Abstract：
OBJECTIVE:The immediate overwhelming release of inflammatory mediators in septic shock is rapidly followed by strong anti-inflammatory responses inducing a state of immunosuppression. The patients who survive the initial hyper-inflammatory step of septic shock but subsequently die may be those who do not recover from immunosuppression. We assessed whether a low monocyte human leukocyte antigen-DR (mHLA-DR) expression, proposed as a marker of immunosuppression, is an independent predictor of mortality in patients who survived the initial 48 h of septic shock. DESIGN AND SETTING:Prospective observational study performed in two adult intensive care units at a university hospital. PATIENTS:93 consecutive patients with septic shock. MEASUREMENTS AND RESULTS:At days 1-2, mHLA-DR values (determined by flow cytometry) were not significantly different between survivors and non-survivors. A sharp difference became highly significant at days 3-4 when survivors had increased their values, while non-survivors had not (43% vs. 18%, percentage of HLA-DR positive monocyte, p < 0.001). Multivariate logistic regression analysis revealed that low mHLA-DR (< 30%) at days 3-4 remained independently associated with mortality after adjustment for usual clinical confounders, adjusted odds ratio (CI): 6.48 (95% CI: 1.62-25.93). CONCLUSION:The present preliminary results show that mHLA-DR is an independent predictor of mortality in septic shock patients. Being a marker of immune failure, low mHLA-DR may provide a rationale for initiating therapy to reverse immunosuppression. After validation of the current results in multicenter studies, mHLA-DR may help to stratify patients when designing a mediator-directed therapy in a time-dependent manner.
journal_name
Intensive Care Medjournal_title
Intensive care medicineauthors
Monneret G,Lepape A,Voirin N,Bohé J,Venet F,Debard AL,Thizy H,Bienvenu J,Gueyffier F,Vanhems Pdoi
10.1007/s00134-006-0204-8subject
Has Abstractpub_date
2006-08-01 00:00:00pages
1175-83issue
8eissn
0342-4642issn
1432-1238journal_volume
32pub_type
杂志文章abstract：OBJECTIVE:This study assessed parameters of free radical damage to biomolecules, mitochondrial superoxide production, superoxide dismutase, and catalase activities and their relationship to sepsis mortality. DESIGN AND SETTING:Prospective animal study in a university laboratory for experimental. SUBJECTS:140 male Wis...
journal_title：Intensive care medicine
pub_type： 杂志文章
doi：10.1007/s00134-003-1789-9
更新日期：2003-10-01 00:00:00
abstract：OBJECTIVE:An investigation into the incidence of post-operative complications after thoracic surgery with 3 different physiotherapy masks. DESIGN:A prospective, consecutive, randomized comparison. SETTING:Department of Thoracic and Heart Surgery at a University Hospital. The treatments were performed by experienced 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/BF01690551
更新日期：1993-01-01 00:00:00
abstract：:Type III procollagen N-peptides (PIIINPs) are believed to be released in stoichiometric amounts as type III collagen molecules are secreted from cells. We hypothesized that if the human lung actively produces type III collagen a detectable transpulmonary gradient in PIIINPs would exist in normal individuals that might...
journal_title：Intensive care medicine
pub_type： 杂志文章
doi：10.1007/BF01706477
更新日期：1992-01-01 00:00:00
abstract：OBJECTIVE:Postoperative pneumonia is a potentially devastating complication associated with high mortality in intensive care unit (ICU)-patients. One of the major predisposing factors is the perioperative occurrence of atelectatic formations in non-dependent lung areas. Perioperative ventilation/perfusion mismatch due ...
journal_title：Intensive care medicine
pub_type： 杂志文章
doi：10.1007/s00134-008-1122-8
更新日期：2008-10-01 00:00:00
abstract：PURPOSE:To test the hypothesis that a carbamylated EPO-FC fusion protein (cEPO-FC) or recombinant human erythropoietin (rhEPO) would protect against kidney ischemia/reperfusion (I/R) injury in pigs with atherosclerosis. METHODS:Anesthetized and mechanically ventilated animals received cEPO-FC (50 μg kg(-1)), rhEPO (5,...
