Abstract:
BACKGROUND:Animal models of ventilator-associated pneumonia (VAP) in primates, sheep, and pigs differ in the underlying pulmonary injury, etiology, bacterial inoculation methods, and time to onset. The most common ovine and porcine models do not reproduce the primary pathogenic mechanism of the disease, through the aspiration of oropharyngeal pathogens, or the most prevalent human etiology. Herein the authors characterize a novel porcine model of VAP due to aspiration of oropharyngeal secretions colonized by Pseudomonas aeruginosa. METHODS:Ten healthy pigs were intubated, positioned in anti-Trendelenburg, and mechanically ventilated for 72 h. Three animals did not receive bacterial challenge, whereas in seven animals, a P. aeruginosa suspension was instilled into the oropharynx. Tracheal aspirates were cultured and respiratory mechanics were recorded. On autopsy, lobar samples were obtained to corroborate VAP through microbiological and histological studies. RESULTS:In animals not challenged, diverse bacterial colonization of the airways was found and monolobar VAP rarely developed. In animals with P. aeruginosa challenge, colonization of tracheal secretion increased up to 6.39 ± 0.34 log colony-forming unit (cfu)/ml (P < 0.001). VAP was confirmed in six of seven pigs, in 78% of the cases developed in the dependent lung segments (right medium and lower lobes, P = 0.032). The static respiratory system elastance worsened to 41.5 ± 5.8 cm H2O/l (P = 0.001). CONCLUSIONS:The authors devised a VAP model caused by aspiration of oropharyngeal P. aeruginosa, a frequent causative pathogen of human VAP. The model also overcomes the practical and legislative limitations associated with the use of primates. The authors' model could be employed to study pathophysiologic mechanisms, as well as novel diagnostic/preventive strategies.
journal_name
Anesthesiologyjournal_title
Anesthesiologyauthors
Li Bassi G,Rigol M,Marti JD,Saucedo L,Ranzani OT,Roca I,Cabanas M,Muñoz L,Giunta V,Luque N,Rinaudo M,Esperatti M,Fernandez-Barat L,Ferrer M,Vila J,Ramirez J,Torres Adoi
10.1097/ALN.0000000000000222subject
Has Abstractpub_date
2014-05-01 00:00:00pages
1205-15issue
5eissn
0003-3022issn
1528-1175journal_volume
120pub_type
杂志文章相关文献
ANESTHESIOLOGY文献大全abstract:BACKGROUND:Aprotinin has been reported to reduce blood loss and transfusion requirements in patients having major orthopedic operations. Data on whether epsilon amino-caproic acid (EACA) is effective in this population are sparse. METHODS:Sixty-nine adults with malignancy scheduled for either pelvic, extremity or spin...
journal_title:Anesthesiology
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1097/00000542-200302000-00011
更新日期:2003-02-01 00:00:00
abstract:BACKGROUND:Cardiac complications are common during the postoperative period and may be associated with hypoxemia and tachycardia. Preliminary studies in high-risk patients after operation have shown a possible beneficial effect of oxygen therapy on arterial oxygen saturation and heart rate. METHODS:The authors studied...
journal_title:Anesthesiology
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1097/00000542-199902000-00008
更新日期:1999-02-01 00:00:00
abstract:BACKGROUND:We have previously shown that intralipid (lipid emulsion) protects the heart against ischemia/reperfusion injury and bupivacaine-induced cardiotoxicity. However, the precise underlying mechanisms are not fully understood. Here we explored the hypothesis that free fatty acid receptor-1 or G-protein-coupled re...
journal_title:Anesthesiology
pub_type: 杂志文章
doi:10.1097/ALN.0000000000002195
更新日期:2018-07-01 00:00:00
abstract:BACKGROUND:The pharmacokinetics and pharmacodynamics of succinylcholine were studied simultaneously in anesthetized patients to understand why the drug has a rapid onset and short duration of action. A quantitative model describing the concentration-effect relation of succinylcholine was proposed. The correlation betwe...
