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<article article-type="research-article" dtd-version="1.3" xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" xml:lang="ru"><front><journal-meta><journal-id journal-id-type="publisher-id">rmt</journal-id><journal-title-group><journal-title xml:lang="ru">Общая реаниматология</journal-title><trans-title-group xml:lang="en"><trans-title>General Reanimatology</trans-title></trans-title-group></journal-title-group><issn pub-type="ppub">1813-9779</issn><issn pub-type="epub">2411-7110</issn><publisher><publisher-name>FSBI "SRIGR" RAMS</publisher-name></publisher></journal-meta><article-meta><article-id pub-id-type="doi">10.15360/1813-9779-2024-2-55-64</article-id><article-id custom-type="elpub" pub-id-type="custom">rmt-2387</article-id><article-categories><subj-group subj-group-type="heading"><subject>Research Article</subject></subj-group><subj-group subj-group-type="section-heading" xml:lang="ru"><subject>ЭКСПЕРИМЕНТАЛЬНЫЕ ИССЛЕДОВАНИЯ</subject></subj-group><subj-group subj-group-type="section-heading" xml:lang="en"><subject>EXPERIMENTAL STUDIES</subject></subj-group></article-categories><title-group><article-title>Асфиксическая остановка кровообращения с комплексом реанимационных мероприятий в экспериментальной модели</article-title><trans-title-group xml:lang="en"><trans-title>Asphyxial Circulatory Arrest with a Complex of Resuscitation Measures in an Experimental Model</trans-title></trans-title-group></title-group><contrib-group><contrib contrib-type="author" corresp="yes"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0001-6350-6445</contrib-id><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Дубенский</surname><given-names>А. Ю.</given-names></name><name name-style="western" xml:lang="en"><surname>Dubensky</surname><given-names>A. Y.</given-names></name></name-alternatives><bio xml:lang="ru"><p>Алексей Юрьевич Дубенский - врач анестезиолог-реаниматолог.</p><p>107031, Москва, ул. Петровка, д. 25, стр. 2; 105203, Москва, ул. Нижняя Первомайская, д. 70</p></bio><bio xml:lang="en"><p>Alexey Y. Dubensky</p><p>25 Petrovka Str., Bldg. 2, 107031 Moscow; 70 Nizhnyaya Pervomayskaya Str., 105203 Moscow</p></bio><email xlink:type="simple">dubkoal@gmail.com</email><xref ref-type="aff" rid="aff-1"/></contrib><contrib contrib-type="author" corresp="yes"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0002-0631-5666</contrib-id><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Рыжков</surname><given-names>И. А.</given-names></name><name name-style="western" xml:lang="en"><surname>Ryzhkov</surname><given-names>I. A.</given-names></name></name-alternatives><bio xml:lang="ru"><p>Иван Александрович Рыжков - Заведующий Лабораторией экспериментальных исследований, Врач анестезиолог-реаниматолог.</p><p>107031, Москва, ул. Петровка, д. 25, стр. 2</p></bio><bio xml:lang="en"><p>Ivan A. Ryzhkov</p><p>25 Petrovka Str., Bldg. 2, 107031 Moscow</p></bio><email xlink:type="simple">iryzhkov@fnkcrr.ru</email><xref ref-type="aff" rid="aff-2"/></contrib><contrib contrib-type="author" corresp="yes"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0002-7760-3526</contrib-id><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Лапин</surname><given-names>К. Н.</given-names></name><name name-style="western" xml:lang="en"><surname>Lapin</surname><given-names>K. N.</given-names></name></name-alternatives><bio xml:lang="ru"><p>Константин Николаевич Лапин</p><p>107031, Москва, ул. Петровка, д. 25, стр. 2</p></bio><bio xml:lang="en"><p>Konstantin N. Lapin</p><p>25 Petrovka Str., Bldg. 2, 107031 Moscow</p></bio><email xlink:type="simple">klapin@fnkcrr.ru</email><xref ref-type="aff" rid="aff-2"/></contrib><contrib contrib-type="author" corresp="yes"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0001-7017-7897</contrib-id><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Калабушев</surname><given-names>С. Н.</given-names></name><name name-style="western" xml:lang="en"><surname>Kalabushev</surname><given-names>S. N.