Abstract:
OBJECTIVE:Erythrocytes influence the magnitude of hypoxia-induced pulmonary artery pressure increase. It is, however, unknown to what extent haemoconcentration and haemodilution affect this response and whether intrapulmonary blood volume (and thus vessel dimensions) alters the magnitude of pressure increase. Furthermore, it is unclear whether the haemodilution/ haemoconcentration-dependent pressure increase is flow-related, via flow-dependent changes in vasomotor tone or rheologic effects, or can also be observed under no-flow conditions. DESIGN:Experimental study in isolated rabbit lungs (n = 12) perfused with autologous blood at constant flow (100 ml/min) and ventilated with 5% carbon dioxide in air. SETTING:Laboratory for experimental studies. INTERVENTIONS:Haemoconcentration (centrifugation) and haemodilution (Krebs-Henseleit/albumin) were carried out, resulting in haematocrits between 50% and 0%. During hypoxic ventilation, inspiratory oxygen fraction was reduced from 0.20 to 0.03. MEASUREMENTS AND RESULTS:Under constant flow conditions, haemodilution (from a Hct of 34-36% to 0-1%) decreased hypoxic pulmonary artery pressure response to one-third (from 10.8 +/- 2.3 cmH2O to 3.1 +/- 1.0 cmH2O, P < 0.05), while haemoconcentration did not affect the magnitude of hypoxic response (10.5 +/- 2.0 cmH2O). For all haematocrit values an increase in pulmonary blood volume (by 5 ml) decreased the magnitude of pressure response. Hypoxia-induced changes in static vascular filling pressure (double occlusion pressure) and vascular compliance were used to assess the strength of hypoxic vasoconstriction under static conditions. Neither haemoconcentration nor haemodilution altered hypoxia-induced changes in either variable. CONCLUSIONS:The magnitude of the acute hypoxic pressure response is not altered by haemoconcentration, but significantly reduced by haemodilution. In contrast, neither haemoconcentration nor haemodilution influenced hypoxia-induced changes in static vascular filling pressure and compliance. This suggests that the degree of hypoxic pulmonary vasoconstriction is not affected under static conditions and that the red blood cell-dependence of the magnitude of hypoxic pressure response is based on flow-related mechanisms.
journal_name
Intensive Care Medjournal_title
Intensive care medicineauthors
Loer SA,Peters Jdoi
10.1007/s001340051327keywords:
subject
Has Abstractpub_date
2000-08-01 00:00:00pages
1124-30issue
8eissn
0342-4642issn
1432-1238journal_volume
26pub_type
杂志文章abstract::An 18-month-old male infant presented with hypoglycemic coma and clinical signs of bronchopneumonia. He was suspected of suffering from septic shock. The patient progressed to irreversible multiple organ failure before the diagnosis of adrenal crisis was established. Plasma levels of ACTH and cortisol remained undetec...
journal_title:Intensive care medicine
pub_type: 杂志文章
doi:10.1007/s001340050021
更新日期:2000-01-01 00:00:00
abstract:BACKGROUND:Limiting the duration of invasive ventilation is an important goal in caring for critically ill patients. Several clinical trials have shown that compared to traditional care, protocols can reduce the total duration of mechanical ventilation. Computerized or automated weaning has the potential to improve wea...
journal_title:Intensive care medicine
pub_type: 杂志文章,评审
doi:10.1007/s00134-008-1154-0
更新日期:2008-10-01 00:00:00
abstract::We report a fatal case of a child presenting Reye's syndrome associated with a variety of arrhythmias and ischemia-like ST-T ECG changes. At autopsy, fatty infiltration and patchy myocytolysis were detected in sections of the heart. This case report emphasizes cardiac involvement in Reye's syndrome and the possible me...
journal_title:Intensive care medicine
pub_type: 杂志文章
doi:10.1007/BF01728333
更新日期:1996-01-01 00:00:00
abstract:OBJECTIVE:To test the feasibility of the transcardiac conductance (TCC) method for continuous, on-line measurement of absolute left ventricular (LV) volume and to validate the method by comparison with biplane angiography. DESIGN AND SETTING:Prospective clinical feasibility and validation study in a cardiac catheteriz...
