Abstract:
:In 9 Goettingen minipigs we studied the effect of E. coli bacteremia on effective pulmonary capillary pressure and the longitudinal distribution of pulmonary vascular resistance. Precapillary pressure gradient (dPa) was calculated as the difference between mean pulmonary artery pressure (MPP) and effective pulmonary capillary pressure (Pc) (dPa = MPP-Pc), postcapillary pressure gradient (dPv) as the difference between Pc and left atrial pressure (dPv = Pc-LAP). The disturbance of pulmonary gas exchange was quantified by the AaDO2 quotient 1-PaO2/PAO2. Live E. coli infusion resulted in hypodynamic circulatory failure. Cardiac index fell from 3.7 +/- 0.81 . min-1.m-2 to 2.2 +/- 0.71 .min-1.m-2 after bacteremia lasting for 3.5 h. Simultaneously venous pulmonary vascular resistance rose from 25% of total pulmonary vascular resistance before to 32% after 3.5 h bacteremia, thus raising Pc from 11 mmHg to 16 mmHg. The degree of respiratory insufficiency was correlated with changes of MPP, dPa and dPv: 1-PaO2/PAO2 = 0.2 + 0.035.dPv (r = 0.829). Our results show, that the longitudinal distribution of pulmonary vascular resistance changes during septicemia, thus raising Pc. This may be an important factor in the genesis of septic pulmonary failure.
journal_name
Intensive Care Medjournal_title
Intensive care medicineauthors
Fretschner R,Klöss T,Guggenberger H,Heuser D,Schmid HJ,Widmann Mdoi
10.1007/BF01709400subject
Has Abstractpub_date
1990-01-01 00:00:00pages
500-5issue
8eissn
0342-4642issn
1432-1238journal_volume
16pub_type
杂志文章abstract:OBJECTIVE:To determine the presence of tricuspid regurgitation (TR) in patients affected by acute lung injury (ALI) and the adult respiratory distress syndrome (ARDS) during mechanical ventilation with positive end-expiratory pressure (PEEP). DESIGN:A prospective clinical study. SETTING:10-bed general intensive care ...
journal_title:Intensive care medicine
pub_type: 临床试验,杂志文章
doi:10.1007/s001340050419
更新日期:1997-08-01 00:00:00
abstract::A randomized study of 30 patients undergoing uncomplicated surgery under spinal anesthesia was conducted to assess the influence of colloids on the kinetics of plasma fibronectin and complement. Both are opsonins of the reticuloendothelial system; moreover fibronectin is concerned with host resistance against septic c...
journal_title:Intensive care medicine
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1007/BF01691428
更新日期:1991-01-01 00:00:00
abstract:PURPOSE:The intravenous fluid 6% hydroxyethyl starch (130/0.4) (6% HES 130/0.4) is used widely for resuscitation but there is limited information on its efficacy and safety. A large-scale multi-centre randomised controlled trial (CHEST) in critically ill patients is currently underway comparing fluid resuscitation with...
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/s00134-010-2117-9
更新日期:2011-05-01 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:OBJECTIVE:To compare outcome prediction using the Multiple Organ Dysfunction Score (MODS) and the Sequential Organ Failure Assessment (SOFA), two of the systems most commonly used to evaluate organ dysfunction in the intensive care unit (ICU). DESIGN:Prospective, observational study. SETTING:Thirty-one-bed, universit...
journal_title:Intensive care medicine
pub_type: 杂志文章
doi:10.1007/s00134-002-1491-3
更新日期:2002-11-01 00:00:00
abstract:OBJECTIVE:To describe hyperglycaemia as a possible marker of morbidity and mortality in critically ill medical and surgical patients admitted to a multidisciplinary ICU. DESIGN:Prospective cohort study. SETTING:A 13-bed non-cardiac multidisciplinary ICU in a university hospital. PATIENTS AND PARTICIPANTS:Adult patie...
journal_title:Intensive care medicine
pub_type: 杂志文章
doi:10.1007/s00134-004-2325-2
更新日期:2004-08-01 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 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
更新日期:2004-07-01 00:00:00
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
更新日期:1996-10-01 00:00:00
abstract::A case of aspiration pneumonitis during Caesarean section is described. The patient was treated with high-level continuous positive airway pressure (CPAP) resulting in marked improvement and discharge from the Intensive Care Unit 44 hours after the aspiration had occurred. ...
journal_title:Intensive care medicine
pub_type: 杂志文章
doi:10.1007/BF01757304
更新日期:1980-05-01 00:00:00
abstract:OBJECTIVE:Real-time measurement of stroke volume variation by arterial pulse contour analysis (SVV) is useful in predicting volume responsiveness and monitoring volume therapy in mechanically ventilated patients. This study investigated the influence of the depth of tidal volume (V(t)) on SVV both during the state of f...
journal_title:Intensive care medicine
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1007/s00134-003-1649-7
更新日期:2003-03-01 00:00:00
abstract:OBJECTIVE:Five commercially available oesophageal balloon catheters (OBCs) were tested to evaluate the accuracy in transmitting fast-changing pressure signals which can be observed, for example, during phrenic nerve stimulation. SETTING:Research laboratory of a university hospital. METHOD:The OBCs tested varied in le...
journal_title:Intensive care medicine
pub_type: 杂志文章
doi:10.1007/s001340051182
更新日期:2000-04-01 00:00:00
abstract:OBJECTIVE:We examined in rabbits the effects of more than 48 h of mechanical ventilation on the contractile properties and fiber type adaptations of the respiratory muscles. DESIGN AND SETTING:Experimental prospective study in a university laboratory. ANIMALS AND INTERVENTIONS:Nineteen rabbits were randomly allocated...
