Abstract:
BACKGROUND:After resuscitation, asphyxiated neonates often develop poor cardiac function with hypotension, pulmonary hypertension and multiorgan ischemia. In a swine model of neonatal hypoxia-reoxygenation, effects of epinephrine, dobutamine and milrinone on systemic, pulmonary and regional hemodynamics and oxygen transport were compared. DESIGN:Controlled, block-randomized study. SETTING:University research laboratory. SUBJECT:Mixed breed piglets (1-3 days, 1.5-2.3 kg). INTERVENTIONS:In acutely instrumented piglets, normocapnic alveolar hypoxia (10-15% oxygen) was induced for 2 h followed by reoxygenation with 100% oxygen (1 h) then 21% oxygen (3 h). At 2 h of reoxygenation, after volume loading (Ringer's lactate 10 ml/kg), either saline (placebo), epinephrine (0.5 microg/kg/min), dobutamine (20 microg/kg/min) or milrinone (0.75 microg/kg/min) were infused for 2 h in a blinded, block-randomized fashion (n = 6/group). MAIN RESULTS:All medications similarly improved cardiac output, stroke volume and systemic oxygen delivery (vs. placebo-controls, p < 0.05). Epinephrine and dobutamine significantly increased, while milrinone maintained, mean arterial pressure over pretreatment values while placebo-treated piglets developed hypotension and shock. The mean arterial to pulmonary arterial pressures ratio was not different among groups. All medications significantly increased carotid and intestinal, but not renal, arterial blood flows and oxygen delivery, whereas milrinone caused lower renal vascular resistance than epinephrine and dobutamine-treated groups. Plasma troponin I, plasma and myocardial lactate levels, and histologic ischemic features were not different among groups. CONCLUSIONS:In newborn piglets with hypoxia-reoxygenation, epinephrine, dobutamine and milrinone are effective inotropes to improve cardiac output, carotid and intestinal perfusion, without aggravating pulmonary hypertension. Milrinone may also improve renal perfusion.
journal_name
Intensive Care Medjournal_title
Intensive care medicineauthors
Joynt C,Bigam DL,Charrois G,Jewell LD,Korbutt G,Cheung PYdoi
10.1007/s00134-010-1820-xsubject
Has Abstractpub_date
2010-06-01 00:00:00pages
1058-66issue
6eissn
0342-4642issn
1432-1238journal_volume
36pub_type
杂志文章abstract:OBJECTIVE:To compare the total plasma cortisol values obtained from three widely used immunoassays and a high pressure liquid chromatography (HPLC) technique on samples obtained from patients with sepsis. DESIGN AND SETTING:Observational interventional in the general intensive care unit of a metropolitan hospital PAT...
journal_title:Intensive care medicine
pub_type: 杂志文章
doi:10.1007/s00134-006-0389-x
更新日期:2006-11-01 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: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:To compare the effects of a cerebral perfusion pressure (CPP) intervention achieved with dopamine and norepinephrine after severe head injury. DESIGN:Prospective, controlled, trial. SETTING:Neurosciences critical care unit. PATIENTS:Eleven patients with a head injury, requiring dopamine or norepinephrine i...
journal_title:Intensive care medicine
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1007/s00134-003-2155-7
更新日期:2004-05-01 00:00:00
abstract:: ...
journal_title:Intensive care medicine
pub_type: 评论,信件
doi:10.1007/s00134-018-5461-9
更新日期:2019-01-01 00:00:00
abstract:OBJECTIVE:In contrast to indocyanine green (ICG) blood clearance, the plasma disappearance rate (PDR) of ICG does not require absolute ICG blood concentrations and today can be assessed transcutaneously. In this study, we analyzed the relation between ICG disappearance rate and ICG blood clearance as parameters of live...
journal_title:Intensive care medicine
pub_type: 杂志文章
doi:10.1007/s00134-006-0109-6
更新日期:2006-05-01 00:00:00
abstract:OBJECTIVE:To evaluate the physiological effects of decannulation on breathing patterns and respiratory mechanics by comparing mouth breathing (MB) to tracheal breathing (TB) in tracheostomized patients. DESIGN AND SETTING:Prospective cross-over study in a critical and neuromuscular care unit. PATIENTS AND METHODS:Nin...
