Ventricular function in myocardial contusion: a preliminary study.

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, the incidence of myocardial contusion in patients with blunt chest trauma increased from 7% when viewed retrospectively to 15% when viewed prospectively. Five patients had determinations of cardiac index of which 4 were less than 2.9 L/min . M2. An additional 9 patients underwent a standard fluid challenge of 500 ml of 5% plasma protein faction infused over 30 min allowing construction of a Starling myocardial performance curve. Of these patients, 6 had biventricular dysfunction, 1 had isolated abnormal left ventricular function, and 2 had isolated abnormal right ventricular function in the absence of chronic obstructive pulmonary disease or preexisting heart disease. Multiple gated acquisition scans (MUGA) were abnormal in 6 patients and normal in 4 patients. Of the latter group, 3 had biventricular dysfunction and 1 had depressed cardiac index. Morbidity and mortality for myocardial contusion occurred in 40% (6 of 15) of patients in this series. Direct hemodynamic measurement with construction of a Starling curve was useful in monitoring the degree of impairment and subsequent recovery of myocardial function. This information was important in delaying semiurgent operations or in determining the best alternative of otherwise equally acceptable methods of patient management.

journal_name

Crit Care Med

journal_title

Critical care medicine

authors

Torres-Mirabal P,Gruenberg JC,Talbert JG,Brown RS

doi

10.1097/00003246-198201000-00005

subject

Has Abstract

pub_date

1982-01-01 00:00:00

pages

19-24

issue

1

eissn

0090-3493

issn

1530-0293

journal_volume

10

pub_type

杂志文章
  • Gabexate mesilate, a synthetic protease inhibitor, prevents compression-induced spinal cord injury by inhibiting activation of leukocytes in rats.

    abstract:OBJECTIVE:Gabexate mesilate is a synthetic protease inhibitor capable of inhibiting both coagulation and cytokine production by monocytes. To investigate whether gabexate mesilate is useful for the prevention of posttraumatic spinal cord injury, we examined its effect on compression trauma-induced spinal cord injury in...

    journal_title:Critical care medicine

    pub_type: 杂志文章

    doi:10.1097/00003246-199705000-00026

    authors: Taoka Y,Okajima K,Uchiba M,Murakami K,Kushimoto S,Johno M,Naruo M,Okabe H,Takatsuki K

    更新日期:1997-05-01 00:00:00

  • Transbrachial insertion of a 7.5-Fr intra-aortic balloon pump in a severely atherosclerotic patient.

    abstract:OBJECTIVE:Preoperative intra-aortic balloon pumping (IABP) improves the results of complex coronary surgery. However, its insertion may be harmful or contraindicated in cases of severe and diffuse atherosclerosis of the descending aorta and peripheral arteries. We sought to evaluate the efficacy and safety of transbrac...

    journal_title:Critical care medicine

    pub_type: 杂志文章

    doi:10.1097/01.CCM.0000229884.94475.DB

    authors: Onorati F,Bilotta M,Pezzo F,Impiombato B,Caroleo S,Santangelo E,Renzulli A

    更新日期:2006-08-01 00:00:00

  • Mean airway pressure: physiologic determinants and clinical importance--Part 1: Physiologic determinants and measurements.

    abstract:PURPOSES:To discuss the theoretical relationship of mean alveolar pressure to its most easily measured analog, the mean airway pressure, and to describe the key determinants, measurement considerations, and clinical implications of this index. DATA SOURCES:Relevant articles from the medical and physiologic literature,...

    journal_title:Critical care medicine

    pub_type: 杂志文章

    doi:

    authors: Marini JJ,Ravenscraft SA

    更新日期:1992-10-01 00:00:00

  • Evaluation of a modified piezoresistive technique and a water-capsule technique for direct and continuous measurement of intra-abdominal pressure in a porcine model.

