Abstract：
OBJECTIVE:Endotoxin administration to humans is a common means to study systemic inflammation. Worldwide, thousands of volunteers have received endotoxin, and adverse events are rarely reported. The aim of this report was to increase awareness of specific risks of the intravenous administration of endotoxin to human volunteers. DESIGN:Report of four cases who developed severe bradycardia or protracted asystole after administration of endotoxin. Interviews with investigators at three large centers that conduct normal volunteer endotoxin studies. SETTING:Clinical research unit. CASES:Four subjects developed severe bradycardia or protracted asystole, approximately 1 h after administration of endotoxin. Further analyses revealed that the subjects had a history of vasovagal syncope or a positive head-tilt test, indicating increased vagal sensitivity. Relative volume depletion associated with fasting overnight may have predisposed these subjects to this condition. CONCLUSIONS:These responses are very rare and are likely due to the cardioinhibitory Bezold-Jarisch reflex. A thorough screening regarding a history of vagal sensitivity and liberal oral or intravenous fluid administration prior to and during the endotoxin challenge may decrease the risk of these events.
journal_name
Intensive Care Medjournal_title
Intensive care medicineauthors
van Eijk LT,Pickkers P,Smits P,Bouw MP,van der Hoeven JGdoi
10.1007/s00134-004-2477-0keywords:
subject
Has Abstractpub_date
2004-12-01 00:00:00pages
2279-81issue
12eissn
0342-4642issn
1432-1238journal_volume
30pub_type
杂志文章abstract：OBJECTIVE:To describe the syndrome of rhabdomyolysis during bacterial sepsis with regard to incidence, blood bacteriology and complications and to examine the association between hyperosmolal state and rhabdomyolysis, evaluating the relationship between plasma osmolality (Posm) and serum creatine phosphokinase (CPK) le...
journal_title：Intensive care medicine
pub_type： 杂志文章
doi：10.1007/s001340050882
更新日期：1999-05-01 00:00:00
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：: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:To determine the global metabolomic profile as measured in circulating plasma from surviving and non-surviving patients with community-acquired pneumonia (CAP) and sepsis. METHODS:Random, outcome-stratified case-control sample from a prospective study of 1,895 patients hospitalized with CAP and sepsis. Cases (...
journal_title：Intensive care medicine
pub_type： 杂志文章,随机对照试验
doi：10.1007/s00134-013-2935-7
更新日期：2013-08-01 00:00:00
abstract：OBJECTIVE:To define the different types of costs incurred in the care of critically ill patients and to describe some of the most commonly used methods for measuring and allocating these costs. DESIGN:Literature review. Definitions for opportunity, direct and indirect, fixed, variable, marginal, and total costs are de...
journal_title：Intensive care medicine
pub_type： 杂志文章,评审
doi：10.1007/s00134-002-1279-5
更新日期：2002-06-01 00:00:00
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
更新日期：1999-06-01 00:00:00
abstract：PURPOSE:We evaluated whether oscillatory compliance (C(X5)) measured by forced oscillation technique (FOT) at 5 Hz may be useful for positive end-expiratory pressure (PEEP) optimisation. METHODS:We studied seven pigs in which lung injury was induced by broncho-alveolar lavage. The animals were ventilated in volume con...
journal_title：Intensive care medicine
pub_type： 杂志文章
doi：10.1007/s00134-011-2211-7
更新日期：2011-06-01 00:00:00
abstract：:The use of ultrasonography has become increasingly popular in the everyday management of critically ill patients. It has been demonstrated to be a safe and handy bedside tool that allows rapid hemodynamic assessment and visualization of the thoracic, abdominal and major vessels structures. More recently, M-mode ultras...
journal_title：Intensive care medicine
pub_type： 杂志文章,评审
doi：10.1007/s00134-013-2823-1
更新日期：2013-05-01 00:00:00
abstract：OBJECTIVE:To evaluate the effectiveness of screening strategy and contact precautions for patients with methicillin-resistant Staphylococcus aureus (MRSA). DESIGN AND SETTING:Prospective observational cohort from 1 February 1995 to 31 December 2001 in three intensive care units (45 beds) in a French teaching hospital....
journal_title：Intensive care medicine
pub_type： 杂志文章
doi：10.1007/s00134-005-2679-0
更新日期：2005-08-01 00:00:00
abstract：OBJECTIVE:To investigate the theoretical interactions between ventilator settings, tracheal gas insufflation (TGI), and alveolar ventilation. DESIGN:We derived differential equations governing compartmental volume changes in a one-compartment model of TGI-assisted ventilation and equations governing gas dilution in th...
