Sildenafil attenuates pulmonary arterial pressure but does not improve oxygenation during ARDS.

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 sildenafil is beneficial for patients with ARDS. DESIGN:Prospective, open-label, multicenter, interventional cohort study. SETTING:Medical-surgical ICU of two university hospitals. PATIENTS:Ten consecutive patients meeting the NAECC criteria for ARDS. INTERVENTIONS:A single dose of 50 mg sildenafil citrate administered via a nasogastric tube. MAIN RESULTS:Administration of sildenafil in patients with ARDS decreased mean pulmonary arterial pressure from 25 to 22 mmHg (P = 0.022) and pulmonary artery occlusion pressure from 16 to 13 mmHg (P = 0.049). Systemic mean arterial pressures were markedly decreased from 81 to 75 mmHg (P = 0.005). Sildenafil did not improve pulmonary arterial oxygen tension, but resulted in a further increase in the shunt fraction. CONCLUSION:Although sildenafil reduced pulmonary arterial pressures during ARDS, the increased shunt fraction and decreased arterial oxygenation render it unsuitable for the treatment of patients with ARDS.

journal_name

Intensive Care Med

journal_title

Intensive care medicine

authors

Cornet AD,Hofstra JJ,Swart EL,Girbes AR,Juffermans NP

doi

10.1007/s00134-010-1754-3

subject

Has Abstract

pub_date

2010-05-01 00:00:00

pages

758-64

issue

5

eissn

0342-4642

issn

1432-1238

journal_volume

36

pub_type

临床试验,杂志文章,多中心研究
  • Hemodynamic effects of partial liquid ventilation with perfluorocarbon in acute lung injury.

    abstract:OBJECTIVE:To assess the effect of partial liquid ventilation with perfluorocarbons on hemodynamics and gas exchange in large pigs with induced acute lung injury (ALI). DESIGN:Randomized, prospective, double-control, experimental study. Experimental intensive care unit of a university. MATERIALS:Eighteen large pigs (5...

    journal_title:Intensive care medicine

    pub_type: 杂志文章

    doi:10.1007/BF01700657

    authors: Houmes RJ,Verbrugge SJ,Hendrik ER,Lachmann B

    更新日期:1995-12-01 00:00:00

  • Left ventricular function in tetanus: influence of therapy.

    abstract::Nine patients hospitalized for tetanus were studied under the same protocol which included two haemodynamic studies with a preload trial (PLT). The first being made during therapy (diazepam barbiturate association), on the sixth day of hospitalisation, and the second one after recovery. The comparison of the results s...

    journal_title:Intensive care medicine

    pub_type: 杂志文章

    doi:10.1007/BF01700252

    authors: Desjars P,Pinaud M,Baron D,Rodineau P,Nicolas R

    更新日期:1978-07-01 00:00:00

  • Interferon gamma in trauma-related infections.

    abstract:OBJECTIVE:The efficacy of interferon gamma therapy in reducing infection and improving outcome from infection in patients sustaining major injury was examined. DESIGN:Randomized double-blind placebo control trial SETTING:Nine level one university affiliated trauma centers in the United States. PATIENTS AND PARTICIPA...

    journal_title:Intensive care medicine

    pub_type: 临床试验,杂志文章,多中心研究,随机对照试验

    doi:10.1007/BF01743725

    authors: Dries DJ

    更新日期:1996-10-01 00:00:00

  • Association between tidal volume size, duration of ventilation, and sedation needs in patients without acute respiratory distress syndrome: an individual patient data meta-analysis.