    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

    authors: Schachtrupp A,Henzler D,Orfao S,Schaefer W,Schwab R,Becker P,Schumpelick V

    更新日期:2006-03-01 00:00:00

  • Critical care nursing: workforce issues and potential solutions.

    abstract:OBJECTIVE:To review the history and development of critical care nurses, the supply and demand issues related to critical care nursing, critical care nursing's contribution to patient outcomes, and recommendations to ensure a steady and strong workforce. DATA SOURCE AND SELECTION:Information presented in this article ...

    journal_title:Critical care medicine

    pub_type: 杂志文章,评审

    doi:10.1097/01.CCM.0000203087.42439.53

    authors: Robnett MK

    更新日期:2006-03-01 00:00:00

  • Acute care/blood gas laboratories: profile of current operations.

    abstract::A survey of acute care/blood gas laboratories was conducted through the memberships of the Society of Critical Care Medicine ( SCCM ) and the National Association of Medical Directors of Respiratory Care ( NAMDRC ). Data were obtained from 227 laboratories and analyzed for operational characteristics, personnel, analy...

    journal_title:Critical care medicine

    pub_type: 杂志文章

    doi:10.1097/00003246-198406000-00014

    authors: Hall JR,Shapiro BA

    更新日期:1984-06-01 00:00:00

  • Noninvasive positive-pressure ventilation in acute respiratory failure outside clinical trials: experience at the Massachusetts General Hospital.

    abstract:BACKGROUND:Noninvasive positive-pressure ventilation (NPPV) has been shown to be effective in select patients enrolled in clinical trials. However, few data are available on the use of NPPV as routine standard medical care for patients with respiratory failure outside of controlled trials. MEASUREMENTS AND MAIN RESULT...

    journal_title:Critical care medicine

    pub_type: 杂志文章

    doi:10.1097/01.CCM.0000300084.67277.90

    authors: Schettino G,Altobelli N,Kacmarek RM

    更新日期:2008-02-01 00:00:00

  • Prevalence of Thrombotic Complications in ICU-Treated Patients With Coronavirus Disease 2019 Detected With Systematic CT Scanning.

    abstract:OBJECTIVES:Severe coronavirus disease 2019 is associated with an extensive pneumonitis and frequent coagulopathy. We sought the true prevalence of thrombotic complications in critically ill patients with severe coronavirus disease 2019 on the ICU, with or without extracorporeal membrane oxygenation. DESIGN:We undertoo...

    journal_title:Critical care medicine

    pub_type: 杂志文章

    doi:10.1097/CCM.0000000000004890

    authors: Mirsadraee S,Gorog DA,Mahon CF,Rawal B,Semple TR,Nicol ED,Arachchillage DRJ,Devaraj A,Price S,Desai SR,Ridge CA,Singh S,Padley SPG

    更新日期:2021-01-06 00:00:00

  • Randomization in clinical trials of titrated therapies: unintended consequences of using fixed treatment protocols.

    abstract:OBJECTIVE:Clinical trial designs that randomize patients to fixed treatment regimens may disrupt preexisting relationships between illness severity and level of therapy. The practice misalignments created by such designs may have unintended effects on trial results and safety. METHODS:To illustrate this problem, the T...

    journal_title:Critical care medicine

    pub_type: 杂志文章

    doi:10.1097/01.CCM.0000266584.40715.A6

    authors: Deans KJ,Minneci PC,Suffredini AF,Danner RL,Hoffman WD,Ciu X,Klein HG,Schechter AN,Banks SM,Eichacker PQ,Natanson C

    更新日期:2007-06-01 00:00:00

  • Difficulties in predicting outcome in cardiac surgery patients.

    abstract:OBJECTIVE:To evaluate a novel combination of preoperative, intraoperative, and postoperative variables (including the Parsonnet, and the Acute Physiology and Chronic Health Evaluation II and III [APACHE II and III] scores) in cardiac surgery patients in order to predict hospital outcome, complications, and length of st...

    journal_title:Critical care medicine

    pub_type: 临床试验,杂志文章

    doi:10.1097/00003246-199511000-00010

    authors: Turner JS,Morgan CJ,Thakrar B,Pepper JR

    更新日期:1995-11-01 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

    doi:10.1097/CCM.0000000000002314

    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

  • Management of upper airway obstruction in the intensive care unit.

    abstract::Three patients under observation in ICUs developed mechanical upper airway obstruction requiring surgical intervention for airway control. One patient was treated by tracheotomy placed through a vertical midline incision and 2 patients were treated by cricothyroidotomy followed by elective tracheostomy and closure of ...