journal_title：Intensive care medicine
pub_type： 杂志文章
doi：10.1007/BF01699238
更新日期：1996-10-01 00:00:00
abstract：OBJECTIVE:To determine the relationship between ionized calcium concentrations and blood lactate levels during cardiac arrest and cardiopulmonary resuscitation (CPR). DESIGN:A prospective cohort study. SETTING:Emergency department (ED) and general intensive care unit in a city hospital (tertiary care center). PATIEN...
journal_title：Intensive care medicine
pub_type： 杂志文章
doi：10.1007/s001340050493
更新日期：1997-12-01 00:00:00
abstract：OBJECTIVE:To assess noise exposure during noninvasive ventilation (NIV) with different types of interface (helmet, nasal, and facial masks). SUBJECTS AND METHODS:Ten "naive" healthy volunteers underwent NIV at pressure support levels of 10 and 15 cmH2O with: (a) helmet, (b) helmet equipped with HME filters at the junc...
journal_title：Intensive care medicine
pub_type： 临床试验,杂志文章
doi：10.1007/s00134-004-2347-9
更新日期：2004-09-01 00:00:00
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
更新日期：1989-01-01 00:00:00
abstract：OBJECTIVE:The interchangeability of continuous measurement of cardiac output (CO) with the traditional bolus method in patients after cardiopulmonary bypass (CPB) is uncertain. DESIGN:Prospective observational clinical study. SETTING:A 20-bed surgical ICU at a university hospital. PATIENTS:Fourteen deeply sedated, v...
journal_title：Intensive care medicine
pub_type： 杂志文章
doi：10.1007/s00134-006-0161-2
更新日期：2006-06-01 00:00:00
abstract：PURPOSE:Neutrophil gelatinase-associated lipocalin (NGAL) is a promising biomarker for acute kidney injury (AKI). We evaluated the diagnostic and prognostic accuracies of plasma NGAL (pNGAL) for contrast-induced AKI (CI-AKI) in critically ill patients. METHODS:In a prospective observational study in two adult intensiv...
journal_title：Intensive care medicine
pub_type： 杂志文章
doi：10.1007/s00134-013-2826-y
更新日期：2013-05-01 00:00:00
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
更新日期：2015-11-01 00:00:00
abstract：:Intravenous bolus endotoxin elicits a marked but transient increase in plasma TxB2 and 6-keto-PGF1 alpha in a large number of species. A smaller, delayed and more prolonged increase in TxB2 and 6-keto-PGF1 alpha are reported in animals with septic shock, i.e., those with fecal peritonitis or cecal ligation. Thromboxan...
journal_title：Intensive care medicine
pub_type： 杂志文章,评审
doi：10.1007/BF00254925
更新日期：1986-01-01 00:00:00
abstract：OBJECTIVE:To measure the effect of intense neuromuscular blockade (NMB) on oxygen consumption (VO(2)) in deeply sedated and mechanically ventilated children on the first day after complex congenital cardiac surgery. DESIGN:Prospective clinical interventional study. SETTING:Pediatric intensive care unit of an universi...
journal_title：Intensive care medicine
pub_type： 杂志文章
doi：10.1007/s00134-008-1252-z
更新日期：2008-12-01 00:00:00
abstract：OBJECTIVE:To investigate the role of the inducible nitric oxide synthase activation-induced excess nitric oxide formation on the rate of hepatic glucose production during fully resuscitated murine septic shock. DESIGN:Prospective, controlled, randomized animal study. SETTING:University animal research laboratory. SU...
journal_title：Intensive care medicine
pub_type： 杂志文章
doi：10.1007/s00134-007-0638-7
更新日期：2007-06-01 00:00:00
abstract：OBJECTIVE:To compare the short-term effects of adaptive support ventilation (ASV), an advanced closed-loop mode, with conventional volume or pressure-control ventilation in patients passively ventilated for acute respiratory failure. DESIGN:Prospective crossover interventional multicenter trial. SETTING:Six European ...
journal_title：Intensive care medicine
pub_type： 杂志文章,多中心研究
doi：10.1007/s00134-010-1917-2
更新日期：2010-08-01 00:00:00
abstract：OBJECTIVE:This study compared the recently introduced Microcuff endotracheal tube HVLP ICU featuring an ultrathin (7-microm) polyurethane cuff membrane with endotracheal tubes from different manufacturers regarding fluid leakage past the tube cuff. DESIGN:In vitro setup. MEASUREMENTS AND RESULTS:The following endotra...
