Abstract：
OBJECTIVE:To assess acute cardiorespiratory effects of recruitment manoeuvres in experimental acute lung injury. DESIGN:Experimental study in animal models of acute lung injury. SETTING:Experimental laboratory at a University Medical Centre. ANIMALS:Ten pigs with bronchoalveolar lavage and eight pigs with endotoxin-induced ALI. INTERVENTIONS:Two kinds of recruitment manoeuvres during 1 min; a) vital capacity manoeuvres (ViCM) consisting in a sustained inflation at 30 cmH(2)O and 40 cmH(2)O; b) manoeuvres obtained during ongoing pressure-controlled ventilation (PCRM) with peak airway pressure 30 cmH(2)O, positive end-expiratory pressure (PEEP) 15 and peak airway pressure 40, PEEP 20. Recruitment manoeuvres were repeated after volume expansion (dextran 8 ml/kg). Oxygenation, mean arterial, and pulmonary artery pressures, aortic, mesenteric, and renal blood flow were monitored. MEASUREMENTS AND RESULTS:Lower pressure recruitment manoeuvres (ViCM30 and PCRM30/15) did not significantly improve oxygenation. With ViCM and PCRM at peak airway pressure 40 cmH(2)O, PaO(2) increased to similar levels in both lavage and endotoxin groups. Aortic blood flow was reduced from baseline during PCRM40/20 and ViCM40 by 57+/-3% and 61+/-6% in the lavage group and by 57+/-8% and 82+/-7% (P<0.05 vs PCRM40/20) in endotoxin group. The decrease in blood pressure was less pronounced. Prior volume expansion attenuated circulatory impairment. After cessation of recruitment hemodynamic parameters were restored within 3 min. CONCLUSION:Effective recruitment resulted in systemic hypotension, pulmonary hypertension, and decrease in aortic blood flow especially in endotoxinemic animals. Circulatory depression may be attenuated using recruitment manoeuvres during ongoing pressure-controlled ventilation and by prior volume expansion.
journal_name
Intensive Care Medjournal_title
Intensive care medicineauthors
Odenstedt H,Aneman A,Kárason S,Stenqvist O,Lundin Sdoi
10.1007/s00134-004-2496-xkeywords:
subject
Has Abstractpub_date
2005-01-01 00:00:00pages
112-20issue
1eissn
0342-4642issn
1432-1238journal_volume
31pub_type
杂志文章abstract：OBJECTIVES:Controversy over the optimal intravenous fluid for volume resuscitation continues unabated. Our objectives were to characterize the demographics of physicians who prescribe intravenous colloids and determine factors that enter into their decision to choose a colloid. DESIGN:Questionnaire with 61 items. PAR...
journal_title：Intensive care medicine
pub_type： 杂志文章
doi：10.1007/s00134-002-1337-z
更新日期：2002-07-01 00:00:00
abstract：OBJECTIVE:Nuclear factor-kappaB (NF-kappaB) is a transcription factor which plays a pivotal role in the induction of genes involved in the response to injury and inflammation. Calpain I inhibitor is a potent antioxidant which is an effective inhibitor of NF-kappaB. This study examined whether the postulate that calpain...
journal_title：Intensive care medicine
pub_type： 杂志文章
doi：10.1007/s00134-004-2328-z
更新日期：2004-08-01 00:00:00
abstract：OBJECTIVES:A range of children receive extra-corporeal life support (ECLS) for respiratory failure, but there is little published data on this group. Our aims were: (1) to analyse predictors of outcome and (2) comment on inclusion and exclusion criteria. DESIGN:Retrospective review. SETTING:Tertiary ECLS centre. PAT...
journal_title：Intensive care medicine
pub_type： 杂志文章
doi：10.1007/s00134-008-1232-3
更新日期：2008-12-01 00:00:00
abstract：PURPOSE:Mechanical ventilation with lower tidal volumes (≤6 ml/kg of predicted body weight, PBW) could benefit patients without acute respiratory distress syndrome (ARDS). However, tidal volume reduction could be associated with increased patient discomfort and sedation needs, and consequent longer duration of ventilat...
journal_title：Intensive care medicine
pub_type： 杂志文章,meta分析,评审
doi：10.1007/s00134-014-3318-4
更新日期：2014-07-01 00:00:00
abstract：PURPOSE:Information on predisposing risk factors influencing long-term survival after extracorporeal membrane oxygenation (ECMO) support remains scarce. In critically ill patients chronic obstructive pulmonary disease (COPD) is an independent risk factor for mortality and morbidity. We assessed the influence of COPD on...
journal_title：Intensive care medicine
pub_type： 杂志文章
doi：10.1007/s00134-013-2931-y
更新日期：2013-08-01 00:00:00
abstract：OBJECTIVE:To investigate the accuracy of eight different prognostic scores (Stiehm, Niklasson, Leclerc, Garlund, the MOC score, Tesero, the Glasgow Meningococcal Septicaemia Prognostic Score (GMSPS) and Tüyzüs) in the prediction of fatal outcome in meningococcal disease. DESIGN:Combined prospective and retrospective s...
