Variability of splanchnic blood flow in patients with sepsis.

Abstract:

OBJECTIVES:Previous studies on therapeutic interventions in sepsis have assumed stability of the measure of splanchnic blood flow throughout the study. We assessed the variability of splanchnic blood flow during stable global hemodynamics in eight patients with sepsis requiring treatment with dobutamine and/or norepinephrine. DESIGN AND SETTING:Prospective clinical study in an intensive care unit of a university hospital. MEASUREMENTS AND RESULTS:Global and regional hemodynamics were measured at baseline, 2 h later, and 4 h later. Cardiac output was measured by transpulmonary thermodilution, intrathoracic blood volume as an indicator of cardiac preload, and total blood volume by the double indicator (thermo-dye) dilution technique. Total body oxygen consumption was assessed by indirect calorimetry using a metabolic cart. Splanchnic blood flow was measured by the continuous indocyanine green method, and gastric mucosal CO2 tension by gas tonometry. Neither absolute nor fractional splanchnic blood flow (as ratio of cardiac output) revealed significant global tendencies during the study period. However, variance component analysis showed that splanchnic blood flow determinations varied considerably within patients, for repeated measurements at 5-min intervals (standard error 31.1%) as well as for average values at 2-h intervals (25.6%). CONCLUSION:Stable global hemodynamics during a 4-h period in septic patients does not exclude marked changes in splanchnic blood measured by a hepatic venous catheter technique.

journal_name

Intensive Care Med

journal_title

Intensive care medicine

authors

Sakka SG,Reinhart K,Wegscheider K,Meier-Hellmann A

doi

10.1007/s001340100980

keywords:

subject

Has Abstract

pub_date

2001-08-01 00:00:00

pages

1281-7

issue

8

eissn

0342-4642

issn

1432-1238

journal_volume

27

pub_type

杂志文章
  • ICU-acquired candidemia within selective digestive decontamination studies: a meta-analysis.

    abstract:PURPOSE:To estimate the direct and indirect (contextual) effects of the factorized constituents of selective digestive decontamination and selective oropharyngeal decontamination (SDD/SOD), being topical antibiotic (TA) and protocolized antifungal prophylaxis (PAFP), on ICU-acquired candidemia. METHODS:A broad range o...

    journal_title:Intensive care medicine

    pub_type: 杂志文章,meta分析

    doi:10.1007/s00134-015-4004-x

    authors: Hurley JC

    更新日期:2015-11-01 00:00:00

  • Effects of reducing beta-lactam antibiotic pressure on intestinal colonization of antibiotic-resistant gram-negative bacteria.

    abstract:BACKGROUND:We determined the effects of two antibiotic policies (predominance of either beta-lactam antibiotics or fluroquinolones) on acquisition with third-generation cephalosporin-resistant Enterobacteriaceae (CRE) and fluoroquinolone-resistant CRE (FCRE) in two ICUs, with monitoring of other variables that may infl...

    journal_title:Intensive care medicine

    pub_type: 杂志文章,多中心研究,随机对照试验

    doi:10.1007/s00134-009-1714-y

    authors: Nijssen S,Fluit A,van de Vijver D,Top J,Willems R,Bonten MJ

    更新日期:2010-03-01 00:00:00

  • Nonsurgical control of upper gastrointestinal hemorrhage in old age patients: intragastric norepinephrine and endoscopic alcoholization of lesions.

    abstract::Of 28 consecutive patients over 64 years old, in whom endoscopy revealed gastro-duodenal ulcers with signs of recent hemorrhage (active bleeding, non-bleeding vessel or adherent clot), 14 were randomly assigned to receive endoscopic alcoholization of the lesions preceded by intragastric instillation of norepinephrine,...

    journal_title:Intensive care medicine

    pub_type: 临床试验,杂志文章,随机对照试验

    doi:10.1007/BF01724799

    authors: Acalovschi I,Pascu O,Drăghici A

    更新日期:1990-01-01 00:00:00

  • Long-term evaluation of granulocyte-colony stimulating factor on hypoxic-ischemic brain damage in infant rats.

    abstract:PURPOSE:Hypoxia-ischemia (HI), as a major cause of fetal brain damage, has long-lasting neurological implications. Therefore, therapeutic interventions that attenuate the neuropathological outcome of HI while also improving the neurofunctional outcome are of paramount clinical importance. The aim of this study was to i...