    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

    authors: Serpa Neto A,Simonis FD,Barbas CS,Biehl M,Determann RM,Elmer J,Friedman G,Gajic O,Goldstein JN,Horn J,Juffermans NP,Linko R,de Oliveira RP,Sundar S,Talmor D,Wolthuis EK,de Abreu MG,Pelosi P,Schultz MJ

    更新日期:2014-07-01 00:00:00

  • How many patients with severe sepsis are needed to confirm the efficacy of drotrecogin alfa activated? A Bayesian design.

    abstract:OBJECTIVES:Controversies concerning the pivotal trial and negative results from other Drotrecogin alfa activated (DAA) trials have raised questions about its efficacy in severe sepsis patients. Based on all available evidence, our study aimed to respond to: (1) What is the current probability that DAA is not better tha...

    journal_title:Intensive care medicine

    pub_type: 杂志文章

    doi:10.1007/s00134-008-1159-8

    authors: Kalil AC,Sun J

    更新日期:2008-10-01 00:00:00

  • Muscle perfusion and oxygen consumption by near-infrared spectroscopy in septic-shock and non-septic-shock patients.

    abstract:OBJECTIVE:To measure muscle blood flow (Qtis) and oxygen consumption (VO(2)tis) in septic and non-septic critically ill patients by near-infrared spectroscopy (NIRS). SETTING:Surgical intensive care unit of a university hospital. PATIENTS AND PARTICIPANTS:Four patients with septic shock, eight post-surgical criticall...

    journal_title:Intensive care medicine

    pub_type: 杂志文章

    doi:10.1007/s00134-003-1805-0

    authors: Girardis M,Rinaldi L,Busani S,Flore I,Mauro S,Pasetto A

    更新日期:2003-07-01 00:00:00

  • End-expiratory lung impedance change enables bedside monitoring of end-expiratory lung volume change.

    abstract:OBJECTIVE:The aim of the study was to investigate the effect of lung volume changes on end-expiratory lung impedance change (ELIC) in mechanically ventilated patients, since we hypothesized that ELIC may be a suitable parameter to monitor lung volume change at the bedside. DESIGN:Clinical trial on patients requiring m...

    journal_title:Intensive care medicine

    pub_type: 临床试验,杂志文章

    doi:10.1007/s00134-002-1555-4

    authors: Hinz J,Hahn G,Neumann P,Sydow M,Mohrenweiser P,Hellige G,Burchardi H

    更新日期:2003-01-01 00:00:00

  • Predicting fluid responsiveness in 100 critically ill children: the effect of baseline contractility.

    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

    authors: Saxena R,Durward A,Steeley S,Murdoch IA,Tibby SM

    更新日期:2015-12-01 00:00:00

  • Influence of alveolar ventilation changes on calculated gastric intramucosal pH and gastric-arterial PCO2 difference.

    abstract:OBJECTIVE:To evaluate the influence of changes in alveolar ventilation on the following tonometry-derived variables: gastric intramucosal CO2 tension (PtCO2), gastric arterial CO2 tension difference (PgapCO2), gastric intramucosal pH (pHi) and arterial pH-pHi difference (pHgap). DESIGN:Clinical prospective study. SET...

    journal_title:Intensive care medicine

    pub_type: 临床试验,杂志文章

    doi:10.1007/s001340050834

    authors: Bernardin G,Lucas P,Hyvernat H,Deloffre P,Mattéi M

    更新日期:1999-03-01 00:00:00

  • Influenza vaccination and 1-year risk of myocardial infarction, stroke, heart failure, pneumonia, and mortality among intensive care unit survivors aged 65 years or older: a nationwide population-based cohort study.

    abstract:PURPOSE:We examined whether influenza vaccination affects 1-year risk of myocardial infarction, stroke, heart failure, pneumonia, and death among intensive care unit (ICU) survivors aged ≥ 65 years. METHODS:Danish Intensive Care Database data on all elderly ( ≥ 65 years) patients hospitalized in Danish ICUs in the per...

    journal_title:Intensive care medicine

    pub_type: 杂志文章

    doi:10.1007/s00134-019-05648-4

    authors: Christiansen CF,Thomsen RW,Schmidt M,Pedersen L,Sørensen HT

    更新日期:2019-07-01 00:00:00

  • Ficoll-separated mononuclear cells from sepsis patients are contaminated with granulocytes.

