Abstract：
OBJECTIVE:To determine whether a goal-directed terlipressin infusion increases mean arterial pressure without causing a pulmonary vasopressive effect and whether this response impacts on key parameters of oxygen transport in healthy and endotoxemic sheep. DESIGN AND SETTING:Prospective controlled trial in a university research laboratory. ANIMALS AND INTERVENTIONS:Six conscious adult ewes instrumented for chronic study received terlipressin as titrated infusion started with 10 microg x kg(-1) x h(-1) and increased by 5 microg x kg(-1) x h(-1) every 15 min, either until mean arterial pressure was increased by 15 mmHg from baseline, or a maximum of 40 microg x kg(-1) x h(-1) was given. Following 24 h of recovery sepsis was induced and maintained in the same ewes by a continuous infusion of endotoxin ( Salmonella typhosa, 10 ng x kg(-1) min(-1)). After 16 h of endotoxemia the sheep were again treated with terlipressin. MEASUREMENTS AND RESULTS:Systemic oxygen delivery and consumption were calculated before and after the titration period; hemodynamic parameters were measured every 15 min. The increase in mean arterial pressure was greater during endotoxemia than in healthy controls. In both states terlipressin administration decreased cardiac index and diminished oxygen delivery and consumption. While mean pulmonary arterial pressure remained constant, terlipressin increased the pulmonary vascular resistance index in endotoxemic sheep. CONCLUSIONS:During ovine endotoxemia titrated terlipressin reversed hypotension but impaired the pulmonary circulation. The observed decrease in oxygen delivery may carry the risk of tissue hypoxia especially in sepsis, where oxygen demand is typically increased.
journal_name
Intensive Care Medjournal_title
Intensive care medicineauthors
Westphal M,Stubbe H,Sielenkämper AW,Borgulya R,Van Aken H,Ball C,Bone HGdoi
10.1007/s00134-002-1546-5keywords:
subject
Has Abstractpub_date
2003-02-01 00:00:00pages
301-8issue
2eissn
0342-4642issn
1432-1238journal_volume
29pub_type
杂志文章abstract：OBJECTIVE:To assess the attitudes of physicians in Milan, Italy, intensive care units (ICUs) regarding end-of-life decisions. DESIGN:Anonymous self-administered questionnaire. SETTING:All 20 ICUs in Milan. PARTICIPANTS:Physicians employed in the ICUs. MEASUREMENTS AND RESULTS:The response rate was 87% (225 of 259)....
journal_title：Intensive care medicine
pub_type： 杂志文章
doi：10.1007/s00134-003-1919-4
更新日期：2003-11-01 00:00:00
abstract：PURPOSE:The early diagnosis of traumatic internal carotid artery dissection (TICAD) is essential for initiating appropriate treatment and improving outcome. We searched for criteria from transcranial Doppler (TCD) measurements on admission that could be associated with subsequent TICAD diagnosis in patients with trauma...
journal_title：Intensive care medicine
pub_type： 杂志文章
doi：10.1007/s00134-010-1919-0
更新日期：2010-09-01 00:00:00
abstract：:Total extracorporeal lung assist (ECLA) requires a bypass flow approaching cardiac output. Recirculation of venous blood through the oxygenator is minimized with a veno-right ventricular cannulation technique which separates venous drainage from returned oxygenated blood. A case of posttraumatic ARDS was treated with ...
journal_title：Intensive care medicine
pub_type： 杂志文章
doi：10.1007/BF01691426
更新日期：1991-01-01 00:00:00
abstract：OBJECTIVE:To report the occurrence of life-threatening hyperkalaemia following treatment with therapeutic thiopentone coma. SETTING:The neurosurgical intensive care units of Royal North Shore Hospital and Liverpool Hospital, Sydney, Australia. PATIENTS:Three patients treated with theraputic thiopentone coma. One pati...
journal_title：Intensive care medicine
pub_type： 杂志文章
doi：10.1007/s00134-002-1399-y
更新日期：2002-09-01 00:00:00
abstract：:Central venous catheters (CVCs) are widely used in critically ill patients in intensive care units. However, infectious complications are common and may limit their utility. We critically review the literature to determine the impact of CVC design and composition, insertion site selection, insertion procedures, care a...
journal_title：Intensive care medicine
pub_type： 杂志文章,评审
doi：10.1007/BF01726542
更新日期：1995-02-01 00:00:00
abstract：OBJECTIVES:Trunk position at 45 degrees from the horizontal is associated with a decreased risk of gastroesophageal aspiration. The objectives of this study were to determine the accuracy of trunk flexion estimates compared to a reference standard measurement, and to determine agreement about trunk flexion among ICU cl...
journal_title：Intensive care medicine
pub_type： 杂志文章
doi：10.1007/s00134-002-1225-6
更新日期：2002-03-01 00:00:00
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
更新日期：2007-02-01 00:00:00
abstract：:A prospective study of thiamine status in patients with severe injuries (injury severity scores greater than 12) showed that they all developed signs of severe thiamine deficiency on the basis of transketolase activity, the standard biochemical test for thiamine deficiency. This occurred within the first week after th...
