OBESITY AND CRITICAL ILLNESS: INSIGHTS FROM ANIMAL MODELS
OBESITY AND CRITICAL ILLNESS: INSIGHTS FROM ANIMAL MODELS
复制标题
DOI：
10.1097/shk.0000000000000512
复制
发表时间：
2016-04-01
期刊：
影响因子：
3.1
通讯作者：
Xiang, Lusha
中科院分区：
文献类型：
--
作者：
Mittwede, Peter N.;Clemmer, John S.;Xiang, Lusha
危重病是世界各地发病率和死亡率的主要原因。虽然肥胖在创伤的背景下通常是有害的，但它与一些脓毒症患者的结局改善相关联。造成这些不同结果的原因尚不清楚。许多动物模型已被用于研究肥胖对各种形式的危重疾病的反应。正如已经有许多动物模型试图模拟临床条件一样，在医院和重症监护室的高度异质性危重患者人群中可能发生许多临床情况。这对临床医生和研究人员提出了一个巨大的挑战，他们试图了解疾病的机制，并为特定的患者子集（包括肥胖患者）开发适当的疗法和治疗算法。为了给广泛的患者带来有效的治疗，新的动物模型的开发和现有动物模型的修改是重要的。不仅实验变量需要尽可能与临床情况匹配，而且需要研究预先存在共病条件的动物模型。本文简要综述了出血、钝性创伤、创伤性脑损伤和脓毒症的动物模型。它还讨论了通过使用肥胖模型来研究危重病的病理生理学，并根据临床文献中所证明的内容来学习。
Critical illness is a major cause of morbidity and mortality around the world. While obesity is often detrimental in the context of trauma, it is paradoxically associated with improved outcomes in some septic patients. The reasons for these disparate outcomes are not well understood. A number of animal models have been used to study the obese response to various forms of critical illness. Just as there have been many animal models that have attempted to mimic clinical conditions, there are many clinical scenarios that can occur in the highly heterogeneous critically ill patient population that occupies hospitals and intensive care units. This poses a formidable challenge for clinicians and researchers attempting to understand the mechanisms of disease and develop appropriate therapies and treatment algorithms for specific subsets of patients, including the obese. The development of new, and the modification of existing animal models, is important in order to bring effective treatments to a wide range of patients. Not only do experimental variables need to be matched as closely as possible to clinical scenarios, but animal models with pre-existing comorbid conditions need to be studied. This review briefly summarizes animal models of hemorrhage, blunt trauma, traumatic brain injury, and sepsis. It also discusses what has been learned through the use of obese models to study the pathophysiology of critical illness in light of what has been demonstrated in the clinical literature.