journal_title:Anesthesiology
pub_type: 杂志文章
doi:10.1097/00000542-200211000-00009
更新日期:2002-11-01 00:00:00
abstract:BACKGROUND:Some inhalation anesthetics increase apoptotic cell death in the developing brain. Xenon, an inhalation anesthetic, increases neuroprotection when combined with therapeutic hypothermia after hypoxic-ischemic brain injury in newborn animals. The authors, therefore, examined whether there was any neuroapoptoti...
journal_title:Anesthesiology
pub_type: 杂志文章
doi:10.1097/ALN.0b013e318294934d
更新日期:2013-08-01 00:00:00
abstract:BACKGROUND:The purpose of this study was to determine whether combination of 1-5 microg intrathecal neostigmine would enhance analgesia from a fixed intrathecal dose of morphine. METHODS:A total of 60 patients undergoing gynecologic surgery were randomized to one of five groups. Patients received 15 mg bupivacaine plu...
journal_title:Anesthesiology
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1097/00000542-200302000-00031
更新日期:2003-02-01 00:00:00
abstract::The effects of halothane (0.45 and 0.9 mM, equivalent to 0.7 and 1.5%, respectively), isoflurane (0.54 and 1.23 mM, equivalent to 0.9 and 2.0%, respectively) and enflurane (0.65 and 1.48 mM, equivalent to 1.2 and 2.5%, respectively) on macroscopic L- and T-type Ca2+ channel currents were compared in single canine card...
journal_title:Anesthesiology
pub_type: 杂志文章
doi:10.1097/00000542-199105000-00018
更新日期:1991-05-01 00:00:00
abstract::Thiopental was used in long-term infusion (3-4.5 mg . kg-1 . h-1 during 4-8 days) to protect the brain from injury following trauma. Thiopental plasma concentrations were measured during infusion (48 patients) and after infusion (14 patients) to determine the kinetics of the drug in continuous infusion. All mean value...
journal_title:Anesthesiology
pub_type: 杂志文章
doi:10.1097/00000542-198507000-00007
更新日期:1985-07-01 00:00:00
abstract:BACKGROUND:The study was designed to compare the effects of equimolar concentrations of racemic bupivacaine, levobupivacaine, and ropivacaine on ventricular conduction, anisotropy, duration and homogeneity of refractoriness, and wavelengths, and to provide a potency ratio for effects on conduction velocity. METHODS:Is...
journal_title:Anesthesiology
pub_type: 杂志文章
doi:10.1097/00000542-200203000-00021
更新日期:2002-03-01 00:00:00
abstract:BACKGROUND:Positive end expiratory pressure (PEEP) is an important component of therapy in patients with acute lung injury or acute respiratory distress syndrome. The independent effect of PEEP on mortality is currently unknown. METHODS:A systematic review and meta-analysis of randomized controlled clinical trials com...
journal_title:Anesthesiology
pub_type: 杂志文章,meta分析,评审
doi:10.1097/ALN.0b013e31819fae06
更新日期:2009-05-01 00:00:00
abstract:BACKGROUND:Drugs used for sedation in anesthesia and intensive care may cause pharyngeal dysfunction and increased risk for aspiration. In this study, the authors investigate the impact of sedative doses of morphine and midazolam on pharyngeal function during swallowing and coordination of breathing and swallowing. ME...
journal_title:Anesthesiology
pub_type: 杂志文章
doi:10.1097/ALN.0000000000000657
更新日期:2015-06-01 00:00:00
abstract::To assess the effect of a glucose infusion on brain extracellular fluid (ECF) during systemic hypoxia, changes in glucose and lactate concentrations in cerebral ECF during and after moderate hypoxic hypoxia were measured in adult, conscious, unrestrained rats, with a microdialysis probe in the posterior hippocampus. T...
journal_title:Anesthesiology
pub_type: 杂志文章
doi:10.1097/00000542-199210000-00017
更新日期:1992-10-01 00:00:00
abstract:BACKGROUND:Morphine is widely used in patients undergoing surgical operations and is also reported to mediate cardioprotection of preconditioning. The current study determined effects of morphine at therapeutic to pharmacologic concentrations on cardiac action potential, L-type Ca2+ current (ICa.L), delayed rectifier K...
