Abstract:
OBJECTIVE:To determine the effects of a hydroxyethyl starch-deferoxamine conjugate on hepatic microcirculation in an isobaric, anesthetized rat model of hemorrhagic shock and asanguineous resuscitation. DESIGN:Prospective, randomized, controlled study. SETTING:Laboratory at a university hospital. SUBJECTS:Twenty-three female, inbred Lewis rats (190 to 215 g). INTERVENTIONS:After anesthesia (pentobarbital-sodium; 50 mg/kg), tracheotomy, and cannulation, animals were assigned to a hemorrhagic shock (mean arterial pressure at 40 +/- 3 mm Hg for 45 mins) or a time-matched sham protocol. Rats in the shock groups received either hydroxyethyl starch or a starch-deferoxamine conjugate for resuscitation. Liver microcirculation was assessed in vivo 60 mins after onset of volume therapy by epifluorescence microscopy. MEASUREMENTS AND MAIN RESULTS:Conventional resuscitation with the starch-vehicle failed to restore sinusoidal blood flow compared with either time-matched controls (71% of control value; p < .01) or the starch-deferoxamine-treated animals (89% of control value; p < .05 compared with starch-vehicle), although a comparable restoration of central hemodynamics was achieved with both starch preparations. Additionally, treatment with the starch-deferoxamine conjugate resulted in a significant attenuation of sinusoidal leukocyte margination (sham 72.4 +/- 11.0/mm2; starch-vehicle 194.5 +/- 19.0/mm2 [p < .01 compared with controls]; starch-deferoxamine conjugate 135.9 +/- 12.1/mm2 [p < .02 compared with sham and starch-vehicle]). CONCLUSIONS:Asanguineous resuscitation with conventional hydroxyethyl starch failed to restore hepatic microvascular blood flow, despite otherwise effective resuscitation. In contrast, the starch-deferoxamine conjugate improved volumetric blood flow and attenuated leukocyte margination in hepatic sinusoids compared with starch-vehicle, suggesting involvement of iron-dependent, oxygen-derived radicals in shock-induced hepatic microcirculatory disturbances.
journal_name
Crit Care Medjournal_title
Critical care medicineauthors
Bauer M,Feucht K,Ziegenfuss T,Marzi Idoi
10.1097/00003246-199502000-00018subject
Has Abstractpub_date
1995-02-01 00:00:00pages
316-22issue
2eissn
0090-3493issn
1530-0293journal_volume
23pub_type
杂志文章abstract:OBJECTIVES:Visual assessment of the electroencephalogram by experienced clinical neurophysiologists allows reliable outcome prediction of approximately half of all comatose patients after cardiac arrest. Deep neural networks hold promise to achieve similar or even better performance, being more objective and consistent...
journal_title:Critical care medicine
pub_type: 杂志文章,多中心研究
doi:10.1097/CCM.0000000000003854
更新日期:2019-10-01 00:00:00
abstract:OBJECTIVES:To determine the amount of spontaneous variability of cardiac output over time in critically ill patients, and to determine the effect of mechanical ventilation on cardiac output variability over time. DESIGN:Case series. SETTING:Medical intensive care unit in a Veterans Affairs Medical Center. PATIENTS:T...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/00003246-199402000-00012
更新日期:1994-02-01 00:00:00
abstract::Gastric mucosal damage occurs in critically ill patients in intensive care units and develops in the setting of severe physiologic stress. Within 24 hrs of admission to the intensive care unit, 75% to 100% of critically ill patients demonstrate evidence of stress-related mucosal disease. Stress ulcers present a risk o...
journal_title:Critical care medicine
pub_type: 杂志文章,评审
doi:10.1097/00003246-200206001-00002
更新日期:2002-06-01 00:00:00
abstract:OBJECTIVE:To test the effects of three hemoglobin solutions on liver function and hepatic morphology after resuscitation from severe hemorrhagic shock. DESIGN:Prospective study. SETTING:Laboratory. SUBJECTS:Thirty-three beagle dogs. INTERVENTION:Hemorrhagic shock was induced in anesthetized dogs by removal of blood...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/00003246-199604000-00019
更新日期:1996-04-01 00:00:00
abstract:OBJECTIVE:To quantify glucose balance related to continuous arteriovenous hemofiltration (CAVH) when a glucose-rich replacement fluid is used for the plasma ultrafiltrate removed. DESIGN:Prospective, nonintervention study. SETTING:Medical/surgical and cardiac surgical intensive care units of a university hospital. P...
