Abstract:
OBJECTIVE:To test the hypothesis that levosimendan increases systemic and intestinal oxygen delivery (DO(2)) and prevents intramucosal acidosis in septic shock. DESIGN:Prospective, controlled experimental study. SETTING:University-based research laboratory. SUBJECTS:Nineteen anesthetized, mechanically ventilated sheep. INTERVENTIONS:Endotoxin-treated sheep were randomly assigned to three groups: control (n=7), dobutamine (10 microg/kg/min, n=6) and levosimendan (100 microg/kg over 10 min followed by 100 microg/kg/h, n=6) and treated for 120 min. MEASUREMENTS AND MAIN RESULTS:After endotoxin administration, systemic and intestinal DO(2) decreased (24.6+/-5.2 vs 15.3+/-3.4 ml/kg/min and 105.0+/-28.1 vs 55.8+/-25.9 ml/kg/min, respectively; p<0.05 for both). Arterial lactate and the intramucosal-arterial PCO(2) difference (DeltaPCO(2)) increased (1.4+/-0.3 vs 3.1+/-1.5 mmHg and 9+/-6 vs 23+/-6 mmHg mmol/l, respectively; p<0.05). Systemic DO(2) was preserved in the dobutamine-treated group (22.3+/-4.7 vs 26.8+/-7.0 ml/min/kg, p=NS) but intestinal DO(2) decreased (98.9+/-0.2 vs 68.0+/-22.9 ml/min/kg, p<0.05) and DeltaPCO(2) increased (12+/-5 vs 25+/-11 mmHg, p<0.05). The administration of levosimendan prevented declines in systemic and intestinal DO(2) (25.1+/-3.0 vs 24.0+/-6.3 ml/min/kg and 111.1+/-18.0 vs 98.2+/-23.1 ml/min/kg, p=NS for both) or increases in DeltaPCO(2) (7+/-7 vs 10+/-8, p=NS). Arterial lactate increased in both the dobutamine and levosimendan groups (1.6+/-0.3 vs 2.5+/-0.7 and 1.4+/-0.4 vs. 2.9+/-1.1 mmol/l, p=NS between groups). CONCLUSIONS:Compared with dobutamine, levosimendan increased intestinal blood flow and diminished intramucosal acidosis in this experimental model of sepsis.
journal_name
Intensive Care Medjournal_title
Intensive care medicineauthors
Dubin A,Murias G,Sottile JP,Pozo MO,Barán M,Edul VS,Canales HS,Etcheverry G,Maskin B,Estenssoro Edoi
10.1007/s00134-006-0519-5subject
Has Abstractpub_date
2007-03-01 00:00:00pages
485-94issue
3eissn
0342-4642issn
1432-1238journal_volume
33pub_type
杂志文章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 compare some of the confirmatory investigations of brain death with clinical criteria in order to achieve the most sensitive and accurate diagnosis of brain death. DESIGN:All patients with isolated brain lesions and Glasgow Coma Scale (GCS) = 3 were subjected to neurological examination after ruling out h...
journal_title:Intensive care medicine
pub_type: 杂志文章
doi:10.1007/BF01711544
更新日期:1995-08-01 00:00:00
abstract:OBJECTIVE:To determine the relationship between the clinically evaluated depth of midazolam-induced sedation and the cardiac beat-to-beat variability (RR variability) in ICU patients in the intensive care unit (ICU). DESIGN:Prospective study. SETTING:ICU of a university hospital. PATIENTS:20 consecutive patients stu...
journal_title:Intensive care medicine
pub_type: 杂志文章
doi:10.1007/BF01709555
更新日期:1996-12-01 00:00:00
abstract:BACKGROUND:Peripherally inserted central venous catheters (PICC) have been proposed as an alternative to central venous catheters (CVC). The aim of this study was to determine the thrombosis rate in relation to PICC placement in patients discharged from the intensive care unit (ICU). METHODS:Data of patients admitted ...
journal_title:Intensive care medicine
pub_type: 杂志文章
doi:10.1007/s00134-010-2043-x
更新日期:2011-02-01 00:00:00
abstract:OBJECTIVE:To investigate the sources of hemorrhage and use of endoscopic hemostasis in patients with clinically significant upper gastrointestinal (UGI) hemorrhage after admission to the intensive care unit (ICU). DESIGN AND SETTING:Prospective study, 123 beds of ICU in a 1,629-bed medical center. MEASUREMENTS AND RE...