    journal_title:Critical care medicine

    pub_type: 杂志文章

    doi:10.1097/00003246-198108000-00004

    authors: Schecter WP,Wilson RS

    更新日期:1981-08-01 00:00:00

  • Trauma index revisited: a better triage tool.

    abstract::In the development of triage and bypass protocols, many different scoring systems and triage criteria are being used. Our purpose was to evaluate the Revised Trauma Index (RTI) as a triage tool for both its severity prediction ability and triage accuracy. A total of 2,340 trauma admissions were evaluated using the RTI...

    journal_title:Critical care medicine

    pub_type: 杂志文章

    doi:10.1097/00003246-199002000-00010

    authors: Smith JS Jr,Bartholomew MJ

    更新日期:1990-02-01 00:00:00

  • Endotracheal and endobronchial lidocaine administration: effects on plasma lidocaine concentration and blood gases.

    abstract:OBJECTIVE:To compare four different methods of endotracheal lidocaine administration with respect to the site of administration. DESIGN:Randomized controlled trial. SETTING:University hospital. PATIENTS:Thirty-two female patients (43.6 +/- 11.5 years old) undergoing elective gynecologic operations with an anesthesio...

    journal_title:Critical care medicine

    pub_type: 临床试验,杂志文章,随机对照试验

    doi:10.1097/00003246-199107000-00015

    authors: Prengel AW,Lindner KH,Hähnel J,Ahnefeld FW

    更新日期:1991-07-01 00:00:00

  • Renal function in critically ill postoperative patients: sequential assessment of creatinine osmolar and free water clearance.

    abstract::Sequential assessment of renal function in 50 critically ill postoperative patients was done by simultaneous determinants of osmolar, free water, creatinine and sodium clearances, and fractional excretion of sodium. The traumatic and nontraumatic critically ill surgical patients had a characteristic pattern of creatin...

    journal_title:Critical care medicine

    pub_type: 杂志文章

    doi:10.1097/00003246-198002000-00004

    authors: Brown R,Babcock R,Talbert J,Gruenberg J,Czurak C,Campbell M

    更新日期:1980-02-01 00:00:00

  • Prevention of colonization and infection in critically ill patients: a prospective randomized study.

    abstract::In a prospective randomized study to determine whether prevention of colonization of Gram-negative bacteria results in prevention of Gram-negative bacterial infections, 96 intensive care patients were randomly allocated into a control group and a study group. The study group received oral nonabsorbable antimicrobial a...

    journal_title:Critical care medicine

    pub_type: 临床试验,杂志文章,随机对照试验

    doi:10.1097/00003246-198811000-00001

    authors: Kerver AJ,Rommes JH,Mevissen-Verhage EA,Hulstaert PF,Vos A,Verhoef J,Wittebol P

    更新日期:1988-11-01 00:00:00

  • Assessing Variability in Hospital-Level Mortality Among U.S. Medicare Beneficiaries With Hospitalizations for Severe Sepsis and Septic Shock.

    abstract:OBJECTIVES:To assess the variability in short-term sepsis mortality by hospital among Centers for Medicare and Medicaid Services beneficiaries in the United States during 2013-2014. DESIGN:A retrospective cohort design. SETTING:Hospitalizations from 3,068 acute care hospitals that participated in the Centers for Medi...

    journal_title:Critical care medicine

    pub_type: 杂志文章

    doi:10.1097/CCM.0000000000003324

    authors: Hatfield KM,Dantes RB,Baggs J,Sapiano MRP,Fiore AE,Jernigan JA,Epstein L

    更新日期:2018-11-01 00:00:00

  • Joint Society of Critical Care Medicine-Extracorporeal Life Support Organization Task Force Position Paper on the Role of the Intensivist in the Initiation and Management of Extracorporeal Membrane Oxygenation.

    abstract:OBJECTIVES:To define the role of the intensivist in the initiation and management of patients on extracorporeal membrane oxygenation. DESIGN:Retrospective review of the literature and expert consensus. SETTING:Series of in-person meetings, conference calls, and emails from January 2018 to March 2019. SUBJECTS:A mult...

