Development of a septic shock experimental model oriented at training. Application in the training of depuration techniques in the management of severe sepsis
Desarrollo de un modelo experimental de shock séptico orientado a la formación. Aplicación en el entrenamiento de técnicas de depuración en el manejo de la sepsis grave
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"apellidos" => "Jaimes" ] ] ] ] ] "idiomaDefecto" => "en" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S217357271170011X?idApp=WMIE" "url" => "/21735727/0000003500000002/v1_201212101042/S217357271170011X/v1_201212101042/en/main.assets" ] "en" => array:14 [ "idiomaDefecto" => true "titulo" => "Development of a septic shock experimental model oriented at training. Application in the training of depuration techniques in the management of severe sepsis" "tieneTextoCompleto" => 0 "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "84" "paginaFinal" => "91" ] ] "autores" => array:1 [ 0 => array:4 [ "autoresLista" => "M.E. Herrera-Gutiérrez, G. Seller-Pérez, G. Quesada García, M.M. Granados, J.M. Domínguez, R.J. Gómez-Villamandos" "autores" => array:6 [ 0 => array:4 [ "nombre" => "M.E." "apellidos" => "Herrera-Gutiérrez" "email" => array:1 [ 0 => "mehguci@gmail.com" ] "referencia" => array:2 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff0005" ] 1 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">ast;</span>" "identificador" => "cor0005" ] ] ] 1 => array:3 [ "nombre" => "G." "apellidos" => "Seller-Pérez" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff0005" ] ] ] 2 => array:3 [ "nombre" => "G." "apellidos" => "Quesada García" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff0005" ] ] ] 3 => array:3 [ "nombre" => "M.M." "apellidos" => "Granados" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">b</span>" "identificador" => "aff0010" ] ] ] 4 => array:3 [ "nombre" => "J.M." 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"apellidos" => "Gómez-Villamandos" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">b</span>" "identificador" => "aff0010" ] ] ] ] "afiliaciones" => array:2 [ 0 => array:3 [ "entidad" => "Cuidados Críticos y urgencias, Hospital Universitario Carlos Haya, Málaga, Spain" "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff0005" ] 1 => array:3 [ "entidad" => "Departamento de Medicina y Cirugía Animal, Universidad de Córdoba, Córdoba, Spain" "etiqueta" => "<span class="elsevierStyleSup">b</span>" "identificador" => "aff0010" ] ] "correspondencia" => array:1 [ 0 => array:3 [ "identificador" => "cor0005" "etiqueta" => "ast;" "correspondencia" => "Corresponding author." ] ] ] ] "titulosAlternativos" => array:1 [ "es" => array:1 [ "titulo" => "Desarrollo de un modelo experimental de shock séptico orientado a la formación. Aplicación en el entrenamiento de técnicas de depuración en el manejo de la sepsis grave" ] ] "pdfFichero" => "main.pdf" "tienePdf" => true "fechaRecibido" => "2010-06-03" "fechaAceptado" => "2010-12-18" "PalabrasClave" => array:2 [ "en" => array:1 [ 0 => array:4 [ "clase" => "keyword" "titulo" => "Keywords" "identificador" => "xpalclavsec10656" "palabras" => array:3 [ 0 => "Septic shock" 1 => "Extracorporeal depuration" 2 => "Animal research" ] ] ] "es" => array:1 [ 0 => array:4 [ "clase" => "keyword" "titulo" => "Palabras clave" "identificador" => "xpalclavsec10657" "palabras" => array:3 [ 0 => "<span class="elsevierStyleItalic">Shock</span> séptico" 1 => "Depuración extracorpórea" 2 => "Experimentación animal" ] ] ] ] "tieneResumen" => true "resumen" => array:2 [ "en" => array:2 [ "titulo" => "Abstract" "resumen" => "<span class="elsevierStyleSectionTitle">Objective</span><p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">To define a septic shock experimental model that can be used in for training in the early management of septic shock, specifically by extracorporeal depuration (ECD).</p> <span class="elsevierStyleSectionTitle">Design</span><p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">A case-control experimental study.</p> <span class="elsevierStyleSectionTitle">Setting</span><p id="spar0015" class="elsevierStyleSimplePara elsevierViewall">Veterinary university hospital.</p> <span class="elsevierStyleSectionTitle">Subjects</span><p id="spar0020" class="elsevierStyleSimplePara elsevierViewall">Ten Beagle dogs (weight 12–15<span class="elsevierStyleHsp" style=""></span>kg).</p> <span class="elsevierStyleSectionTitle">Interventions</span><p id="spar0025" class="elsevierStyleSimplePara elsevierViewall">Shock was induced using 1<span class="elsevierStyleHsp" style=""></span>mg/kg <span class="elsevierStyleItalic">Escherichia coli</span> lipopolysaccharide (LPS) diluted in 20<span class="elsevierStyleHsp" style=""></span>mL saline infused in 10<span class="elsevierStyleHsp" style=""></span>minutes, with a subsequent follow-up at 6<span class="elsevierStyleHsp" style=""></span>hours. There was no intervention in 5 animals in order to define the natural course of the shock and 5 underwent high volume hemofiltration (HVHF, 100<span class="elsevierStyleHsp" style=""></span>mL/kg/h) to define delay in response to treatment.</p> <span class="elsevierStyleSectionTitle">Variables</span><p id="spar0080" class="elsevierStyleSimplePara elsevierViewall">Pressures (arterial and pulmonary), hemodynamic parameters, gastric tonometry and respiratory function were recorded.