的分析潜在的炎症。此外，可能需要几个小时到几天导致肺损伤，如在大型动物为VILI的情况。 肺损伤的诱导通过表面活性剂的洗脱反复肺灌洗液，因为它首先由拉赫曼等人所述。豚鼠3，是诱导的肺损伤与再现的功能和机械的妥协，以及肺血管阻力的变化的时间有效的方法。该模型适配到机械通气的约30-60公斤体重的猪支持与临床上使用的机械通风，导管和监视器的基础研究，而在气体交换和血流动力学的妥协是在同一时间4高度可重复的。此外，感应肺损伤通过灌洗不需要特定的设备，是不是在设计用于大型动物实验呼吸实验室常用的。在这篇文章中提出的模型是适用于设计用于人类，进而保证了肺功能的恶化产生一个高重复性的研究苛刻的设备（ 如呼吸机）。该模型的标准化，有助于确保实验之间的可比性并减少所需的动物数量。萎陷的肺区有故意或未知的招聘演习的潜力recruitability是这个特定模型的一个严重的限制。在下面的文章中，我们给出了肺损伤的诱导的灌洗模型的详细说明，并提供表示数据以表征在肺功能的妥协的稳定性。

<table border="0" cellpadding="0" cellspacing="0" width="735">
	<tbody>
		<tr height="21">
			<td height="21" style="height:21px;width:313px;">Evita Infinity V500</td>
			<td style="width:103px;">Dr&#228;ger</td>
			<td style="width:152px;"></td>
			<td style="width:167px;">intensive care ventilator</td>
		</tr>
		<tr height="21">
			<td height="21" style="height:21px;width:313px;">Vigilance I&#160;</td>
			<td style="width:103px;">Edwards</td>
			<td style="width:152px;"></td>
			<td>monitor</td>
		</tr>
		<tr height="21">
			<td height="21" style="height:21px;width:313px;">Vasofix Braun&#252;le 20G</td>
			<td style="width:103px;">B Braun</td>
			<td style="width:152px;">4268113B</td>
			<td>peripheral vein catheter</td>
		</tr>
		<tr height="21">
			<td height="21" style="height:21px;width:313px;">Mallinckrodt Tracheal Tube Cuffed</td>
			<td style="width:103px;">Covidien</td>
			<td style="width:152px;">107-80</td>
			<td>&#160;8.0 mm ID</td>
		</tr>
		<tr height="21">
			<td height="21" style="height:21px;width:313px;">MultiCath3</td>
			<td style="width:103px;">Vygon</td>
			<td style="width:152px;">157,300</td>
			<td>3 lumen central venous catheter, 20 cm length</td>
		</tr>
		<tr height="21">
			<td height="21" style="height:21px;width:313px;">Leader Cath Set</td>
			<td style="width:103px;">Vygon</td>
			<td style="width:152px;">115,805</td>
			<td>arterial catheter</td>
		</tr>
		<tr height="21">
			<td height="21" style="height:21px;">Percutaneus Sheath Introducer Set</td>
			<td style="width:103px;">Arrow</td>
			<td style="width:152px;">SI-09600</td>
			<td>introducer sheath for pulmonary artery catheter of 4-6 Fr., 10 cm length</td>
		</tr>
		<tr height="41">
			<td height="41" style="height:41px;width:313px;">Swan-Ganz True Size Thermodilution Catheter</td>
			<td style="width:103px;">Edwards</td>
			<td style="width:152px;">132F5</td>
			<td>pulmonary artery catheter, 75 cm length</td>
		</tr>
		<tr height="21">
			<td height="21" style="height:21px;width:313px;">Flow through chamber thermistor</td>
			<td style="width:103px;">Baxter</td>
			<td style="width:152px;">93-505</td>
			<td>for measuring cardiac output</td>
		</tr>
		<tr height="21">
			<td height="21" style="height:21px;width:313px;">urinary catheter</td>
			<td style="width:103px;"></td>
			<td style="width:152px;"></td>
			<td>no specific model requiered</td>
		</tr>
	</tbody>
</table>

lavage-induced surfactant depletion in pigs as a model of the acute respiratory distress syndrome (ards)

肺损伤的各种动物模型中存在研究人类急性呼吸窘迫综合征（ARDS）的复杂病理机制并评估未来的疗法。严重的肺损伤肺部气体交换和血流动力学的可重复的恶化可以麻醉用猪用温0.9％生理盐水反复灌洗肺（50毫升/公斤体重）诱导。包括标准呼吸和血液动力学监测与在此模型中临床应用的设备允许的新的治疗策略（药物，现代换气机，体外膜式人工氧合，ECMO）的评价，并且桥接长凳和床头之间的差距。此外，肺损伤诱导肺灌洗不需要对亲和抗炎细胞因子的测量病原体/内毒素影响的注入。该模型的缺点是不张的肺组织高recruitability。模型的标准化有助于避免陷阱，保证Ç实验之间omparability，并减少所需的动物数量。

P 上 O 2 / F I O期间肺灌洗2 -ratio下降，但单灌洗的确切影响很难预测。我们开始采取从第三灌洗动脉血气体样品开始检测P中减少一 O 2 / F I O 2 -ratio低于100毫米汞柱。一旦P中减少一 O 2 / F I O 2 -ratio低于100毫米汞柱实现时，我们要求这一比率仍低于100毫米汞柱一小时在PEEP≥5厘?...

Watch this Scientific Journal Video about Lavage-induced Surfactant Depletion in Pigs As a Model of the Acute Respiratory Distress Syndrome ARDS at JoVE.com

Lavage-induced Surfactant Depletion in Pigs As a Model of the Acute Respiratory Distress Syndrome ARDS

在麻醉的猪反复灌洗肺引起的肺损伤类似人类急性呼吸窘迫综合征（ARDS）的主要方面。为了这个目的，肺用0.9％盐水在37℃下反复灌洗。该协议的目标是在ARDS研究气体交换和血流动力学的可重复的缓解作用。

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Lavage-induced Surfactant Depletion in Pigs As a Model of the Acute Respiratory Distress Syndrome (ARDS)

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