脓毒症临床前研究最低质量标准(MQTiPSS):改进脓毒症动物模型的国际专家共识倡议(全译)

Minimum quality threshold in pre-clinical sepsis studies(MQTiPSS):an international expert consensus initiative for improvement of animal modeling in sepsis

临床前的动物研究先于大多数临床试验。虽然脓毒症的临床定义和推荐的治疗指南在定期更新,但对脓毒症的临床前模型尚无系统综述,并且缺乏明确的建模指南。为弥补这一缺陷,于2017年5月在维也纳召开了脓毒症临床前建模的韦格斯-伯纳德会议。该会议的目的是明确脓毒症临床前模型的局限性,并为提高脓毒症模型的转化价值而提出一套指南,该指南被定义为"脓毒症临床前研究最低质量标准"(MQTiPSS)。来自13个国家的31名专家参加了此次会议,并分为研究设计、人道建模、感染类型、器官衰竭/功能障碍、液体复苏和抗菌药物治疗6个专题工作组。与会人员对260篇关于脓毒症模型的高被引科研论文(2003至2012年)进行了文献综述,将其作为MQTiPSS讨论的基础。总体来说,与会专家就29个要点达成了共识,其中包括20项"推荐"建议和9项"考虑"建议。本篇执行MQTiPSS的摘要是对MQTiPSS共识的概述。我们相信,这些推荐和考虑建议将在某种程度上推进脓毒症临床前模型的标准化,并最终改进脓毒症临床前研究的转化。我们建议这些指导要点应该作为脓毒症动物模型的"最佳实践"而被执行。同时,为鼓励其广泛传播,本文可在Shock、Infection、IntensiveCareMedicineExperimental3本杂志免费获取。

Preclinical animal studies precede the majority of clinical trials.While the clinical definitions of sepsis and recommended treatments are regularly updated,a systematic review of preclinical models of sepsis has not been done and clear modeling guidelines are lacking.To address this deficit,a Wiggers-Bernard Conference on preclinical sepsis modeling was held in Vienna in May,2017.The goal of the conference was to identify limitations of preclinical sepsis models and to propose a set of guidelines,defined as the"Minimum Quality Threshold in Pre-clinical Sepsis Studies"(MQTiPSS),to enhance translational value of these models.A total of 31 experts from 13 countries participated and were divided into six thematic Working Groups:Study Design,Humane modeling,Infection types,Organ failure/dysfunction,Fluid resuscitation,and Antimicrobial therapy endpoints.As basis for the MQTiPSS discussions,the participants conducted a literature review of the 260 most highly cited scientific articles on sepsis models(2003-2012).Overall,the participants reached consensus on 29 points;20 at"recommendation"and nine at"consideration"strength.This Executive Summary provides a synopsis of the MQTiPSS consensus.We believe that these recommendations and considerations will serve to bring a level of standardization to preclinical models of sepsis and ultimately improve translation of preclinical findings.These guideline points are proposed as"best practices"for animal models of sepsis that should be implemented.To encourage its wide dissemination,this article is freely accessible on the Intensive Care Medicine Experimental and Infection journal websites.In order to encourage its wide dissemination,this article is freely accessible in Shock,Infection,and Intensive Care Medicine Experimental.