journal_title:Intensive care medicine
pub_type: 杂志文章
doi:10.1007/s00134-002-1545-6
更新日期:2002-12-01 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:OBJECTIVE:To evaluate clinical and microbiologic characteristics, modalities of treatment and outcome of patients with cervical necrotizing fasciitis admitted to our institution. DESIGN:Retrospective clinical investigation. PATIENTS AND METHODS:We reviewed the charts of 20 consecutive patients hospitalized in our Int...
journal_title:Intensive care medicine
pub_type: 杂志文章
doi:10.1007/s001340050959
更新日期:1999-08-01 00:00:00
abstract:OBJECTIVE:Atracurium besylate and laudanosine cause excitement and seizures when introduced into the central nervous system of laboratory animals. We examined the modulation of lipid-protein interaction in the lipid environment of rat brain synaptosomal plasma membrane (SPM)-bound enzymes as a possible mechanism leadin...
journal_title:Intensive care medicine
pub_type: 杂志文章
doi:10.1007/s001340050605
更新日期:1998-05-01 00:00:00
abstract:PURPOSE:To assess the utility of two in situ techniques, differential time to positivity (DTP) and semiquantitative superficial cultures (SQSC) for diagnosing catheter-related bloodstream infection (CR-BSI) in critically ill adults. METHODS:This was a prospective cohort study in patients with suspected CR-BSI arising ...
journal_title:Intensive care medicine
pub_type: 杂志文章
doi:10.1007/s00134-012-2689-7
更新日期:2013-01-01 00:00:00
abstract:OBJECTIVE:(1) To describe the pattern of intracranial pressure (ICP) and cerebral perfusion pressure (CPP) in a group of severe head-injured patients, (2) to quantify complications of ICP monitoring, and (3) to describe a management protocol and its results. DESIGN:Prospective observational study. SETTING:General int...
journal_title:Intensive care medicine
pub_type: 杂志文章
doi:10.1007/s001340050860
更新日期:1999-04-01 00:00:00
abstract:OBJECTIVE:To assess the ability of the Clinical Risk Index for Babies (CRIB) to predict long-term neurodevelopmental impairment in very low birth weight (VLBW) infants. DESIGN:Single-center cohort study. SETTING:Tertiary neonatal care hospital and follow-up clinic. PATIENTS:Four hundred fifty-five VLBW infants conse...
journal_title:Intensive care medicine
pub_type: 杂志文章
doi:10.1007/s001340051157
更新日期:2000-03-01 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:OBJECTIVES:To investigate at what time the peak level should be determined under conventional thrice daily (t.i.d.) administration of the aminoglycoside netilmicin and to study its serum concentrations under once daily (od) treatment to define the required daily dose and to gain information about convenient drug monito...
journal_title:Intensive care medicine
pub_type: 杂志文章
doi:10.1007/BF01694773
更新日期:1993-01-01 00:00:00
abstract:PURPOSE:To assess the feasibility of remifentanil-based sedation in hypoxemic acute respiratory failure (HARF) patients refusing to continue noninvasive ventilation (NPPV) for intolerance to two different interfaces-helmet and total face mask. DESIGN AND SETTING:Prospective uncontrolled clinical investigation in a 14-...
journal_title:Intensive care medicine
pub_type: 临床试验,杂志文章
doi:10.1007/s00134-010-2026-y
更新日期:2010-12-01 00:00:00
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
更新日期:1995-12-01 00:00:00
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
更新日期:2008-10-01 00:00:00
abstract:OBJECTIVE:To compare the effectiveness of traditional and online teaching methods for educating anesthesiology residents in the principles and practice of difficult airway management. DESIGN:Prospective, randomized, controlled trial. SETTING:University hospital. PARTICIPANTS:Two randomly selected groups, each contai...
