CONCEPTS animal research
The Use of Animals for Research in Emergency Medicine
From the Research Committee, Societyfor Academic Emergency Medicine, Lansing, Michigan.
Society for Academic Emergency Medicine
Received for publication November 8, 1991. Accepted for publication November 26, 1991. This position statement was developed by the SAEM Research Committee and opproved by the Board of Directors.
[Yealy D, Levitt A, Heggers J, Spivey W, Abramson N, Angeles M, Biros M, Cline D, Derlet R, Dire D, Fligner D, Goldfrank L, Henneman P, Krause G, Lowe R, Martin G, Mickel H, Neumar R, @son J, Runge J, Van Ligten P, Zalenski R, Zink B: The use of animals for research in emergency medicine. Ann EmergMed September1992;21:1138-1139.] INTRODUCTION Animals have been used in medical research for centuries, and data gathered from these experiments have b r o a d e n e d the understanding of human physiology and disease. F o r example, the basic observations that led to the understanding of circulation and gas exchange were made in animal studies, x-4 The direct benefit of this knowledge has been an improvement in the length and quahty of human life. Despite these benefits, opposition to animal research has been present for nearly 400 years in Europe and more than 100 years in the United states. 3-5 Recently, protection of animals has become a p o p u l a r cause for both the lay and scientific communities. ¢-7 Highly publicized activities and protests have served to galvanize the forces seeking to limit the use of animals for research, including both industrial and medical investigations. Animal protection activists usually disseminate materials that supp o r t their positions and organize legal challenges to impede the use of animals for medical research. However, some groups seeking to "protect" animals have resorted to terroristic activities, such as bombings and death threats.2 The American Medical Association recently released a consensus document 4 that supports the use of animals in biomedical research. The Society for Academic Emergency Medicine supports these positions and wishes to offer a brief emergency medicine perspective and position statement.
ANIMAL
RESEARCH
IN E M E R G E N C Y
MEDICINE
Research in emergency medicine addresses the mechanisms and treatment of acute illnesses. F o r example, observations in animal models have led to a better understanding of artificial circulatory support and resuscitation during cardiopulmonary arrest, a 14 the treatment of hemorrhagic shock ~s-17 and overdoses, 18,19 and airway management.20 Although the data from these and other emergency medicine research
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A N I M A L RESEARCH SAEM
areas have been beneficial, more research is needed to better u n d e r s t a n d and treat the varied problems of patients seeking care in the emergency department. THE
SAEM
POSITION
ON
ANIMAL
RESEARCH
The following outlines the position of the SAEM on the use of animals in emergency medicine research: • Animal research is necessary to improve the care and quality of life for human beings and to enhance the knowledge base in emergency medicine; in many instances, there are no available substitutes for carefully designed animal research trials. "Where appropriate, research using alternative techniques 21 such as computer modeling or organ, tissue, and cell cultures is encouraged to decrease the n u m b e r of animal trials needed. "Basic principles of research must be followed when performing research with an animal model. The research hypothesis must be clear, testable, and in need of investigation. Allprevious research must be reviewed before data collection. The proper model, based on previous data, must be chosen. A pretrial power calculation must be performed to ensure that an adequate n u m b e r of animals is studied and that no animals are needlessly enrolled. All trials must be approved by an animal review committee. Adequate anesthesia and analgesia must be provided unless extenuating conditions exist, and animals must be treated with respect throughout the trials, with humane euthanasia provided as indicated. 21-23 "Local institutions, through the investigators, research directors, and animal review board members, must monitor all animal research closely to uncover cruelty or waste. • SAEM will monitor all animal research trials presented at its national and regional meetings to ensure that the quality and execution meet the aforementioned standards. No trial without approval by an animal use committee will be accepted for presentation or publication. Researchers suspected of animal cruelty in any form deserve an opportunity to defend their protocols to their peers. Ultimately, all physicians must participate in this process by critically appraising animal experiments.
