Name: integrated compensatory responses in a human model of hemorrhage
Uploaded: 2016-11-20T15:00:00
Description: Watch this Scientific Journal Video about Integrated Compensatory Responses in a Human Model of Hemorrhage at JoVE.com

この作品は、アメリカ陸軍、医学研究および資材コマンド、戦闘死傷者ケアプログラムからの資金提供によってサポートされています。私たちはビデオを作るの彼らの援助のためにLTCケビン・S.エイカーズ、MDさんとクリステンR.ライに感謝します。

あらゆる人間の手続きの前に、治験審査委員会（IRB）は、プロトコルを承認する必要があります。この研究で使用されるプロトコルは、米陸軍医学研究および資材コマンドIRBによって承認されました。プロトコルは、制御され再現可能な実験室の設定で進行中の出血時の個人によって経験と同様の中央の血液量の漸進的減少を補償の生理学的応答を示すように設計されています。 25℃ - 実験室の室温は23で?...

<ol>
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A. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Lower+body+negative+pressure+as+a+model+to+study+progression+to+acute+hemorrhagic+shock+in+humans.">Lower body negative pressure as a model to study progression to acute hemorrhagic shock in humans.</a> J. Appl. Physiol. 96, 1249-1261 (2004).</li><li>Convertino, V. A., 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=Inspiratory+resistance+maintains+arterial+pressure+during+central+hypovolemia:+implications+for+treatment+of+patients+with+severe+hemorrhage.">Inspiratory resistance maintains arterial pressure during central hypovolemia: implications for treatment of patients with severe hemorrhage.</a> Crit Care Med. 35 (4), 1145-1152 (2007).</li><li>Carter, R., Hinojosa-Laborde, C., Convertino, V. 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中央の血液量の漸進的かつ継続的な減少を引き起こすLBNPを使用して、我々は低血圧や徐脈（ 図7）の突然の発症によって特徴づけられる被験者における血行動態代償不全の典型的な応答を誘導することができました。出血に統合された代償性反応が非常に複雑であることを理解することが重要である19は、血液の損失に対する耐性が大幅に個体差が生じる。他の人が同様?...

心臓血管系の最も重要な機能は、動脈血圧の恒常性の調節を介して身体のすべての組織に十分な灌流（血流および酸素送達）の制御です。補償（ 例えば 、自律神経系の活動、心拍数と収縮、静脈還流、血管収縮、呼吸）の様々なメカニズムが、組織内の酸素の正常な生理的レベルを維持するために貢献しています。そのような出血によって引き起こされるもののような循環血液量での1削減が妥協することができます心血管代償機構の能力、最終的には致命的なことができ、低動脈血圧、深刻な組織低酸素症、及び循環性ショックにつながります。 重度の出血（ すなわち、出血性ショック）によって引き起こされる循環性ショック、外傷による死亡の主な原因である。ショックの発症から患者を防ぐ最も挑戦的な側面の2つが私たちですその早期発症を認識することができません。ショックの開発に向けた進行の早期および正確な評価は、現在あるため、体の多数の代償の血液損失の初期段階ではほとんど変更バイタルサインの測定値を提供する技術（ すなわち、医療モニター）により、臨床設定で制限されています血圧を調節するための機構。3-6このように、血液の損失を補償するために、身体の準備の合計を測定する能力は、組織灌流状態とショックを発症するリスクの最も正確な反射を表す。1この予備が呼び出され正確に動脈波形の特徴の変化をリアルタイムで測定することにより評価することができる補償引当金補償引当金の1枯渇は、低血圧の突然の発症と重症患者で観察され、端末心血管不安定性を複製します。;血行動態デコとして知られている状態mpensation。7 ヒトにおける進行中の失血中代償準備および血圧の調節の使用との関係は（生理学的測定の包括的なセットを使用して実験室で実証することができ、例えば 、血圧、心拍数、動脈血酸素飽和度、一回拍出量、出血中に発生したものと同様の中央の血液量の継続的な進歩的な削減の際に、標準的な生理学的モニタリングによって提供さ心拍出量、血管抵抗、呼吸数、パルスの文字、精神状態、呼吸終期CO 2、組織の酸素）。下げ中心血液量が下半身陰圧（LBNP）の漸進的増加で非侵襲的に誘導することができる。8生理学的測定とLBNPのこの組み合わせを使用して、縮小中心血液量を補償する身体能力を評価する方法の概念理解を容易にすることができます悪魔trated。この研究はprelab準備、シミュレートされた出血中に他の生理学的反応に関連した代償性反応のデモンストレーション、および結果のpostlab評価を示しています。補償引当金の測定を行うために必要な実験技術は、ヒトのボランティアで実証されています。

