Comparisons of Three Surgical Procedures on Intestine Ischemia Reperfusion Injury in a Superior Mesenteric Artery Injury Model

Ding, Weiwei; Li, Jieshou; Ni, Lideng; Zhao, Kun; Ji, Wu; Li, Ning; Wu, Xingjiang

doi:10.1016/j.jss.2009.07.010

Cited by 3 publications

(4 citation statements)

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“…Systematic reviews of animal intervention studies are therefore important to guide the transition of scientific findings from the bench to the bedside [ 78 ]. These reviews may be used to determine that interventions with consistent positive outcomes across several experimental studies may safely be generalized to the design and conduct of clinical trials [ 29 , 30 , 55 , 79 ]. For example, a systematic review of the effect of hypothermia in acute ischemic stroke demonstrated that infarct size was consistently reduced across all animal models when core body temperature was cooled to approximately 35°C [ 79 ].…”

Section: Discussionmentioning

confidence: 99%

“…Several systematic reviews have suggested how the design, construct validity, methodological rigor, and reporting of animal studies may be improved such that their relevance to human healthcare is enhanced [ 56 , 57 , 82 ]. In addition, the compilation of world literature regarding pre-clinical animal models outlines which studies have already been conducted in animals, thereby potentially preventing wasteful allocation of future resources to studies that will be ineffective or repetitive (and protecting animals from potentially unwarranted future experimentation) [ 30 ].…”

Section: Discussionmentioning

confidence: 99%

“…These types of studies may also be used to provide a biological foundation for surgical procedures [ 28 , 29 ]. Thus, the efficacy and safety of damage control may potentially be able to be informed by research conducted in animals [ 30 - 40 ].…”

Section: Introductionmentioning

confidence: 99%

“…In support of this, a large number of animal studies have evaluated the efficacy of damage control surgery and specific damage control interventions (e.g., rapid bowel ligation without reanastomosis [ 31 , 41 ], intraluminal balloon occlusion of the aorta [ 33 , 42 ], and temporary intravascular shunting of the superior mesenteric artery [ 30 , 39 , 40 ]) or adjuncts (e.g., commercial topical hemostatic agents for massively bleeding groin injuries [ 37 , 43 ]). See Table 1 for a complete list of damage control interventions/adjuncts that are currently used in clinical practice, including a sample of those that have been evaluated in animal models [ 30 - 32 , 39 - 41 , 43 - 53 ]. These studies may collectively provide insight into which interventions have the most promise for further clinical evaluation and use [ 27 , 29 , 54 ].…”

Section: Introductionmentioning

confidence: 99%

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Efficacy and safety of damage control in experimental animal models of injury: protocol for a systematic review and meta-analysis

2014

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BackgroundAlthough abbreviated surgery with planned reoperation (damage control surgery) is now widely used to manage major trauma patients, the procedure and its component interventions have not been evaluated in randomized controlled trials (RCTs). While some have suggested the need for such trials, they are unlikely to be conducted because of patient safety concerns. As animal studies may overcome several of the limitations of existing observational damage control studies, the primary objective of this study is to evaluate the efficacy and safety of damage control versus definitive surgery in experimental animal models of injury.Methods/designWe will search electronic databases (Medline, Embase, PubMed, Web of Science, Scopus, and the Cochrane Library), conference abstracts, personal files, and bibliographies of included articles. We will include RCTs and prospective cohort studies that utilized an animal model of injury and compared damage control surgery (or specific damage control interventions or adjuncts) to definitive surgery (or specific definitive surgical interventions). Two investigators will independently evaluate the internal and external/construct validity of individual studies. The primary outcome will be all-cause mortality. Secondary outcomes will include blood loss amounts; blood pressures and heart rates; urinary outputs; core body temperatures; arterial lactate, pH, and base deficit/excess values; prothrombin and partial thromboplastin times; international normalized ratios; and thromboelastography (TEG) results/activated clotting times. We will calculate summary relative risks (RRs) of mortality and mean differences (for continuous outcomes) using DerSimonian and Laird random effects models. Heterogeneity will be explored using subgroup meta-analysis and meta-regression. We will assess for publication bias using funnel plots and Begg’s and Egger’s tests. When evidence of publication bias exists, we will use the Duval and Tweedie trim and fill method to estimate the potential influence of this bias on pooled summary estimates.DiscussionThis study will evaluate the efficacy and safety of damage control in experimental animal models of injury. Study results will be used to guide future clinical evaluations of damage control surgery, determine which animal study outcomes may potentially be generalizable to the clinical setting, and to provide guidelines to strengthen the conduct and relevance of future pre-clinical studies.

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