</p> <span class="elsevierStyleSectionTitle">Results</span><p id="spar0030" class="elsevierStyleSimplePara elsevierViewall">The LPS effect was evidenced at 2<span class="elsevierStyleHsp" style=""></span>minutes of the infusion and the 10 animals showed severe shock at the end of the infusion. At 2-hours, changes between treated and non-treated animals were seen in cardiac output, systolic volume variability and mucous CO<span class="elsevierStyleInf">2</span>. Mean arterial pressure was significantly different at four hours. All non-treated subjects died during the 6-hour follow-up and all the treated animals survived for this period. Based on these results, we developed a workshop that has been used in five courses (<span class="elsevierStyleInterRef" href="http://www.ccmijesususon.com-www.crrtcordoba.com.es/">www.ccmijesususon.com-www.crrtcordoba.com.es/</span>), obtaining the previous results.</p> <span class="elsevierStyleSectionTitle">Conclusions</span><p id="spar0035" class="elsevierStyleSimplePara elsevierViewall">Our shock model shows a predictable behavior, very short latency and a sufficiently rapid improvement in the treated animals for it to be applied in training workshops. It is useful for training in the high-volume hemofilitration (HVHF) and can be used for training in the early management of septic shock.</p>" ] "es" => array:2 [ "titulo" => "Resumen" "resumen" => "<span class="elsevierStyleSectionTitle">Objetivo</span><p id="spar0040" class="elsevierStyleSimplePara elsevierViewall">Definir un modelo experimental de shock séptico que pueda aplicarse al entrenamiento en el manejo inicial del <span class="elsevierStyleItalic">shock</span> séptico, de forma concreta mediante el uso de técnicas de depuración extrarrenal (TDE).</p> <span class="elsevierStyleSectionTitle">Diseño</span><p id="spar0045" class="elsevierStyleSimplePara elsevierViewall">Estudio experimental de casos-control.</p> <span class="elsevierStyleSectionTitle">Ámbito</span><p id="spar0050" class="elsevierStyleSimplePara elsevierViewall">Hospital veterinario universitario.</p> <span class="elsevierStyleSectionTitle">Sujetos</span><p id="spar0055" class="elsevierStyleSimplePara elsevierViewall">Diez perros Beagle (peso 12–15<span class="elsevierStyleHsp" style=""></span>kg).</p> <span class="elsevierStyleSectionTitle">Intervenciones</span><p id="spar0060" class="elsevierStyleSimplePara elsevierViewall">Se provocó <span class="elsevierStyleItalic">shock</span> infundiendo 1<span class="elsevierStyleHsp" style=""></span>mg/kg de lipopolisacárido de <span class="elsevierStyleItalic">Escherichia coli</span> (LPS) en 20<span class="elsevierStyleHsp" style=""></span>ml salino en 10<span class="elsevierStyleHsp" style=""></span>min, con un seguimiento posterior de 6<span class="elsevierStyleHsp" style=""></span>h. Cinco animales no recibieron intervención para definir el curso del <span class="elsevierStyleItalic">shock</span> y 5 fueron tratados con hemofiltración de alto volumen (HVHF, 100<span class="elsevierStyleHsp" style=""></span>ml/kg/h) para valorar la rapidez de respuesta.</p> <span class="elsevierStyleSectionTitle">Variables de interés</span><p id="spar0065" class="elsevierStyleSimplePara elsevierViewall">Se monitorizaron presiones (arterial y pulmonar), parámetros hemodinámicos, tonometría gástrica y función respiratoria.</p> <span class="elsevierStyleSectionTitle">Resultados</span><p id="spar0070" class="elsevierStyleSimplePara elsevierViewall">A los 2<span class="elsevierStyleHsp" style=""></span>min el efecto de la infusión de LPS era apreciable y al final de la infusión los 10 animales mostraban <span class="elsevierStyleItalic">shock</span> severo. A las 2<span class="elsevierStyleHsp" style=""></span>h se apreciaban diferencias en gasto cardíaco, variabilidad de volumen sistólico y CO<span class="elsevierStyleInf">2</span> mucoso entre tratados y no tratados. En 4<span class="elsevierStyleHsp" style=""></span>h la diferencia era evidente también en presión arterial media. Ningún control y todos los tratados sobrevivieron las 6<span class="elsevierStyleHsp" style=""></span>h del experimento. Posteriormente, hemos desarrollado un taller docente basado en este protocolo que se ha aplicado en cinco cursos de formación (<span class="elsevierStyleInterRef" href="http://www.ccmijesususon.com/">www.ccmijesususon.com</span>; <span class="elsevierStyleInterRef" href="http://www.crrtcordoba.com.es/">www.crrtcordoba.com.es/</span>), obteniendo los resultados previstos.</p> <span class="elsevierStyleSectionTitle">Conclusiones</span><p id="spar0075" class="elsevierStyleSimplePara elsevierViewall">Este modelo de <span class="elsevierStyleItalic">shock</span> muestra una respuesta predecible en el tiempo, una latencia muy corta y una mejoría en animales tratados suficientemente rápida como para aplicarlo en talleres de formación. 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| Year/Month | Html | Total | |
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| 2024 November | 8 | 11 | 19 |
| 2024 October | 39 | 68 | 107 |
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| 2023 September | 14 | 40 | 54 |
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