    abstract:OBJECTIVE:To determine the cell content and purity of Ficoll-separated peripheral blood mononuclear cells and granulocyte isolates in sepsis patients compared to healthy controls. DESIGN AND SETTING:Prospective study in the adult and pediatric intensive care departments of the Erasmus University Medical Center in the ...

    journal_title:Intensive care medicine

    pub_type: 杂志文章

    doi:10.1007/s00134-007-0989-0

    authors: van den Akker EL,Baan CC,van den Berg B,Russcher H,Joosten K,Hokken-Koelega AC,Lamberts SW,Koper JW

    更新日期:2008-05-01 00:00:00

  • Theoretical interactions between ventilator settings and proximal deadspace ventilation during tracheal gas insufflation.

    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

    authors: Hotchkiss JR Jr,Crooke PS 3rd,Marini JJ

    更新日期:1996-10-01 00:00:00

  • The safety and efficacy of sustained inflations as a lung recruitment maneuver in pediatric intensive care unit patients.

    abstract:OBJECTIVE:To assess the safety and efficacy of sustained inflations (SI) as lung recruitment maneuvers (RMs) in ventilated pediatric intensive care unit (PICU) patients. DESIGN:Observational, prospective data collection. SETTING:Tertiary-care PICU. PATIENTS AND PARTICIPANTS:Thirty-two consecutive ventilated pediatri...

    journal_title:Intensive care medicine

    pub_type: 杂志文章

    doi:10.1007/s00134-007-0764-2

    authors: Duff JP,Rosychuk RJ,Joffe AR

    更新日期:2007-10-01 00:00:00

  • Inappropriate ventilator triggering caused by an in-line suction catheter.

    abstract:OBJECTIVE:To examine the phenomenon of inappropriate triggering caused by an in-line suction catheter. DESIGN:We used a test lung to assess inappropriate triggering in four ventilators with both pressure and flow triggering. RESULTS:With pressure triggering, inappropriate triggering occurred only in the presence of P...

    journal_title:Intensive care medicine

    pub_type: 杂志文章

    doi:10.1007/s00134-002-1239-0

    authors: Al-Khafaji A,Manning HL

    更新日期:2002-04-01 00:00:00

  • Control of an epidemic spread of a multi-resistant strain of Acinetobacter calcoaceticus in a hospital.

    abstract::The spread of a multi-resistant glucose-acidifying Acinetobacter calcoaceticus strain in a community hospital was studied. After admission of a colonized patient to the hospital the strain was found in clinical specimens from ICU patients and subsequently from several of these patients after transfer to medical wards....

    journal_title:Intensive care medicine

    pub_type: 杂志文章

    doi:10.1007/BF01058568

    authors: Crombach WH,Dijkshoorn L,van Noort-Klaassen M,Niessen J,van Knippenberg-Gordebeke G

    更新日期:1989-01-01 00:00:00

  • Bench testing of a new hyperbaric chamber ventilator at different atmospheric pressures.

    abstract:PURPOSE:Providing mechanical ventilation is challenging at supra-atmospheric pressure. The higher gas density increases resistance, reducing the flow delivered by the ventilator. A new hyperbaric ventilator (Siaretron IPER 1000) is said to compensate for these effects automatically. The aim of this bench test study was...

    journal_title:Intensive care medicine

    pub_type: 杂志文章

    doi:10.1007/s00134-012-2590-4

    authors: Lefebvre JC,Lyazidi A,Parceiro M,Sferrazza Papa GF,Akoumianaki E,Pugin D,Tassaux D,Brochard L,Richard JC

    更新日期:2012-08-01 00:00:00

  • Antibiotic susceptibility in aerobic gram-negative bacilli isolated in intensive care units in 39 French teaching hospitals (ICU study).

    abstract:OBJECTIVE:Evaluation of the distribution and antibiotic susceptibility of the aerobic gram-negative bacilli (AGNB) isolated from patients in intensive care units (ICU study). DESIGN AND SETTING:Microbiological study carried out in 1991 in 39 teaching hospitals. A standardized method was used to determine the minimum i...

    journal_title:Intensive care medicine

    pub_type: 杂志文章

    doi:10.1007/BF01699228

    authors: Jarlier V,Fosse T,Philippon A

    更新日期:1996-10-01 00:00:00

  • Source control in the management of sepsis.

