Abstract:
OBJECTIVE:To determine the accuracy and reproducibility of four thermodilution indicators (5-mL room temperature, 10-mL room temperature, 5-mL iced, and 10-mL iced injectates) at clinically relevant flow rates. DESIGN:Quasi-experimental study. SETTING:Animal research laboratory of a health sciences university. SUBJECTS:Six virgin western-breed ewes. INTERVENTIONS:Data were collected from six ewes that had ascending aorta electromagnetic flow probes and inferior vena cava occluders. Cardiac output was manipulated by inferior vena cava occlusion and isoproterenol infusion. Four thermodilution indicators were tested at high and low levels of cardiac output and compared with the electromagnetic flowmeter measurements of cardiac output. MEASUREMENTS AND MAIN RESULTS:The indicator amounts were determined from both injectate volume and temperature difference between the injectate and blood. Using 5-mL room temperature injectate as a reference, 10-mL room contained 2 x, 5-mL iced 2.1 x, and 10-mL iced 4.1 x the indicator amount of 5-mL room temperature injectate. Approximately 210 simultaneous thermodilution and electromagnetic flow measurements were made for each injectate over a flow range of 1.5 to 15.7 L/min. For the entire cardiac output range, systematic error was not present. However, the r2 value (.92) for the 10-mL iced injectate group was greater (p < .05) than that value (.79) for the 5-mL iced injectate group, while r2 values were .79 for the 10-mL room temperature group and .49 for the 5-mL room temperature group. At flow rates of < 4.7 L/min, r2 was not different among injectates, but reduced indicator amounts progressively overestimated output (p < .05), reaching 21% for the 5-mL room temperature group. At flow rates of > 7.7 L/min, the r2 value (.81) for the 10-mL iced group was greater (p < .05) than that value (.45) for the 5-mL iced group, while r2 values were .24 for the 10-mL room temperature group and .08 for the 5-mL room temperature group. Systematic error was not present. CONCLUSIONS:At low cardiac output levels, reduced indicator impairs accuracy but not reproducibility, a phenomenon that is perhaps related to indicator loss. At high cardiac output rates, reduced indicator impairs reproducibility. This phenomenon is probably related to low signal-to-noise ratio. Thermodilution indicator amounts should be tailored to the output range.
journal_name
Crit Care Medjournal_title
Critical care medicineauthors
Renner LE,Morton MJ,Sakuma GYdoi
10.1097/00003246-199304000-00021subject
Has Abstractpub_date
1993-04-01 00:00:00pages
586-97issue
4eissn
0090-3493issn
1530-0293journal_volume
21pub_type
杂志文章abstract::Critical Care Medicine encompasses an extremely broad scope. Examination questions were, therefore, chosen to cover a wide variety of critical care topics. A near Gaussian distribution of scores was found for all physician groups studied. We believe the low mean score of 15% reflects the general difficulty of the exam...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/00003246-198305000-00014
更新日期:1983-05-01 00:00:00
abstract:OBJECTIVE:A 3-yr study funded by the U.S. Department of Health and Human Services was conducted to identify potential barriers to and opportunities for increasing the number hospitals with donation after cardiac death (DCD) protocols, the support of DCD by individuals involved in the donation request process, and the n...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/CCM.0b013e3181691b2b
更新日期:2008-04-01 00:00:00
abstract:OBJECTIVES:To investigate attitudes and practices regarding oxygen therapy in intensive care units (ICUs) and to devise quantitative descriptive indices. SETTING:Canadian university-affiliated adult ICUs. PARTICIPANTS:Fifty-two medical directors of ICUs in 48 institutions. INTERVENTION:Structured postal questionnair...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/00003246-199912000-00033
更新日期:1999-12-01 00:00:00
abstract:BACKGROUND:Septic shock represents the major cause of infection-associated mortality in the intensive care unit. The possibility that combination antibiotic therapy of bacterial septic shock improves outcome is controversial. Current guidelines do not recommend combination therapy except for the express purpose of broa...
