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Other Comments:
Having proper physiological models are important for shock and trauma research. This paper highlights the importance of anesthetic technique and mode of ventilation in predicting hemodynamic tolerance of hemorrhage in a rabbit model.
While the volume of blood withdrawn (constant hypotensive blood pressure target model) was greater with isoflurane and mechanical ventilation, other variables were also close to significance, highlighting, as the authors point out, the small sample size studied.
Future studies using this model should be larger, then. In addition, in the current study, spontaneous and mechanically ventilated and spontaneously breathing animals had different anesthetic regimens. In the future, therefore, larger studies should include 4 groups, 2 x 2, based on 2 anesthetic regimens and 2 ventilation regimens, in order to distinguish anesthetic vs. ventilatory mode effects on hemorrhage volume at constant BP.
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Competing interests:
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Invited by the author to review this article? :
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Have you previously published on this or a similar topic?:
Yes
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References:
Fulminant liver failure after radical prostatectomy in the hyperlordotic position. Tung A, Roth S, O'Connor MF, Liu W, Ellis JE. Anesth Analg. 2006 Oct;103(4):986-8. Right heart dysfunction, pulmonary embolism, and paradoxical embolization during liver transplantation. A transesophageal two-dimensional echocardiographic study. Ellis JE, Lichtor JL, Feinstein SB, Chung MR, Polk SL, Broelsch C, Emond J, Thistlethwaite JR, Roizen MF. Anesth Analg. 1989 Jun;68(6):777-82. -
Experience and credentials in the specific area of science:
Anesthesia and critical care. Vascular surgery.
- How to cite: Ellis J E.Pilot Of Spontaneous Breathing Vs. Ventilated Model For Hemorrhage And Resuscitation In The Rab[Review of the article 'Pilot Of Spontaneous Breathing Vs. Ventilated Model For Hemorrhage And Resuscitation In The Rabbit ' by Cheung, PhD A].WebmedCentral 2011;2(1):WMCRW00336
Shock and trauma research has had a great impact on clinical advances in recent decades. The pilot paper in the rabbit model by Jahr, et al., amplifies the significance of anesthesia and ventilatory considerations in predicting hemodynamic tolerance of hemorrhage. The volume of blood withdrawn was larger with the inhalational agent, isoflurane, and with mechanical ventilation.
Larger additional studies in the future will more precisely identify the role of these and other factors. It should be noted that in the present study, spontaneous and mechanically ventilated rabbits had varied anesthetic regimens and future work should divide each group into separate anesthetic and ventilatory subgroups.
Future studies with this model may help to better clarify anesthetic versus ventilatory mode effects on influencing hemorrhage volume.
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I have a PhD in pulmonary pharmacology and am the medical director of Anesthesia at a Level One Trauma Center.