journal_title:Intensive care medicine
pub_type: 杂志文章
doi:10.1007/s00134-003-1921-x
更新日期:2003-10-01 00:00:00
abstract:OBJECTIVE:The association of acute-phase reaction and outcome of patients with acute vascular diseases is controversial. The prognostic value of admission C-reactive protein (CRP) in patients with acute aortic aneurysm or dissection has not yet been investigated. DESIGN AND SETTING:Cohort study including 255 consecuti...
journal_title:Intensive care medicine
pub_type: 杂志文章
doi:10.1007/s00134-002-1299-1
更新日期:2002-06-01 00:00:00
abstract:OBJECTIVE:To study the pharmacokinetics and local tissue effects resulting from the intratracheal administration of preservative-free fentanyl. DESIGN:Prospective, randomized, blinded and controlled animal study. SETTING:University research laboratory. SUBJECTS:Eighteen adult male New Zealand rabbits. INTERVENTIONS...
journal_title:Intensive care medicine
pub_type: 杂志文章
doi:10.1007/BF01720719
更新日期:1996-02-01 00:00:00
abstract:OBJECTIVE:The study was undertaken to determine if critically ill patients under mechanical ventilation could reactivate latent cytomegalovirus (CMV) in either lung or blood. DESIGN:Prospective study in critically ill patients was performed in a multidisciplinary intensive care unit in a university hospital. PATIENTS...
journal_title:Intensive care medicine
pub_type: 杂志文章
doi:10.1007/BF01709343
更新日期:1996-11-01 00:00:00
abstract::Paediatric admissions to a general ITU are briefly reviewed. Although it may not be an ideal arrangement it is suggested that children can be safely cared for in such a unit. The problems created by the child with acute upper airway obstruction are discussed to demonstrate the way in which the unit is organized to rec...
journal_title:Intensive care medicine
pub_type: 杂志文章
doi:10.1007/BF00260356
更新日期:1985-01-01 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:OBJECTIVE:In normal subjects cerebral CO2 vasoreactivity is measured during spontaneous hyperventilation, breathholding, or adding CO2 to inspiratory gases. The correlation between CO2 and cerebral blood flow may, however, be invalidated by the effects of a modified respiratory pattern on venous return, sympathovagal b...
journal_title:Intensive care medicine
pub_type: 临床试验,杂志文章
doi:10.1007/s001340051239
更新日期:2000-06-01 00:00:00
abstract:OBJECTIVE:Growing evidence suggests that acute respiratory distress syndrome (ARDS) occurring as a consequence of primary (direct) lung injury differs from that resulting from secondary (indirect) lung injury in terms of radiographic appearance, response to interventions, and outcomes. We examined whether there are dif...
journal_title:Intensive care medicine
pub_type: 杂志文章,多中心研究
doi:10.1007/s00134-006-0344-x
更新日期:2006-11-01 00:00:00
abstract:PURPOSE:Common opioids for analgesia and sedation of mechanically ventilated infants may tend to accumulate and cause prolonged sedation with an unpredictable extubation time. Remifentanil is a promising option due to its unique pharmacokinetic properties, which seem to be valid in adults as well as in infants. METHOD...
journal_title:Intensive care medicine
pub_type: 杂志文章,随机对照试验
doi:10.1007/s00134-012-2532-1
更新日期:2012-06-01 00:00:00
abstract:OBJECTIVE:a) to describe a non-barotraumatic ventilatory setting for independent lung ventilation (ILV); b) to determine the utility of single lung end-tidal CO(2) (EtCO(2)) monitoring to evaluate the ventilation to perfusion (V/Q) matching in each lung during ILV and for ILV weaning. DESIGN:prospective study. SETTIN...
journal_title:Intensive care medicine
pub_type: 临床试验,杂志文章
doi:10.1007/s00134-001-1149-6
更新日期:2001-12-01 00:00:00
abstract:PURPOSE:Type 1 angiotensin II (AT1) receptor antagonists have anti-inflammatory effects in vitro and in patients. The purpose of this study was to investigate whether losartan (LOS), an AT1 receptor antagonist, reduces lung damage by inhibiting the induction of high mobility group box 1 (HMGB1) protein and cytokines by...