journal_title:Critical care medicine
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doi:10.1097/00003246-199308000-00014
更新日期:1993-08-01 00:00:00
abstract:OBJECTIVE:To describe the symptom experiences of family members of patients at high risk for dying in the intensive care unit and to assess risk factors associated with higher symptom burden. DESIGN:Prospective, cross-sectional study. SETTING:Three intensive care units at a large academic medical center. PARTICIPANT...
journal_title:Critical care medicine
pub_type: 杂志文章,多中心研究
doi:10.1097/CCM.0b013e3181cf6d94
更新日期:2010-04-01 00:00:00
abstract:PURPOSE:Periodic diagnostic tests and continuous and intermittent monitoring are integral to critical care medicine. The focus of this article is understanding the impact of existing diagnostic technology, as well as that of new diagnostic technology. DATA SYNTHESIS:We use literature about gastric tonometry to illustr...
journal_title:Critical care medicine
pub_type: 杂志文章,评审
doi:10.1097/00003246-199909000-00005
更新日期:1999-09-01 00:00:00
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journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/00003246-198503000-00016
更新日期:1985-03-01 00:00:00
abstract:OBJECTIVE:To study the impact of diabetes mellitus on the relationship between glycemia and mortality in critically ill patients. DESIGN:Retrospective observational study. SETTING:Intensive care units of two university hospitals. PATIENTS:Cohort of 4946 critically ill patients including 728 patients with diabetes me...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/CCM.0b013e318181039a
更新日期:2008-08-01 00:00:00
abstract::We analyzed 35 samples of fresh frozen plasma (FFP), finding mean concentrations of 535 mg/dl glucose, 172 mEq/L sodium, 73 mEq/L chloride, 3.5 mEq/L potassium, 15 mEq/L bicarbonate, and 5.5 g/dl protein with 60% albumin. Thus, FFP is a hyperosmolal, hyperglycemic, hypernatremic, and hypochloremic solution which may b...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/00003246-198602000-00015
更新日期:1986-02-01 00:00:00
abstract:OBJECTIVES:To determine if vecuronium doses individualized by peripheral nerve stimulation are lower than those doses chosen by standard clinical techniques; and to determine whether patients monitored by peripheral nerve stimulation exhibit shorter recovery times and less prolonged neuromuscular blockade after discont...
journal_title:Critical care medicine
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1097/00003246-199704000-00005
更新日期:1997-04-01 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:PURPOSE:To determine the durability of the effects of a change in practice designed to promote the use of advanced supportive technology when it is of benefit but to limit its burdens when it is ineffective. We have reported that institution of a process of intensive communication reduced length of intensive care unit ...
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pub_type: 杂志文章
doi:10.1097/01.CCM.0000065279.77449.B4
更新日期:2003-05-01 00:00:00
abstract:OBJECTIVE:To compare three devices that measure core body temperature at the bedside in ICU patients. DESIGN:Prospective, consecutive sample. SETTING:Voluntary community teaching hospital. PATIENTS:Fifteen patients, 78 +/- 6 (SD) yrs of age, admitted to the medical ICU over a 5-month period who had pulmonary artery ...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/00003246-199106000-00015
更新日期:1991-06-01 00:00:00
abstract:OBJECTIVE:Critical care medicine trainees and faculty must acquire and maintain the skills necessary to provide state-of-the art clinical care to critically ill patients, to improve patient outcomes, optimize intensive care unit utilization, and continue to advance the theory and practice of critical care medicine. Thi...
