Abstract:
OBJECTIVE:To assess whether paralysis alters pulmonary deposition of albuterol delivered by metered dose inhaler and spacer to small animals. DESIGN:A parallel group study of intubated and ventilated rabbits. INTERVENTIONS:Animals in group 1 (n = 7) were paralyzed with intravenous pancuronium, and ventilated at a rate of 30 breaths/ min. The animals in group 2 (n = 6) were ventilated at a rate of 10 breaths/min under light anesthesia without paralysis. In this latter group, spontaneous respiration continued at a rate of 40 to 50 breaths/min. Both groups were maintained at PaCO2 of 35 to 40 torr (4.7 to 5.3 kPa), and other ventilatory settings were identical. MEASUREMENTS AND MAIN RESULTS:Technetium-99m labeled albuterol aerosol was delivered by metered dose inhaler via a spacer device to both groups. Pulmonary deposition of the aerosol, determined by measuring the radioactivity in the lung tissues at autopsy, was expressed as percent of the total radioactivity dispensed by the metered dose inhaler. Group 2 showed significantly greater lung deposition than group 1 (0.510 +/- 0.076 [SEM]% vs. 0.226 +/- 0.054%, p = .0094). Deposition in the airway, the endotracheal tube, and the ventilator circuit did not differ significantly. CONCLUSION:Metered dose inhaler delivery of aerosolized medications to ventilated rabbits is significantly enhanced if respiration is not controlled. This observation might have implications for the delivery of therapeutic aerosols to newborns and young infants receiving slow, intermittent, mandatory ventilation.
journal_name
Crit Care Medjournal_title
Critical care medicineauthors
Fok TF,al-Essa M,Monkman S,Dolovich M,Girard L,Coates G,Kirpalani Hdoi
10.1097/00003246-199701000-00026subject
Has Abstractpub_date
1997-01-01 00:00:00pages
140-4issue
1eissn
0090-3493issn
1530-0293journal_volume
25pub_type
杂志文章abstract:OBJECTIVE:To describe a postpartum patient who presented with fulminant hepatic failure and hepatic coma as a result of unrecognized peripartum cardiomyopathy. DESIGN:Case report. SETTING:Medical intensive care unit of a tertiary care academic medical center. PATIENT:A 35-yr-old woman 5 wks postpartum from an uneven...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/01.ccm.0000158517.25962.8e
更新日期:2005-04-01 00:00:00
abstract::Conventional wisdom suggests that the "human factor" in critical care environments is reason for inadequate medication and patient safety. "Human factors" (or human factors engineering) is also a scientific discipline and practice of improving human performance. Using decades of human factors research, this paper eval...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/CCM.0b013e3181dd8de2
更新日期:2010-06-01 00:00:00
abstract:OBJECTIVE:The emergency department (ED) often serves as the first site for the recognition and treatment of patients with suspected severe sepsis. However, few evaluations of the national epidemiology and distribution of severe sepsis in the ED exist. We sought to determine national estimates of the number, timing, ED ...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/01.CCM.0000277043.85378.C1
更新日期:2007-08-01 00:00:00
abstract:OBJECTIVE:To evaluate premorbid conditions and sociodemographic characteristics associated with differences in hospitalization and mortality rates of sepsis in blacks and whites. DESIGN:Secondary data analysis of the publicly available New Jersey State Inpatient Database for 2002. SETTING:Acute care hospitals in New ...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/01.CCM.0000256726.80998.BF
更新日期:2007-03-01 00:00:00
abstract::The effect of positive-pressure ventilation (PPV) with PEEP on the release of alpha-atrial natriuretic peptide (ANP) was investigated in both humans and an experimental model. In the human study, systemic artery blood samples from 22 critically ill patients were analyzed for ANP. Seventeen of these patients received P...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/00003246-199008000-00007
更新日期:1990-08-01 00:00:00
abstract:OBJECTIVES:Although pentoxifylline produces various beneficial effects following adverse circulatory conditions, it is not known whether this agent has any effects on gut lipid metabolism after trauma-hemorrhage and resuscitation. The aim of this study, therefore, was to determine whether or not administration of pento...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/00003246-199801000-00023
更新日期:1998-01-01 00:00:00
abstract:OBJECTIVE:The objective of this study was to test the hypothesis that cocaine-induced cerebral vasodilation in newborn sheep is mediated via beta-adrenergic receptor activation. DESIGN:The cerebral effects of a single intravenous injection of cocaine (4 mg/kg) given 30 mins after pretreatment with propranolol (1 mg/kg...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/00003246-199904000-00036
更新日期:1999-04-01 00:00:00
abstract:OBJECTIVE:Perfluorocarbon liquid ventilation has been shown to enhance pulmonary mechanics and gas exchange in the setting of respiratory failure. To optimize the total liquid ventilation process, we developed a volume-limited, time-cycled liquid ventilatory support, consisting of an electrically actuated, microprocess...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/00003246-200005000-00038
更新日期:2000-05-01 00:00:00
abstract:OBJECTIVE:Rapid fluid loading is standard treatment for hypovolemia. Because volume expansion does not always improve hemodynamic status, predictive parameters of fluid responsiveness are needed. Passive leg raising is a reversible maneuver that mimics rapid volume expansion. Passive leg raising-induced changes in stro...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/CCM.0b013e3181c8fe7a