journal_title：Intensive care medicine
pub_type： 杂志文章
doi：10.1007/BF00256767
更新日期：1988-01-01 00:00:00
abstract：OBJECTIVE:Pressure-volume (PV) curves are recorded after induction of complete muscle paralysis, which may limit their clinical use. The feasibility of recording PV curves without paralysis has not been tested. In 19 patients with acute respiratory distress syndrome (ARDS) and no hemodynamic instability we prospectivel...
journal_title：Intensive care medicine
pub_type： 杂志文章,随机对照试验
doi：10.1007/s00134-006-0265-8
更新日期：2006-09-01 00:00:00
abstract：OBJECTIVE:To examine variables associated with postextubation respiratory distress in chronic obstructive pulmonary disease (COPD) patients. DESIGN:Prospective, clinical investigation. SETTING:Intensive care unit of a university hospital. PATIENTS:Forty COPD patients, considered ready for extubation. MEASUREMENTS A...
journal_title：Intensive care medicine
pub_type： 临床试验,杂志文章
doi：10.1007/s001340050762
更新日期：1998-12-01 00:00:00
abstract：PURPOSE:During neurally adjusted ventilatory assist (NAVA) the ventilator is driven by the patients electrical activation of the diaphragm (EAdi), detected by a special esophageal catheter. A reliable positioning of the EAdi-catheter is mandatory to trace a representative EAdi signal. We aimed to determine whether a fo...
journal_title：Intensive care medicine
pub_type： 杂志文章
doi：10.1007/s00134-009-1587-0
更新日期：2009-10-01 00:00:00
abstract：OBJECTIVE:Real-time measurement of stroke volume variation by arterial pulse contour analysis (SVV) is useful in predicting volume responsiveness and monitoring volume therapy in mechanically ventilated patients. This study investigated the influence of the depth of tidal volume (V(t)) on SVV both during the state of f...
journal_title：Intensive care medicine
pub_type： 临床试验,杂志文章,随机对照试验
doi：10.1007/s00134-003-1649-7
更新日期：2003-03-01 00:00:00
abstract：:As part of a nationwide evaluation of intensive care, we examined patient- and hospital-related factors which could influence the patterns of utilization of arterial cannulae and central venous and pulmonary artery catheters. We also studied the possible impact of these interventions on the short-term outcome among 14...
journal_title：Intensive care medicine
pub_type： 杂志文章
doi：10.1007/BF01713935
更新日期：1991-01-01 00:00:00
abstract：OBJECTIVE:To evaluate the Datex Deltatrac II for measurements in neonates requiring mechanical ventilation. DESIGN:Prospective laboratory evaluation, using a ventilated lung model and gas injection. During simulation of 79 neonatal respiratory settings, assessment of oxygen consumption (VO2), carbon dioxide production...
journal_title：Intensive care medicine
pub_type： 杂志文章
doi：10.1007/s001340000708
更新日期：2001-01-01 00:00:00
abstract：OBJECTIVE:To compare available instruments for assessing delirium in critically ill adults that have undergone validity testing and provide clinicians with strategies to incorporate these instruments into clinical practice. DESIGN:Medline (1966-September 2006) was searched using the key words: delirium, cognitive dysf...
journal_title：Intensive care medicine
pub_type： 杂志文章,评审
doi：10.1007/s00134-007-0603-5
更新日期：2007-06-01 00:00:00
abstract：OBJECTIVE:To assess if the observed respiratory cycle-related variation in intra-abdominal pressure is reliably quantifiable and a possible indirect indicator of abdominal compliance. Secondary issues were to assess the roles played by respiratory parameters in determining this oscillation and by patients' position in ...
journal_title：Intensive care medicine
pub_type： 杂志文章
doi：10.1007/s00134-008-1155-z
更新日期：2008-09-01 00:00:00
abstract：PURPOSE:A retrieval program was developed in New South Wales (NSW), Australia to provide extracorporeal membrane oxygenation support (ECMO) for the safe transport of adults with severe, acute respiratory or cardiac failure. We describe the development and results of this program and the impact of the 2009 H1N1 epidemic...
journal_title：Intensive care medicine
pub_type： 杂志文章
doi：10.1007/s00134-011-2158-8
更新日期：2011-05-01 00:00:00
abstract：:A 63-year-old man underwent distal oesophagectomy and proximal gastrectomy. Postoperatively, controlled ventilation was necessary for 53 days because of anastomotic leakage. Multiple sedative regimens proved to be inadequate. By contrast, a fentanyl-midazolam combination with continuous supplementation of clonidine 0....
journal_title：Intensive care medicine
pub_type： 杂志文章
doi：10.1007/BF01705163
更新日期：1990-01-01 00:00:00
abstract：PURPOSE:To describe the course of early organ dysfunction in a cohort of patients admitted in ICU suffering classic heatstroke. METHODS:Prospective observational single-centre cohort study with a 1-year follow-up. INTERVENTIONS:None. MEASUREMENTS AND MAIN RESULTS:Clinical and biological data of 22 patients were anal...
