Abstract:
OBJECTIVE:The role of haemofiltration as an adjunctive treatment of sepsis remains a contentious issue. To address the role of dose and to explore the biological effects of haemofiltration we compared the effects of standard and high-volume haemofiltration (HVHF) in a peritonitis-induced model of porcine septic shock. DESIGN AND SETTING:Randomized, controlled experimental study. SUBJECTS:Twenty-one anesthetized and mechanically ventilated pigs. INTERVENTIONS:After 12 h of hyperdynamic peritonitis, animals were randomized to receive either supportive treatment (Control, n = 7) or standard haemofiltration (HF 35 ml/kg per h, n = 7) or HVHF (100 ml/kg per hour, n = 7). MEASUREMENTS AND RESULTS:Systemic and hepatosplanchnic haemodynamics, oxygen exchange, energy metabolism (lactate/pyruvate, ketone body ratios), ileal and renal cortex microcirculation and systemic inflammation (TNF-alpha, IL-6), nitrosative/oxidative stress (TBARS, nitrates, GSH/GSSG) and endothelial/coagulation dysfunction (von Willebrand factor, asymmetric dimethylarginine, platelet count) were assessed before, 12, 18, and 22 h of peritonitis. Although fewer haemofiltration-treated animals required noradrenaline support (86, 43 and 29% animals in the control, HF and HVHF groups, respectively), neither of haemofiltration doses reversed hyperdynamic circulation, lung dysfunction and ameliorated alterations in gut and kidney microvascular perfusion. Both HF and HVHF failed to attenuate sepsis-induced alterations in surrogate markers of cellular energetics, nitrosative/oxidative stress, endothelial injury or systemic inflammation. CONCLUSIONS:In this porcine model of septic shock early HVHF proved superior in preventing the development of septic hypotension. However, neither of haemofiltration doses was capable of reversing the progressive disturbances in microvascular, metabolic, endothelial and lung function, at least within the timeframe of the study and severity of the model.
journal_name
Intensive Care Medjournal_title
Intensive care medicineauthors
Sykora R,Chvojka J,Krouzecky A,Radej J,Karvunidis T,Varnerova V,Novak I,Matejovic Mdoi
10.1007/s00134-008-1318-ysubject
Has Abstractpub_date
2009-02-01 00:00:00pages
371-80issue
2eissn
0342-4642issn
1432-1238journal_volume
35pub_type
杂志文章abstract::We report a clinical observation of acute pancreatitis due to severe hypertriglyceridemia in a pregnant woman. In order to decrease the serum triglyceride level rapidly, two lipaphereses were undertaken using the double-filtration technique. This lipoprotein apheresis technique is briefly described and the efficacy in...
journal_title:Intensive care medicine
pub_type: 杂志文章
doi:10.1007/BF01709884
更新日期:1991-01-01 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:OBJECTIVE:To determine the magnitude and time course of adrenergic effects on metabolism in volunteers and possible implications for the use of sympathomimetics in the critically ill. DESIGN:Descriptive laboratory investigation. SUBJECTS:7 volunteers. INTERVENTION:Primed continuous infusions of stable isotope tracer...
journal_title:Intensive care medicine
pub_type: 杂志文章
doi:10.1007/BF01707665
更新日期:1994-01-01 00:00:00
abstract::The process of surgical decision making is based on both general principles that are amenable to evaluation using rigorous techniques of clinical research and the intangible element of surgical judgment that seeks to apply those principles to the care of an individual patient. The role of surgical judgment is inescapa...
journal_title:Intensive care medicine
pub_type: 指南,杂志文章,实务指引,评审
doi:10.1007/pl00003797
更新日期:2001-01-01 00:00:00
abstract::Production of beta-lactamases is the most important means of bacterial resistance to beta-lactam antibiotics. The traditional, plasmid-mediated beta-lactamases were initially confined to Enterobacteriaceae but have now spread to other genera and species including Pseudomonas aeruginosa, Haemophilus influenzae, and Nei...