    journal_title:Intensive care medicine

    pub_type: 杂志文章

    doi:10.1007/s00134-010-1913-6

    authors: Fathali N,Lekic T,Zhang JH,Tang J

    更新日期:2010-09-01 00:00:00

  • Pressure support ventilation (PSV) reverses hyperinflation induced isorhythmic A-V dissociation.

    abstract::We report a case of hyperinflation induced isorythmic atrio-ventricular dissociation with circulatory failure in a patient with chronic obstructive pulmonary disease. The arrythmia was successfully treated by applying "pressure support ventilation" (PSV: 20 cmH2O) which, by decreasing the respiratory rate and increasi...

    journal_title:Intensive care medicine

    pub_type: 杂志文章

    doi:10.1007/BF00263868

    authors: Conti G,Bufi M,Antonelli M,Rocco M,Gasparetto A

    更新日期:1989-01-01 00:00:00

  • Profound and persistent decrease of circulating dendritic cells is associated with ICU-acquired infection in patients with septic shock.

    abstract:PURPOSE:Septic shock induces a decrease in dendritic cells (DCs) that may contribute to sepsis-induced immunosuppression. We analyzed the time course of circulating DCs in patients with septic shock and its relation to susceptibility to intensive care unit (ICU)-acquired infections. METHODS:We enrolled adult patients ...

    journal_title:Intensive care medicine

    pub_type: 杂志文章

    doi:10.1007/s00134-011-2306-1

    authors: Grimaldi D,Louis S,Pène F,Sirgo G,Rousseau C,Claessens YE,Vimeux L,Cariou A,Mira JP,Hosmalin A,Chiche JD

    更新日期:2011-09-01 00:00:00

  • Errors in tracheal pressure recording in patients with a tracheostomy tube--a model study.

    abstract::The recording of intratracheal pressure in patients breathing through a tracheostomy tube is marred by methodological problems. In model experiments it has been shown that the introduction of a recording catheter into the tracheostomy tube alters the recorded pressure by as much as 20-40%. To avoid such inaccuracy, a ...

    journal_title:Intensive care medicine

    pub_type: 杂志文章

    doi:10.1007/BF01735176

    authors: Holst M,Striem J,Hedenstierna G

    更新日期:1990-01-01 00:00:00

  • A profile of European ICU nursing.

    abstract:OBJECTIVE:To evaluate major similarities and major differences between Western European countries in intensive care unit (ICU) nurse staffing, education, training, responsibilities, and initiative. DESIGN:A questionnaire was sent to Western European doctor members of the European Society of Intensive Care Medicine, to...

    journal_title:Intensive care medicine

    pub_type: 杂志文章,多中心研究

    doi:10.1007/s001340050693

    authors: Depasse B,Pauwels D,Somers Y,Vincent JL

    更新日期:1998-09-01 00:00:00

  • Intensive insulin therapy: enhanced Model Predictive Control algorithm versus standard care.

    abstract:OBJECTIVE:To investigate the effectiveness of an enhanced software Model Predictive Control (eMPC) algorithm for intravenous insulin infusion, targeted at tight glucose control in critically ill patients, over 72 h, in two intensive care units with different management protocols. DESIGN:Comparison with standard care i...

    journal_title:Intensive care medicine

    pub_type: 杂志文章,多中心研究,随机对照试验

    doi:10.1007/s00134-008-1236-z

    authors: Cordingley JJ,Vlasselaers D,Dormand NC,Wouters PJ,Squire SD,Chassin LJ,Wilinska ME,Morgan CJ,Hovorka R,Van den Berghe G

    更新日期:2009-01-01 00:00:00

  • The "sinusogram", a real-time ultrasound sign of maxillary sinusitis.

    abstract:OBJECTIVE:To describe a real-time ultrasound sign, the visualization of the cavity and the walls of the maxillary sinus ("sinusogram"), and to assess its correlation with total opacity of the sinus. DESIGN:Prospective clinical study. SETTING:The medical ICU of a university-affiliated hospital. PATIENTS:The significa...

    journal_title:Intensive care medicine

    pub_type: 杂志文章

    doi:10.1007/s001340050716

    authors: Lichtenstein D,Biderman P,Mezière G,Gepner A

    更新日期:1998-10-01 00:00:00

  • Helmet CPAP vs. oxygen therapy in severe hypoxemic respiratory failure due to pneumonia.

    abstract:PURPOSE:The efficacy of noninvasive continuous positive airway pressure (CPAP) to improve outcomes in severe hypoxemic acute respiratory failure (hARF) due to pneumonia has not been clearly established. The aim of this study was to compare CPAP vs. oxygen therapy to reduce the risk of meeting criteria for endotracheal ...