journal_title：Intensive care medicine
pub_type： 杂志文章
doi：10.1007/s00134-012-2766-y
更新日期：2013-03-01 00:00:00
abstract：:In alcoholic patients, metabolic acidosis can be related to lactate acidosis associated with sepsis or thiamine deficiency, ketoacidosis, methanol or ethylene glycol poisoning. High resolution proton nuclear magnetic resonance (NMR) can be used to detect abnormal organic acid metabolites in urine or serum from patient...
journal_title：Intensive care medicine
pub_type： 杂志文章
doi：10.1007/s001340100892
更新日期：2001-04-01 00:00:00
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
更新日期：2014-07-01 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：:During the last two decades, severe group A beta-haemolytic streptococcal infections have been defined as the "toxic strep syndrome", and have been reported not only in immunocompromised or elderly people, but also occasionally in previously healthy patients. We describe 4 patients presenting with the toxic strep synd...
journal_title：Intensive care medicine
pub_type： 杂志文章
doi：10.1007/BF01709279
更新日期：1993-01-01 00:00:00
abstract：OBJECTIVE:To assess procalcitonin (PCT) and C-reactive protein (CRP) plasma concentrations and clearance in nonseptic end-stage renal failure patients undergoing their first three hemodialysis sessions. DESIGN AND SETTING:Prospective observational consecutive clinical study at a university hospital. PATIENTS:The stud...
journal_title：Intensive care medicine
pub_type： 杂志文章
doi：10.1007/s00134-003-1664-8
更新日期：2003-04-01 00:00:00
abstract：PURPOSE:We evaluated the impact of increasing tidal volume (V (t)), decreased chest wall compliance, and left ventricular (LV) contractility during intermittent positive-pressure ventilation (IPPV) on the relation between pulse pressure (PP) and LV stroke volume (SV(LV)) variation (PPV and SVV, respectively), and intra...
journal_title：Intensive care medicine
pub_type： 杂志文章
doi：10.1007/s00134-011-2304-3
更新日期：2011-10-01 00:00:00
abstract：:The side effects of positive pressure ventilation on cardiovascular function are well known. However, in most clinical studies its influence on left ventricular function was examined. In the present study right ventricular (RV) performance was studied in 13 patients undergoing coronary artery bypass grafting during me...
journal_title：Intensive care medicine
pub_type： 杂志文章
doi：10.1007/BF00256962
更新日期：1988-01-01 00:00:00
abstract：:A 29-year-old woman suffered a cardiac arrest, due to profound hyperkalaemia, caused by the use of a potassium-containing salt substitute. She was resuscitated, but post-hypoxic brain damage occurred. Some of the sparse literature is reviewed. ...
journal_title：Intensive care medicine
pub_type： 杂志文章,评审
doi：10.1007/BF00255641
更新日期：1988-01-01 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：:Placement of a Swan-Ganz catheter can cause many complications. This case report presents a new complication of Swan-Ganz catheter insertion--placement of the Swan-Ganz catheter tip in the coronary sinus. ...
journal_title：Intensive care medicine
pub_type： 杂志文章
doi：10.1007/BF00254707
更新日期：1987-01-01 00:00:00
abstract：:A case of brainstem encephalitis complicated by torsade de pointes is described. The possible occurrence of ventricular arrhythmias may contribute to the mortality in this condition. We recommend the admission of patients with brainstem encephalitis to an intensive care unit, for a period of electrocardiographic monit...
journal_title：Intensive care medicine
pub_type： 杂志文章
doi：10.1007/BF00263564
更新日期：1987-01-01 00:00:00
abstract：OBJECTIVE:Comparison of side effects (fever shivering and/or allergic reactions, collapse, symptomatic hypocalcaemia) of the different substitution fluids used during therapeutical plasmapheresis. DESIGN:Multicentric retrospective comparative study designed to explore the side effects due to the replacements fluids (a...
