Abstract:
OBJECTIVES:Inhalation of nitric oxide (NO) selectively dilates pulmonary vessels in well-ventilated regions. Prostaglandin F2 alpha (PGF2 alpha) is a vasoconstrictor and is reported to enhance hypoxic pulmonary vasoconstriction. The objective of this study was to examine whether the combination of intravenous PGF2 alpha and inhaled NO in ARDS lungs has a beneficial effect on oxygenation. DESIGN:We investigated the effect of intravenous PGF2 alpha infusion (0.05-10.0 micrograms/kg per min) with and without NO inhalation (60 ppm) on the hemodynamics and gas exchange in an ovine ARDS model, examining the pulmonary artery pressure versus the flow plot by varying cardiac output. MEASUREMENTS AND RESULTS:After lung lavage, NO inhalation reduced the mean pulmonary arterial pressure (MPAP) by decreasing the zero-flow pressure intercept from 10.6 +/- 3.8 (mean +/- SD) to 8.5 +/- 3.8 mmHg (p < 0.05) with no significant change in slope. NO inhalation improved PaO2 from 56 +/- 12 to 84 +/- 38 mmHg (p < 0.005) and reduced pulmonary shunt from 65 +/- 5 to 53 +/- 8% (Qs/Qt) (p < 0.001). The dose-dependent effects of PGF2 alpha infusion were: (1) increased MPAP attributed to an increased slope in pulmonary artery pressure-flow plot; (2) decreased cardiac index; (3) decreased Qs/Qt with unchanged PaO2. The dose-dependent decrease in Qs/Qt after PGF2 alpha infusion was attributed to the decreased cardiac output. CONCLUSIONS:It is suggested that inhalation of NO reduced the critical vascular pressure near alveoli without affecting upstream vessels, while infused PGF2 alpha constricted the larger upstream pulmonary artery vessels without appreciably affecting the critical pressure. Inhalation of NO into well-ventilated lung areas shifted perfusion to well-oxygenated areas, and there was no supplemental shift in blood flow by adding an infusion of PGF2 alpha.
journal_name
Intensive Care Medjournal_title
Intensive care medicineauthors
Kobayashi H,Tanaka N,Winkler M,Zapol WMdoi
10.1007/BF01709742subject
Has Abstractpub_date
1996-07-01 00:00:00pages
656-63issue
7eissn
0342-4642issn
1432-1238journal_volume
22pub_type
杂志文章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
更新日期:1978-07-01 00:00:00
abstract:PURPOSE:Extracorporeal life support (ECLS) is used for patients with refractory heart failure with or without respiratory failure. This temporary support is provided by blood pumps which are connected to large vessels. Bleeding episodes are a typical complication in patients with ECLS. Recently, several studies illustr...
journal_title:Intensive care medicine
pub_type: 杂志文章
doi:10.1007/s00134-011-2370-6
更新日期:2012-01-01 00:00:00
abstract:OBJECTIVE:To test the hypothesis that the rate of degradation of exogenously administered albumin is faster with bolus administration than with continuous infusion and thus that a bolus administration is less efficacious in restoring blood albumin concentration (BAC) in the hypoalbuminemic critically ill pediatric pati...
journal_title:Intensive care medicine
pub_type: 临床试验,杂志文章
doi:10.1007/BF01712175
更新日期:1996-05-01 00:00:00
abstract:PURPOSE:The efficacy of noninvasive continuous positive airway pressure (CPAP) to improve outcomes in severe hypoxemic acute respiratory failure (hARF) due to pneumonia has not been clearly established. The aim of this study was to compare CPAP vs. oxygen therapy to reduce the risk of meeting criteria for endotracheal ...
