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. METHODS:This study was a prospective, single-center crossover study in a medical/surgical intensive care unit at a university hospital. Hemodynamically stable patients under mechanical ventilation for >24 h without severe respiratory failure (PaO2/FiO2 >250). A basal FiO2 of 0.40 was reduced to 0.21 provided SpO2 remained higher than 90 %. Patients who could not tolerate the reduction in FiO2 to 0.21 were excluded. RESULTS:We screened 40 patients, but only 28 (70 %) tolerated FiO2 0.21. We measured common clinical variables and inflammatory mediators in plasma and in exhaled breath condensate (EBC) at the end of three 4-h periods: (1) basal (FiO2 0.40), (2) after FiO2 reduction to 0.21, and (3) after returning FiO2 0.40. We used one-way ANOVA for repeated measurements with FiO2 as the grouping variable. Median values of inflammatory mediators in EBC showed nonsignificant changes among the three periods: NO2 + NO3 17.1, 14.1 and 11.0 μmol/L (p = 0.2), and 8-isoprostane 4.4, 8.2 and 5.3 pg/ml (p = 0.6) for the three periods, respectively. Plasma levels also showed nonsignificant changes during the period of the study: NO2 + NO3 12.6, 16.3 and 15.0 μmol/L (p = 0.9), TNFα 13.5, 18.0 and 14.5 pg/ml (p = 0.8), IL-4 12.9, 18.7 and 23.9 pg/ml (p = 0.1), IL-6 50.9, 35.1 and 28.3 pg/ml (p = 0.6), and IL-10 15.2, 22.2 and 22.2 pg/ml (p = 0.7) for the three periods, respectively. CONCLUSION:FiO2 0.40 in mechanically ventilated patients without severe respiratory failure did not increase systemic or pulmonary inflammation.
journal_name
Intensive Care Medjournal_title
Intensive care medicineauthors
Fernandez R,Gili G,Villagra A,Lopez-Aguilar J,Artigas Adoi
10.1007/s00134-012-2801-zsubject
Has Abstractpub_date
2013-04-01 00:00:00pages
711-6issue
4eissn
0342-4642issn
1432-1238journal_volume
39pub_type
杂志文章abstract:OBJECTIVE:To determine whether health-related quality of life (HRQL) in survivors of acute renal failure (ARF) occurring in intensive care is predictable from data available at the time of acute illness. DESIGN AND SETTING:Prospective pilot study in academic intensive care units. PATIENTS AND METHODS:Patients requiri...
journal_title:Intensive care medicine
pub_type: 杂志文章
doi:10.1007/s00134-003-1837-5
更新日期:2003-09-01 00:00:00
abstract:OBJECTIVE:The interchangeability of continuous measurement of cardiac output (CO) with the traditional bolus method in patients after cardiopulmonary bypass (CPB) is uncertain. DESIGN:Prospective observational clinical study. SETTING:A 20-bed surgical ICU at a university hospital. PATIENTS:Fourteen deeply sedated, v...
journal_title:Intensive care medicine
pub_type: 杂志文章
doi:10.1007/s00134-006-0161-2
更新日期:2006-06-01 00:00:00
abstract:OBJECTIVE:To investigate efficacy and safety of enoxaparin for catheter-related arterial thrombosis in infants with congenital heart disease. DESIGN:Prospective observational study. SETTING:Pediatric Intensive Care and Cardiology Unit at the University Children's Hospital of Zurich. PATIENTS:A cohort of 32[Symbol: s...
journal_title:Intensive care medicine
pub_type: 杂志文章
doi:10.1007/s00134-007-0718-8
更新日期:2007-11-01 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 pressure-volume (P/V) curve has been proposed as a tool to adjust the ventilatory settings in cases of acute respiratory distress syndrome (ARDS). The aim of this study was to test the influence of P/V tracing methodology on the presence and value of the upper inflection point (UIP). METHODS:In 13 medica...
journal_title:Intensive care medicine
pub_type: 杂志文章
doi:10.1007/s00134-002-1293-7
更新日期:2002-07-01 00:00:00
abstract::We describe a case of the dialysis disequilibrium syndrome (DDS) that was marked by the rapid onset of cerebral edema and the subsequent development of acute respiratory failure. The patient was treated successfully with a combination of mechanical hyperventilation and mannitol. The clinical presentation, pathogenesis...