<table border="1" fo:keep-together.within-page="1" fo:keep-with-next.within-page="always">
	<tbody>
		<tr>
			<td>Dynamic Research Evaluation Workstation (DREW) data acquisition syetem</td>
			<td>NA</td>
			<td>NA</td>
			<td>Custom Built by ISR personnel.&#160; The DREW allows for time synchronization of both digital and analog signal data collection from up to 16 independent instruments with a sampling rate of 1000 Hz.</td>
		</tr>
		<tr>
			<td>Finometer</td>
			<td>Finapress Medical Systems (FMS)</td>
			<td>Model 1</td>
			<td>Device that provides non-invasive, continuous measurements of brachial artery blood pressure and arterial oxygen saturation (SpO2) using two separate infrared finger photophlethymography cuff sensors.</td>
		</tr>
		<tr>
			<td>BCI Capnocheck Plus</td>
			<td>Smith Medical PM Inc.</td>
			<td>9004</td>
			<td>Capnograph used to measure&#160; end tidal CO2 and respiration rate</td>
		</tr>
		<tr>
			<td>CipherOX&#160;</td>
			<td>Flashback Technologies Inc.</td>
			<td>R200</td>
			<td>Investigational device used to calculate Compensatory Reserve Index (CRI)</td>
		</tr>
		<tr>
			<td>Nonin 9560 Pulse Oximeter</td>
			<td>Nonin</td>
			<td>9560</td>
			<td>finger pulse oximeter</td>
		</tr>
		<tr>
			<td>Lower Body Negative Pressure Chamber (LBNP)</td>
			<td>NASA</td>
			<td>79K32632-1</td>
			<td>Custom Chamber built by NASA</td>
		</tr>
		<tr>
			<td>ECG Biotach</td>
			<td>Gould</td>
			<td>13-6615-65</td>
			<td>Electrocardiograph for measuring ECG</td>
		</tr>
		<tr>
			<td>Nasal CO2 Sample Line</td>
			<td>Salter Labs</td>
			<td>REF 4000</td>
			<td>Latex free nasal cannula for sampling expired air</td>
		</tr>
	</tbody>
</table>

integrated compensatory responses in a human model of hemorrhage

出血は、血液の損失の重大性の早期診断が困難である理由の一つ、トラウマに関連した死亡の主な原因です。現在の臨床ツールが原因代償機構に出血の初期段階で安定したままでバイタルサインの対策を提供するため、出血患者の評価は困難です。従って、減少循環血液量と、それらがどのように進行中の進行性の出血中に変化を補償するためのメカニズムの合計統合を理解し、測定する必要があります。身体の準備金は減少し、循環血液量を補償するための「補償引当金」と呼ばれています。補償金は正確に高性能のコンピュータを使用して測定された動脈波形の特徴の変化のリアルタイム測定を用いて評価することができます。下半身陰圧（LBNP）は、出血に関連したヒトにおける生理学的反応の多くをシミュレートすることが示されていますそして、出血に対する代償応答を研究するために使用されます。本研究の目的は、出血のシミュレーションとしてLBNPと中央の血液量の漸進的な削減の際に評価される方法を補償引当金を実証することです。

LBNP手順は胴体下部と脚周りの空気圧の低下を引き起こします。この真空が漸進的に増加すると、下半身に頭と胴体上部からの血液量の変化は、中心血液量減少の状態を作成します。中央の血液量（ すなわち 、LBNP）の漸進的な減少は、赤外指の光電脈波（ 図5）を用いて測定した動脈波形の特徴で有意な変化を生成します。補償準備指数（CRI）は?...