journal_title:Intensive care medicine
pub_type: 临床试验,杂志文章
doi:10.1007/s00134-004-2300-y
更新日期:2004-07-01 00:00:00
abstract:PURPOSE:Rapid shallow breathing may occur at any time during spontaneous breathing trials (SBT), questioning the utility of a single determination of the rapid shallow breathing index (RSBI). We hypothesize that change in RSBI during SBT may more accurately predict successful extubation than a single determination. ME...
journal_title:Intensive care medicine
pub_type: 杂志文章
doi:10.1007/s00134-009-1735-6
更新日期:2010-03-01 00:00:00
abstract:OBJECTIVE:To investigate the effects of prone positioning on systemic hemodynamics, intra-abdominal pressure (IAP), plasma disappearance rate of indocyanine green (PDR(ICG)), and gastric intramucosal to arterial PCO2 difference (Pi-aCO2). DESIGN AND SETTING:Prospective randomized study in the intensive care unit of a ...
journal_title:Intensive care medicine
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1007/s00134-001-1166-5
更新日期:2002-01-01 00:00:00
abstract:OBJECTIVE:To measure water balance and changes in distribution, and the effect of giving supplementary albumin, early after a burn injury. DESIGN:Consecutive patients (matched groups) and healthy controls. SETTING:National burn unit in a Swedish university hospital. PATIENTS AND SUBJECTS:Eighteen patients with 18%-9...
journal_title:Intensive care medicine
pub_type: 杂志文章
doi:10.1007/s001340100935
更新日期:2001-05-01 00:00:00
abstract:OBJECTIVE:In contrast to indocyanine green (ICG) blood clearance, the plasma disappearance rate (PDR) of ICG does not require absolute ICG blood concentrations and today can be assessed transcutaneously. In this study, we analyzed the relation between ICG disappearance rate and ICG blood clearance as parameters of live...
journal_title:Intensive care medicine
pub_type: 杂志文章
doi:10.1007/s00134-006-0109-6
更新日期:2006-05-01 00:00:00
abstract:OBJECTIVE:To determine the relation of malnutrition and underlying diagnosis to the length of stay in the Intensive Care Unit (ICU) and to mortality after lung transplantation (LTX). DESIGN:Retrospective ICU chart review. SETTING:Cardiothoracic ICU in a University hospital. PATIENTS:Fifty-one consecutive patients wh...
journal_title:Intensive care medicine
pub_type: 杂志文章
doi:10.1007/BF01709333
更新日期:1996-11-01 00:00:00
abstract::One hundred and eighteen 20-g radial artery catheters were prospectively evaluated in 109 cardiovascular surgical patients. 0.024% papaverine in saline was used as a continuous flushing solution. Using the Doppler method, obstruction of the radial artery with the catheter in situ was found in 11 (9.8%) patients. Decan...
journal_title:Intensive care medicine
pub_type: 杂志文章
doi:10.1007/BF00254675
更新日期:1986-01-01 00:00:00
abstract::Hepatic encephalopathy is a complex neuropsychiatric syndrome associated with acute, subacute and chronic liver failure, involving increased neural inhibition by activation of the GABA/benzodiazepine inhibitory neurotransmitter system. Improvement by GABA and benzodiazepine receptor antagonists as well as by chloride ...
journal_title:Intensive care medicine
pub_type: 杂志文章,评审
doi:10.1007/BF01731153
更新日期:1991-01-01 00:00:00
abstract::In oleic acid-induced pulmonary oedema (OAPO) sequential intrapulmonary fluid accumulation occurs leading to different expiratory flow pattern in dependent lung regions. The potential effects on efficacy of high-frequency jet ventilation (HFJV, f = 3 Hz, I: E = 0.43, FiO2 = 0.4) were studied and compared with continuo...
journal_title:Intensive care medicine
pub_type: 杂志文章
doi:10.1007/BF00295986
更新日期:1989-01-01 00:00:00
abstract::Clearly the main determinant of outcome in severe acute pancreatitis is the extent of pancreatic necrosis and the subsequent risk for the development of infected necrosis. A thorough assessment using appropriate scoring systems and the early use of dynamic contrast-enhanced CT will highlight those patients likely to b...