journal_title：Intensive care medicine
pub_type： 杂志文章
doi：10.1007/s00134-009-1500-x
更新日期：2009-08-01 00:00:00
abstract：OBJECTIVES:To measure plasma levels and pharmacokinetics of cefpirome in critically ill septic patients with normal renal function. To use the pharmacokinetic model to simulate alternate dosing regimens and identify those that predict sustained levels. DESIGN AND SETTING:A prospective, open-label, descriptive study in...
journal_title：Intensive care medicine
pub_type： 杂志文章
doi：10.1007/s001340000741
更新日期：2001-02-01 00:00:00
abstract：OBJECTIVE:Do-not-resuscitate orders (DNR orders) and advance directives (AD) have been developed and their use by patients is increasing. The objective of the study was to evaluate the compliance with patient's wishes and doctors' and nurses' agreement on decision-making in the treatment of elderly patients from a cros...
journal_title：Intensive care medicine
pub_type： 杂志文章
doi：10.1007/s001340000602
更新日期：2000-09-01 00:00:00
abstract：PURPOSE:The clinical significance of septic myocardial dysfunction is controversial, a fact that may be explained by the influence of loading conditions. Many indices may be useful to characterize cardiac function during septic shock, but their feasibility and physiological coherence in the clinical setting are unknown...
journal_title：Intensive care medicine
pub_type： 杂志文章
doi：10.1007/s00134-017-4698-z
更新日期：2017-05-01 00:00:00
abstract：:Helicobacter pylori is estimated to infect over 50% of the world's population, the majority of whom are asymptomatic. Although most research to date has focused on local gastroduodenal disease manifestations, the potential impact of H. pylori infection and the associated chronic active inflammation on systemic disease...
journal_title：Intensive care medicine
pub_type： 杂志文章,评审
doi：10.1007/s00134-003-1838-4
更新日期：2003-11-01 00:00:00
abstract：OBJECTIVE:To compare the effectiveness of 70-mg and 200-mg doses of intravenous erythromycin in improving gastric emptying in critically ill patients. DESIGN:Gastric emptying was measured on consecutive days; day 1 (pre-treatment), day 2 (post-treatment) after an intravenous infusion of either 70 or 200 mg erythromyci...
journal_title：Intensive care medicine
pub_type： 临床试验,杂志文章,随机对照试验
doi：10.1007/s00134-005-2663-8
更新日期：2005-07-01 00:00:00
abstract：OBJECTIVE:To apply the modified pediatric RIFLE criteria for severity of acute kidney injury (AKI) to pediatric burn ICU patients and to evaluate the overall incidence of AKI, risk factors for AKI and influence of AKI on outcome. DESIGN:Retrospective, descriptive cohort study. SETTING:10-bed burn PICU facility. PATI...
journal_title：Intensive care medicine
pub_type： 杂志文章
doi：10.1007/s00134-009-1638-6
更新日期：2009-12-01 00:00:00
abstract：OBJECTIVE:Antithrombin exerts direct effects on neutrophils by inhibiting chemokine-induced migration. This study examined the potency of different pharmaceutical antithrombin preparations in inhibiting neutrophil chemotaxis toward interleukin 8. METHODS:Cell migration was tested by the leading front assay in modified...
journal_title：Intensive care medicine
pub_type： 杂志文章
doi：10.1007/s00134-002-1432-1
更新日期：2002-10-01 00:00:00
abstract：OBJECTIVE:There is considerable heterogeneity among randomized trials comparing high-frequency ventilation (HFV) with conventional mechanical ventilation (CMV) in premature neonates with respiratory distress syndrome. We investigated what factors explained differences in outcome among these trials. DESIGN:Meta-regress...
journal_title：Intensive care medicine
pub_type： 杂志文章,meta分析
doi：10.1007/s00134-007-0545-y
更新日期：2007-04-01 00:00:00
abstract：OBJECTIVE:The efficacy of interferon gamma therapy in reducing infection and improving outcome from infection in patients sustaining major injury was examined. DESIGN:Randomized double-blind placebo control trial SETTING:Nine level one university affiliated trauma centers in the United States. PATIENTS AND PARTICIPA...
journal_title：Intensive care medicine
pub_type： 临床试验,杂志文章,多中心研究,随机对照试验
doi：10.1007/BF01743725
更新日期：1996-10-01 00:00:00
abstract：:The increase of the inflationary lung volume created by a respiratory maneuver is critical for preventing postoperative alveolar collapse. We measured this volume as achieved with IPPB or incentive spirometry (IS) in 20 postoperative surgical patients. Using IPPB, with gas flow and peak airway pressures carefully adju...
journal_title：Intensive care medicine
pub_type： 杂志文章
doi：10.1007/BF01641120
更新日期：1977-12-01 00:00:00
abstract：PURPOSE:This prospective observational study aimed at describing prescription patterns of tigecycline and patient outcomes in 26 French intensive care units (ICU). METHODS:Data of consecutive cases of adult patients treated with tigecycline were collected from the initiation until 7 days after the end of treatment. Re...
journal_title：Intensive care medicine
pub_type： 杂志文章,多中心研究
doi：10.1007/s00134-014-3323-7
更新日期：2014-07-01 00:00:00