Watch this Scientific Journal Video about Integrated Compensatory Responses in a Human Model of Hemorrhage at JoVE.com

Integrated Compensatory Responses in a Human Model of Hemorrhage

このプロトコルの目的は、ヒトの血液量不足の代償機構の合計積分を定量化するために使用することができる人間の出血の非侵襲的な実験モデルとして下半身陰圧を用いて還元中央の血液量に対する代償応答を測定するための技術を実証することです。

出血の人体モデルで統合代償応答

Hemorrhage is the leading cause of trauma-related deaths, partly because early diagnosis of the severity of blood loss is difficult. Assessment of ...

Research

JoVE Journal

Medicine

Stem Cell Transplantation in an in vitro Simulated Ischemia/Reperfusion Model

Stem Cell Transplantation in an in vitro Simulated Ischemia/Reperfusion Model

における幹細胞移植 in vitroで模擬虚血/再灌流モデル

Stem cell transplantation protocols are finding their way into clinical practice1,2,3. Getting better results, making the protocols more robust, and ...

A Low Mortality Rat Model to Assess Delayed Cerebral Vasospasm After Experimental Subarachnoid Hemorrhage

実験的くも膜下出血後の脳血管攣縮遅延を評価するための低死亡率のラットモデル

Objective: To characterize and establish a reproducible model that demonstrates delayed cerebral vasospasm after aneurysmal subarachnoid hemorrhage (SAH) ...

Modeling Intracerebral Hemorrhage in Mice: Injection of Autologous Blood or Bacterial Collagenase

マウスにおけるモデリング脳出血：自己血または細菌性コラゲナーゼの注入

Spontaneous intracerebral hemorrhage (ICH) defines a potentially life-threatening neurological malady that accounts for 10-15% of all stroke-related ...

A Murine Model of Subarachnoid Hemorrhage

くも膜下出血のマウスモデル

In this video publication a standardized mouse model of subarachnoid  hemorrhage (SAH) is presented. Bleeding is induced by endovascular Circle of  Willis ...

Excitotoxic Stimulation of Brain Microslices as an In vitro Model of Stroke

Excitotoxic Stimulation of Brain Microslices as an In vitro Model of Stroke

脳Microslicesの興奮毒性刺激<em&gt;インビトロ</em&gt;脳卒中のモデル

Examining molecular mechanisms involved in neuropathological conditions, such as ischemic stroke, can be difficult when using whole animal systems. As ...

Urinary Bladder Distention Evoked Visceromotor Responses as a Model for Bladder Pain in Mice

マウスの膀胱痛に対するモデルとしての膀胱膨満誘発内臓運動応答

Approximately 3-8 million people in the United States suffer from interstitial cystitis/bladder pain syndrome (IC/BPS), a debilitating condition ...

The Rabbit Blood-shunt Model for the Study of Acute and Late Sequelae of Subarachnoid Hemorrhage: Technical Aspects

くも膜下出血の急性および後期後遺症の研究のためのウサギの血液シャントモデル：技術的側面

Early brain injury and delayed cerebral vasospasm both contribute to unfavorable outcomes after subarachnoid hemorrhage (SAH). Reproducible and ...

Mouse Pneumonectomy Model of Compensatory Lung Growth

代償肺の成長のマウス肺モデル

In humans, disrupted repair and remodeling of injured lung contributes to a host of acute and chronic lung disorders which may ultimately lead to ...

Pre-clinical Orthotopic Murine Model of Human Prostate Cancer

ヒト前立腺癌の前臨床同所性マウスモデル

To study the multifaceted biology of prostate cancer, pre-clinical in vivo models offer a range of options to uncover critical biological information ...

Induction of Accelerated Atherosclerosis in Mice: The "Wire-Injury" Model

マウスにおける加速アテローム性動脈硬化症の誘導:ワイヤー傷害モデル

Atherosclerosis is a proliferative fibro-inflammatory disease developing in the arterial wall, inducing a deficient blood flow or a lack of blood flow. ...