Cardiac arrest remains a leading cause of death and permanent disability worldwide. Although many victims are initially resuscitated, they often succumb to the extensive ischemia-reperfusion injury inflicted on the in...Cardiac arrest remains a leading cause of death and permanent disability worldwide. Although many victims are initially resuscitated, they often succumb to the extensive ischemia-reperfusion injury inflicted on the internal organs, especially the brain. Cardiac arrest initiates a complex cellular injury cascade encompassing reactive oxygen and nitrogen species, Ca2+ overload, ATP depletion, pro- and anti-apoptotic proteins, mitochondrial dysfunction, and neuronal glutamate excitotoxity, which injures and kills cells, compromises function of internal organs and ignites a destructive systemic inflammatory response. The sheer complexity and scope of this cascade challenges the development of experimental models of and effective treatments for cardiac arrest. Many experimental animal preparations have been developed to decipher the mechanisms of damage to vital internal organs following cardiac arrest and cardiopulmonary resuscitation(CPR), and to develop treatments to interrupt the lethal injury cascades. Porcine models of cardiac arrest and resuscitation offer several important advantages over other species, and outcomes in this large animal are readily translated to the clinical setting. This review summarizes porcine cardiac arrest-CPR models reported in the literature, describes clinically relevant phenomena observed during cardiac arrest and resuscitation in pigs, and discusses numerous methodological considerations in modeling cardiac arrest/CPR. Collectively, published reports show the domestic pig to be a suitable large animal model of cardiac arrest which is responsive to CPR, defibrillatory countershocks and medications, and yields extensive information to foster advances in clinical treatment of cardiac arrest.展开更多
目的 了解美国军队野战输血医学发展的主要方向和最新动态。方法 通过www.clinicaltrials.gov网站首页,以“United States Department of Defense”“U.S.Army Medical Research and Development Command”“United States Naval Medica...目的 了解美国军队野战输血医学发展的主要方向和最新动态。方法 通过www.clinicaltrials.gov网站首页,以“United States Department of Defense”“U.S.Army Medical Research and Development Command”“United States Naval Medical Research Center”为检索词,检索自ClinicalTrials.gov成立(2002年)起至2021年5月1日野战输血医学相关临床试验项目的完整备案信息,通过研究进展状态、临床分期、任务分配、地域分布和主要研究内容及研究成果等,分析其主要特点。结果 共检索到临床试验项目931项,与野战输血医学密切相关的有16项;其中全血病原体处置占25%(4/16)、血小板输注占25%(4/16)、血浆输注占25%(4/16)、全血输注占18.75(3/16)和其他类型研究占6.25%(1/16)。美国军方注重在血液安全、血液贮存等方面的新技术突破,在抗休克输血输液治疗方面的效果评价,在全血早期输注治疗方面的应用探索和在血液保障技术产品研发方面的军地互动优势。结论 基于ClinicalTrials.gov对美国军方野战输血医学的分析,有利于快速了解美国军队野战输血医学的发展现状和趋势。展开更多
基金Supported by Grants from The United States National Institute of Neurological Disorders and Stroke,No.R01 NS076975-03a predoctoral fellowship from the United States National Institute of Aging,Training in the Neurobiology of Aging,No.T31 AG020494a predoctoral fellowship from the University of North Texas Health Science Center’s Physician Scientist Program
文摘Cardiac arrest remains a leading cause of death and permanent disability worldwide. Although many victims are initially resuscitated, they often succumb to the extensive ischemia-reperfusion injury inflicted on the internal organs, especially the brain. Cardiac arrest initiates a complex cellular injury cascade encompassing reactive oxygen and nitrogen species, Ca2+ overload, ATP depletion, pro- and anti-apoptotic proteins, mitochondrial dysfunction, and neuronal glutamate excitotoxity, which injures and kills cells, compromises function of internal organs and ignites a destructive systemic inflammatory response. The sheer complexity and scope of this cascade challenges the development of experimental models of and effective treatments for cardiac arrest. Many experimental animal preparations have been developed to decipher the mechanisms of damage to vital internal organs following cardiac arrest and cardiopulmonary resuscitation(CPR), and to develop treatments to interrupt the lethal injury cascades. Porcine models of cardiac arrest and resuscitation offer several important advantages over other species, and outcomes in this large animal are readily translated to the clinical setting. This review summarizes porcine cardiac arrest-CPR models reported in the literature, describes clinically relevant phenomena observed during cardiac arrest and resuscitation in pigs, and discusses numerous methodological considerations in modeling cardiac arrest/CPR. Collectively, published reports show the domestic pig to be a suitable large animal model of cardiac arrest which is responsive to CPR, defibrillatory countershocks and medications, and yields extensive information to foster advances in clinical treatment of cardiac arrest.
文摘目的 了解美国军队野战输血医学发展的主要方向和最新动态。方法 通过www.clinicaltrials.gov网站首页,以“United States Department of Defense”“U.S.Army Medical Research and Development Command”“United States Naval Medical Research Center”为检索词,检索自ClinicalTrials.gov成立(2002年)起至2021年5月1日野战输血医学相关临床试验项目的完整备案信息,通过研究进展状态、临床分期、任务分配、地域分布和主要研究内容及研究成果等,分析其主要特点。结果 共检索到临床试验项目931项,与野战输血医学密切相关的有16项;其中全血病原体处置占25%(4/16)、血小板输注占25%(4/16)、血浆输注占25%(4/16)、全血输注占18.75(3/16)和其他类型研究占6.25%(1/16)。美国军方注重在血液安全、血液贮存等方面的新技术突破,在抗休克输血输液治疗方面的效果评价,在全血早期输注治疗方面的应用探索和在血液保障技术产品研发方面的军地互动优势。结论 基于ClinicalTrials.gov对美国军方野战输血医学的分析,有利于快速了解美国军队野战输血医学的发展现状和趋势。