journal_title:Intensive care medicine
pub_type: 杂志文章,评审
doi:10.1007/BF01745244
更新日期:1994-07-01 00:00:00
abstract::We report the intensive care management of 23 children (age 3-15 years) following orthotopic heart (HT) and combined heart and lung transplantation (HLT) performed at our 2 institutes between February 1985 and August 1989. Cyclosporin A, azathioprine and steroids were given as routine immunosuppression, whilst anti-th...
journal_title:Intensive care medicine
pub_type: 杂志文章
doi:10.1007/BF01711219
更新日期:1990-01-01 00:00:00
abstract:OBJECTIVE:Pulmonary flow resistance is mainly determined by vessel calibres, resulting from the interaction of volume-passive distension and active vasomotion. However, quantitative information on the interplay between these counteracting forces in the lung is lacking. Therefore, we aimed at quantifying (1) the effects...
journal_title:Intensive care medicine
pub_type: 杂志文章
doi:10.1007/s001340051090
更新日期:1999-12-01 00:00:00
abstract::The endothelium is a highly dynamic cell layer that is involved in a multitude of physiological functions, including the control of vascular tone, the movement of cells and nutrients, the maintenance of blood fluidity and the growth of new vessels. During severe sepsis, the endothelium becomes proadhesive, procoagulan...
journal_title:Intensive care medicine
pub_type: 杂志文章,评审
doi:10.1007/s00134-010-1893-6
更新日期:2010-08-01 00:00:00
abstract::The influence of varying cardiac output (CO) on thermal-dye extravascular lung water (EVLW) was investigated in a total of 40 cardiac surgery patients before the onset of the operation. EVLW was measured by means of the double indicator dilution technique with indocyanine green as the non-diffusible indicator and a mi...
journal_title:Intensive care medicine
pub_type: 杂志文章
doi:10.1007/BF00255785
更新日期:1987-01-01 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::Physicians are increasingly involved in how their critically ill patients die [72]. The more this happens, the more physicians will have to understand not only how their own backgrounds and biases influence their medical management, but also the cultural and religious backgrounds of the patient and surrogate [72, 73]....
journal_title:Intensive care medicine
pub_type: 杂志文章,评审
doi:10.1007/s001340000641
更新日期:2000-10-01 00:00:00
abstract::Status epilepticus is one of the most frequent neurological emergencies in the intensive care unit. Standard treatment includes intravenous barbiturates, benzodiazepines and phenytoin. However, drug coma is sometimes necessary to control refractory status epilepticus. We report such a case, successfully treated by int...
journal_title:Intensive care medicine
pub_type: 杂志文章
doi:10.1007/BF01707672
更新日期:1994-01-01 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:OBJECTIVE:Brain death may induce cardiac dysfunction. In potential organ donors measurements of N-terminal pro-brain natriuretic peptide (NT-proBNP) and circulating cardiac troponins T and I (cTnT and cTnI), alone or in combination, are performed to investigate the accuracy of these biomarkers for early diagnosis of le...
journal_title:Intensive care medicine
pub_type: 杂志文章
doi:10.1007/s00134-007-0601-7
更新日期:2007-06-01 00:00:00
abstract:OBJECTIVE:To examine whether an appropriately designed combination of an index of ventilatory endurance and the frequency divided by tidal volume ratio (f/VT) provides prognostic information for weaning outcome not offered by any index alone. DESIGN AND SETTING:Prospective study in a multidisciplinary intensive care u...
journal_title:Intensive care medicine
pub_type: 杂志文章
doi:10.1007/s00134-006-0104-y
更新日期:2006-05-01 00:00:00
abstract:OBJECTIVE:We report the first patient to developed abdominal compartment syndrome (ACS) with intrahepatic portal venous gas (IHPVG) and pneumatosis cystoides intestinalis following emergency upper gastrointestinal endoscopy. CASE PRESENTATION:A 53-year-old man underwent an emergency upper gastrointestinal endoscopy fo...
journal_title:Intensive care medicine
pub_type: 信件
doi:10.1007/s00134-002-1492-2
更新日期:2002-11-01 00:00:00
abstract:PURPOSE:We set out to summarize the current challenges in academic conflict of interest. METHODS:This is a narrative review by a multidisciplinary, multinational panel of academic officers including deans of medical/pharmacy schools. RESULTS AND CONCLUSIONS:Disclosing conflict of interest has become the appropriate p...