journal_title：Intensive care medicine
pub_type： 杂志文章
doi：10.1007/BF01709565
更新日期：1996-12-01 00:00:00
abstract：OBJECTIVE:To determine whether health-related quality of life (HRQL) in survivors of acute renal failure (ARF) occurring in intensive care is predictable from data available at the time of acute illness. DESIGN AND SETTING:Prospective pilot study in academic intensive care units. PATIENTS AND METHODS:Patients requiri...
journal_title：Intensive care medicine
pub_type： 杂志文章
doi：10.1007/s00134-003-1837-5
更新日期：2003-09-01 00:00:00
abstract：:The reliability of cardiac output estimation by thermodilution during artificial ventilation was studied in anesthetized pigs at the right side of the heart. The estimates exhibited a cyclic modulation related to the ventilation. The amplitude of the modulation was independent of the level of positive end-expiratory p...
journal_title：Intensive care medicine
pub_type： 杂志文章
doi：10.1007/BF00254515
更新日期：1986-01-01 00:00:00
abstract：PURPOSE:Indications and optimal timing for tracheostomy in traumatic brain-injured (TBI) patients are uncertain. This study aims to describe the patients' characteristics, timing, and factors related to the decision to perform a tracheostomy and differences in strategies among different countries and assess the effect ...
journal_title：Intensive care medicine
pub_type： 杂志文章
doi：10.1007/s00134-020-05935-5
更新日期：2020-05-01 00:00:00
abstract：OBJECTIVE:To evaluate whether soluble triggering receptor expressed on myeloid cells 1 (sTREM-1) in CSF can serve as a biomarker for the presence of bacterial meningitis and outcome in patients with this disease. DESIGN:Retrospective study of diagnostic accuracy. SETTING AND PATIENTS:CSF was collected from 92 adults ...
journal_title：Intensive care medicine
pub_type： 杂志文章
doi：10.1007/s00134-006-0240-4
更新日期：2006-08-01 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：PURPOSE:Fluid overload is a risk factor for poor outcome in intensive care; thus volume loading should be tailored towards patients who are likely to increase stroke volume. We aimed to evaluate the paediatric predictive ability (stroke volume increase of at least 15 % after fluid bolus) of novel and established volume...
journal_title：Intensive care medicine
pub_type： 杂志文章
doi：10.1007/s00134-015-4075-8
更新日期：2015-12-01 00:00:00
abstract：:Marked respiratory insufficiency was established in 20 of 91 patients with acute pancreatitis. 16 of them died, 12 from uncontrollable hypoxaemia. At postmortem the most prominent finding was microatelectasis, the occurrence of which correlated highly with the serum amylase activity. ...
journal_title：Intensive care medicine
pub_type： 杂志文章
doi：10.1007/BF01683069
更新日期：1977-08-01 00:00:00
abstract：:A randomized study of 30 patients undergoing uncomplicated surgery under spinal anesthesia was conducted to assess the influence of colloids on the kinetics of plasma fibronectin and complement. Both are opsonins of the reticuloendothelial system; moreover fibronectin is concerned with host resistance against septic c...
journal_title：Intensive care medicine
pub_type： 临床试验,杂志文章,随机对照试验
doi：10.1007/BF01691428
更新日期：1991-01-01 00:00:00
abstract：:During a 3-year period, a clinical diagnosis of invasive candidosis was made in 8 out of 2054 consecutive surgical intensive care unit (ICU) patients. These patients were retrospectively matched with 16 control patients who underwent similar surgical procedures and had a similar clinical course except for negative Can...
journal_title：Intensive care medicine
pub_type： 杂志文章
doi：10.1007/s001340100891
更新日期：2001-05-01 00:00:00
abstract：:We analysed the case histories of 22 patients with life threatening asthma retrospectively. Fifteen patients needed mechanical ventilation. Three patients, all of them in cardiac arrest before or at the moment of admission, died. In five patients, halothane therapy was successfully used as a last resort. No major comp...
journal_title：Intensive care medicine
pub_type： 杂志文章
doi：10.1007/BF00260352
更新日期：1985-01-01 00:00:00
abstract：PURPOSE:Sedatives administered to critically ill children should be titrated to effect, because both under- and oversedation may have negative effects. We conducted a systematic review to examine reported incidences of under-, optimal, and oversedation in critically ill children receiving intensive care. METHODS:A sys...
journal_title：Intensive care medicine
pub_type： 杂志文章,评审
doi：10.1007/s00134-013-2971-3
更新日期：2013-09-01 00:00:00
abstract：OBJECTIVE:Pulmonary hypertension is a characteristic feature of acute respiratory distress syndrome (ARDS) and contributes to mortality. Administration of sildenafil in ambulatory patients with pulmonary hypertension improves oxygenation and ameliorates pulmonary hypertension. Our aim was to determine whether sildenafi...
