Abstract:
:Eleven patients in hypertensive crisis were treated with iv sodium nitroprusside (SNP). In all cases, rapid clinical improvement was obtained. Nevertheless, 9 patients developed progressive resistance to the hypotensive effect of the drug. For the first 2 h, the mean infusion rate was 1.68 +/- 0.64 micrograms/kg . min. For the next 6 h, the mean infusion rate had to be increased to 3.1 +/- 1.14 micrograms/kg . min in order to maintain diastolic blood pressure below 110 mm Hg. Hemodynamic measurements demonstrated that this resistance was related to a marked rise in cardiac index without tachycardia. In the 6 patients with pulmonary edema who developed resistance to SNP, blood pressure control was obtained by fluid depletion. In the 3 patients without pulmonary edema who developed resistance to SNP, blood pressure control was obtained by iv acebutolol. The authors conclude that SNP rapidly improves critical hypertension. Progressive resistance to the hypotensive effect of the drug can occur in some cases and is related to a marked rise in cardiac index, which can be rapidly antagonized with fluid depletion or a beta-blocking agent to avoid SNP accumulation and cyanide toxicity.
journal_name
Crit Care Medjournal_title
Critical care medicineauthors
Rouby JJ,Gory G,Bourrelli B,Glaser P,Viars Pdoi
10.1097/00003246-198205000-00002subject
Has Abstractpub_date
1982-05-01 00:00:00pages
301-4issue
5eissn
0090-3493issn
1530-0293journal_volume
10pub_type
杂志文章abstract::Last year, >28,000 people received organ transplants from >14,000 donors in the United States. Unfortunately, the wait list now tops 91,000, with the gap between recipient needs and available donor organs at around 60,000. This has motivated a host of efforts to increase organ supply, including driver's license and do...
journal_title:Critical care medicine
pub_type: 杂志文章,评审
doi:10.1097/01.CCM.0000252915.76019.19
更新日期:2007-02-01 00:00:00
abstract:OBJECTIVES:A 2400-mOsm/L hypertonic solution (isosal) with a lower sodium content, compared with conventional 7.5% hypertonic saline, was formulated using a mixture of sodium chloride, glucose, and mixed amino acids. This solution was developed to minimize hypernatremia during resuscitation. We assessed the effects of ...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/00003246-199607000-00027
更新日期:1996-07-01 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:OBJECTIVE:To define the impact of prehospital hypotension on the dynamic, systemic acute inflammatory response to blunt trauma. DESIGN:Retrospective study. SETTINGS:Tertiary care institution. PATIENTS:Twenty-two hypotensive blunt trauma patients matched with 28 normotensive blunt trauma patients. INTERVENTION:None....
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/CCM.0000000000000964
更新日期:2015-07-01 00:00:00
abstract:OBJECTIVE:To explore the feedback regulation of glucocorticoids on corticotropin secretion in patients with septic and nonseptic circulatory shock. DESIGN:Prospective study. SETTING:An intensive care unit of a general hospital. PATIENTS:Two groups of patients with septic shock (n = 11) or nonseptic shock (n = 7). A ...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/00003246-199303000-00018
更新日期:1993-03-01 00:00:00
abstract:OBJECTIVES:Ethicists advise that life-sustaining treatment decisions should be made in keeping with patient preferences. Until recently, there has been little systematic study of the impact of patient preferences on the use of various life-sustaining treatments or the consequent cost of hospital care. This prospective ...