</given-names></name></name-alternatives><bio xml:lang="ru"><p>Сергей Николаевич Калабушев</p><p>107031, Москва, ул. Петровка, д. 25, стр. 2</p></bio><bio xml:lang="en"><p>Sergey N. Kalabushev</p><p>25 Petrovka Str., Bldg. 2, 107031 Moscow</p></bio><email xlink:type="simple">skalabushev@fnkcrr.ru</email><xref ref-type="aff" rid="aff-2"/></contrib><contrib contrib-type="author" corresp="yes"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0003-4420-1923</contrib-id><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Варнакова</surname><given-names>Л. А.</given-names></name><name name-style="western" xml:lang="en"><surname>Varnakova</surname><given-names>L. A.</given-names></name></name-alternatives><bio xml:lang="ru"><p>Лидия Александровна Варнакова</p><p>107031, Москва, ул. Петровка, д. 25, стр. 2</p></bio><bio xml:lang="en"><p>Lydia A. Varnakova</p><p>25 Petrovka Str., Bldg. 2, 107031 Moscow</p></bio><email xlink:type="simple">lvarnakova@fnkcrr.ru</email><xref ref-type="aff" rid="aff-2"/></contrib><contrib contrib-type="author" corresp="yes"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0003-2441-6062</contrib-id><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Цоколаева</surname><given-names>З. И.</given-names></name><name name-style="western" xml:lang="en"><surname>Tsokolaeva</surname><given-names>Z. I.</given-names></name></name-alternatives><bio xml:lang="ru"><p>Зоя Ивановна Цоколаева</p><p>107031, Москва, ул. Петровка, д. 25, стр. 2</p></bio><bio xml:lang="en"><p>Zoya I. Tsokolaeva</p><p>25 Petrovka Str., Bldg. 2, 107031 Moscow</p></bio><email xlink:type="simple">Tsokolarvazoya@mail.ru</email><xref ref-type="aff" rid="aff-2"/></contrib><contrib contrib-type="author" corresp="yes"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0001-9034-4912</contrib-id><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Долгих</surname><given-names>В. Т.</given-names></name><name name-style="western" xml:lang="en"><surname>Dolgikh</surname><given-names>V. T.</given-names></name></name-alternatives><bio xml:lang="ru"><p>Владимир Терентьевич Долгих - доктор медицинских наук, профессор, заслуженный деятель науки РФ.</p><p>107031, Москва, ул. Петровка, д. 25, стр. 2</p></bio><bio xml:lang="en"><p>Vladimir T. Dolgikh</p><p>25 Petrovka Str., Bldg. 2, 107031 Moscow</p></bio><email xlink:type="simple">prof_dolgih@mail.ru</email><xref ref-type="aff" rid="aff-2"/></contrib><contrib contrib-type="author" corresp="yes"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0003-3318-796X</contrib-id><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Гречко</surname><given-names>А. В.</given-names></name><name name-style="western" xml:lang="en"><surname>Grechko</surname><given-names>A. V.</given-names></name></name-alternatives><bio xml:lang="ru"><p>Андрей Вячеславович Гречко - Член-корреспондент РАН, Директор ФНКЦ РР.</p><p>107031, Москва, ул. Петровка, д. 25, стр. 2</p></bio><bio xml:lang="en"><p>Andrey V. Grechko</p><p>25 Petrovka Str., Bldg. 2, 107031 Moscow</p></bio><email xlink:type="simple">avgrechko@fnkcrr.ru</email><xref ref-type="aff" rid="aff-3"/></contrib></contrib-group><aff-alternatives id="aff-1"><aff xml:lang="ru"><institution>Институт высшего и дополнительного профессионального образования Федерального научно-клинического центра реаниматологии и реабилитологии; Национальный медико-хирургический центр им. Н.И. Пирогова Минздрава России</institution><country>Россия</country></aff><aff xml:lang="en"><institution>Institute of Higher and Additional Professional Education, Federal Research and Clinical Center of Intensive Care Medicine and Rehabilitology; N.I. Pirogov National Medical Surgical Center, Ministry of Health of Russia</institution><country>Russian Federation</country></aff></aff-alternatives><aff-alternatives id="aff-2"><aff xml:lang="ru"><institution>Научно-исследовательский институт общей реаниматологии им. В.А. Неговского Федерального научно-клинического центра реаниматологии и реабилитологии</institution><country>Россия</country></aff><aff xml:lang="en"><institution>V.A. Negovsky Research Institute of General Reanimatology, Federal Research and Clinical Center of Intensive Care Medicine and Rehabilitology</institution><country>Russian Federation</country></aff></aff-alternatives><aff-alternatives id="aff-3"><aff xml:lang="ru"><institution>Федеральный научно-клинический центр реаниматологии и реабилитологии</institution><country>Россия</country></aff><aff xml:lang="en"><institution>Federal Research and Clinical Center of Intensive Care Medicine and Rehabilitology</institution><country>Russian Federation</country></aff></aff-alternatives><pub-date pub-type="collection"><year>2024</year></pub-date><pub-date pub-type="epub"><day>25</day><month>04</month><year>2024</year></pub-date><volume>20</volume><issue>2</issue><fpage>55</fpage><lpage>64</lpage><permissions><copyright-statement>Copyright &amp;#x00A9; Дубенский А.