    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

    authors: Jimenez MF,Marshall JC,International Sepsis Forum.

    更新日期:2001-01-01 00:00:00

  • Sonographic evaluation of the diaphragm in critically ill patients. Technique and clinical applications.

    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

    authors: Matamis D,Soilemezi E,Tsagourias M,Akoumianaki E,Dimassi S,Boroli F,Richard JC,Brochard L

    更新日期:2013-05-01 00:00:00

  • Acute kidney injury in critically ill patients with 2009 influenza A (H1N1) viral pneumonia: an observational study.

    abstract:OBJECTIVE:To describe the incidence, risk factors, and impact on mortality of acute kidney injury (AKI) in patients with 2009 influenza A (H1N1) viral pneumonia requiring mechanical ventilation. DESIGN:Observational cohort study. PATIENTS AND METHODS:AKI was defined as risk, injury or failure, according to the RIFLE ...

    journal_title:Intensive care medicine

    pub_type: 杂志文章

    doi:10.1007/s00134-011-2167-7

    authors: Nin N,Lorente JA,Soto L,Ríos F,Hurtado J,Arancibia F,Ugarte S,Echevarría E,Cardinal P,Saldarini F,Bagnulo H,Cortés I,Bujedo G,Ortega C,Frutos F,Esteban A

    更新日期:2011-05-01 00:00:00

  • Interventions to reduce medication prescribing errors in a paediatric cardiac intensive care unit.

    abstract:OBJECTIVE:To identify and reduce medication-prescribing errors by introducing systematic physician education and post-cardiac surgery admission prescription forms. DESIGN:Errors were defined as: incomplete prescriptions; potential adverse drug events (ADEs), i.e. either intercepted or non-intercepted incorrect prescri...

    journal_title:Intensive care medicine

    pub_type: 杂志文章

    doi:10.1007/s00134-008-1054-3

    authors: Burmester MK,Dionne R,Thiagarajan RR,Laussen PC

    更新日期:2008-06-01 00:00:00

  • NovoSeven: mode of action and use in acquired haemophilia.

    abstract::Recombinant activated factor VII (rFVIIa, 'NovoSeven') is indicated for the treatment of spontaneous and surgical bleeding in patients with haemophilia A or B with antibodies to factors VIII or IX (FVIII or FIX) worldwide, and in patients with acquired haemophilia in Europe. In vitro cell models have demonstrated that...

    journal_title:Intensive care medicine

    pub_type: 杂志文章,评审

    doi:10.1007/s00134-002-1469-1

    authors: Von Depka M

    更新日期:2002-10-01 00:00:00

  • Steady-state trough serum and epithelial lining fluid concentrations of teicoplanin 12 mg/kg per day in patients with ventilator-associated pneumonia.

    abstract:OBJECTIVE:To determine the steady-state trough serum and epithelial lining fluid (ELF) concentrations of teicoplanin 12 mg/kg per day in critically ill patients with ventilator associated pneumonia. DESIGN AND SETTING:Prospective, pharmacokinetic study in the surgical intensive care unit in a university hospital. PAT...

    journal_title:Intensive care medicine

    pub_type: 杂志文章

    doi:10.1007/s00134-006-0136-3

    authors: Mimoz O,Rolland D,Adoun M,Marchand S,Breilh D,Brumpt I,Debaene B,Couet W

    更新日期:2006-05-01 00:00:00

  • Luxatio cordis due to right pericardium tear, a difficult diagnosis: report of a case.

    abstract:BACKGROUND:Dislocation of the heart is a rare complication of thoracic blunt trauma. A high index of suspicion of pericardium rupture is necessary to formulate an early diagnosis to reduce morbidity and mortality. PATIENTS:A 23-year-old man suffered a blunt thoracoabdominal trauma and was admitted 3 days later to a un...