journal_title:Intensive care medicine
pub_type: 杂志文章,评审
doi:10.1007/s00134-018-5458-4
更新日期:2019-01-01 00:00:00
abstract:OBJECTIVE:Infection is the most frequent cause of acute respiratory distress syndrome (ARDS). However, little is known about the influence of infection sites on ARDS. This study aimed to assess the associations of infection sites with ARDS development and mortality in critically ill infected patients. DESIGN:Prospecti...
journal_title:Intensive care medicine
pub_type: 杂志文章
doi:10.1007/s00134-010-1851-3
更新日期:2010-06-01 00:00:00
abstract:OBJECTIVE:To investigate whether the addition of intrapulmonary percussive ventilation to the usual chest physiotherapy improves gas exchange and lung mechanics in tracheostomized patients. DESIGN AND SETTING:Randomized multicenter trial in two weaning centers in northern Italy. PATIENTS AND PARTICIPANTS:46 tracheost...
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/s00134-006-0427-8
更新日期:2006-12-01 00:00:00
abstract:PURPOSE:Motion-mode (MM) echography allows precise measurement of diaphragmatic excursion when the ultrasound beam is parallel to the diaphragmatic displacement. However, proper alignment is difficult to obtain in patients after cardiac surgery; thus, measurements might be inaccurate. A new imaging modality named the a...
journal_title:Intensive care medicine
pub_type: 杂志文章,随机对照试验
doi:10.1007/s00134-014-3625-9
更新日期:2015-04-01 00:00:00
abstract:PURPOSE:This study explored differences in end-of-life (EOL) decisions and respect for patient autonomy of religious members versus those only affiliated to that particular religion (affiliated is a member without strong religious feelings). METHODS:In 2005 structured questionnaires regarding EOL decisions were distri...
journal_title:Intensive care medicine
pub_type: 杂志文章
doi:10.1007/s00134-012-2554-8
更新日期:2012-07-01 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:To determine the prevalence and the prognostic significance of microalbuminuria in patients after aneurysmal subarachnoid hemorrhage (SAH). DESIGN:Prospective and observational clinical study. SETTING:Multidisciplinary intensive care unit. PATIENTS:Fifty-one consecutive patients who underwent aneurysm clip...
journal_title:Intensive care medicine
pub_type: 杂志文章
doi:10.1007/s00134-007-0617-z
更新日期:2007-06-01 00:00:00
abstract::The purpose of this study was noninvasive assessment of respiratory compliance and resistance in mechanically ventilated patients with acute respiratory failure (ARF). To this end, flow, change in lung volume, and airway pressure were measured at the proximal tip of the endotracheal tubes in twenty nine critically ill...
journal_title:Intensive care medicine
pub_type: 杂志文章
doi:10.1007/BF00263528
更新日期:1988-01-01 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 compare characteristics, clinical evolution and outcome in adult patients with influenza A (H1N1) acute respiratory distress syndrome (ARDS) treated with or without extracorporeal membrane oxygenation (ECMO). METHODS:A prospective observational study of patients treated in Marseille South Hospital from Octo...
journal_title:Intensive care medicine
pub_type: 杂志文章
doi:10.1007/s00134-010-2021-3
更新日期:2010-11-01 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:PURPOSE:Intensive care unit survivors suffer from prolonged impairment, reduced quality of life, and higher mortality rates after discharge compared to the general population. Socioeconomic status may play a partial but important role in mortality and recovery. Therefore, the detection of factors that are responsible f...
journal_title:Intensive care medicine
pub_type: 杂志文章,多中心研究
doi:10.1007/s00134-018-5412-5
更新日期:2018-12-01 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 define the changes in middle cerebral artery flow velocity (Vmca) and the electroencephalogram (EEG) during rapid reduction in arterial carbon dioxide (PCO2) from acute hypercapnia. DESIGN. Human volunteer study. SETTING:University-affiliated hospital experimental laboratory. PARTICIPANTS:Nine healthy vo...
journal_title:Intensive care medicine
pub_type: 杂志文章
doi:10.1007/s00134-003-1917-6
更新日期:2003-10-01 00:00:00