journal_title:Anesthesiology
pub_type: 杂志文章
doi:10.1097/00000542-200508000-00011
更新日期:2005-08-01 00:00:00
abstract::Dexmedetomidine (DMED) is a novel alpha 2 adrenergic agonist that has been shown to have potent analgesic and anesthetic sparing effects. This study was designed to investigate the effects of DMED, both alone and combined with isoflurane, on resting ventilation, the hypercapnic response, and the hypoxic response in do...
journal_title:Anesthesiology
pub_type: 杂志文章
doi:10.1097/00000542-199204000-00014
更新日期:1992-04-01 00:00:00
abstract:BACKGROUND:The current study was designed to investigate the influence of pretreatment with the oxygen radical scavengers polyethylene glycol superoxide dismutase and catalase (SODCAT) on altered opioid-induced pial artery dilation after fluid percussion brain injury (FPI) in the newborn pig. It has been observed previ...
journal_title:Anesthesiology
pub_type: 杂志文章
doi:10.1097/00000542-199603000-00017
更新日期:1996-03-01 00:00:00
abstract:BACKGROUND:A class Ib antiarrhythmic drug, mexiletine, augments relaxations produced by adenosine triphosphate (ATP) sensitive K+ channel openers in isolated rat aortas, suggesting that it produces changes in the vasodilation mediated by ATP-sensitive K+ channels. Nitric oxide can induce its vasodilator effect via K+ c...
journal_title:Anesthesiology
pub_type: 杂志文章
doi:10.1097/00000542-200003000-00025
更新日期:2000-03-01 00:00:00
abstract:BACKGROUND:The current study was designed to test the hypothesis that the fibromyalgia survey criteria would be directly associated with increased opioid consumption after hysterectomy even when accounting for other factors previously described as being predictive for acute postoperative pain. METHODS:Two hundred eigh...
journal_title:Anesthesiology
pub_type: 杂志文章
doi:10.1097/ALN.0000000000000637
更新日期:2015-05-01 00:00:00
abstract:BACKGROUND:Intraoperative remifentanil infusions have been associated with postoperative opioid-induced hyperalgesia and tolerance. Using a previously identified subpopulation of spinal neurons that displays an augmentation in N-methyl-D-aspartate (NMDA) receptor current after chronic morphine, investigations were unde...
journal_title:Anesthesiology
pub_type: 杂志文章
doi:10.1097/ALN.0b013e31817f4c5d
更新日期:2008-08-01 00:00:00
abstract::The hemodynamic effects of prolonged mechanical ventilation with positive end-expiratory pressure (PEEP), with and without blood volume augmentation, were studied in 18 beagles anesthetized with halothane (0.7 per cent end-tidal). Addition of 12 cm H2O PEEP during mechanical ventilation in normavolemic dogs was associ...
journal_title:Anesthesiology
pub_type: 杂志文章
doi:10.1097/00000542-197501000-00009
更新日期:1975-01-01 00:00:00
abstract::In a recent editorial, Kapur described perioperative nausea and vomiting as "the big 'little problem' following ambulatory surgery."257 Although the actual morbidity associated with nausea is relatively low in health outpatients, it should not be considered an unavoidable part of the perioperative experience. The avai...
journal_title:Anesthesiology
pub_type: 杂志文章,评审
doi:10.1097/00000542-199207000-00023
更新日期:1992-07-01 00:00:00
abstract::Sevoflurane, 1.4 per cent (MAC), was administered to groups of Fischer 344 rats for 10 hours, 4 hours, or 1 hour; additional rats received 0.5 per cent methoxyflurane for 3 hours or 1 hour. Urinary inorganic fluoride excretion of sevoflurane in vivo was a third to a fourth that of methoxyflurane. However, using hepati...
journal_title:Anesthesiology
pub_type: 杂志文章
doi:10.1097/00000542-197507000-00015
更新日期:1975-07-01 00:00:00
abstract::Respiratory function is fundamental in the practice of anesthesia. Knowledge of basic physiologic principles of respiration assists in the proper implementation of daily actions of induction and maintenance of general anesthesia, delivery of mechanical ventilation, discontinuation of mechanical and pharmacologic suppo...