journal_title:Intensive care medicine
pub_type: 杂志文章
doi:10.1007/s00134-002-1548-3
更新日期:2003-01-01 00:00:00
abstract:PURPOSE:Critical care ultrasonography has utility for the diagnosis and management of critical illness and is in widespread use by frontline intensivists. As there is a need for research to validate and extend its utility, the Editor of Intensive Care Medicine included critical care ultrasonography as a topic in the IC...
journal_title:Intensive care medicine
pub_type: 杂志文章,评审
doi:10.1007/s00134-017-4734-z
更新日期:2017-09-01 00:00:00
abstract:OBJECTIVE:The aim of the present study was (1) to determine the prevalence of intensive care unit (ICU) admissions due to an adverse drug reaction (ADR), and (2) to compare affected patients with patients admitted to the ICU for the treatment of deliberate self-poisoning using medical drugs. DESIGN:Prospective observa...
journal_title:Intensive care medicine
pub_type: 杂志文章
doi:10.1007/s00134-008-1250-1
更新日期:2009-02-01 00:00:00
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 sildenafi...
journal_title:Intensive care medicine
pub_type: 临床试验,杂志文章,多中心研究
doi:10.1007/s00134-010-1754-3
更新日期:2010-05-01 00:00:00
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
更新日期:2003-07-01 00:00:00
abstract:PURPOSE:To determine the global metabolomic profile as measured in circulating plasma from surviving and non-surviving patients with community-acquired pneumonia (CAP) and sepsis. METHODS:Random, outcome-stratified case-control sample from a prospective study of 1,895 patients hospitalized with CAP and sepsis. Cases (...
journal_title:Intensive care medicine
pub_type: 杂志文章,随机对照试验
doi:10.1007/s00134-013-2935-7
更新日期:2013-08-01 00:00:00
abstract:PURPOSE:Sedatives administered to critically ill children should be titrated to effect, because both under- and oversedation may have negative effects. We conducted a systematic review to examine reported incidences of under-, optimal, and oversedation in critically ill children receiving intensive care. METHODS:A sys...
journal_title:Intensive care medicine
pub_type: 杂志文章,评审
doi:10.1007/s00134-013-2971-3
更新日期:2013-09-01 00:00:00
abstract:OBJECTIVE:The primary objective was to test the hypothesis that clinical re-expansion pulmonary edema is predominantly due to increased permeability of the alveolar-capillary barrier. A secondary objective was to determine if the alveolar epithelium was functionally intact in patients with re-expansion pulmonary edema ...
journal_title:Intensive care medicine
pub_type: 杂志文章
doi:10.1007/s00134-004-2379-1
更新日期:2004-10-01 00:00:00
abstract:PURPOSE:Although low doses of oxygen (FiO2 <0.50) are considered nontoxic, recent studies have shown that even lower doses increase pulmonary inflammatory mediators. We aimed to evaluate the acute effects of reducing FiO2 on pulmonary inflammation in mechanically ventilated patients without respiratory failure. METHOD...
journal_title:Intensive care medicine
pub_type: 杂志文章
doi:10.1007/s00134-012-2801-z
更新日期:2013-04-01 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:OBJECTIVE:Biomarkers allowing accurate early staging of septic shock patients are lacking despite their obvious interest for patient management. Experimental models of septic shock in mouse previously noted a decrease in dendritic cell numbers. The aim of the study was to find a rapid reproducible biological test for a...
journal_title:Intensive care medicine
pub_type: 杂志文章
doi:10.1007/s00134-006-0436-7
更新日期:2007-01-01 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::Nosocomial infections are a major problem in intensive care patients. Thirty-nine patients, requiring intensive care for 5 days or more (mean 15.8 days) were prospectively investigated, to determine the relation between colonisation and nosocomial infection. Thrice weekly, cultures from the oropharynx, respiratory and...
journal_title:Intensive care medicine
pub_type: 杂志文章
doi:10.1007/BF00255792
更新日期:1987-01-01 00:00:00
abstract::We report a case of hyperinflation induced isorythmic atrio-ventricular dissociation with circulatory failure in a patient with chronic obstructive pulmonary disease. The arrythmia was successfully treated by applying "pressure support ventilation" (PSV: 20 cmH2O) which, by decreasing the respiratory rate and increasi...
journal_title:Intensive care medicine
pub_type: 杂志文章
doi:10.1007/BF00263868
更新日期:1989-01-01 00:00:00
abstract:OBJECTIVE:Oxygen consumption (VO2) obtained from respiratory gases by indirect calorimetry (VO2,IC) with a metabolic monitor integrated in a ventilator were to be compared to VO2 obtained by the Fick principle (VO2,Fick) in septic patients following an increase in oxygen delivery (DO2) induced by positive inotropic sup...
journal_title:Intensive care medicine
pub_type: 临床试验,杂志文章
doi:10.1007/s001340000635
更新日期:2000-12-01 00:00:00
abstract:OBJECTIVE:There are a number of potential etiologies of severe bleeding encountered in the intensive care unit. Although rare, acquired hemophilia is one such etiology that often presents with major bleeding requiring intensive care. Despite the introduction of effective treatments, the reported mortality rate of patie...
journal_title:Intensive care medicine
pub_type: 杂志文章,评审
doi:10.1007/s00134-011-2258-5
更新日期:2011-08-01 00:00:00
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
更新日期:2007-10-01 00:00:00
abstract:OBJECTIVE:To determine the diagnostic performance of a Bayesian Decision-Support System (BDSS) for ventilator-associated pneumonia (VAP). DESIGN:A previously developed BDSS, automatically obtaining patient data from patient information systems, provides likelihood predictions of VAP. In a prospectively studied cohort ...
journal_title:Intensive care medicine
pub_type: 杂志文章
doi:10.1007/s00134-007-0728-6
更新日期:2007-08-01 00:00:00