    journal_title:Critical care medicine

    pub_type: 杂志文章

    doi:10.1097/CCM.0000000000004330

    authors: DellaVolpe J,Barbaro RP,Cannon JW,Fan E,Greene WR,Gunnerson KJ,Napolitano LM,Ovil A,Pamplin JC,Schmidt M,Sorce LR,Brodie D

    更新日期:2020-06-01 00:00:00

  • Extracorporeal gas exchange and spontaneous breathing for the treatment of acute respiratory distress syndrome: an alternative to mechanical ventilation?*.

    abstract:OBJECTIVES:Venovenous extracorporeal gas exchange is increasingly used in awake, spontaneously breathing patients as a bridge to lung transplantation. Limited data are available on a similar use of extracorporeal gas exchange in patients with acute respiratory distress syndrome. The aim of this study was to investigate...

    journal_title:Critical care medicine

    pub_type: 杂志文章

    doi:10.1097/CCM.0000000000000121

    authors: Langer T,Vecchi V,Belenkiy SM,Cannon JW,Chung KK,Cancio LC,Gattinoni L,Batchinsky AI

    更新日期:2014-03-01 00:00:00

  • Value of human factors to medication and patient safety in the intensive care unit.

    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

    authors: Scanlon MC,Karsh BT

    更新日期:2010-06-01 00:00:00

  • Continuous infusion of lorazepam versus medazolam in patients in the intensive care unit: sedation with lorazepam is easier to manage and is more cost-effective.

    abstract:OBJECTIVE:To evaluate the effectiveness of lorazepam and midazolam for long-term sedation of critically ill, mechanically ventilated patients. DESIGN:Double-blind, randomized, controlled study. SETTING:Medical intensive care unit in a university teaching hospital. PATIENTS:Sixty-four evaluable adult patients admitte...

    journal_title:Critical care medicine

    pub_type: 临床试验,杂志文章,随机对照试验

    doi:10.1097/00003246-199908000-00009

    authors: Swart EL,van Schijndel RJ,van Loenen AC,Thijs LG

    更新日期:1999-08-01 00:00:00

  • Beneficial effects of mercaptoethylguanidine, an inhibitor of the inducible isoform of nitric oxide synthase and a scavenger of peroxynitrite, in a porcine model of delayed hemorrhagic shock.

    abstract:OBJECTIVE:In rodent models, enhanced formation of nitric oxide and formation of peroxynitrite have been implicated in the pathogenesis of various forms of shock. Here we examined the effect of mercaptoethylguanidine (MEG), an inducible nitric oxide synthase inhibitor and peroxynitrite scavenger, in a severe hemorrhagic...

    journal_title:Critical care medicine

    pub_type: 杂志文章

    doi:10.1097/00003246-199907000-00027

    authors: Szabó A,Hake P,Salzman AL,Szabó C

    更新日期:1999-07-01 00:00:00

  • ST changes during sodium nitroprusside therapy in acute myocardial infarction.

    abstract::Nineteen patients with acute anterior myocardial infarction who were hypertensive (systolic BP greater than or equal to 170 mm Hg and/or diastolic BP greater than or equal to 100 mm Hg) at the time of admission were treated with continuous infusion of sodium nitroprusside (NP). The administration of NP resulted in a s...

    journal_title:Critical care medicine

    pub_type: 杂志文章

    doi:10.1097/00003246-198310000-00010

    authors: Rucabado L,Miñana J,Cebrián J,Monsalve F,Cuñat J,Ruano M

    更新日期:1983-10-01 00:00:00

  • Prospective validation of the intensive care unit admission Mortality Probability Model (MPM0-III).

    abstract:OBJECTIVE:To validate performance characteristics of the intensive care unit (ICU) admission mortality probability model, version III (MPM0-III) on Project IMPACT data submitted in 2004 and 2005. This data set was external from the MPM0-III developmental and internal validation data collected between 2001 and 2004. DE...