Ю., Рыжков И.А., Лапин К.Н., Калабушев С.Н., Варнакова Л.А., Цоколаева З.И., Долгих В.Т., Гречко А.В., 2024</copyright-statement><copyright-year>2024</copyright-year><copyright-holder xml:lang="ru">Дубенский А.Ю., Рыжков И.А., Лапин К.Н., Калабушев С.Н., Варнакова Л.А., Цоколаева З.И., Долгих В.Т., Гречко А.В.</copyright-holder><copyright-holder xml:lang="en">Dubensky A.Y., Ryzhkov I.A., Lapin K.N., Kalabushev S.N., Varnakova L.A., Tsokolaeva Z.I., Dolgikh V.T., Grechko A.V.</copyright-holder><license xml:lang="ru" license-type="creative-commons-attribution" xlink:href="https://creativecommons.org/licenses/by/4.0/" xlink:type="simple"><license-p>Данная работа распространяется под лицензией Creative Commons Attribution 4.0.</license-p></license><license xml:lang="en" license-type="creative-commons-attribution" xlink:href="https://creativecommons.org/licenses/by/4.0/" xlink:type="simple"><license-p>This work is licensed under a Creative Commons Attribution 4.0 License.</license-p></license></permissions><self-uri xlink:href="https://www.reanimatology.com/rmt/article/view/2387">https://www.reanimatology.com/rmt/article/view/2387</self-uri><abstract><p>Большинству моделей асфиксической остановки кровообращения (ОК) присущ ряд недостатков, таких как отсутствие единых критериев фиксации остановки и восстановления спонтанного кровообращения, небольшая длительность и ограниченный объем постреанимационной интенсивной терапии, низкая схожесть с практикой реанимационных мероприятий в современной клинической анестезиологии-реаниматологии.</p><sec><title>Цель исследования</title><p>Цель исследования: усовершенствовать экспериментальную модель асфиксической ОК за счет стандартизации экспериментальных процедур и применения комплекса реанимационных мероприятий, соответствующего практике ведения пациентов с ОК в клинической анестезиологии-реаниматологии.</p></sec><sec><title>Материалы и методы</title><p>Материалы и методы. Эксперименты провели на 34 крысах самцах линии Wistar с разделением на 2 группы: I группа — ложно оперированные животные (ЛО, n=12) и II группа — животные с асфиксической остановкой кровообращения и последующей реанимацией (ОК, n=22). Для индукции асфиксии в группе ОК анестезированным крысам вводили рокурония бромид с последующей регистрацией электрокардиограммы (ЭКГ), артериального давления (АД) с помощью инвазивного метода и параметров лазерной допплеровской флуометрии (ЛДФ) для оценки перфузии кожи. Длительность собственно ОК составляла 2 мин, после чего проводили комплекс реанимационных мероприятий с последующей интенсивной терапией в течение 2 ч. Оценивали динамику показателей кровообращения (ЭКГ, АД, ЛДФ), газового состава и кислотно-основного состояния (КОС) артериальной крови.</p></sec><sec><title>Результаты</title><p>Результаты. В исходном состоянии после периода стабилизации группы животных не отличались ни по одному из исследуемых параметров. После применения критериев исключения в последующем анализе учитывали 11 животных группы ЛО и 18 — группы ОК. В первые минуты после успешно проведенных реанимационных мероприятий в группе ОК отмечали тахикардию (ЧСС, мин–1, ЛО vs ОК): 218 [205; 236] vs 286 [272; 305], p⩽0,0001), а также восстановление кожной перфузии до субнормальных показателей. На 10-й мин постреанимационного периода у животных группы ОК отмечали снижение перфузии кожи (М, пф. ед., ЛО vs ОК): 14,7 [12,1; 16,5] vs 10,1 [7,0; 12,5], p=0,0014, декомпенсированный смешанный ацидоз (pH, ЛО vs ОК): 7,42 [7,40; 7,43] vs 7,20 [7,13; 7,23], p⩽0,0001, однако группы не различались по значениям АД (АД, мм рт. ст., ЛО vs ОК): 60 [58; 72] vs 67 [62; 82], p=0,482. К 120-й мин постреанимационного периода на фоне проводимой интенсивной терапии группы не различались по большинству исследуемых показателей. В группе ОК после реанимации умерло 3 из 18 животных.