journal_title：Intensive care medicine
pub_type： 杂志文章
doi：10.1007/s00134-003-1933-6
更新日期：2003-10-01 00:00:00
abstract：PURPOSE:Inflammatory markers may have a role in predicting severity of illness of intensive care unit (ICU) patients. The aim of this study is to determine whether low eosinophil count can predict 28-day mortality in medical ICU. METHODS:A prospective study over a 4-month period. To evaluate the prognosis information ...
journal_title：Intensive care medicine
pub_type： 杂志文章
doi：10.1007/s00134-011-2170-z
更新日期：2011-07-01 00:00:00
abstract：:Arterial blood ketone body ratio, reflecting hepatic mitochondrial redox state, was measured in 26 brain-dead patients who were hypotensive but hemodynamically stable. All of them had substantially normal hepatic function. In 18 of the patients, blood ketone body ratio was maintained within the normal range in spite o...
journal_title：Intensive care medicine
pub_type： 杂志文章
doi：10.1007/BF01691432
更新日期：1991-01-01 00:00:00
abstract：OBJECTIVE:Both serum levels of tumor necrosis factor-alpha (TNF alpha) and interleukin-6 (IL-6) and blood lactate levels in patients with septic shock have been shown to correlate with prognosis. The aim of the study was to define the relative predictive value of these measures. PATIENTS:38 hospitalized patients with ...
journal_title：Intensive care medicine
pub_type： 杂志文章
doi：10.1007/BF01712155
更新日期：1996-05-01 00:00:00
abstract：OBJECTIVE:Lung injury is a severe complication of acute pancreatitis that increases the mortality rate of the disease. The pathophysiology of acute pancreatitis has been studied in several experimental models, but the kinetics of pulmonary complications in relation to the pancreatic disease is not completely understood...
journal_title：Intensive care medicine
pub_type： 杂志文章
doi：10.1007/s00134-006-0264-9
更新日期：2006-11-01 00:00:00
abstract：:The Limulus amoebocyte lysate assay was used as one of a series of laboratory and clinical investigations on a group of 31 patients suffering from septic shock in order to assess the clinical significance of this assay for the detection of circulating endotoxin in clinical gram-negative sepsis. Four patients with card...
journal_title：Intensive care medicine
pub_type： 杂志文章
doi：10.1007/BF01772577
更新日期：1983-01-01 00:00:00
abstract：OBJECTIVE:The purpose of the study was do describe the architecture of accretions occurring on the tips of central venous catheters (CVC). DESIGN:A conservative procedure was used followed by two different techniques of electron microscopy. SETTING AND PATIENTS:the study included 19 catheters which have been used on ...
journal_title：Intensive care medicine
pub_type： 杂志文章
doi：10.1007/BF01708582
更新日期：1992-01-01 00:00:00
abstract：OBJECTIVE:To evaluate the use of antidotal therapy in patients with an elevated digitalis concentration following chronic or acute exposure. DESIGN AND SETTING:Retrospective review of patient records over 2 years in 20 city hospitals in France. PATIENTS:Overall 838 patients with an elevated serum digitalis concentrat...
journal_title：Intensive care medicine
pub_type： 杂志文章
doi：10.1007/s00134-008-1092-x
更新日期：2008-08-01 00:00:00
abstract：:We have treated 30 patients with flail chest, with priority given to associated factors (pain, secretions retention, hemo-/pneumothorax and underlying pulmonary contusion). When this treatment was insufficient IMV + PEEP was instituted; in this group there was a 58.8% incidence of pneumonia, 47.5% of sepsis and 11.7 d...
journal_title：Intensive care medicine
pub_type： 杂志文章
doi：10.1007/BF01687161
更新日期：1980-08-01 00:00:00
abstract：:A cardiorespiratory monitoring system allows the measurement of FAECO2 and FECO2 in the expired air of the patient at the mouth (endtidal CO2) and in a mixing box. From these parameters, combined with the measured PACO2, the alveolo-expired (DuA = PECO2/PAECO2) and alveolar-arterial (Dua = PAECO2/PACO2) ductances whic...
journal_title：Intensive care medicine
pub_type： 杂志文章
doi：10.1007/BF01687162
更新日期：1980-08-01 00:00:00
