L-arginine: nitric oxide pathway in endotoxemia and human septic shock.


OBJECTIVE:To investigate the relationship between nitric oxide production, endotoxemia, and hemodynamic alterations in human septic shock. DESIGN:Prospective study. SETTING:A 32-bed intensive care unit in a university referral hospital. PATIENTS:Two groups of septic patients with shock (n = 13) or without shock (n = 16) and an additional group of nonseptic patients as control group (n = 25). MEASUREMENTS:Plasma nitrite and nitrate concentrations were measured as an index of nitric oxide generation. Nitrite and nitrate concentrations were correlated with plasma endotoxin and hemodynamic variables. MAIN RESULTS:Increased plasma nitrite and nitrate concentrations were found in patients with septic shock (p < .01). Nitrite and nitrate correlated directly with endotoxin concentration (r2 = .21, p < .05) and cardiac output (r2 = .49, p < .05), and inversely with systolic blood pressure (r2 = .24, p < .01). CONCLUSIONS:This study demonstrated the activation of the L-arginine:nitric oxide pathway in human endotoxemic septic shock, suggesting that nitric oxide may be an important mediator of the hemodynamic disturbances in this pathophysiologic situation.


Crit Care Med


Critical care medicine


Gómez-Jiménez J,Salgado A,Mourelle M,Martín MC,Segura RM,Peracaula R,Moncada S




Has Abstract


1995-02-01 00:00:00












  • The international sepsis forum consensus conference on definitions of infection in the intensive care unit.

    abstract:OBJECTIVE:To develop definitions of infection that can be used in clinical trials in patients with sepsis. CONTEXT:Infection is a key component of the definition of sepsis, yet there is currently no agreement on the definitions that should be used to identify specific infections in patients with sepsis. Agreeing on a ...

    journal_title:Critical care medicine

    pub_type: 共识发展会议,杂志文章,评审


    authors: Calandra T,Cohen J,International Sepsis Forum Definition of Infection in the ICU Consensus Conference.

    更新日期:2005-07-01 00:00:00

  • Polynitroxylated pegylated hemoglobin: a novel neuroprotective hemoglobin for acute volume-limited fluid resuscitation after combined traumatic brain injury and hemorrhagic hypotension in mice.

    abstract:OBJECTIVE:Resuscitation of hemorrhagic hypotension after traumatic brain injury is challenging. A hemoglobin-based oxygen carrier may offer advantages. The novel therapeutic hemoglobin-based oxygen carrier, polynitroxylated pegylated hemoglobin (PNPH), may represent a neuroprotective hemoglobin-based oxygen carrier for...

    journal_title:Critical care medicine

    pub_type: 杂志文章


    authors: Shellington DK,Du L,Wu X,Exo J,Vagni V,Ma L,Janesko-Feldman K,Clark RS,Bayir H,Dixon CE,Jenkins LW,Hsia CJ,Kochanek PM

    更新日期:2011-03-01 00:00:00

  • Thermodilution and Fick cardiac index determinations following cardiac surgery.

    abstract::With the thermodilution technique, repeated determination of cardiac index (CI) has become a rapid, easily accomplished, safe procedure. We paired 77 CI determinations measured by direct Fick and thermodilution techniques in 21 patients who underwent myocardial revascularization. Commercially available thermistor-tipp...

    journal_title:Critical care medicine

    pub_type: 杂志文章


    authors: Hodges M,Downs JB,Mitchell LA

    更新日期:1975-09-01 00:00:00

  • Withholding and withdrawing of life support from patients with severe head injury.

    abstract:OBJECTIVE:To characterize the withholding or withdrawing of life support from patients with severe head injury. SETTING:San Francisco General Hospital, a city and county hospital with a Level I trauma center. DESIGN:A standardized questionnaire was used to collect data on demographics and functional outcome of severe...

    journal_title:Critical care medicine

    pub_type: 杂志文章


    authors: O'Callahan JG,Fink C,Pitts LH,Luce JM

    更新日期:1995-09-01 00:00:00

  • Exogenous interleukin-10 fails to decrease the mortality or morbidity of sepsis.