    journal_title:Critical care medicine

    pub_type: 杂志文章

    doi:10.1097/CCM.0b013e31819ded31

    authors: Higgins TL,Kramer AA,Nathanson BH,Copes W,Stark M,Teres D

    更新日期:2009-05-01 00:00:00

  • Second annual SCCM lecture. The role of hemodynamic monitoring in the management of the critically ill.

    abstract::Balloon flotation catheterization of the central circulation provides data which may be most meaningful and important to the management of critically ill patients. It allows the measurements of the filling pressures of the right and left ventricle as well as the cardiac output. These data combined with information con...

    journal_title:Critical care medicine

    pub_type: 杂志文章

    doi:10.1097/00003246-197505000-00001

    authors: Swan HJ

    更新日期:1975-05-01 00:00:00

  • Use of intensive care at the end of life in the United States: an epidemiologic study.

    abstract:OBJECTIVE:Despite concern over the appropriateness and quality of care provided in an intensive care unit (ICU) at the end of life, the number of Americans who receive ICU care at the end of life is unknown. We sought to describe the use of ICU care at the end of life in the United States using hospital discharge data ...

    journal_title:Critical care medicine

    pub_type: 杂志文章,多中心研究

    doi:10.1097/01.ccm.0000114816.62331.08

    authors: Angus DC,Barnato AE,Linde-Zwirble WT,Weissfeld LA,Watson RS,Rickert T,Rubenfeld GD,Robert Wood Johnson Foundation ICU End-Of-Life Peer Group.

    更新日期:2004-03-01 00:00:00

  • Exhaled nitric oxide level decreases after cardiopulmonary bypass in adult patients.

    abstract:OBJECTIVE:To measure exhaled nitric oxide (NO) and compare it with lung function after cardiopulmonary bypass (CPB) in adult patients. Pulmonary dysfunction is sometimes observed after CPB. Impaired production of NO may account for this dysfunction. DESIGN:Prospective, single-center, observational study. SETTING:Univ...

    journal_title:Critical care medicine

    pub_type: 杂志文章

    doi:10.1097/00003246-200012000-00012

    authors: Ishibe Y,Liu R,Hirosawa J,Kawamura K,Yamasaki K,Saito N

    更新日期:2000-12-01 00:00:00

  • Accurate and precise delivery of nitric oxide during high-frequency oscillatory ventilation.

    abstract:BACKGROUND:We have previously described a method for the precise delivery of inhaled nitric oxide (iNO) via a conventional, continuous-flow, pressure-limited, time-cycled ventilator. Because of the augmented effect of iNO decreasing pulmonary vascular resistance with high-frequency oscillatory ventilation (HFOV), we de...

    journal_title:Critical care medicine

    pub_type: 杂志文章

    doi:10.1097/00003246-199911000-00038

    authors: Espinosa RM,Marks KH

    更新日期:1999-11-01 00:00:00

  • Preventable adverse drug events in hospitalized patients: a comparative study of intensive care and general care units.

    abstract:OBJECTIVES:To compare the frequency and preventability of adverse drug events and potential adverse drug events in intensive care units (ICUs) and non-ICUs. To evaluate systems factors involving the individual caregivers, care unit teams, and patients involved in each adverse drug event by comparing ICUs with non-ICUs ...

    journal_title:Critical care medicine

    pub_type: 杂志文章

    doi:10.1097/00003246-199708000-00014

    authors: Cullen DJ,Sweitzer BJ,Bates DW,Burdick E,Edmondson A,Leape LL

    更新日期:1997-08-01 00:00:00

  • Sleep and Work in ICU Physicians During a Randomized Trial of Nighttime Intensivist Staffing.

    abstract:OBJECTIVES:To compare sleep, work hours, and behavioral alertness in faculty and fellows during a randomized trial of nighttime in-hospital intensivist staffing compared with a standard daytime intensivist model. DESIGN:Prospective observational study. SETTING:Medical ICU of a tertiary care academic medical center du...

    journal_title:Critical care medicine

    pub_type: 杂志文章

    doi:10.1097/CCM.0000000000003773

    authors: Bakhru RN,Basner M,Kerlin MP,Halpern SD,Hansen-Flaschen J,Rosen IM,Dinges DF,Schweickert WD

    更新日期:2019-07-01 00:00:00