RESUMEN
Despite the urgent need for experimental research in the field of acute heart failure and, particularly cardiogenic shock, currently there are only limited options in large animal models enabling research using devices applied to human subjects. The majority of available models are either associated with an unacceptably high rate of acute mortality or are incapable of developing sufficient severity of acute heart failure. The objective of our research was to develop a novel large animal model of acute severe cardiogenic shock. Advanced left ventricular dysfunction was induced by global myocardial hypoxia by perfusing the upper body (including coronary arteries) with deoxygenated venous blood. The model was tested in 12 pigs: cardiogenic shock with signs of tissue hypoxia developed in all animals with no acute mortality. Cardiac output decreased from a mean (+/- SD) of 6.61+/-1.14 l/min to 2.75+/-0.63 l/min, stroke volume from 79.7+/-9.8 ml to 25.3+/-7.8 ml and left ventricular ejection fraction from 61.2+/-4.3 % to 17.7+/-4.8 % (P=0.001 for all comparisons). In conclusion, the porcine model of acute cardiogenic shock developed in the present study may provide a basis for studying severe left ventricular dysfunction, low cardiac output and hypotension in large animals. The global myocardial hypoxia responsible for the decrease in cardiac contractility was not associated with acute death in this model.
Asunto(s)
Modelos Animales de Enfermedad , Hipoxia/complicaciones , Choque Cardiogénico/etiología , Animales , Oxigenación por Membrana Extracorpórea , Femenino , Monitoreo Fisiológico , PorcinosRESUMEN
The protective effect of therapeutic hypothermia in cardiac arrest survivors (CAS) has been previously well documented. Animal studies have indicated that attenuation of tissue oxidative stress (OS) may be involved in the mechanisms that lead to the beneficial effect of hypothermia. The extent of OS and nitric oxide (NO) production in adult CAS treated with endovascular hypothermia is, however, unknown. A total of 11 adult patients who experienced cardiac arrest out of hospital were included in the present study, and all were treated with mild hypothermia using the Thermogard XP (Alsius, USA) endovascular system. A target core temperature of 33 °C was maintained for 24 hours, with a subsequent rewarming rate of 0.15 °C per hour, followed by normothermia at 36.8 °C. Blood samples for the measurement of nitrotyrosine and nitrate/nitrite levels were drawn at admission and every 6 hours thereafter for two days. During the hypothermic period, the levels of nitrotyrosine and nitrates/nitrites were comparable with baseline values. During the rewarming period, serum levels of both parameters gradually increased and, during the normothermic period, the levels were significantly higher compared with hypothermic levels (nitrotyrosine, P<0.001; nitrates/nitrites, P<0.05). In our study, significantly lower levels of nitrotyrosine and nitrates/nitrites were demonstrated during hypothermia compared with levels during the normothermic period in adult CAS. These data suggest that attenuation of OS and NO production may be involved in the protective effect of hypothermia in adult CAS.
Asunto(s)
Paro Cardíaco/fisiopatología , Hipotermia/fisiopatología , Nitratos/sangre , Nitritos/sangre , Tirosina/análogos & derivados , Femenino , Paro Cardíaco/sangre , Humanos , Hipotermia Inducida , Masculino , Persona de Mediana Edad , Nitritos/metabolismo , Estrés Oxidativo , Tirosina/sangreAsunto(s)
Fibrinógeno , Radioisótopos de Yodo , Tromboflebitis/diagnóstico , Adulto , Anciano , Femenino , Humanos , Pierna/irrigación sanguínea , Masculino , Persona de Mediana EdadAsunto(s)
Capilares , Encía/irrigación sanguínea , Masaje , Adulto , Velocidad del Flujo Sanguíneo , Enfermedad Crónica , Femenino , Gingivitis/terapia , Humanos , MasculinoRESUMEN
Virological and serological methods were used in examination of 28 patients suffering from subacute thyroiditis de Quervain. Attempts to isolate a presumed viral agent from 8 patients were performed by inoculation of serum, urine, and aspiration biopsies of thyroid glands taken at different stages of the illness, into tissue cultures of different types of human and animal cells. Recovery of a cytopathic viral agent on cells of a rabbit lung continuous line was successful in 5 cases. Serological cross reactions exist between the isolated viruses and patient serum but not with serum of healthy people. Cases with the acquired illness and positive antibodies against the isolated viruses who had been in close and prolonged contact with patients suffering from subacute thyroiditis de Quervain were also investigated.