</p></sec><sec><title>Заключение</title><p>Заключение. При асфиксии ОК у крыс наступает по механизму электромеханической диссоциации. Использование ЛДФ для оценки периферического кровотока позволяет стандартизировать тяжесть ишемически-реперфузионных повреждений и улучшить воспроизводимость модели. Применение комплекса реанимационных мероприятий обоснованно с биоэтических позиций и позволяет улучшить транслируемость результатов доклинических исследований в клиническую медицину.</p></sec></abstract><trans-abstract xml:lang="en"><p>The majority of asphyxial circulatory arrest (CA) models have a number of disadvantages, such as the lack of uniform criteria for ﬁxing CA and recovery of spontaneous circulation, short duration of CA episode and limited volume of post-resuscitation intensive care, poor similarity with resuscitation measures in current clinical anesthesiology/intensive care settings.</p><sec><title>The aim of the study</title><p>The aim of the study: to improve the experimental model of asphyxicial CA by standardizing experimental procedures and using a complex of resuscitation measures replicating current CA management in clinical anesthesiology-intensive care.</p></sec><sec><title>Materials and methods</title><p>Materials and methods. The experiments were conducted on 34 male Wistar rats, distributed into 2 groups: Group I included animals subjected to sham procedure (SP, N=12) and Group II – animals subjected to asphyxial circulatory arrest (CA, N=22) and subsequent resuscitation. Asphyxia in anesthetized rats was induced by rocuronium bromide injection, followed by recording of electrocardiogram (ECG), parameters of invasive blood pressure (BP) measurement and laser Doppler ﬂuxmetry (LDF) to assess skin perfusion. CA episode was maintained for 2 min, followed by a series of resuscitation measures and intensive therapy for 2 h. Circulatory parameters (ECG, BP, LDF), gas composition and arterial blood acid-base state (ABS) dynamics were evaluated.</p></sec><sec><title>Results</title><p>Results. Monitored parameters were comparable in both groups at baseline after stabilization period. After exclusion criteria were applied 11 animals from SP group and 18 — from CA were included in the analysis. Tachycardia (heart rate, beats/min–1, SP vs CA) was documented in the CA group: 218 [205; 236] vs 286 [272; 305], P⩽0.0001), as well as recovery of skin perfusion to subnormal parameters in the ﬁrst minutes after successful resuscitation. At minute 10 in the post-resuscitation period worsening of skin perfusion (M, perfusion units, SP vs CA): 14.7 [12.1; 16.5] vs 10.1 [7.0; 12.5], P=0.0014), and decompensated mixed acidosis (pH, SP vs CA): 7.42 [7.40; 7.43] vs 7.20 [7.13; 7.23], P⩽0.0001) were documented in the CA group, however BP values were comparable (BP, mmHg, SP vs CA): 60 [58; 72] vs 67 [62; 82], P=0.482). At minute 120 post-resuscitation and at the end of intensive care period, both groups demonstrated similar values of the monitored parameters. Three out of 18 animals in the CA group died after resuscitation.</p></sec><sec><title>Conclusion</title><p>Conclusion. Electromechanical dissociation underlies CA in rats subjected to asphyxia. The use of LDF to assess peripheral blood ﬂow makes it possible to standardize the severity of ischemic reperfusion injuries and improve reproducibility of the model. Series of resuscitation measures in experimental setting is justiﬁed from a bioethical point of view, and makes it possible to improve repeatability of preclinical research results in clinical practice.</p></sec></trans-abstract><kwd-group xml:lang="ru"><kwd>остановка кровообращения</kwd><kwd>асфиксия</kwd><kwd>реанимационные мероприятия</kwd><kwd>экспериментальная модель</kwd><kwd>крыса</kwd></kwd-group><kwd-group xml:lang="en"><kwd>circulatory arrest</kwd><kwd>asphyxia</kwd><kwd>resuscitation measures</kwd><kwd>experimental model</kwd><kwd>rat</kwd></kwd-group></article-meta></front><back><ref-list><title>References</title><ref id="cit1"><label>1</label><citation-alternatives><mixed-citation xml:lang="ru">Nolan J. P., Sandroni C., Böttiger B. W., Cariou A., Cronberg T., Friberg H., Genbrugge C., et al. 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