更新日期:2010-03-01 00:00:00
abstract::Cerebral arteriovenous differences in oxygen content [C(a-v)O2] and glucose content [C(a-v)gluc] were used to predict outcome in 20 patients who remained comatose after resuscitation for cardiopulmonary arrest. Cerebral prognosis was good when C(a-v)O2 values were greater than 1.8 mMol/L and the oxygen glucose index (...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/00003246-198410000-00013
更新日期:1984-10-01 00:00:00
abstract:OBJECTIVE:To evaluate the efficacy and tolerability of intravenous empiric treatment with meropenem compared with ceftazidime-tobramycin in patients with hospital-acquired lower respiratory tract infections. DESIGN:Prospective, nonblind, randomized trial. SETTING:Multicenter trial conducted at 22 centers. PATIENTS:T...
journal_title:Critical care medicine
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1097/00003246-199710000-00015
更新日期:1997-10-01 00:00:00
abstract:BACKGROUND AND METHODS:This study was designed to explore the effect of mild cerebral and systemic hypothermia (34 degrees C) on outcome after prolonged cardiac arrest in dogs. After ventricular fibrillation with no flow of 10 min, and standard external CPR with epinephrine (low flow) from ventricular fibrillation time...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/00003246-199103000-00017
更新日期:1991-03-01 00:00:00
abstract::Previous studies have confirmed the improved tolerance of a peptide enteral compared to standard enteral alimentation in hypoalbuminemic, critically ill patients. Animal studies, including hypoproteinemic, volume-expanded rats, demonstrated that the protein hydrolysate of a peptide enteral formula was responsible for ...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/00003246-198907000-00012
更新日期:1989-07-01 00:00:00
abstract::Hemodynamic effects of controlled mechanical ventilation (CMV), intermittent mandatory ventilation (IMV), and intermittent mandatory ventilation with 5 cm H20 PEEP (IMV 5 peep) were studied in 20 patients after aortocoronary bypass surgery. Significant increases in cardiac index (CI) and stroke volume index (SI) (p le...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/00003246-198207000-00001
更新日期:1982-07-01 00:00:00
abstract:OBJECTIVE:Inotropic and vasopressor drugs are routinely used in critically ill patients to maintain adequate blood pressure and cardiac output in patients with cardiogenic shock although potentially at the expense of increasing myocardial oxygen demand. Pacing optimization has been demonstrated as effective in reducing...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/CCM.0000000000001655
更新日期:2016-08-01 00:00:00
abstract:OBJECTIVE:Recent studies have demonstrated the therapeutic effectiveness and pharmacologic mechanisms of hyperbaric oxygen therapy (HBOT) in the treatment of a systemic shock state. To elucidate the in vivo role of HBOT during sepsis, we evaluated the effects of HBOT on intestinal mucosal injury and bacterial transloca...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/01.ccm.0000132898.27101.6c
更新日期:2004-08-01 00:00:00
abstract:OBJECTIVE:Intravesical pressure measurement is considered to be the gold standard for the assessment of intra-abdominal pressure. However, this method is indirect and depends on a physiologic bladder function. We evaluated a modified piezoresistive technique and a water-capsule technique for direct and continuous intra...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/01.CCM.0000198526.04530.36
更新日期:2006-03-01 00:00:00
abstract:OBJECTIVES:Case fatality in pregnancy-associated severe sepsis or septic shock appears reduced compared with nonpregnant women with severe sepsis or septic shock. It remains unclear if this difference is due to pregnancy or better baseline health status, among others. Our study compared adverse outcomes of pregnancy-as...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/CCM.0000000000003348
更新日期:2018-11-01 00:00:00
abstract::Biological systems are innately complex, display nonlinear behavior, and respond to both disease and its treatment in similar complex ways. Complex systems display self-organization and predictive behavior along a range of possible states, often referred to as chaotic behavior, and can be both characterized and quanti...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/CCM.0b013e3181f24484
更新日期:2010-10-01 00:00:00
abstract:OBJECTIVE:Peripheral perfusion in critically ill patients frequently is assessed by use of clinical signs. Recently, the pulse oximetry signal has been suggested to reflect changes in peripheral perfusion. A peripheral perfusion index based on analysis of the pulse oximetry signal has been implemented in monitoring sys...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/00003246-200206000-00006
更新日期:2002-06-01 00:00:00
abstract:OBJECTIVE:To investigate the role of regulatory T cells in the modulation of long-term immune dysfunction during experimental sepsis. It is well established that sepsis predisposes to development of a pronounced immunosuppression. Nevertheless, the mechanisms underlying the immune dysfunction after sepsis are still not...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/CCM.0b013e3181e78ad0
更新日期:2010-08-01 00:00:00
abstract::A high rate of death from septic shock persists despite general improvements in care. The relative failure of mechanistically based therapies in various clinical trials should also trigger a reconsideration of such mechanistic approaches. Despite reversion of shock by hydrocortisone, the similar death rate compared wi...