    abstract:OBJECTIVE:To determine if exogenous interleukin (IL)-10 will decrease the morbidity or mortality of sepsis induced by cecal ligation and puncture. DESIGN:Prospective, randomized, controlled study. SETTING:University research laboratory. SUBJECTS:Adult, female, Balb¿c mice. INTERVENTIONS:Balb¿c mice were subjected t...

    journal_title:Critical care medicine

    pub_type: 杂志文章


    authors: Remick DG,Garg SJ,Newcomb DE,Wollenberg G,Huie TK,Bolgos GL

    更新日期:1998-05-01 00:00:00

  • Exacerbation by granulocyte colony-stimulating factor of prior acute lung injury: implication of neutrophils.

    abstract:OBJECTIVE:Granulocyte colony-stimulating factor is widely prescribed to hasten recovery from cancer chemotherapy-induced neutropenia and has been reported to induce pulmonary toxicity. However, circumstances and mechanisms of this toxicity remain poorly known. DESIGN:To reproduce a routine situation in cancer patients...

    journal_title:Critical care medicine

    pub_type: 杂志文章


    authors: Azoulay E,Attalah H,Yang K,Jouault H,Schlemmer B,Brun-Buisson C,Brochard L,Harf A,Delclaux C

    更新日期:2002-09-01 00:00:00

  • Vecuronium by continuous infusion for neuromuscular blockade in infants and children.

    abstract::Vecuronium's short half-life and minimal cardiopulmonary side-effects make it a suitable drug for continuous infusion. Vecuronium is used frequently in critically ill patients to increase their total compliance and to minimize the adverse effects of mechanical ventilation. This crossover, prospective study evaluates t...

    journal_title:Critical care medicine

    pub_type: 临床试验,杂志文章,随机对照试验


    authors: Eldadah MK,Newth CJ

    更新日期:1989-10-01 00:00:00

  • Acute effects of tidal volume strategy on hemodynamics, fluid balance, and sedation in acute lung injury.

    abstract:OBJECTIVE:To examine the effects of mechanical ventilation with a tidal volume of 6 mL/kg compared with 12 mL/kg predicted body weight on hemodynamics, vasopressor use, fluid balance, diuretics, sedation, and neuromuscular blockade within 48 hrs in patients with acute lung injury and acute respiratory distress syndrome...

    journal_title:Critical care medicine

    pub_type: 临床试验,杂志文章,多中心研究,随机对照试验


    authors: Cheng IW,Eisner MD,Thompson BT,Ware LB,Matthay MA,Acute Respiratory Distress Syndrome Network.

    更新日期:2005-01-01 00:00:00

  • The Impella 2.5 and 5.0 devices for ST-elevation myocardial infarction patients presenting with severe and profound cardiogenic shock: the Academic Medical Center intensive care unit experience.

    abstract:OBJECTIVE:Cardiogenic shock remains an important therapeutic challenge, with high in-hospital mortality rates. Mechanical circulatory support may be beneficial in these patients. Since the efficacy of the intra-aortic balloon pump seems limited, new percutaneously placed mechanical left ventricular support devices, suc...

    journal_title:Critical care medicine

    pub_type: 杂志文章


    authors: Engström AE,Cocchieri R,Driessen AH,Sjauw KD,Vis MM,Baan J,de Jong M,Lagrand WK,van der Sloot JA,Tijssen JG,de Winter RJ,de Mol BA,Piek JJ,Henriques JP

    更新日期:2011-09-01 00:00:00

  • Economic implications of an evidence-based sepsis protocol: can we improve outcomes and lower costs?

    abstract:OBJECTIVE:To determine the financial impact of a sepsis protocol designed for use in the emergency department. DESIGN:Retrospective analysis of a before-after study testing the implications of sepsis protocol. SETTING:Academic, tertiary care hospital in the United States. PATIENTS:Persons with septic shock presentin...

    journal_title:Critical care medicine

    pub_type: 杂志文章


    authors: Shorr AF,Micek ST,Jackson WL Jr,Kollef MH

    更新日期:2007-05-01 00:00:00

  • Effectiveness Analysis of a Part-Time Rapid Response System During Operation Versus Nonoperation.