journal_title:Intensive care medicine
pub_type: 杂志文章,评审
doi:10.1007/s001340050808
更新日期:1999-02-01 00:00:00
abstract::We evaluated the effect of a cimetidine continuous infusion (2 g in 24 h) on the intragastric pH of 16 critically ill patients (11 men, 5 women, mean age 45 years). During the 24 h pre-trial period and the subsequent 24 h cimetidine infusion, an intragastric combined electrode was placed in the fundus and the pH recor...
journal_title:Intensive care medicine
pub_type: 杂志文章
doi:10.1007/BF00262892
更新日期:1988-01-01 00:00:00
abstract:OBJECTIVE:To analyze the effect of endothelin-1 on pulmonary arterial and venous contractile force in vitro and on up- and downstream pulmonary vascular resistance in vivo under sham and endotoxemic conditions in pigs. MATERIALS AND METHODS:In vitro: paired preparations of pulmonary arteries and veins were mounted in ...
journal_title:Intensive care medicine
pub_type: 杂志文章
doi:10.1007/s00134-007-0980-9
更新日期:2008-05-01 00:00:00
abstract::Changes in the inspiratory flow rate of mechanically ventilated patients can affect arterial oxygenation. Although the mechanism producing this alteration is not certain, one possible mechanism is a change in ventilation inhomogeneity. This study was performed to determine if the inspiratory flow setting would affect ...
journal_title:Intensive care medicine
pub_type: 杂志文章
doi:10.1007/BF00254316
更新日期:1984-01-01 00:00:00
abstract:OBJECTIVES:(a). To describe the glucose content of normal human airways secretions; (b). to observe the effects of hyperglycemia and airways inflammation on airways glucose. DESIGN:Observational studies. SETTINGS:(a). St George's Hospital Medical School; (b). diabetes mellitus outpatient clinics; (c). adult general i...
journal_title:Intensive care medicine
pub_type: 杂志文章
doi:10.1007/s00134-003-1961-2
更新日期:2003-12-01 00:00:00
abstract:OBJECTIVE:To report the first case of ARDS in children treated with nitric oxide (NO) inhalation. METHODS:A 13-months infant presented with BPD and severe hypoxemia related to RSV infection and ARDS. Inhaled NO was delivered in the ventilatory circuit of a continuous flow ventilator (Babylog 8000, Dräger) in a concent...
journal_title:Intensive care medicine
pub_type: 杂志文章
doi:10.1007/BF01711907
更新日期:1994-08-01 00:00:00
abstract::Fifteen polytrauma patients with asymmetric pulmonary contusion were treated with differential lung ventilation (DLV) for a mean of 106 hours (range 24-298, median 83). The differential time constant (Tc), compliance (Ct), inspiratory and expiratory airway resistance (Rawinsp, Rawexp) and peak-airway pressure (Pawpeak...
journal_title:Intensive care medicine
pub_type: 杂志文章
doi:10.1007/BF00255602
更新日期:1989-01-01 00:00:00
abstract:PURPOSE:Acute kidney injury (AKI) frequently occurs in critically ill patients and often precipitates use of renal replacement therapy (RRT). However, the ideal circumstances for whether and when to start RRT remain unclear. We performed evidence synthesis of the available literature to evaluate the value of biomarkers...
journal_title:Intensive care medicine
pub_type: 杂志文章,评审
doi:10.1007/s00134-018-5126-8
更新日期:2018-03-01 00:00:00
abstract:OBJECTIVE:The Guillain-Barré syndrome (GBS) is an acute inflammatory polyneuropathy related to autoimmunity. However, no conclusive etiological concept has yet been found. We examined the variation in autoantibodies to lipids in serum of GBS patients in response to the course of the disease but investigated titer modif...
journal_title:Intensive care medicine
pub_type: 杂志文章
doi:10.1007/s00134-005-2736-8
更新日期:2005-10-01 00:00:00
abstract:OBJECTIVE:We undertook this study to evaluate the influence of the inspiration:expiration (I:E) ratio on intracranial pressure and cerebral perfusion in patients with acute stroke. DESIGN:Ventilated patients with acute stroke were examined under a protocol involving variations of I:E ratio from 1:2 to 1:1 to 1:2 under...