REFERENCES 1. Animals in research. JAMA 1989;261:3602-3606. 2. Loeb JM, Hendee WR, Smith SJ, et al: Human vs animal rights: In defense of animal research. JAMA 1989;262:2716-2720. 3. Smith SJ, Evans RM, Sullivan-Fowler M, et al: Use of animals in biomedical research. Historical role of the American Medical Association and the American physician. Arch Intern Med 1988;148:1849-1853. 4. American Medical Association: Use of Animals in Biomedical Research: The Chaflenge and Response, white paper. Chicago, AMA, 1989. 5. Rowan AN, Rollins BE: Animal research--for and against: A philosophical, social, and historical perspective. PerspectBiolMed 1983;27:1-17. 6. Ryder R: Victims of Science. London, Davis-Poynter, 1975. 7. Singer P: Animal Liberation: A New Ethic for Our Treatmentof Animals. New York, Random House, Inc, 1975. 8. Luce JM, Ross BK, O'Quin RJ, et al: Regional blood flow during cardiopulmanary resuscitation in dogs using simultaneous and non-simultaneous compression and ventilation. Circulation 1983;67:258-265. 9. Maier GW, Tyson GS, O[sen CO, et al: The physiology of external cardiac massage: High-impulse cardiopulmonary resuscitation. Circulation 1984;70:86-101. 10. Brown CG, Werman HA, Davis EA, et al: Comparative effect of graded doses of epinephrine on regional brain blood flow during CPR in a swine model. Ann Emerg Med 1986;15:1138-1144. 11. Brown CG, Werman HA, Davis EA, et el: The effect of graded doses of epinephrine on regional myocardial blood flow during cardiopulmonarv resuscitation in swine. Circulation 1987;75:491-497. 12. Hoekstra JW, Rinnert K, Van Ligten P, et al: The effectiveness of bystander CPR in an animal model. Ann Emerg Med 1990;19:881-886. 13. Angeles M, Gaddis M, 6addis G, et el: Cardiopulmonary bypass in a model of acute myocardial infarction and cardiac arrest. Ann Emerg Med 1990;19:874-880. 14. Niemann JT, Rosborough JP, Pelikan PCD: Hemodynamic determinants of subdiaphragmatic venous return during closed chest CPR in a canine cardiac arrest mode[. Ann Emerg Med 1990;19:1232-1237. 15. Bickell WH, Bruttig SP, Wade CE, et al: The detrimental effects of IV crystalloid after aortotomy in the swine. Ann Emerg Met 1989;18:476. 16. Van Ligten PF, Messick GM, Neumar R, et al: Norepinephrine in hemorrhagic shock. Ann Emerg Med 1989;18:460. 17. Mazzoni MC, Borgstrom P, Arfors KE, et al: The efficacy of [so- and hyperosmotic fluids as volume expanders in fixed-volume and uncontrolled hemorrhage. Ann Emerfl M ed 1990;19:350-358. 18. Spivey WH, Schoffstall JM, Kirkpatrick R, et al: Comparison of labetolol, diazepam, and haloperidol for the treatment of cocaine toxicity in a swine model. Ann Emerg Med 1990;19:467-468. 19. Schoffsta]l JM, Spivey WH, Gambone L, et el: Comparison of epinephrine and calcium therapy of calcium channel blocker toxicity in a conscious dog model (abstract). Ann Emerg IVied1990;19:468. 20. Yealy DM, Plewa MC, Reed J J, et al: Manual translaryngeal jet ventilation and the risk of aspiration in a canine model. Ann Emerg Med 1990;19:1238-1241. 21. Alternatives to Animal Use in Research, Testing,and Education. Washington, DC, Office of Technology Assessment, Publication OTA-BA-273, 1986. 22. Committee on the Use of Animals in Biomedical and Behavioral Research: Use of Laboratory in Biomediealand BehavioralResearch. Washington, DC, National Academy Press, 1988. 23. Biomedical Investigator's Handbook. Washington, DC, Foundation for Biomedical Research, 1987. Address for reprints: Mary Ann Schropp Society for Academic Emergency Medicine 900 West Ottawa Street Lansing, Michigan 48915
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The Use of Animals for Research in Emergency Medicine
From the Research Committee, Societyfor Academic Emergency Medicine, Lansing, Michigan.