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/s00134-014-3325-5
更新日期:2014-07-01 00:00:00
abstract::The World Health Organization defines overweight and obesity as the condition where excess or abnormal fat accumulation increases risks to health. The prevalence of obesity is increasing worldwide and is around 20% in ICU patients. Adipose tissue is highly metabolically active, and especially visceral adipose tissue h...
journal_title:Intensive care medicine
pub_type: 杂志文章,评审
doi:10.1007/s00134-019-05594-1
更新日期:2019-06-01 00:00:00
abstract:OBJECTIVE:Intracerebral hemorrhage (ICH) is associated with a high mortality. The present study sought to determine the incidence of spontaneous ICH in an intensive care unit (ICU) and associated factors. DESIGN:A 6 year retrospective study. SETTING:A general ICU in a university hospital. PATIENTS:All ICU patients d...
journal_title:Intensive care medicine
pub_type: 杂志文章
doi:10.1007/s001340050788
更新日期:1999-01-01 00:00:00
abstract:OBJECTIVE:To analyze the actual cost of pediatric intensive care and its different components, particularly the differences between various patient groups, with special reference to the variable cost and the elements included in it. DESIGN:Prospective, observational study. SETTING:Multidisciplinary 12-bed pediatric i...
journal_title:Intensive care medicine
pub_type: 杂志文章
doi:10.1007/s001340050320
更新日期:1997-02-01 00:00:00
abstract:OBJECTIVE:To compare haemodynamic and gas exchange effects after either atracurium or pancuronium given to ventilated neonates with respiratory failure. DESIGN:In this prospective study neonates were alternately assigned to receive either atracurium or pancuronium, intravenously. SETTING:Paediatric and neonatal ICU i...
journal_title:Intensive care medicine
pub_type: 杂志文章
doi:10.1007/BF01724880
更新日期:1993-01-01 00:00:00
abstract:OBJECTIVE:To report the first case of ARDS in children treated with nitric oxide (NO) inhalation. METHODS:A 13-months infant presented with BPD and severe hypoxemia related to RSV infection and ARDS. Inhaled NO was delivered in the ventilatory circuit of a continuous flow ventilator (Babylog 8000, Dräger) in a concent...
journal_title:Intensive care medicine
pub_type: 杂志文章
doi:10.1007/BF01711907
更新日期:1994-08-01 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::Breathing pattern was studied non-invasively in 20 coronary artery bypass surgery patients before the operation and post-operatively after weaning from mechanical ventilation. Post-operatively minute ventilation (VE), breathing frequency (Fr) and mean inspiratory flow (VT/TI) increased (28%, 42%, 27%; p less than 0.01...
journal_title:Intensive care medicine
pub_type: 杂志文章
doi:10.1007/BF01716198
更新日期:1991-01-01 00:00:00
abstract::Total extracorporeal lung assist (ECLA) requires a bypass flow approaching cardiac output. Recirculation of venous blood through the oxygenator is minimized with a veno-right ventricular cannulation technique which separates venous drainage from returned oxygenated blood. A case of posttraumatic ARDS was treated with ...
journal_title:Intensive care medicine
pub_type: 杂志文章
doi:10.1007/BF01691426
更新日期:1991-01-01 00:00:00
abstract:OBJECTIVE:The objective was to identify factors associated with thrombocytopenia and to assess to what extent thrombocytopenia increases bleeding complications in liver transplant patients. DESIGN:Retrospective study. SETTING:Surgical intensive care unit in a university hospital. PATIENTS:One hundred and sixty-one p...
journal_title:Intensive care medicine
pub_type: 杂志文章
doi:10.1007/s00134-003-1727-x
更新日期:2003-05-01 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 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
abstract:OBJECTIVE:The role of critical care pharmacists in the United States has recently been documented; however, little information exists about the role of international critical care pharmacists. The objective of this study was to describe the duties and activities of international pharmacists who practice in critical car...
journal_title:Intensive care medicine
pub_type: 杂志文章
doi:10.1007/s00134-007-0918-2
更新日期:2008-03-01 00:00:00
abstract:OBJECTIVES:To measure the extent of dilution of helium-oxygen (heliox) by room air when given via high concentration reservoir mask to spontaneously breathing subjects. Substantial dilution of heliox by room air under these circumstances might alter its physical properties sufficiently to negate any potential clinical ...