    journal_title:Intensive care medicine

    pub_type: 杂志文章,多中心研究,随机对照试验

    doi:10.1007/s00134-014-3325-5

    authors: Brambilla AM,Aliberti S,Prina E,Nicoli F,Del Forno M,Nava S,Ferrari G,Corradi F,Pelosi P,Bignamini A,Tarsia P,Cosentini R

    更新日期:2014-07-01 00:00:00

  • Acquired hemophilia: a rare but life-threatening potential cause of bleeding in the intensive care unit.

    abstract:OBJECTIVE:There are a number of potential etiologies of severe bleeding encountered in the intensive care unit. Although rare, acquired hemophilia is one such etiology that often presents with major bleeding requiring intensive care. Despite the introduction of effective treatments, the reported mortality rate of patie...

    journal_title:Intensive care medicine

    pub_type: 杂志文章,评审

    doi:10.1007/s00134-011-2258-5

    authors: Shander A,Walsh CE,Cromwell C

    更新日期:2011-08-01 00:00:00

  • Ultrasound-guided percutaneous dilatational tracheostomy: a safe method to avoid cranial misplacement of the tracheostomy tube.

    abstract::The aim of this investigation was to evaluate the role of ultrasonography in avoiding cranial misplacement of the tracheostomy tube and tracheal ring fractures during percutaneous dilatational tracheostomy (PDT). The tracheas of 26 consecutive ICU patients who had undergone PDT but who later died were removed en bloc ...

    journal_title:Intensive care medicine

    pub_type: 杂志文章

    doi:10.1007/s001340000589

    authors: Sustić A,Kovac D,Zgaljardić Z,Zupan Z,Krstulović B

    更新日期:2000-09-01 00:00:00

  • Evaluation of a transcutaneous carbon dioxide monitor in severe obesity.

    abstract:OBJECTIVE:To determine the reliability of estimating arterial CO(2) pressure (PaCO(2)) using a recently introduced transcutaneous CO(2) pressure (PtcCO(2)) monitor in severe obese patients. DESIGN:Observational and interventional study. SETTING:District hospital with respiratory ward and bariatric surgery unit. PATI...

    journal_title:Intensive care medicine

    pub_type: 杂志文章

    doi:10.1007/s00134-008-1078-8

    authors: Maniscalco M,Zedda A,Faraone S,Carratù P,Sofia M

    更新日期:2008-07-01 00:00:00

  • Prognostic evaluation in meningococcal disease. A retrospective study of 115 cases.

    abstract::A retrospective study of the medical records of 115 consecutive cases of meningococcal disease with 11 fatalities was carried out in order to evaluate the power of 15 clinical and laboratory variables available on admission in predicting a fatal outcome. On linear discriminant analysis, six variables showed a signific...

    journal_title:Intensive care medicine

    pub_type: 杂志文章

    doi:10.1007/BF00261740

    authors: Gårdlund B

    更新日期:1986-01-01 00:00:00

  • Respiratory changes after open-heart surgery.

    abstract::Breathing pattern was studied non-invasively in 20 coronary artery bypass surgery patients before the operation and post-operatively after weaning from mechanical ventilation. Post-operatively minute ventilation (VE), breathing frequency (Fr) and mean inspiratory flow (VT/TI) increased (28%, 42%, 27%; p less than 0.01...

    journal_title:Intensive care medicine

    pub_type: 杂志文章

    doi:10.1007/BF01716198

    authors: Tulla H,Takala J,Alhava E,Huttunen H,Kari A,Manninen H

    更新日期:1991-01-01 00:00:00

  • Rescue therapy with C1-esterase inhibitor concentrate after emergency coronary surgery for failed PTCA.

    abstract::Administration of C1-esterase inhibitor (C1-INH) attenuates myocardial necrosis and sustains normal cardiac performance after myocardial ischemia and reperfusion in animal experiments. We report on our first experience of C1-INH application as rescue therapy in patients undergoing emergency surgical revascularization ...

    journal_title:Intensive care medicine

    pub_type: 杂志文章

    doi:10.1007/s001340050629

    authors: Bauernschmitt R,Böhrer H,Hagl S

    更新日期:1998-06-01 00:00:00

  • Intrapulmonary percussive ventilation in tracheostomized patients: a randomized controlled trial.