journal_title：Intensive care medicine
pub_type： 杂志文章,多中心研究
doi：10.1007/s001340050595
更新日期：1998-05-01 00:00:00
abstract：OBJECTIVE:To investigate whether serum procalcitonin (PCT) levels could be useful to differentiate between systemic infection and the activity of the underlying disease in autoimmune disease. METHODS:In 18 patients with systemic lupus erythematodes (SLE) and 35 patients with systemic antineutrophil cytoplasmic antibod...
journal_title：Intensive care medicine
pub_type： 杂志文章
doi：10.1007/BF02900738
更新日期：2000-03-01 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:To determine the impact of missing Acute Physiology Score (APS) values on risk-adjusted mortality. DESIGN:Retrospective review of prospectively collected Acute Physiology and Chronic Health Evaluation (APACHE) III database. SETTING:The intensive care units (ICUs) of an academic medical center. PATIENTS:38,...
journal_title：Intensive care medicine
pub_type： 杂志文章
doi：10.1007/s00134-005-2751-9
更新日期：2005-11-01 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：:In severe status asthmaticus basic medical treatment often fails to improve the patient's condition. Mechanical ventilation in this situation is associated with a high incidence of serious complications. After the bronchodilating effect of moderate-dose magnesium sulfate in asthmatic patients had been demonstrated in ...
journal_title：Intensive care medicine
pub_type： 杂志文章
doi：10.1007/BF01711089
更新日期：1993-01-01 00:00:00
abstract：PURPOSE:Some patients presenting with acute respiratory failure and meeting the Berlin criteria for acute respiratory distress syndrome (ARDS) lack exposure to common risk factors (CRF). These so-called ARDS mimickers often lack histological diffuse alveolar damage. We aimed to describe such ARDS mimickers lacking CRF ...
journal_title：Intensive care medicine
pub_type： 杂志文章
doi：10.1007/s00134-015-4064-y
更新日期：2016-02-01 00:00:00
abstract：INTRODUCTION:A prospective physiological study was performed in 12 paediatric patients with acute moderate hypercapnic respiratory insufficiency to assess the ability of noninvasive positive pressure ventilation (NPPV) to unload the respiratory muscles and improve gas exchange. MATERIALS AND METHODS:Breathing pattern,...
journal_title：Intensive care medicine
pub_type： 临床试验,杂志文章
doi：10.1007/s00134-008-1202-9
更新日期：2008-12-01 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：:Pulmonary artery (PA) catheterization is now a routine procedure in the care of critically ill patients. We report a case in which a pulmonary artery catheter was a major factor in the demise of a patient who developed adult respiratory distress syndrome following a septic abortion. ...
journal_title：Intensive care medicine
pub_type： 杂志文章
doi：10.1007/BF00295990
更新日期：1989-01-01 00:00:00
abstract：OBJECTIVE:To determine the incidence rates of hospital acquired infections (HAI) during the first 14 days after ICU discharge after treatment during ICU-stay with Selective Decontamination of the Digestive tract (SDD), Selective Oropharyngeal Decontamination (SOD) or Standard Care (SC). DESIGN:Prospective observationa...
journal_title：Intensive care medicine
pub_type： 杂志文章
doi：10.1007/s00134-009-1554-9
更新日期：2009-09-01 00:00:00
abstract：OBJECTIVE:The liver plays a key role in the inflammatory response during major surgery or infection. The influence of age on liver function and hepatic acute phase protein (APP) synthesis should be serially studied in elderly patients undergoing major abdominal surgery. DESIGN AND SETTING:Prospective and descriptive s...
journal_title：Intensive care medicine
pub_type： 杂志文章
doi：10.1007/s00134-001-1126-0
更新日期：2001-11-01 00:00:00
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-...
journal_title：Intensive care medicine
pub_type： 杂志文章
doi：10.1007/s00134-004-2496-x
更新日期：2005-01-01 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