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:OBJECTIVES:The impact of recruitment maneuvers on gas exchange, hemodynamics, alveolar recruitment, and hyperinflation is highly variable among patients with acute respiratory distress syndrome. The objective was to determine whether differences in lung morphology, defined as differences in the pulmonary distribution o...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/CCM.0b013e3181d451ec
更新日期:2010-04-01 00:00:00
abstract:OBJECTIVE:To describe critical illnesses that occur commonly in patients with human immunodeficiency virus (HIV) infection. METHODS:We reviewed and summarized the literature on critical illness in HIV infection using a computerized MEDLINE search. SUMMARY:In the last 10 yrs, our perception of HIV infection and acquir...
journal_title:Critical care medicine
pub_type: 杂志文章,评审
doi:10.1097/01.CCM.0000232491.15369.AB
更新日期:2006-09-01 00:00:00
abstract:OBJECTIVES:Sepsis remains a serious clinical problem despite intensive research efforts and numerous attempts to improve outcome by modifying the inflammatory response. Substance P, the principal ligand for the neurokinin-1 receptor, is a potent proinflammatory mediator that exacerbates inflammatory responses and cardi...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/CCM.0000000000002075
更新日期:2017-02-01 00:00:00
abstract:OBJECTIVES:To describe the physiologic mechanisms of ventilator-induced lung injury and to define the major ventilator and host-dependent risk factors that contribute to such injury. DATA SOURCE:Basic science and clinical studies related to ventilator-induced barotrauma and lung pathophysiology. STUDY SELECTION:Empha...
journal_title:Critical care medicine
pub_type: 杂志文章,评审
doi:10.1097/00003246-199301000-00024
更新日期:1993-01-01 00:00:00
abstract::Malaria is one of the most common infectious diseases in the world, and severe respiratory complications have been described mainly in association with Plasmodium falciparum. We describe a case of acute respiratory distress syndrome complicating infection with P. vivax in the setting of relatively low parasitemia in a...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/00003246-200103000-00037
更新日期:2001-03-01 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::We previously reported that small volume infusions of 7.5% NaCl in 6% dextran-70 (HSD) are superior to equal volumes of normal saline (NS) or 7.5% NaCl in the ability to resuscitate animals from an otherwise lethal hemorrhage. In the present experiment, we evaluated organ blood flow in unanesthetized swine bled 46 ml/...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/00003246-198712000-00009
更新日期:1987-12-01 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::Two new catecholamines, dopamine and dobutamine, have found widespread use for cardiovascular support. The relative efficacy of these drugs in aiding resuscitation from cardiopulmonary arrest is unknown. Dogs were subjected to either asphyxial or fibrillatory cardiac arrest. Resuscitation was attempted with artificial...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/00003246-198109000-00005
更新日期:1981-09-01 00:00:00
abstract:OBJECTIVE:To assess the effects of dopexamine on splanchnic blood flow and splanchnic oxygen uptake in septic patients. DESIGN:A prospective, controlled trial. SETTING:A ten-bed intensive care unit (ICU) in a university hospital. PATIENTS:Twelve patients with severe sepsis (according to the criteria of the 1992 Amer...
journal_title:Critical care medicine
pub_type: 临床试验,杂志文章
doi:10.1097/00003246-199910000-00015
更新日期:1999-10-01 00:00:00
abstract:OBJECTIVE:To evaluate the use of enriched thioglycolate as a transport medium of protected specimen brush samples, in particular its value in direct examination of respiratory specimens and in guiding initial antibiotic prescription. DESIGN:Prospective, randomized, pilot study. SETTING:Medical-surgical teaching inten...
journal_title:Critical care medicine
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1097/00003246-200202000-00008
更新日期:2002-02-01 00:00:00
abstract:OBJECTIVE:To evaluate the tolerance and the efficacy of noninvasive continuous positive airway pressure (CPAP) in severe acute respiratory failure occurring in intensive care unit (ICU) neutropenic patients with hematologic malignancies, and to establish predictive variables of efficacy of this method. DESIGN:Prospect...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/00003246-200009000-00012
更新日期:2000-09-01 00:00:00
abstract::It has become accepted that nitric oxide serves important functions in biological systems as a second messenger. Another diatomic gaseous molecule, carbon monoxide (CO), is also rapidly gaining acceptance as a signaling agent. Some of the activities of CO are analogous to those of nitric oxide in the vascular system a...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:
更新日期:2001-01-01 00:00:00
abstract:OBJECTIVE:Develop a scoring system that can assess the management of septic shock by individuals and teams. DESIGN:Retrospective review of videotapes of critical care house staff managing a standardized simulation of septic shock. SETTING:Academic medical center; videotapes were made in a recreated intensive care uni...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/01.CCM.0000256849.75799.20
更新日期:2007-03-01 00:00:00
abstract:OBJECTIVE:The goals of this review article are to review the importance and value of standardized definitions in clinical research, as well as to propose the necessary tools and infrastructure needed to advance nosology and medial taxonomy to improve the quality of clinical trials in the field of critical care. DATA S...