    abstract:OBJECTIVE:To investigate whether the addition of intrapulmonary percussive ventilation to the usual chest physiotherapy improves gas exchange and lung mechanics in tracheostomized patients. DESIGN AND SETTING:Randomized multicenter trial in two weaning centers in northern Italy. PATIENTS AND PARTICIPANTS:46 tracheost...

    journal_title:Intensive care medicine

    pub_type: 杂志文章,多中心研究,随机对照试验

    doi:10.1007/s00134-006-0427-8

    authors: Clini EM,Antoni FD,Vitacca M,Crisafulli E,Paneroni M,Chezzi-Silva S,Moretti M,Trianni L,Fabbri LM

    更新日期:2006-12-01 00:00:00

  • Hemodynamics in experimental gastric juice induced aspiration pneumonitis.

    abstract:OBJECTIVE:To characterize hemodynamic changes during experimental aspiration pneumonitis, paying special attention to echocardiographic assessment. DESIGN AND SETTING:Animal study in a university-based research laboratory. SUBJECTS:Fourteen mechanically ventilated New Zealand white rabbits INTERVENTIONS:We instilled...

    journal_title:Intensive care medicine

    pub_type: 杂志文章

    doi:10.1007/s00134-006-0457-2

    authors: Fraisse A,Bregeon F,Delpierre S,Gaudart J,Payan MJ,Pugin J,Papazian L

    更新日期:2007-02-01 00:00:00

  • Association of social deprivation with 1-year outcome of ICU survivors: results from the FROG-ICU study.

    abstract:PURPOSE:Intensive care unit survivors suffer from prolonged impairment, reduced quality of life, and higher mortality rates after discharge compared to the general population. Socioeconomic status may play a partial but important role in mortality and recovery. Therefore, the detection of factors that are responsible f...

    journal_title:Intensive care medicine

    pub_type: 杂志文章,多中心研究

    doi:10.1007/s00134-018-5412-5

    authors: Bastian K,Hollinger A,Mebazaa A,Azoulay E,Féliot E,Chevreul K,Fournier MC,Guidet B,Michel M,Montravers P,Pili-Floury S,Sonneville R,Siegemund M,Gayat E,FROG-ICU Study Investigators.

    更新日期:2018-12-01 00:00:00

  • Inhaled nitric oxide (NO) for the treatment of early allograft failure after lung transplantation. Munich Lung Transplant Group.

    abstract:OBJECTIVE:Inhalation of high concentrations of nitric oxide (NO) has been shown to improve gas exchange and to reduce pulmonary vascular resistance in individuals with ischemia-reperfusion injury following orthotopic lung transplantation. We assessed the cardiopulmonary effects of low doses of NO in early allograft dys...

    journal_title:Intensive care medicine

    pub_type: 临床试验,杂志文章

    doi:10.1007/s001340050741

    authors: Kemming GI,Merkel MJ,Schallerer A,Habler OP,Kleen MS,Haller M,Briegel J,Vogelmeier C,Fürst H,Reichart B,Zwissler B

    更新日期:1998-11-01 00:00:00

  • Effects of acid-base abnormalities on blood capacity of transporting CO(2): adverse effect of metabolic acidosis.

    abstract:OBJECTIVE:To investigate the effects of some acid-base abnormalities on blood capacity of transporting CO(2). DESIGN:Prospective study. SETTING:General and Cardiosurgical ICUs of a University hospital. PATIENTS:Six groups of ten patients characterized by: metabolic alkalosis; respiratory alkalosis; absence of acid-b...

    journal_title:Intensive care medicine

    pub_type: 杂志文章

    doi:10.1007/s00134-002-1259-9

    authors: Cavaliere F,Antonelli M,Arcangeli A,Conti G,Pennisi MA,Proietti R

    更新日期:2002-05-01 00:00:00

  • Preliminary results on nursing workload in a dedicated weaning center.

    abstract:OBJECTIVE:To evaluate the nursing time required for difficult-to-wean patients in a dedicated weaning center (WC) and to examine the correlation of the nursing time with nursing workload (NW) scores and with clinical severity and dependency. SETTING:Four-bed WC of a pulmonary rehabilitation department. INTERVENTION:N...

    journal_title:Intensive care medicine

    pub_type: 杂志文章

    doi:10.1007/s001340051249

    authors: Vitacca M,Clini E,Porta R,Ambrosino N

    更新日期:2000-06-01 00:00:00

  • The importance of religious affiliation and culture on end-of-life decisions in European intensive care units.

    abstract:OBJECTIVE:To determine the influence of religious affiliation and culture on end-of-life decisions in European intensive care units (ICUs). DESIGN AND SETTING:A prospective, observational study of European ICUs was performed on consecutive patients with any limitation of therapy. Prospectively defined end-of-life prac...

    journal_title:Intensive care medicine

    pub_type: 杂志文章,多中心研究

    doi:10.1007/s00134-007-0693-0

    authors: Sprung CL,Maia P,Bulow HH,Ricou B,Armaganidis A,Baras M,Wennberg E,Reinhart K,Cohen SL,Fries DR,Nakos G,Thijs LG,Ethicus Study Group.