journal_title:Intensive care medicine
pub_type: 杂志文章
doi:10.1007/s00134-002-1351-1
更新日期:2002-08-01 00:00:00
abstract:OBJECTIVE:To test the hypothesis whether PMN-Elastase in bronchoalveolar lavage fluid (BALF) could reflect neutrophil activity in the lower respiratory tract. DESIGN:Prospectively, morphologic findings of acute and chronic inflammation in the transbronchial lung biopsy specimens were compared with the numbers of neutr...
journal_title:Intensive care medicine
pub_type: 杂志文章
doi:10.1007/BF01720908
更新日期:1994-05-01 00:00:00
abstract:OBJECTIVE:In normal subjects cerebral CO2 vasoreactivity is measured during spontaneous hyperventilation, breathholding, or adding CO2 to inspiratory gases. The correlation between CO2 and cerebral blood flow may, however, be invalidated by the effects of a modified respiratory pattern on venous return, sympathovagal b...
journal_title:Intensive care medicine
pub_type: 临床试验,杂志文章
doi:10.1007/s001340051239
更新日期:2000-06-01 00:00:00
abstract:PURPOSE:To provide evidence-based guidelines for early enteral nutrition (EEN) during critical illness. METHODS:We aimed to compare EEN vs. early parenteral nutrition (PN) and vs. delayed EN. We defined "early" EN as EN started within 48 h independent of type or amount. We listed, a priori, conditions in which EN is o...
journal_title:Intensive care medicine
pub_type: 杂志文章,meta分析,实务指引,评审
doi:10.1007/s00134-016-4665-0
更新日期:2017-03-01 00:00:00
abstract:OBJECTIVE:To provide evidence for the upregulation of endothelial nitric oxide synthase (eNOS) or inducible nitric oxide synthase (iNOS) in the assumed imbalance in the pathophysiology of rapid progressive pulmonary hypertension of the newborn (RPPHN), which is characterized by abnormal hypertrophy of the pulmonary art...
journal_title:Intensive care medicine
pub_type: 杂志文章
doi:10.1007/s00134-003-1892-y
更新日期:2003-10-01 00:00:00
abstract:OBJECTIVE:To derive recommendations for the dosing of commonly used medications in the morbidly obese patient in the ICU. DATA SOURCES:Articles were obtained through computerized searches involving MEDLINE. The bibliographies of retrieved publications and textbooks were reviewed for additional references. STUDY SELEC...
journal_title:Intensive care medicine
pub_type: 杂志文章,评审
doi:10.1007/s00134-003-2059-6
更新日期:2004-01-01 00:00:00
abstract:OBJECTIVE:A closed suction system (CS) maintains connection with the mechanical ventilator during tracheal suctioning and is claimed to limit loss in lung volume and oxygenation. We compared changes in lung volume, oxygenation, airway pressure and hemodynamics during endotracheal suctioning performed with CS and with a...
journal_title:Intensive care medicine
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1007/s001340100897
更新日期:2001-04-01 00:00:00
abstract:OBJECTIVE:To evaluate the perceived health and cognitive status in survivors of chronic obstructive pulmonary disease (COPD) exacerbations requiring mechanical ventilation. DESIGN AND SETTING:Prospective controlled cohort study in a respiratory intermediate intensive care unit. PATIENTS:Sixty-three COPD patients at t...
journal_title:Intensive care medicine
pub_type: 临床试验,杂志文章
doi:10.1007/s00134-001-1165-6
更新日期:2002-02-01 00:00:00
abstract:PURPOSE:Extracorporeal life support (ECLS) is used for patients with refractory heart failure with or without respiratory failure. This temporary support is provided by blood pumps which are connected to large vessels. Bleeding episodes are a typical complication in patients with ECLS. Recently, several studies illustr...
journal_title:Intensive care medicine
pub_type: 杂志文章
doi:10.1007/s00134-011-2370-6
更新日期:2012-01-01 00:00:00