journal_title:Critical care medicine
pub_type: 杂志文章,评审
doi:10.1097/CCM.0b013e3181920ee8
更新日期:2009-01-01 00:00:00
abstract:OBJECTIVES:To confirm early, marked decrease in plasma selenium concentrations in patients admitted to a surgical and medical intensive care unit (ICU), and to study this decrease according to the presence or absence of systemic inflammatory response syndrome (SIRS), sepsis, or direct ischemia-reperfusion. DESIGN:Pros...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/00003246-199809000-00021
更新日期:1998-09-01 00:00:00
abstract:OBJECTIVE:In patients undergoing surgical repair of aortic dissection, false lumen perfusion during cardiopulmonary bypass may produce central nervous system damage, myocardial ischemia, aortic rupture, and death. We describe a method to detect false lumen perfusion at the beginning of retrograde aortic perfusion that ...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/00003246-200006000-00026
更新日期:2000-06-01 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...
journal_title:Critical care medicine
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:OBJECTIVES:The role of nitric oxide in mediating the early phase of hypotension and cardiovascular hyporeactivity in sepsis, and the cellular sources of inducible nitric oxide synthase expression under in vivo conditions, remain unclear. The objective of this study was to elucidate the time course and cellular location...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/00003246-199703000-00022
更新日期:1997-03-01 00:00:00
abstract:OBJECTIVE:To provide a meta-analysis of current literature concerning the validation of thoracic impedance cardiography (TIC) and to explain the variations in the reported results from the differences in the studies. DATA SOURCES:A computer-assisted search of English-language, German, and Dutch literature was performe...
journal_title:Critical care medicine
pub_type: 杂志文章,meta分析
doi:10.1097/00003246-199906000-00053
更新日期:1999-06-01 00:00:00
abstract:OBJECTIVES:The electronic health record is a primary source of information for all professional groups participating in ICU rounds. We previously demonstrated that, individually, all professional groups involved in rounds have significant blind spots in recognition of patient safety issues in the electronic health reco...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/CCM.0000000000003302
更新日期:2018-10-01 00:00:00
abstract:OBJECTIVES:We investigated whether patients with chronic obstructive pulmonary disease could safely receive noninvasive ventilation outside of the ICU. DESIGN:Retrospective cohort study. SETTING:Twelve states with ICU utilization flag from the State Inpatient Database from 2014. PATIENTS:Patients greater than or equ...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/CCM.0000000000003660
更新日期:2019-05-01 00:00:00
abstract::The venous-arterial PCO2 gradient may increase in certain low-flow states, such as CPR and canine endotoxemia. To determine whether venous hypercarbia also occurs in hemorrhagic shock, we studied 12 anesthetized, mechanically ventilated dogs. We performed laparotomies on the animals, inserting catheters into their ren...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/00003246-198705000-00013
更新日期:1987-05-01 00:00:00
abstract:OBJECTIVE:Our first objective was to determine a blood lactate threshold predictive of survival in human immunodeficiency virus patients experiencing lactic acidosis related to nucleoside analogs, and second, to test l-carnitine for the treatment of patients exceeding that threshold. DESIGN:a) Retrospective study usin...
journal_title:Critical care medicine
pub_type: 临床试验,杂志文章,多中心研究
doi:10.1097/01.CCM.0000053649.69377.08
更新日期:2003-04-01 00:00:00