Society for Academic Emergency Medicine
Received for publication November 8, 1991. Accepted for publication November 26, 1991. This position statement was developed by the SAEM Research Committee and opproved by the Board of Directors.
[Yealy D, Levitt A, Heggers J, Spivey W, Abramson N, Angeles M, Biros M, Cline D, Derlet R, Dire D, Fligner D, Goldfrank L, Henneman P, Krause G, Lowe R, Martin G, Mickel H, Neumar R, @son J, Runge J, Van Ligten P, Zalenski R, Zink B: The use of animals for research in emergency medicine. Ann EmergMed September1992;21:1138-1139.] INTRODUCTION Animals have been used in medical research for centuries, and data gathered from these experiments have b r o a d e n e d the understanding of human physiology and disease. F o r example, the basic observations that led to the understanding of circulation and gas exchange were made in animal studies, x-4 The direct benefit of this knowledge has been an improvement in the length and quahty of human life. Despite these benefits, opposition to animal research has been present for nearly 400 years in Europe and more than 100 years in the United states. 3-5 Recently, protection of animals has become a p o p u l a r cause for both the lay and scientific communities. ¢-7 Highly publicized activities and protests have served to galvanize the forces seeking to limit the use of animals for research, including both industrial and medical investigations. Animal protection activists usually disseminate materials that supp o r t their positions and organize legal challenges to impede the use of animals for medical research. However, some groups seeking to "protect" animals have resorted to terroristic activities, such as bombings and death threats.2 The American Medical Association recently released a consensus document 4 that supports the use of animals in biomedical research. The Society for Academic Emergency Medicine supports these positions and wishes to offer a brief emergency medicine perspective and position statement.
ANIMAL
RESEARCH
IN E M E R G E N C Y
MEDICINE
Research in emergency medicine addresses the mechanisms and treatment of acute illnesses. F o r example, observations in animal models have led to a better understanding of artificial circulatory support and resuscitation during cardiopulmonary arrest, a 14 the treatment of hemorrhagic shock ~s-17 and overdoses, 18,19 and airway management.20 Although the data from these and other emergency medicine research
~SEPTEMBER1992 21:9 ANNALSOF EMERGENCYMEDIOINE
1138/125
A N I M A L RESEARCH SAEM
areas have been beneficial, more research is needed to better u n d e r s t a n d and treat the varied problems of patients seeking care in the emergency department. THE
SAEM
POSITION
ON
ANIMAL
RESEARCH
The following outlines the position of the SAEM on the use of animals in emergency medicine research: • Animal research is necessary to improve the care and quality of life for human beings and to enhance the knowledge base in emergency medicine; in many instances, there are no available substitutes for carefully designed animal research trials. "Where appropriate, research using alternative techniques 21 such as computer modeling or organ, tissue, and cell cultures is encouraged to decrease the n u m b e r of animal trials needed. "Basic principles of research must be followed when performing research with an animal model. The research hypothesis must be clear, testable, and in need of investigation. Allprevious research must be reviewed before data collection. The proper model, based on previous data, must be chosen. A pretrial power calculation must be performed to ensure that an adequate n u m b e r of animals is studied and that no animals are needlessly enrolled. All trials must be approved by an animal review committee. Adequate anesthesia and analgesia must be provided unless extenuating conditions exist, and animals must be treated with respect throughout the trials, with humane euthanasia provided as indicated. 21-23 "Local institutions, through the investigators, research directors, and animal review board members, must monitor all animal research closely to uncover cruelty or waste. • SAEM will monitor all animal research trials presented at its national and regional meetings to ensure that the quality and execution meet the aforementioned standards. No trial without approval by an animal use committee will be accepted for presentation or publication. Researchers suspected of animal cruelty in any form deserve an opportunity to defend their protocols to their peers. Ultimately, all physicians must participate in this process by critically appraising animal experiments.