    abstract:OBJECTIVES:To evaluate the effect of a part-time rapid response system on the occurrence rate of cardiopulmonary arrest by comparing the times of rapid response system operation versus nonoperation. DESIGN:Retrospective cohort study. SETTING:A 1,360-bed tertiary care hospital. PATIENTS:Adult patients admitted to the...

    journal_title:Critical care medicine

    pub_type: 杂志文章


    authors: Kim Y,Lee DS,Min H,Choi YY,Lee EY,Song I,Park JS,Cho YJ,Jo YH,Yoon HI,Lee JH,Lee CT,Do SH,Lee YJ

    更新日期:2017-06-01 00:00:00

  • Myocardial ischemia and weaning failure in patients with coronary artery disease: an update.

    abstract:OBJECTIVE:To determine the frequency and effects of weaning-related myocardial ischemia on weaning outcomes in patients with coronary artery disease. DESIGN:Prospective cohort study. SETTING:Medical and cardiac intensive care units of a 300-bed teaching community hospital. MEASUREMENTS AND MAIN RESULTS:Three-lead ST...

    journal_title:Critical care medicine

    pub_type: 临床试验,杂志文章


    authors: Srivastava S,Chatila W,Amoateng-Adjepong Y,Kanagasegar S,Jacob B,Zarich S,Manthous CA

    更新日期:1999-10-01 00:00:00

  • Treatment of multifocal atrial tachycardia with metoprolol.

    abstract::We used metoprolol orally or iv in 25 patients with multifocal atrial tachycardia that was complicating severe cardiopulmonary illness, and we observed its effect on heart rate and rhythm, BP, and arterial blood gases. All patients showed a dramatic slowing of heart rate, averaging 54.0 +/- 4.0 beat/min (p less than ....

    journal_title:Critical care medicine

    pub_type: 杂志文章


    authors: Hazard PB,Burnett CR

    更新日期:1987-01-01 00:00:00

  • The Very Elderly Admitted to ICU: A Quality Finish?

    abstract:OBJECTIVE:Very elderly persons admitted to ICUs are at high risk of death. To document life-sustaining interventions (mechanical ventilation, vasopressors, renal replacement therapy) provided in the ICU and outcomes of care. DESIGN:Multicenter, prospective cohort study. SETTING:ICUs of 24 Canadian hospitals. PARTICI...

    journal_title:Critical care medicine

    pub_type: 杂志文章,多中心研究


    authors: Heyland D,Cook D,Bagshaw SM,Garland A,Stelfox HT,Mehta S,Dodek P,Kutsogiannis J,Burns K,Muscedere J,Turgeon AF,Fowler R,Jiang X,Day AG,Canadian Critical Care Trials Group.,Canadian Researchers at the End of Life Network.

    更新日期:2015-07-01 00:00:00

  • Acute-phase gene expression correlates with intrahepatic tumor necrosis factor-alpha abundance but not with plasma tumor necrosis factor concentrations during sepsis/systemic inflammatory response syndrome in the rat.

    abstract:OBJECTIVES:To test the hypothesis that after cecal ligation and puncture in the rat, there is increased expression of the tumor necrosis factor (TNF)/interleukin-1-dependent, acute-phase reactant alpha 1-acid glycoprotein in the liver, and that this change correlates temporally with increased abundance of TNF-alpha in ...

    journal_title:Critical care medicine

    pub_type: 杂志文章


    authors: Andrejko KM,Deutschman CS

    更新日期:1996-12-01 00:00:00

  • Resolution of pneumothorax in neonates.

    abstract::The resolution time of pneumothorax in neonates requiring tube thoracotomy is not known. We found that 28%, 50%, and 83% of 54 pneumothoraces in 40 neonates resolved within 24, 96, and 168 h of tube thoracotomy, respectively. Pneumothoraces that persisted beyond 168 h were in infants requiring ventilatory assistance. ...