journal_title：Intensive care medicine
pub_type： 临床试验,杂志文章,多中心研究
doi：10.1007/s00134-010-1754-3
更新日期：2010-05-01 00:00:00
abstract：:A technique for the estimation of LVEF from first passage radionuclide angiocardiography was adapted to provide estimates of RVEF. In 17 subjects with no history of cardiovascular disease mean LVEF was 0.71 +/- 0.08 and mean RVEF 0.65 +/- 0.08. Mean values for 15 subjects with coronary artery disease but no previous h...
journal_title：Intensive care medicine
pub_type： 杂志文章
doi：10.1007/BF01683193
更新日期：1979-09-01 00:00:00
abstract：OBJECTIVE:To assess the effects of intravenous fish oil fat emulsion on the metabolic alterations induced by lipopolysaccharide (LPS) challenge in healthy volunteers. DESIGN:Two groups of eight healthy subjects were randomized to receive either two pharmacological doses of intravenous FO fat emulsion or no treatment. ...
journal_title：Intensive care medicine
pub_type： 杂志文章,随机对照试验
doi：10.1007/s00134-007-0591-5
更新日期：2007-05-01 00:00:00
abstract：:In the past two years several guidelines for suggested components of emergency medical systems for children have been suggested, and for the first time, specific standards of pediatric trauma care have also been formulated. The American Academy of Pediatrics new Provisional Committee on Emergency Medicine has been cha...
journal_title：Intensive care medicine
pub_type： 杂志文章
doi：10.1007/BF00260888
更新日期：1989-01-01 00:00:00
abstract：OBJECTIVE:To study the wishes of a sample of French patients about medical information and surrogacy, at a time when the French Ministry of Health is supporting increased patient autonomy. DESIGN:A cohort of competent patients with non-critical illnesses or injuries completed an intention-to-act questionnaire on the a...
journal_title：Intensive care medicine
pub_type： 杂志文章
doi：10.1007/s001340050011
更新日期：2000-01-01 00:00:00
abstract：PURPOSE:Gastrointestinal motility can be impaired by serious illness or medications, compromising enteral feeding in critical care patients. We compared small bowel transit time and morphology in neurosurgical critical care (ICU) patients with those in healthy subjects. METHODS:We evaluated small intestinal transit ti...
journal_title：Intensive care medicine
pub_type： 杂志文章
doi：10.1007/s00134-009-1415-6
更新日期：2009-06-01 00:00:00
abstract：PURPOSE:Protective mechanical ventilation based on multiple ventilator parameters such as tidal volume, plateau pressure, and driving pressure has been widely used in acute respiratory distress syndrome (ARDS). More recently, mechanical power (MP) was found to be associated with mortality. The study aimed to investigat...
journal_title：Intensive care medicine
pub_type： 杂志文章
doi：10.1007/s00134-019-05627-9
更新日期：2019-06-01 00:00:00
abstract：OBJECTIVE:Antipyrine metabolism is a "gold standard" measure of mixed cytochrome P450 (CYP) mediated drug metabolism in humans. Cytokines (e.g., interleukin-6) and nitric oxide reduce CYP 450 activity in vitro and in vivo. Because interleukin-6 and nitric oxide production increases in children with sepsis-induced multi...
journal_title：Intensive care medicine
pub_type： 杂志文章
doi：10.1007/s00134-003-1758-3
更新日期：2003-06-01 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：OBJECTIVE:To determine the frequency and the eventual clinical characteristics of nosocomial sinusitis with anaerobic bacteria isolation in patients in the intensive care unit (ICU). DESIGN:Retrospective study. SETTING:A 12-bed medical ICU in a teaching hospital. PATIENTS:30 adult patients with documented nosocomial...
journal_title：Intensive care medicine
pub_type： 杂志文章
doi：10.1007/s001340051013
更新日期：1999-10-01 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：PURPOSE:Clinical examination is often the first step to diagnose shock and estimate cardiac index. In the Simple Intensive Care Studies-I, we assessed the association and diagnostic performance of clinical signs for estimation of cardiac index in critically ill patients. METHODS:In this prospective, single-centre coho...
journal_title：Intensive care medicine
pub_type： 杂志文章
doi：10.1007/s00134-019-05527-y
更新日期：2019-02-01 00:00:00
abstract：INTRODUCTION:The concept of weaning-induced cardiac dysfunction emerged 26 years ago with the publication of a clinical study conducted by François Lemaire and collaborators. OBJECTIVES:One objective of this article is to remember the results and the historical context under which our pivotal study was conducted. Anot...
journal_title：Intensive care medicine
pub_type： 历史文章,杂志文章,评审
doi：10.1007/s00134-014-3334-4
更新日期：2014-08-01 00:00:00