journal_title:Critical care medicine
pub_type: 指南,杂志文章,实务指引
doi:10.1097/01.CCM.0000104916.33769.9A
更新日期:2004-01-01 00:00:00
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pub_type: 杂志文章
doi:10.1097/CCM.0b013e3182746704
更新日期:2013-04-01 00:00:00
abstract:OBJECTIVES:To assess the reversibility of acute kidney injury-induced neutrophil dysfunction and to identify involved mechanisms. DESIGN:Controlled laboratory experiment and prospective observational clinical study. SETTING:University laboratory and hospital. SUBJECTS:C57BL/6 wild-type mice. PATIENTS:Patients with ...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/CCM.0000000000001472
更新日期:2016-07-01 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:OBJECTIVES:Capillary refill time is a noninvasive method to assess tissue perfusion to determine shock status. Capillary refill time is defined as the time required to regain skin color after blanching pressure is applied. Although common methods to measure capillary refill time depend on clinicians' visual assessment,...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/CCM.0000000000004506
更新日期:2020-10-01 00:00:00
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pub_type: 杂志文章,评审
doi:10.1097/CCM.0b013e318270e771
更新日期:2012-12-01 00:00:00
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pub_type: 杂志文章
doi:10.1097/CCM.0000000000003272
更新日期:2018-09-01 00:00:00
abstract:OBJECTIVE:Cocaine, which first made its appearance >1,000 yrs ago, is now widely used throughout the world. The physiologic responses to cocaine may cause severe pathologic effects. This review highlights the many critical care challenges resulting from these effects. DESIGN:Historical vignettes, epidemiologic factors...
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pub_type: 杂志文章,评审
doi:10.1097/01.CCM.0000063258.68159.71
更新日期:2003-06-01 00:00:00
abstract::Pulmonary barotrauma developed in 18/430 patients receiving respirator support for longer than 12 hours. Pneumothorax occurred in 15 of these patients and was treated with tube thoracostomy and 15-20 cm H2O pleural suction. Full reexpansion of the lungs were achieved in all but three patients, two of whom had bronchop...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/00003246-197503000-00004
更新日期:1975-03-01 00:00:00
abstract::High-risk patients who survived general (noncardiac) surgery were observed to have cardiac index (CI) values averaging 4.5 L/min.m2, oxygen delivery (DO2) greater than 600 ml/min.m2, and oxygen consumption (VO2) 170 ml/min.m2 during the first 2 or three days postoperatively. Patients who subsequently died maintained r...
journal_title:Critical care medicine
pub_type: 杂志文章,评审
doi:
更新日期:1990-01-01 00:00:00
abstract:OBJECTIVE:Cytokines and adhesion molecules have a decisive role in the development of early inflammatory response as well as the late sequelae of sepsis. Because L-selectin-deficient mice are protected from lethal endotoxemia, blockade of L-selectin may provide a useful therapeutic option in human sepsis. Heparin has i...
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.0000059441.70680.DC
更新日期:2003-04-01 00:00:00
abstract::A new iridium/iridium-oxide electrode heated to 42 degrees C was used to monitor transcutaneous carbon dioxide levels during surgery in 27 adult patients. The purpose of this study was to compare arterial and transcutaneous CO2 values. This metal electrode performed similarly to glass CO2 electrodes. In addition, its ...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/00003246-198510000-00015
更新日期:1985-10-01 00:00:00
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journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/CCM.0000000000000100
更新日期:2014-04-01 00:00:00
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journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/00003246-199611000-00009
更新日期:1996-11-01 00:00:00
abstract:OBJECTIVE:This study tested the hypothesis that intra-coronary transfusion of circulation-derived autologous CD34+ cells can improve ischemia-related left ventricular dysfunction in patients with severe diffuse coronary artery disease refractory to medication and unsuitable for coronary intervention. DESIGN:A prospect...
journal_title:Critical care medicine
pub_type: 杂志文章,随机对照试验
doi:10.1097/CCM.0000000000001138
更新日期:2015-10-01 00:00:00
abstract:OBJECTIVE:To examine the effect of hypertonic saline on bacterial translocation and the number and function of natural killer and T cells in controlled hemorrhagic shock. DESIGN:Randomized controlled study. Duration of follow-up was 24 hrs. SETTING:University research laboratory. SUBJECTS:Adult male Sprague-Dawley r...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/00003246-200204000-00025
更新日期:2002-04-01 00:00:00