    journal_title:Critical care medicine

    pub_type: 杂志文章


    authors: Bhatia J,Mathew OP

    更新日期:1985-05-01 00:00:00

  • Mild or moderate hypothermia, but not increased oxygen breathing, increases long-term survival after uncontrolled hemorrhagic shock in rats.

    abstract:OBJECTIVE:To test the hypotheses that, for uncontrolled hemorrhagic shock (UHS) in rats, mild hypothermia, compared with normothermia, would increase long-term survival as well as moderate hypothermia, oxygen breathing would increase survival further, and hypothermia and oxygen would mitigate visceral ischemia (dysoxia...

    journal_title:Critical care medicine

    pub_type: 杂志文章


    authors: Takasu A,Stezoski SW,Stezoski J,Safar P,Tisherman SA

    更新日期:2000-07-01 00:00:00

  • Influence of political power, medical provincialism, and economic incentives on the rationing of surgical intensive care unit beds.

    abstract:OBJECTIVE:To determine factors influencing rationing decisions in a surgical ICU during a temporary nursing shortage when two to six of the unit's 16 beds were closed. DESIGN:Blinded, concurrent data collection, retrospective chart review. SETTING:Surgical ICU. PATIENTS:All patients (n = 308) for whom a surgical ICU...

    journal_title:Critical care medicine

    pub_type: 杂志文章


    authors: Marshall MF,Schwenzer KJ,Orsina M,Fletcher JC,Durbin CG Jr

    更新日期:1992-03-01 00:00:00

  • Simultaneous monitoring of transcutaneous blood gases and heart-rate variability in neonates.

    abstract::Instantaneous heart rate, indices of long-term and short-term heart-rate variability (HRV), and transcutaneous O2 (PtcO2) and CO2 (PtcCO2) tensions were recorded simultaneously on 164 occasions in 16 neonates. There was significant inverse correlation between PtcCO2 and both HRV indices, while no linear correlation wa...

    journal_title:Critical care medicine

    pub_type: 杂志文章


    authors: Aärimaa T,Kero P,Välimäki I

    更新日期:1985-01-01 00:00:00

  • Predictors of noninvasive ventilation failure in patients with hematologic malignancy and acute respiratory failure.

    abstract:OBJECTIVES:The current trend to manage critically ill hematologic patients admitted with acute respiratory failure is to perform noninvasive ventilation to avoid endotracheal intubation. However, failure of noninvasive ventilation may lead to an increased mortality. DESIGN:Retrospective study to determine the frequenc...

    journal_title:Critical care medicine

    pub_type: 杂志文章


    authors: Adda M,Coquet I,Darmon M,Thiery G,Schlemmer B,Azoulay E

    更新日期:2008-10-01 00:00:00

  • Cytochrome P450 3A4 activity after surgical stress.

    abstract:OBJECTIVE:To evaluate the relationship between the acute inflammatory response after surgical trauma and changes in hepatic cytochrome P450 3A4 activity, compare changes in cytochrome P450 3A4 activity after procedures with varying degrees of surgical stress, and to explore the time course of any potential drug-cytokin...

    journal_title:Critical care medicine

    pub_type: 杂志文章


    authors: Haas CE,Kaufman DC,Jones CE,Burstein AH,Reiss W

    更新日期:2003-05-01 00:00:00

  • Meconium and amniotic fluid embolism: effects on coagulation in pregnant mini-pigs.

    abstract:OBJECTIVE:A hallmark of amniotic fluid embolism is the induction of coagulation defects. Little is known about the nature of these defects or the causative agent or agents. The purpose of this study was to assess the effects of meconium containing (native) meconium-amniotic-fluid infusion (MAFI) and meconium-free (cent...

    journal_title:Critical care medicine

    pub_type: 杂志文章


    authors: Petroianu GA,Altmannsberger SH,Maleck WH,Assmus HP,Friedberg C,Bergler WF,Rüfer R

    更新日期:1999-02-01 00:00:00

  • Early postoperative enteral nutrition improves gut oxygenation and reduces costs compared with total parenteral nutrition.