journal_title:Intensive care medicine
pub_type: 杂志文章,随机对照试验
doi:10.1007/s00134-008-1064-1
更新日期:2008-08-01 00:00:00
abstract:OBJECTIVE:An instrument able to estimate the direct costs of stays in Intensive Care Units (ICUs) simply would be very useful for resource allocation inside a hospital, through a global budget system. The aim of this study was to propose such a tool. DESIGN:Since 1991, a region-wide common data base has collected stan...
journal_title:Intensive care medicine
pub_type: 杂志文章
doi:10.1007/s001340050619
更新日期:1998-06-01 00:00:00
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
更新日期:2006-05-01 00:00:00
abstract::Specific regulations regarding oversight of research in children vary from country to country, but most share common principles derived from major consensus documents. Whereas the permissibility of research on adults depends heavily upon the informed consent of the subject, the regulation of research in pediatrics is ...
journal_title:Intensive care medicine
pub_type: 杂志文章
doi:10.1007/s00134-007-0917-3
更新日期:2008-01-01 00:00:00
abstract:PURPOSE:Indications and optimal timing for tracheostomy in traumatic brain-injured (TBI) patients are uncertain. This study aims to describe the patients' characteristics, timing, and factors related to the decision to perform a tracheostomy and differences in strategies among different countries and assess the effect ...
journal_title:Intensive care medicine
pub_type: 杂志文章
doi:10.1007/s00134-020-05935-5
更新日期:2020-05-01 00:00:00
abstract:OBJECTIVES:Critically ill patients often develop anaemia which can be related to a number of factors. However, the exact causes of anaemia in many patients remain unexplained. We hypothesized that the relationship between erythropoietin (EPO) and haematocrit may be altered in critically ill patients. DESIGN:Serum conc...
journal_title:Intensive care medicine
pub_type: 杂志文章,多中心研究
doi:10.1007/s001340050310
更新日期:1997-02-01 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::We analysed the case histories of 22 patients with life threatening asthma retrospectively. Fifteen patients needed mechanical ventilation. Three patients, all of them in cardiac arrest before or at the moment of admission, died. In five patients, halothane therapy was successfully used as a last resort. No major comp...
journal_title:Intensive care medicine
pub_type: 杂志文章
doi:10.1007/BF00260352
更新日期:1985-01-01 00:00:00
abstract::In oleic acid-induced pulmonary oedema (OAPO) sequential intrapulmonary fluid accumulation occurs leading to different expiratory flow pattern in dependent lung regions. The potential effects on efficacy of high-frequency jet ventilation (HFJV, f = 3 Hz, I: E = 0.43, FiO2 = 0.4) were studied and compared with continuo...
journal_title:Intensive care medicine
pub_type: 杂志文章
doi:10.1007/BF00295986
更新日期:1989-01-01 00:00:00
abstract:OBJECTIVE:To evaluate a least squares fitting technique for the purpose of measuring total respiratory compliance (Crs) and resistance (Rrs) in patients submitted to partial ventilatory support, without the need for esophageal pressure measurement. DESIGN:Prospective, randomized study. SETTING:A general ICU of a Univ...
journal_title:Intensive care medicine
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1007/BF01707409
更新日期:1995-05-01 00:00:00
abstract:OBJECTIVE:Assessing pulse pressure variation (PPV) to predict fluid responsiveness in mechanically ventilated patients with tidal volume (VT) and the impact of VT and airway driving pressure (P(plat) - PEEP) on the ability of PPV for predicting fluid responsiveness. DESIGN:Prospective interventional study. SETTING:IC...
journal_title:Intensive care medicine
pub_type: 杂志文章
doi:10.1007/s00134-009-1686-y
更新日期:2010-03-01 00:00:00
abstract:OBJECTIVE:Alterations in coagulation, including elevated pulmonary and systemic concentrations of urokinase, are frequent in patients with acute lung injury (ALI). Urokinase potentiates neutrophil activation and contributes to the severity of pulmonary injury in preclinical models of ALI. The objective of this study wa...
journal_title:Intensive care medicine
pub_type: 杂志文章,多中心研究
doi:10.1007/s00134-007-0930-6
更新日期:2008-02-01 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: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