journal_title:Intensive care medicine
pub_type: 杂志文章
doi:10.1007/s001340051214
更新日期:2000-05-01 00:00:00
abstract:OBJECTIVE:Invasive candidiasis (IC) outcomes in intensive care units (ICUs) could be improved by the early administration of antifungals. The Candida Score (CS) prediction rule has been proposed for the selection of patients who could develop IC. Procalcitonin (PCT) levels allow prompt identification of sepsis, but the...
journal_title:Intensive care medicine
pub_type: 杂志文章
doi:10.1007/s00134-009-1623-0
更新日期:2009-12-01 00:00:00
abstract:OBJECTIVES:(1) To demonstrate that metabolic parameters are better indicators of tissue hypoxia than regional and whole oxygen consumption (VO(2)). (2) To compare intramucosal pH (pHi) in different gastrointestinal segments. DESIGN:Prospective, interventional study. SETTING:Research laboratory at a university center....
journal_title:Intensive care medicine
pub_type: 杂志文章
doi:10.1007/s00134-001-1138-9
更新日期:2001-12-01 00:00:00
abstract:OBJECTIVE:To assess the effect of strict guidelines and a rigorous training program on variability in scoring the revised Acute Physiology and Chronic Health Evaluation (APACHE II). DESIGN AND SETTING:Prospective survey and intervention in the surgical ICU of a university teaching hospital. MEASUREMENTS:Seven experie...
journal_title:Intensive care medicine
pub_type: 临床试验,杂志文章
doi:10.1007/s001340101012
更新日期:2001-08-01 00:00:00
abstract:OBJECTIVE:To determine the relationship between ionized calcium concentrations and blood lactate levels during cardiac arrest and cardiopulmonary resuscitation (CPR). DESIGN:A prospective cohort study. SETTING:Emergency department (ED) and general intensive care unit in a city hospital (tertiary care center). PATIEN...
journal_title:Intensive care medicine
pub_type: 杂志文章
doi:10.1007/s001340050493
更新日期:1997-12-01 00:00:00
abstract:OBJECTIVE:To investigate the effect of respiratory physiotherapy on the prevention and treatment of ventilator-associated pneumonia (VAP) for adults in an intensive care unit (ICU) with an acquired brain injury (ABI). DESIGN AND SETTING:Two-part, prospective, randomised controlled trial. PATIENTS:A total of 144 subje...
journal_title:Intensive care medicine
pub_type: 杂志文章,随机对照试验
doi:10.1007/s00134-008-1278-2
更新日期:2009-02-01 00:00:00
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
更新日期:1999-03-01 00:00:00
abstract:OBJECTIVE:To investigate the regional partial pressure of oxygen (PO2) and partial pressure of carbon dioxide (PCO2) of the perfluorocarbon liquid (PpfcO2, PpfcCO2) during partial liquid ventilation (PLV). DESIGN:Prospective, controlled study. SETTING:A research laboratory at a university medical center. SUBJECTS:Th...
journal_title:Intensive care medicine
pub_type: 杂志文章
doi:10.1007/s001340000706
更新日期:2001-01-01 00:00:00
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
更新日期:2002-04-01 00:00:00
abstract::In the first study 6 patients with raised intracranial pressure due to brain oedema following head injury were given dihydroergotamine because of low perfusion pressure. The intracranial pressure fell simultaneously with the increase in arterial pressure. The intracranial pressure fell from 24 +/- 2 mmHg by a maximum ...
journal_title:Intensive care medicine
pub_type: 杂志文章
doi:10.1007/BF00273564
更新日期:1989-01-01 00:00:00
abstract:PURPOSE:To test the hypothesis that RNA editing is altered in pediatric patients with cyanotic congenital heart disease (CHD) and to determine whether A-to-I RNA editing is associated with the postoperative course following cardiac surgery. Cyanotic CHD is associated with a unique pathophysiology caused by chronic hypo...