    abstract:OBJECTIVE:To evaluate the potential clinical, metabolic, and economic advantages of enteral nutrition over total parenteral nutrition. DESIGN:Prospective, randomized clinical trial. SETTING:Department of surgery in a university hospital. PATIENTS:Two hundred and fifty-seven patients with cancer of the stomach (n = 1...

    journal_title:Critical care medicine

    pub_type: 临床试验,杂志文章,随机对照试验


    authors: Braga M,Gianotti L,Gentilini O,Parisi V,Salis C,Di Carlo V

    更新日期:2001-02-01 00:00:00

  • Steroid controversy in sepsis and septic shock: a meta-analysis.

    abstract:OBJECTIVE:The use of corticosteroids in patients with sepsis or septic shock has been controversial for many decades. Clinical studies have reported beneficial, as well as negative results. We conducted a meta-analysis to assess the clinical evidence and to evaluate treatment effects in specific subgroups of patients. ...

    journal_title:Critical care medicine

    pub_type: 杂志文章,meta分析


    authors: Lefering R,Neugebauer EA

    更新日期:1995-07-01 00:00:00

  • Scientific evaluation of clinical interventions in resuscitation medicine.

    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


    authors: Detre K

    更新日期:1988-10-01 00:00:00

  • Clinical validation of a new metabolic monitor suitable for use in critically ill patients.

    abstract::This report documents the validity of clinical measurements of oxygen consumption (VO2) and carbon dioxide production (VCO2) made with a new metabolic gas monitor (MGM) suitable for use in critically ill patients receiving mechanical ventilatory support. Paired samples of inspired and expired gases were obtained, and ...

    journal_title:Critical care medicine

    pub_type: 杂志文章


    authors: Nelson LD,Anderson HB,Garcia H

    更新日期:1987-10-01 00:00:00

  • Prophylactic anticoagulation with enoxaparin: Is the subcutaneous route appropriate in the critically ill?

    abstract:BACKGROUND:Subcutaneously administered low-molecular-weight heparins are widely used for prevention of venous thromboembolism. The appropriateness of the subcutaneous route in critically ill patients has never been established. OBJECTIVE:To determine anti-Xa activities in critically ill patients and in noncritically i...

    journal_title:Critical care medicine

    pub_type: 临床试验,杂志文章


    authors: Priglinger U,Delle Karth G,Geppert A,Joukhadar C,Graf S,Berger R,Hülsmann M,Spitzauer S,Pabinger I,Heinz G

    更新日期:2003-05-01 00:00:00

  • Resuscitation from experimental heatstroke by hyperbaric oxygen therapy.

    abstract:OBJECTIVE:Heatstroke is characterized by hyperthermia, vasoplegic shock, and cerebral ischemia and hypoxia. Hyperbaric oxygen (HBO) has been shown to reduce brain ischemia and behavioral dysfunction during cerebral artery occlusion. The efficacy of HBO therapy for resuscitation from heatstroke remains to be determined ...

    journal_title:Critical care medicine

    pub_type: 杂志文章


    authors: Tsai HM,Gao CJ,Li WX,Lin MT,Niu KC

    更新日期:2005-04-01 00:00:00

  • Cost accounting of adult intensive care: methods and human and capital inputs.

    abstract:OBJECTIVE:To cost adult intensive care by determining inputs to production, resource consumption per patient, and total cost per intensive care unit (ICU) stay. DESIGN:Prospective cost-accounting analysis of each patient stay in the ICU, over a 1-yr period. SETTING:An 11-bed, medical/surgical adult ICU, in a 932-bad ...

    journal_title:Critical care medicine

    pub_type: 杂志文章


    authors: Noseworthy TW,Konopad E,Shustack A,Johnston R,Grace M

    更新日期:1996-07-01 00:00:00

  • Metabolic support in sepsis and multiple organ failure: more questions than answers ...

    abstract::The metabolic support of critically ill patients is a relatively new topic of active research and discussion, and surprisingly little is known about the effects of critical illness on metabolic physiology and activity. The metabolic changes seen in critical illness are highly complex, and how and when to treat them ar...

    journal_title:Critical care medicine

    pub_type: 杂志文章,评审


    authors: Vincent JL

    更新日期:2007-09-01 00:00:00