journal_title:Critical care medicine
pub_type: 杂志文章,评审
doi:10.1097/CCM.0b013e3181eb3ccd
更新日期:2010-09-01 00:00:00
abstract:OBJECTIVE:To evaluate the effect of treatment with murine recombinant interleukin-1 beta on inflammatory infiltrate and tissue damage after experimental endotoxic challenge. DESIGN:Randomized, controlled study. SETTING:Experimental Unit, Virgen de las Nieves University Hospital. SUBJECTS:Seventy-two female CBA/H mic...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/00003246-200208000-00025
更新日期:2002-08-01 00:00:00
abstract::Arterial catheterization for blood gas analysis and direct monitoring of blood pressure in infants and children can be attended by a variety of complications, which limit its use to short periods of time. An improved technique, consisting of elimination of stopcocks, the use of a continuous flushing system adapted for...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/00003246-197605000-00010
更新日期:1976-05-01 00:00:00
abstract::Calcium chloride is administered frequently to critically ill patients to improve cardiac output and BP. However, Ca has been implicated in the pathophysiology of shock and ischemic disorders. To test the hypothesis that Ca may be deleterious to shock outcome, we studied the effects of CaCl and Ca chelator (EGTA) infu...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/00003246-198909000-00012
更新日期:1989-09-01 00:00:00
abstract:OBJECTIVE:Although it is established that septic shock induces immunosuppression, the mechanisms for this phenomenon remain poorly understood. Human leukocyte antigen-G exerts strong inhibitory effects that are directed at different arms of the immune system. The main objective of the current study was to measure human...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/01.CCM.0000277039.84372.1C
更新日期:2007-08-01 00:00:00
abstract:OBJECTIVE:To investigate the impact of circulating histones on cardiac injury and dysfunction in a murine model and patients with sepsis. DESIGN:Prospective, observational clinical study with in vivo and ex vivo translational laboratory investigations. SETTING:General ICU and university research laboratory. SUBJECTS...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/CCM.0000000000001162
更新日期:2015-10-01 00:00:00
abstract:OBJECTIVE:Sepsis and acute lung injury continue to be major causes of morbidity and mortality worldwide despite advances in our understanding of pathophysiology and the discovery of new management strategies. Recent investigations show that stem cells may be beneficial as prognostic biomarkers and novel therapeutic str...
journal_title:Critical care medicine
pub_type: 杂志文章,评审
doi:10.1097/CCM.0b013e3181f96f5f
更新日期:2010-12-01 00:00:00
abstract:OBJECTIVES:Evaluate clinicians' sentiments about participating in cardiac arrest resuscitations and identify factors associated with confidence in resuscitation of cardiac arrest. DESIGN:Electronic survey. SETTING:Twenty-one hospitals in Utah and Idaho. SUBJECTS:All attending physicians, residents, and nurses in a m...
journal_title:Critical care medicine
pub_type: 杂志文章,多中心研究
doi:10.1097/CCM.0000000000003612
更新日期:2019-03-01 00:00:00
abstract:OBJECTIVE:To determine whether extreme obesity (morbid obesity; body mass index > or =40 kg/m(2)) is an independent risk factor for death among critically ill patients; this objective is most salient in the subset of patients who sustain a prolonged intensive care unit stay during which the burdens of care imposed by o...
journal_title:Critical care medicine
pub_type: 评论,杂志文章
doi:10.1097/01.CCM.0000205758.18891.70
更新日期:2006-04-01 00:00:00
abstract:OBJECTIVE:To determine the utility of thoracic computed tomography (TCT) in the initial assessment of critically ill patients with chest injuries. DESIGN:Prospective observational study of cohorts. SETTING:Trauma intensive care unit (ICU) of a Spanish Level III hospital (US equivalent Level I). PATIENTS:Three hundre...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/00003246-200005000-00018
更新日期:2000-05-01 00:00:00
abstract:OBJECTIVE:Leucine-rich repeat and immunoglobulin domain-containing protein (LINGO)-1 is expressed in neural stem cells, and its neutralization results in sustained neuronal immaturity. Thus, targeted inhibition of LINGO-1 via RNA interference may enhance transplanted neural stem cell survival and neuronal differentiati...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/CCM.0000000000001351
更新日期:2016-03-01 00:00:00
abstract:OBJECTIVES:Racial/ethnic differences in palliative care resource use after stroke have been recognized, but it is unclear whether patient or hospital characteristics drive this disparity. We sought to determine whether palliative care use after intracerebral hemorrhage and ischemic stroke differs between hospitals serv...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/CCM.0000000000002762
更新日期:2017-12-01 00:00:00
abstract:OBJECTIVE:To determine a) if the admission osmole gap, the difference between osmolality and osmolarity, is the same in the neurologic-neurosurgical intensive care unit (NNICU) population as in healthy controls; b) which of 11 osmole gap formulas, or osmolality, correlates best with mannitol serum concentrations; c) wh...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/01.ccm.0000120057.04528.60
更新日期:2004-04-01 00:00:00
abstract:OBJECTIVE:Within minutes of reperfusing ischemic cardiomyocytes, oxidant stress dramatically increases and is associated with postresuscitation injury. Because mitochondria produce deleterious oxidants and useful metabolic substrates, utilization of electron transport chain inhibitors against reperfusion injury, though...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/01.CCM.0000246014.19486.A1
更新日期:2006-12-01 00:00:00
abstract:OBJECTIVES:To evaluate the association between length of ICU stay and 1-year mortality for elderly patients who survived to hospital discharge in the United States. DESIGN:Retrospective cohort study of a random sample of Medicare beneficiaries who survived to hospital discharge, with 1- and 3-year follow-up, stratifie...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/CCM.0000000000001480
更新日期:2016-04-01 00:00:00
abstract:OBJECTIVE:The acute respiratory distress syndrome may complicate postpartum hemorrhagic shock and resuscitation, but its mechanisms are not yet well defined. We studied the lung inflammatory response to postpartum hemorrhagic shock and resuscitation in a rabbit model and the role of the nuclear factor-κB pathway. DESI...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/CCM.0b013e3182451c17
更新日期:2012-05-01 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:OBJECTIVE:To determine whether preoperative plasma levels of B-type natriuretic peptide would allow for the prediction of perioperative and early postoperative cardiovascular support requirements and hospital bed usage after coronary artery surgery. DESIGN:A prospective observational cohort study. SETTING:A tertiary ...