journal_title:Intensive care medicine
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1007/s00134-005-2561-0
更新日期:2005-04-01 00:00:00
abstract:PURPOSE:Evidence of variation in mortality after surgery may indicate preventable postoperative death. We sought to determine if regional differences in outcome were present in surgical patients admitted to critical care in the UK. METHODS:We extracted data on admission characteristics, case mix and outcome of all pat...
journal_title:Intensive care medicine
pub_type: 杂志文章
doi:10.1007/s00134-015-3980-1
更新日期:2015-10-01 00:00:00
abstract:OBJECTIVES:Children with peripheral airways obstruction suffer the negative effects of intrinsic positive end-expiratory pressure: increased work of breathing and difficulty triggering assisted ventilatory support. We examined whether external positive end-expiratory pressure to offset intrinsic positive end-expiratory...
journal_title:Intensive care medicine
pub_type: 临床试验,杂志文章
doi:10.1007/s00134-006-0445-6
更新日期:2007-01-01 00:00:00
abstract:OBJECTIVE:To describe Enterococcus faecalis colonisation and endocarditis in 5 intensive care patients after treatment with selective decontamination (SDD). SETTING:Intensive care unit (ICU) in a general hospital. PATIENTS:The patients were admitted to the ICU because of adult respiratory distress syndrome, polytraum...
journal_title:Intensive care medicine
pub_type: 杂志文章
doi:10.1007/BF01701478
更新日期:1995-03-01 00:00:00
abstract::Cardiac arrhythmias and circulatory collapse account for the high mortality reported after severe chloroquine poisoning. We have recently observed a 17-year-old man who ingested an 8 g chloroquine overdose. Cardiac arrest occurred within 1 h. Cardiogenic shock was refractory to epinephrine, dopamine and molar sodium l...
journal_title:Intensive care medicine
pub_type: 杂志文章
doi:10.1007/BF01720684
更新日期:1991-01-01 00:00:00
abstract:OBJECTIVE:Aspiration of dead space (ASPIDS) improves carbon dioxide (CO2) elimination by replacing dead space air rich in CO2 with fresh gas during expiration. The hypothesis was that ASPIDS allows normocapnia to be maintained at low tidal volumes (VT). DESIGN:Prospective study. SETTING:Adult intensive care unit in a...
journal_title:Intensive care medicine
pub_type: 杂志文章
doi:10.1007/s001340050929
更新日期:1999-07-01 00:00:00
abstract:: ...
journal_title:Intensive care medicine
pub_type: 信件
doi:10.1007/s00134-018-5180-2
更新日期:2018-06-01 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:OBJECTIVE:To assess the role of antipseudomonal agents on Pseudomonas aeruginosa colonization and acquisition of resistance. DESIGN:Prospective cohort study. SETTING:Two medical intensive care units. PATIENTS AND PARTICIPANTS:346 patients admitted for >or= 48 h. INTERVENTION:Analysis of data from an 8-month study c...
journal_title:Intensive care medicine
pub_type: 杂志文章
doi:10.1007/s00134-008-1326-y
更新日期:2009-03-01 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:OBJECTIVE:To assess noise exposure during noninvasive ventilation (NIV) with different types of interface (helmet, nasal, and facial masks). SUBJECTS AND METHODS:Ten "naive" healthy volunteers underwent NIV at pressure support levels of 10 and 15 cmH2O with: (a) helmet, (b) helmet equipped with HME filters at the junc...
journal_title:Intensive care medicine
pub_type: 临床试验,杂志文章
doi:10.1007/s00134-004-2347-9
更新日期:2004-09-01 00:00:00
abstract:OBJECTIVES:Diagnosing persistent acute kidney injury (AKI) as opposed to transient AKI in critically ill patients may help physicians in making treatment decisions. This diagnosis relies chiefly on urinary indices, which may be of limited value or difficult to obtain. We assessed the performance of the Doppler renal re...
journal_title:Intensive care medicine
pub_type: 杂志文章
doi:10.1007/s00134-010-2050-y
更新日期:2011-01-01 00:00:00