    journal_title:Intensive care medicine

    pub_type: 杂志文章

    doi:10.1007/s00134-002-1328-0

    authors: Piazza O,De Robertis E,Fraioli G,Tufano R

    更新日期:2002-07-01 00:00:00

  • Feasibility and safety of extracorporeal CO2 removal to enhance protective ventilation in acute respiratory distress syndrome: the SUPERNOVA study.

    abstract:PURPOSE:We assessed feasibility and safety of extracorporeal carbon dioxide removal (ECCO2R) to facilitate ultra-protective ventilation (VT 4 mL/kg and PPLAT ≤ 25 cmH2O) in patients with moderate acute respiratory distress syndrome (ARDS). METHODS:Prospective multicenter international phase 2 study. Primary endpoint w...

    journal_title:Intensive care medicine

    pub_type: 杂志文章,多中心研究

    doi:10.1007/s00134-019-05567-4

    authors: Combes A,Fanelli V,Pham T,Ranieri VM,European Society of Intensive Care Medicine Trials Group and the “Strategy of Ultra-Protective lung ventilation with Extracorporeal CO2 Removal for New-Onset moderate to severe ARDS” (SUPERNOVA) investigators

    更新日期:2019-05-01 00:00:00

  • Intra-thoracic placement of central venous catheter despite ultrasound guidance.

    abstract:: ...

    journal_title:Intensive care medicine

    pub_type: 杂志文章

    doi:10.1007/s00134-018-5278-6

    authors: De Cassai A,Dal Cin S,Bertini D

    更新日期:2018-12-01 00:00:00

  • Evaluation of two processed EEG analyzers for assessment of sedation after coronary artery bypass grafting.

    abstract:OBJECTIVES:Processed EEG monitoring has been suggested for sedation depth evaluation in intensive care unit (ICU) patients. The present study investigated the efficacy of two processed EEG monitors using SEF90% or SEF95% and BIS to differentiate between conscious (Ramsay score 4) and unconscious sedation (Ramsay score ...

    journal_title:Intensive care medicine

    pub_type: 临床试验,杂志文章,随机对照试验

    doi:10.1007/s001340000761

    authors: Walder B,Suter PM,Romand JA

    更新日期:2001-01-01 00:00:00

  • Optimal therapy for severe pneumococcal community-acquired pneumonia.

    abstract::Streptococcus pneumoniae is responsible for two-thirds of ICU admissions due to community-acquired pneumonia (CAP) and is the leading cause of CAP-related death. Early death is principally due to cardiovascular collapse, whereas late death is associated with hypoxemic respiratory failure. Outcome depends on interactio...

    journal_title:Intensive care medicine

    pub_type: 杂志文章,评审

    doi:10.1007/s00134-006-0182-x

    authors: Luján M,Gallego M,Rello J

    更新日期:2006-07-01 00:00:00

  • Urgent bedside endoscopy for clinically significant upper gastrointestinal hemorrhage after admission to the intensive care unit.

    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

    authors: Lee YC,Wang HP,Wu MS,Yang CS,Chang YT,Lin JT

    更新日期:2003-10-01 00:00:00

  • Automatic calculation of the nine equivalents of nursing manpower use score (NEMS) using a patient data management system.

    abstract:OBJECTIVE:The most recent approach to estimate nursing resources consumption has led to the generation of the Nine Equivalents of Nursing Manpower use Score (NEMS). The objective of this prospective study was to establish a completely automatically generated calculation of the NEMS using a patient data management syste...

    journal_title:Intensive care medicine

    pub_type: 杂志文章

    doi:10.1007/s00134-004-2239-z

    authors: Junger A,Brenck F,Hartmann B,Klasen J,Quinzio L,Benson M,Michel A,Röhrig R,Hempelmann G

    更新日期:2004-07-01 00:00:00