journal_title:Critical care medicine
pub_type: 评论,杂志文章
doi:10.1097/01.ccm.0000150822.10160.0a
更新日期:2005-02-01 00:00:00
abstract::The image of the physician as a therapist, as well as the general perception of the physician's role in society and in the life of patients and their families, has changed dramatically in past decades. In response, many conferences, editorials, and planning activities for medical and premedical curricula have been dev...
journal_title:Critical care medicine
pub_type: 传,历史文章,杂志文章
doi:10.1097/00003246-198810000-00012
更新日期:1988-10-01 00:00:00
abstract:OBJECTIVE:To determine whether a correlation exists between concentrations of intracellular and extracellular potassium and to determine the frequency of ventricular ectopy in patients after cardiac operations. DESIGN:Prospective, observational clinical evaluation. SETTING:Surgical-respiratory intensive care unit of ...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/00003246-199911000-00018
更新日期:1999-11-01 00:00:00
abstract:OBJECTIVE:To assess the value of soluble triggering receptor expressed on myeloid cells-1 as a biomarker of infection in patients with neutropenic fever comparing with procalcitonin and C-reactive protein. DESIGN:Prospective, comparative, single-center study. SETTING:Hematology ward at a university hospital. SUBJECT...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/CCM.0b013e31820a92dc
更新日期:2011-05-01 00:00:00
abstract::Data at ICU admission and after 24 h in the ICU were collected on 755 patients, to derive multiple logistic regression models for predicting hospital mortality. The derived models contained relatively few and easily obtained variables. The weight associated with each variable was determined objectively. There were sev...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/00003246-198507000-00001
更新日期:1985-07-01 00:00:00
abstract:OBJECTIVES:Extracorporeal membrane oxygenation is increasingly used in the management of severe acute respiratory distress syndrome. With extracorporeal membrane oxygenation, select patients with acute respiratory distress syndrome can be managed without mechanical ventilation, sedation, or neuromuscular blockade. Publ...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/CCM.0000000000003354
更新日期:2018-11-01 00:00:00
abstract:OBJECTIVE:To compare the outcomes and the short- and long-term complications of percutaneous translaryngeal tracheostomy (TLT) and surgical tracheostomy (ST). DESIGN:Prospective, randomized clinical trial with 1-yr double-blind follow-up. SETTING:A general intensive care unit of a university hospital. PATIENTS:A tot...
journal_title:Critical care medicine
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1097/01.ccm.0000163401.77581.86
更新日期:2005-05-01 00:00:00
abstract:OBJECTIVE:Mitochondrial damage and dysfunction are thought to play an important role in the pathogenesis of sepsis-induced organ failures. Unfortunately, specific markers of mitochondrial damage in vital organs do not currently exist. Recently, carbomyl phosphate synthase (CPS)-1, a protein primarily localized to liver...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/01.CCM.0000230240.02216.21
更新日期:2006-09-01 00:00:00
abstract::During a consecutive 17 month period, 15 trauma patients were diagnosed as having a myocardial contusion on the basis of abnormal ECG in 14 patients, elevated creatinine phosphokinase (CPK) in 13 patients, and elevated CPK-Muscle Brain (CPK-MB) isoenzyme determination in 11 patients. Using these screening modalities, ...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/00003246-198201000-00005
更新日期:1982-01-01 00:00:00
abstract:OBJECTIVES:Augmented renal clearance might lead to subtherapeutic plasma levels of drugs with predominant renal clearance. Early identification of augmented renal clearance remains challenging for the ICU physician. We developed and validated our augmented renal clearance predictor, a clinical prediction model for augm...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/CCM.0000000000004667
更新日期:2020-12-01 00:00:00