journal_title:Intensive care medicine
pub_type: 杂志文章
doi:10.1007/s00134-011-2296-z
更新日期:2011-10-01 00:00:00
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
更新日期:2011-05-01 00:00:00
abstract:OBJECTIVES:To determine the effects of an intravenous bolus dose of a vasopressin analogue, terlipressin (1 mg), on systemic haemodynamic parameters and gastric mucosal perfusion (GMP) in patients with catecholamine-treated septic shock using a gastric tonometry and laser-Doppler flowmetry technique. DESIGN:Prospectiv...
journal_title:Intensive care medicine
pub_type: 临床试验,杂志文章
doi:10.1007/s00134-003-2094-3
更新日期:2004-04-01 00:00:00
abstract::The metabolic changes associated with critical illness involve several pathways acting at different steps of the utilization of nutritive substrates. The understanding of the role of these pathways and of their complex regulation has led to the development of new strategies for the metabolic and nutritional management...
journal_title:Intensive care medicine
pub_type: 杂志文章
doi:10.1007/s00134-002-1512-2
更新日期:2002-11-01 00:00:00
abstract::Knowledge translation is an important step for translational research. In this issue of Intensive Care Medicine, a new mini-series of basic research-related reviews is published. Three invited reviews focus on the role of extracellular matrix in ventilator-induced lung injury and mechanotransduction. The major challen...
journal_title:Intensive care medicine
pub_type: 评论,社论
doi:10.1007/s00134-007-0965-8
更新日期:2008-04-01 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::Fifteen polytrauma patients with asymmetric pulmonary contusion were treated with differential lung ventilation (DLV) for a mean of 106 hours (range 24-298, median 83). The differential time constant (Tc), compliance (Ct), inspiratory and expiratory airway resistance (Rawinsp, Rawexp) and peak-airway pressure (Pawpeak...
journal_title:Intensive care medicine
pub_type: 杂志文章
doi:10.1007/BF00255602
更新日期:1989-01-01 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::A 16-month old baby developed severe respiratory failure because of acute laryngitis and required mechanical ventilation. Intubation was complicated by aspiration and development of chemical pneumonia. Following 4 days of treatment the child was successfully extubated. Thirty six hours after extubation the patient aga...
journal_title:Intensive care medicine
pub_type: 杂志文章
doi:10.1007/BF00256065
更新日期:1985-01-01 00:00:00
abstract:OBJECTIVE:A closed suction system (CS) maintains connection with the mechanical ventilator during tracheal suctioning and is claimed to limit loss in lung volume and oxygenation. We compared changes in lung volume, oxygenation, airway pressure and hemodynamics during endotracheal suctioning performed with CS and with 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/s001340100897
更新日期:2001-04-01 00:00:00
abstract:OBJECTIVE:Measurement of functional residual capacity (FRC) during mechanical ventilation is important to standardise respiratory system compliance and adjust the ventilator settings to optimise lung recruitment. In the present study we compared three methods to measure FRC. DESIGN:The bias flow nitrogen washout techn...
journal_title:Intensive care medicine
pub_type: 杂志文章
doi:10.1007/s00134-003-2028-0
更新日期:2004-01-01 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::During a 3-year period, a clinical diagnosis of invasive candidosis was made in 8 out of 2054 consecutive surgical intensive care unit (ICU) patients. These patients were retrospectively matched with 16 control patients who underwent similar surgical procedures and had a similar clinical course except for negative Can...
journal_title:Intensive care medicine
pub_type: 杂志文章
doi:10.1007/s001340100891
更新日期:2001-05-01 00:00:00
abstract::608 patients admitted to a general Intensive Care Unit (ICU) over a 30 month period were analyzed according to the Apache II Severity of Disease Classification System on day one of admission. Hospital outcome details were available on 583 patients in the series. The mean Apache II scores for survivors (396) and non-su...
journal_title:Intensive care medicine
pub_type: 杂志文章
doi:10.1007/BF00263531
更新日期:1988-01-01 00:00:00
abstract:OBJECTIVE:To clarify the effects of hypercapnia (increased PaCO2) on gastric mucosal oxygenation during anaesthesia in dogs. DESIGN:Prospective, controlled animal study. SETTING:Experimental research laboratory of an university hospital. SUBJECTS:Six chronically instrumented dogs. INTERVENTIONS:Dogs were anaestheti...
journal_title:Intensive care medicine
pub_type: 杂志文章
doi:10.1007/s00134-008-1183-8
更新日期:2008-10-01 00:00:00