journal_title:Critical care medicine
pub_type: 杂志文章,评审
doi:10.1097/CCM.0b013e3181f23dc4
更新日期:2010-10-01 00:00:00
abstract:OBJECTIVES:To investigate family perceptions of having a nurse participating in family conferences and to assess the psychologic well being of the same families after ICU discharge. DESIGN:Mixed-method design with a qualitative study embedded in a single-center randomized study. SETTING:Twelve-bed medical-surgical IC...
journal_title:Critical care medicine
pub_type: 杂志文章,随机对照试验
doi:10.1097/CCM.0000000000001632
更新日期:2016-06-01 00:00:00
abstract:OBJECTIVES:Patients requiring admission to an ICU may subsequently experience cognitive decline. Our objective was to investigate longitudinal cognitive trajectories in older adults hospitalized in ICUs. We hypothesized that individuals hospitalized for critical illness develop greater cognitive decline compared with t...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/CCM.0000000000003829
更新日期:2019-08-01 00:00:00
abstract::The effect of halothane on electrodes covered with polypropylene and FEP teflon membranes, used for monitoring transcutaneous oxygen tension, was compared in vitro and in patients anesthetized with halothane. In vitro experiments with halothane showed a false increase in PO2 measured by the electrode covered with poly...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/00003246-198308000-00006
更新日期:1983-08-01 00:00:00
abstract:OBJECTIVE:To evaluate factors which may influence the economic future of academic medical centers (AMCs). DATA SOURCE AND SELECTION:A literature search was performed to identify publications which reviewed the areas of revenue sources for AMCs, costs and expenses incurred by these institutions, and mechanisms for opti...
journal_title:Critical care medicine
pub_type: 杂志文章,评审
doi:10.1097/01.CCM.0000199991.15912.45
更新日期:2006-03-01 00:00:00
abstract::Varying concentrations of lipopolysaccharide (LPS) and mannan suspensions were mixed with either saline or plasma from normal volunteers, heated to 100 degrees C for 10 min, and then subjected to the limulus amebocyte lysate test (LAL). A positive LAL in saline required minimum LPS and mannan concentrations of 10(-11)...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/00003246-198512000-00016
更新日期:1985-12-01 00:00:00
abstract:OBJECTIVES:Cardiac surgery-associated acute kidney injury occurs in up to 50% of patients and is associated with increased mortality and morbidity. This study aimed to discover if perioperative urinary alkalinization with sodium bicarbonate infusion reduces the prevalence of cardiac surgery-associated acute kidney inju...
journal_title:Critical care medicine
pub_type: 杂志文章,多中心研究,随机对照试验
doi:10.1097/CCM.0b013e31828a3f99
更新日期:2013-07-01 00:00:00
abstract::This study evaluates the recall of 100 patients after ICU admission. There was a wide spectrum of race, religion, occupation, and educational levels. The more common diagnoses included asthma, pneumonia, trauma, and adult respiratory distress syndrome. The average Acute Physiology and Chronic Health Evaluation (APACHE...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/00003246-199009000-00012
更新日期:1990-09-01 00:00:00
abstract:OBJECTIVES:Severe sepsis poses a major burden on the U.S. healthcare system. Previous epidemiologic studies have not differentiated community-acquired severe sepsis from healthcare-associated severe sepsis or hospital-acquired severe sepsis hospitalizations. We sought to compare and contrast community-acquired severe s...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/CCM.0000000000001164
更新日期:2015-09-01 00:00:00