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Báo cáo y học: "Recombinant human activated protein C attenuates cardiovascular and microcirculatory dysfunction in acute lung injury and septic shock"

Tuyển tập các báo cáo nghiên cứu về y học được đăng trên tạp chí y học Critical Care giúp cho các bạn có thêm kiến thức về ngành y học đề tài: Recombinant human activated protein C attenuates cardiovascular and microcirculatory dysfunction in acute lung injury and septic shock. | Maybauer et al. Critical Care 2010 14 R217 http ccforum.eom content 14 6 R217 KS CRITICAL CARE RESEARCH Open Access Recombinant human activated protein C attenuates cardiovascular and microcirculatory dysfunction in acute lung injury and septic shock 17 3 12 3 1 1 4 Marc O Maybauer Dirk M Maybauer John F Fraser Csaba Szabo Martin Westphal Levente Kiss Eszter M Horvath4 Yoshimitsu Nakano1 David N Herndon5 Lillian D Traber1 Daniel L Traber1 Abstract Introduction This prospective randomized controlled experimental animal study looks at the effects of recombinant human activated protein C rhAPC on global hemodynamics and microcirculation in ovine acute lung injury ALI and septic shock resulting from smoke inhalation injury. Methods Twenty-one sheep 37 2 kg were operatively prepared for chronic study and randomly allocated to either the sham control or rhAPC group n 7 each . The control and rhAPC groups were subjected to insufflation of four sets of 12 breaths of cotton smoke followed by instillation of live Pseudomonas aeruginosa into both lung lobes according to an established protocol. Healthy sham animals were not subjected to the injury and received only four sets of 12 breaths of room air and instillation of the vehicle normal saline . rhAPC 24 gg kg hour was intravenously administered from 1 hour post injury until the end of the 24-hour experiment. Regional microvascular blood flow was analyzed using colored microspheres. All sheep were mechanically ventilated with 100 oxygen and fluid resuscitated with lactated Ringer s solution to maintain hematocrit at baseline levels. Results The rhAPC-associated reduction in heart malondialdehyde MDA and heart 3-nitrotyrosine a reliable indicator of tissue injury levels occurred parallel to a significant increase in mean arterial pressure and to a significant reduction in heart rate and cardiac output compared with untreated controls that showed a typical hypotensive hyperdynamic response to the injury P 0.05 . In addition .