journal_title:Anesthesiology
pub_type: 杂志文章,评审
doi:10.1097/ALN.0000000000002666
更新日期:2019-06-01 00:00:00
abstract:BACKGROUND:Although one-lung ventilation (OLV) has become an established procedure during thoracic surgery, sparse data exist about inflammatory alterations in the deflated, reventilated lung. The aim of this study was to prospectively investigate the effect of OLV on the pulmonary inflammatory response and to assess p...
journal_title:Anesthesiology
pub_type: 杂志文章,随机对照试验
doi:10.1097/ALN.0b013e3181a10731
更新日期:2009-06-01 00:00:00
abstract:BACKGROUND:Neurally adjusted ventilatory assist (NAVA) is a new mode of mechanical ventilation that delivers ventilatory assist in proportion to the electrical activity of the diaphragm. This study aimed to compare the ventilatory and gas exchange effects between NAVA and pressure support ventilation (PSV) during the w...
journal_title:Anesthesiology
pub_type: 杂志文章,随机对照试验
doi:10.1097/ALN.0b013e3181ee2ef1
更新日期:2010-10-01 00:00:00
abstract:BACKGROUND:The authors report on the appearance of misleading square wave "phantom" capnograph tracings for approximately 3 min after disconnection from the Siemens Servo 900c ventilator. A series of experiments are described to examine the mechanism of this phenomenon. METHODS:Patients were ventilated using the Sieme...
journal_title:Anesthesiology
pub_type: 杂志文章
doi:10.1097/00000542-199703000-00026
更新日期:1997-03-01 00:00:00
abstract::In MH, skeletal muscle acutely and unexpectedly increases its oxygen consumption and lactate production, resulting in greater heat production, respiratory and metabolic acidosis, muscle ridigity, sympathetic stimulation, and increased cellular permeability. The best-accepted theory is that MH is due to an inability to...
journal_title:Anesthesiology
pub_type: 杂志文章,评审
doi:10.1097/00000542-198011000-00007
更新日期:1980-11-01 00:00:00
abstract:BACKGROUND:Intrathecal methylprednisolone acetate (MPA) has been used in patients with chronic pain syndromes. Its safety has been debated after reports of adverse events. No systematic preclinical evaluation of MPA has been reported. In the current study, the acute and long-term effects of intrathecal MPA on dog spina...
journal_title:Anesthesiology
pub_type: 杂志文章
doi:10.1097/ALN.0b013e31823cf035
更新日期:2012-01-01 00:00:00
abstract:BACKGROUND:Studies on receptor knockout mice have so far shown that of the three alpha2-adrenoceptor subtypes, the alpha(2A) adrenoceptor has a major role in mediating the powerful central analgesia induced by synthetic alpha2-adrenoceptor agonists. However, because a knockout of the gene for the alpha(2A) adrenoceptor...
journal_title:Anesthesiology
pub_type: 杂志文章
doi:10.1097/00000542-200407000-00029
更新日期:2004-07-01 00:00:00
abstract:BACKGROUND:Controversy exists regarding the effectiveness of propofol to prevent postoperative nausea and vomiting. This prospective, randomized, single-blinded study was designed to evaluate the antiemetic effectiveness of 0.5 mg/kg propofol when administered intravenously after sevoflurane- compared with desflurane-b...
journal_title:Anesthesiology
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1097/00000542-199810000-00007
更新日期:1998-10-01 00:00:00
abstract:BACKGROUND:We describe the anesthetic management for a new surgical procedure: laser ablation of emphysematous bullae via thoracoscope. Although thoracoscopy is not new, this is the first description of a series of patients with bilateral, chronic lung disease who underwent long periods of one-lung ventilation (OLV) du...
journal_title:Anesthesiology
pub_type: 杂志文章
doi:10.1097/00000542-199301000-00008
更新日期:1993-01-01 00:00:00