    更新日期:2007-10-01 00:00:00

  • Late outcome of percutaneous dilatational tracheostomy in intensive care patients.

    abstract:OBJECTIVE:Percutaneous dilatational tracheostomy is increasingly practiced in intensive care units and has a low incidence of early complications. The late effects of this procedure are still poorly known and were the focus of this study. DESIGN:Prospective descriptive clinical study. SETTING:Interdisciplinary intens...

    journal_title:Intensive care medicine

    pub_type: 杂志文章

    doi:10.1007/BF01706200

    authors: Fischler MP,Kuhn M,Cantieni R,Frutiger A

    更新日期:1995-06-01 00:00:00

  • Alterations of soluble L- and P-selectins during cardiac arrest and CPR.

    abstract:OBJECTIVE:To investigate the relationship between cytokines and the inflammatory responses in patients with out-of-hospital cardiac arrest, we examined the changes of cytokines as well as alterations in the markers of neutrophil activation, platelet and endothelial activation, and endothelial injury. DESIGN:Prospectiv...

    journal_title:Intensive care medicine

    pub_type: 临床试验,杂志文章

    doi:10.1007/s001340050907

    authors: Gando S,Nanzaki S,Morimoto Y,Kobayashi S,Kemmotsu O

    更新日期:1999-06-01 00:00:00

  • Modified score for disseminated intravascular coagulation in the critically ill.

    abstract:OBJECTIVE:To assess the value of the diagnosis of overt disseminated intravascular coagulation (DIC) according to the International Society on Thrombosis and Haemostasis (ISTH) criteria and that of the parameters included in the ISTH score for overt DIC in predicting day 28 mortality in intensive care patients. Also, t...

    journal_title:Intensive care medicine

    pub_type: 杂志文章

    doi:10.1007/s00134-005-2685-2

    authors: Sivula M,Tallgren M,Pettilä V

    更新日期:2005-09-01 00:00:00

  • Early and late onset bacteremia have different risk factors in trauma patients.

    abstract:OBJECTIVE:The aim of this study was to identify risk factors and to describe epidemiological patterns for early-(EOB) and late-onset bacteremias (LOB) after trauma. DESIGN:A prospective study conducted on 141 consecutive trauma patients. SETTING:A general intensive care unit (ICU) of a university hospital. PATIENTS:...

    journal_title:Intensive care medicine

    pub_type: 杂志文章

    doi:10.1007/BF01709514

    authors: Antonelli M,Moro ML,D'Errico RR,Conti G,Bufi M,Gasparetto A

    更新日期:1996-08-01 00:00:00

  • Development of demographics and outcome of very old critically ill patients admitted to intensive care units.

    abstract:PURPOSE:To evaluate the development of demographics and outcome of very old (>80 years) critically ill patients admitted to intensive care units. SETTING:All consecutive patients admitted to 41 Austrian intensive care units (ICUs) over an 11-year period. METHODS:We performed a retrospective cohort study of prospectiv...

    journal_title:Intensive care medicine

    pub_type: 杂志文章,多中心研究

    doi:10.1007/s00134-012-2474-7

    authors: Ihra GC,Lehberger J,Hochrieser H,Bauer P,Schmutz R,Metnitz B,Metnitz PG

    更新日期:2012-04-01 00:00:00

  • Variations in pulmonary artery occlusion pressure to estimate changes in pleural pressure.

    abstract:OBJECTIVE:A readily available assessment of changes in pleural pressure would be useful for ventilator and fluid management in critically ill patients. We examined whether changes in pulmonary artery occlusion pressure (Ppao) adequately reflect respiratory changes in pleural pressure as assessed by changes in intraesop...

    journal_title:Intensive care medicine

    pub_type: 杂志文章

    doi:10.1007/s00134-007-0842-5

    authors: Bellemare P,Goldberg P,Magder SA

    更新日期:2007-11-01 00:00:00