REFERENCES 1. Animals in research. JAMA 1989;261:3602-3606. 2. Loeb JM, Hendee WR, Smith SJ, et al: Human vs animal rights: In defense of animal research. JAMA 1989;262:2716-2720. 3. Smith SJ, Evans RM, Sullivan-Fowler M, et al: Use of animals in biomedical research. Historical role of the American Medical Association and the American physician. Arch Intern Med 1988;148:1849-1853. 4. American Medical Association: Use of Animals in Biomedical Research: The Chaflenge and Response, white paper. Chicago, AMA, 1989. 5. Rowan AN, Rollins BE: Animal research--for and against: A philosophical, social, and historical perspective. PerspectBiolMed 1983;27:1-17. 6. Ryder R: Victims of Science. London, Davis-Poynter, 1975. 7. Singer P: Animal Liberation: A New Ethic for Our Treatmentof Animals. New York, Random House, Inc, 1975. 8. Luce JM, Ross BK, O'Quin RJ, et al: Regional blood flow during cardiopulmanary resuscitation in dogs using simultaneous and non-simultaneous compression and ventilation. Circulation 1983;67:258-265. 9. Maier GW, Tyson GS, O[sen CO, et al: The physiology of external cardiac massage: High-impulse cardiopulmonary resuscitation. Circulation 1984;70:86-101. 10. Brown CG, Werman HA, Davis EA, et al: Comparative effect of graded doses of epinephrine on regional brain blood flow during CPR in a swine model. Ann Emerg Med 1986;15:1138-1144. 11. Brown CG, Werman HA, Davis EA, et el: The effect of graded doses of epinephrine on regional myocardial blood flow during cardiopulmonarv resuscitation in swine. Circulation 1987;75:491-497. 12. Hoekstra JW, Rinnert K, Van Ligten P, et al: The effectiveness of bystander CPR in an animal model. Ann Emerg Med 1990;19:881-886. 13. Angeles M, Gaddis M, 6addis G, et el: Cardiopulmonary bypass in a model of acute myocardial infarction and cardiac arrest. Ann Emerg Med 1990;19:874-880. 14. Niemann JT, Rosborough JP, Pelikan PCD: Hemodynamic determinants of subdiaphragmatic venous return during closed chest CPR in a canine cardiac arrest mode[. Ann Emerg Med 1990;19:1232-1237. 15. Bickell WH, Bruttig SP, Wade CE, et al: The detrimental effects of IV crystalloid after aortotomy in the swine. Ann Emerg Met 1989;18:476. 16. Van Ligten PF, Messick GM, Neumar R, et al: Norepinephrine in hemorrhagic shock. Ann Emerg Med 1989;18:460. 17. Mazzoni MC, Borgstrom P, Arfors KE, et al: The efficacy of [so- and hyperosmotic fluids as volume expanders in fixed-volume and uncontrolled hemorrhage. Ann Emerfl M ed 1990;19:350-358. 18. Spivey WH, Schoffstall JM, Kirkpatrick R, et al: Comparison of labetolol, diazepam, and haloperidol for the treatment of cocaine toxicity in a swine model. Ann Emerg Med 1990;19:467-468. 19. Schoffsta]l JM, Spivey WH, Gambone L, et el: Comparison of epinephrine and calcium therapy of calcium channel blocker toxicity in a conscious dog model (abstract). Ann Emerg IVied1990;19:468. 20. Yealy DM, Plewa MC, Reed J J, et al: Manual translaryngeal jet ventilation and the risk of aspiration in a canine model. Ann Emerg Med 1990;19:1238-1241. 21. Alternatives to Animal Use in Research, Testing,and Education. Washington, DC, Office of Technology Assessment, Publication OTA-BA-273, 1986. 22. Committee on the Use of Animals in Biomedical and Behavioral Research: Use of Laboratory in Biomediealand BehavioralResearch. Washington, DC, National Academy Press, 1988. 23. Biomedical Investigator's Handbook. Washington, DC, Foundation for Biomedical Research, 1987. Address for reprints: Mary Ann Schropp Society for Academic Emergency Medicine 900 West Ottawa Street Lansing, Michigan 48915
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