journal_title:Intensive care medicine
pub_type: 杂志文章
doi:10.1007/s00134-009-1545-x
更新日期:2009-08-01 00:00:00
abstract:OBJECTIVE:The evaluation of incidences and relating factors of severe persisting critical illness polyneuropathy (CIP) in survivors of multiple organ failure (MOF). DESIGN:Prospective study with an entry period of 24 months. Electrophysiological studies for the diagnosis of CIP were performed 1 or 2 days before the pa...
journal_title:Intensive care medicine
pub_type: 杂志文章
doi:10.1007/s001340050471
更新日期:1997-11-01 00:00:00
abstract:OBJECTIVES:To analyse the clinical value of procalcitonin (PCT), C-reactive protein (CRP) and leucocyte count in the diagnosis of paediatric sepsis and in the stratification of patients according to severity. DESIGN:Prospective, observational study. SETTING:Paediatric intensive care unit (PICU). PATIENTS:Ninety-four...
journal_title:Intensive care medicine
pub_type: 杂志文章
doi:10.1007/s00134-006-0509-7
更新日期:2007-03-01 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: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:OBJECTIVE:Alterations in coagulation, including elevated pulmonary and systemic concentrations of urokinase, are frequent in patients with acute lung injury (ALI). Urokinase potentiates neutrophil activation and contributes to the severity of pulmonary injury in preclinical models of ALI. The objective of this study wa...
journal_title:Intensive care medicine
pub_type: 杂志文章,多中心研究
doi:10.1007/s00134-007-0930-6
更新日期:2008-02-01 00:00:00
abstract:INTRODUCTION:Approximately 20 years have passed since we reported our results of histologically proven cytomegalovirus (CMV) pneumonia in non-immunocompromised ICU patients. Even if there are more recent reports suggesting that CMV may worsen the outcomes for ICU patients, there is no definite answer to this question: ...
journal_title:Intensive care medicine
pub_type: 杂志文章
doi:10.1007/s00134-015-4066-9
更新日期:2016-01-01 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::We report the case of a 72-year-old male who suffered a cardiac arrest during an early positive treadmill stress test. After successful resuscitation the patient had evidence of a gastric perforation. Because of his hemodynamic stability, lack of peritoneal signs, and prohibitively high surgical risk, a non-operative ...
journal_title:Intensive care medicine
pub_type: 杂志文章
doi:10.1007/BF01710656
更新日期:1994-07-01 00:00:00
abstract:OBJECTIVE:To determine the effects of increasing dosages of continuously infused arginine-vasopressin (AVP) on mucosal tissue oxygen tension and oxygen supply in an auto-perfused, innervated jejunal segment in an acute endotoxic porcine model. DESIGN:Prospective, randomized, experimental study. SETTING:University hos...
journal_title:Intensive care medicine
pub_type: 杂志文章
doi:10.1007/s00134-005-2858-z
更新日期:2006-01-01 00:00:00
abstract:PURPOSE:Septic shock-induced disseminated intravascular coagulopathy (DIC) contributes to multiple organ failure. Mechanisms governing vascular responses to open occurrence of DIC have not yet been established. Circulating plasma microparticles (MPs), released upon cell stress, constitute a catalytic procoagulant surfa...
journal_title:Intensive care medicine
pub_type: 临床试验,杂志文章,多中心研究
doi:10.1007/s00134-013-2993-x
更新日期:2013-10-01 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:PURPOSE:Limited data exist on the correlation between higher flow rates of high-flow nasal cannula (HFNC) and its physiologic effects in patients with acute hypoxemic respiratory failure (AHRF). We assessed the effects of HFNC delivered at increasing flow rate on inspiratory effort, work of breathing, minute ventilatio...
journal_title:Intensive care medicine
pub_type: 杂志文章
doi:10.1007/s00134-017-4890-1
更新日期:2017-10-01 00:00:00
abstract::The original version of this article unfortunately contained a mistake. ...
journal_title:Intensive care medicine
pub_type: 杂志文章,已发布勘误
doi:10.1007/s00134-020-06009-2
更新日期:2020-05-01 00:00:00
abstract:INTRODUCTION:Microcirculatory abnormalities are frequently observed in patients with severe heart failure and correlate to worse outcomes. We tested the hypothesis that nitroglycerin dose-dependently improves perfusion in severe heart failure and that this could be monitored by measuring central-peripheral temperature ...
journal_title:Intensive care medicine
pub_type: 杂志文章
doi:10.1007/s00134-009-1591-4
更新日期:2009-11-01 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