Abstract:
OBJECTIVES:In this study, we evaluated the inflammatory response in patients with severe acute respiratory infection due to the Middle East respiratory syndrome and non-Middle East respiratory syndrome and assessed the presence of distinct inflammatory subphenotypes using latent class analysis. DESIGN:Prospective cohort study. SETTING:A tertiary care ICU in Riyadh, Saudi Arabia. PATIENTS:Consecutive critically ill patients with laboratory-confirmed Middle East respiratory syndrome severe acute respiratory infection and non-Middle East respiratory syndrome severe acute respiratory infection. INTERVENTION:None. MEASUREMENTS AND MAIN RESULTS:We measured cytokines on days 1, 3, 7, and 14 of ICU stay. We included 116 patients (40 with Middle East respiratory syndrome severe acute respiratory infection and 76 with non-Middle East respiratory syndrome severe acute respiratory infection). On ICU day 1, both patients with Middle East respiratory syndrome severe acute respiratory infection and non-Middle East respiratory syndrome severe acute respiratory infection had higher levels of interleukin-3, interleukin-4, interleukin-6, interleukin-8, interleukin-17A, eotaxin, and epidermal growth factor compared with healthy controls. There were no differences in cytokines over time between patients with Middle East respiratory syndrome severe acute respiratory infection and non-Middle East respiratory syndrome severe acute respiratory infection. Using day 1 cytokine levels, latent class analysis categorized patients into two subphenotypes: subphenotype 1 (n = 74 [64%]) and subphenotype 2 (n = 42 [36%]); the latter had significantly higher levels of interleukin-1β, interleukin-1ra, interleukin-2, interleukin-6, interleukin-7, interleukin-8, interleukin-10, interleukin-12p70, interleukin-15, interleukin-17A, inducible protein-10, monocyte chemoattractant protein-1, macrophage inflammatory protein-1α, macrophage inflammatory protein-1β, tumor necrosis factor-α, granulocyte-macrophage colony-stimulating factor, granulocyte-colony stimulating factor, interferon-α, and interferon-γ. Although baseline characteristics were not different between the two subphenotypes, patients in the subphenotype 2 had higher ICU mortality compared with the subphenotype 1 (18/42 [43%] vs 17/74 [23%]; p = 0.03). CONCLUSIONS:One third of critically ill patients with Middle East respiratory syndrome severe acute respiratory infection and non-Middle East respiratory syndrome severe acute respiratory infection demonstrated a subphenotype characterized by increased proinflammatory cytokines, consistent with cytokine storm. Further research is needed to examine whether immunomodulators have differential effects based on inflammatory subphenotypes.
journal_name
Crit Care Medjournal_title
Critical care medicineauthors
Arabi YM,Jawdat D,Hajeer AH,Sadat M,Jose J,Vishwakarma RK,Almashaqbeh W,Al-Dawood Adoi
10.1097/CCM.0000000000004724subject
Has Abstractpub_date
2021-02-01 00:00:00pages
228-239issue
2eissn
0090-3493issn
1530-0293pii
00003246-202102000-00007journal_volume
49pub_type
杂志文章abstract:OBJECTIVE:To determine the association of pulmonary artery catheter (PAC) use with in-hospital mortality. DESIGN:Prospective, observational study. SETTING:The medical intensive care units (MICU) of two teaching hospitals. METHODS:The study included 751 adults who were admitted to the MICU, excluding those who stayed...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/00003246-200106000-00010
更新日期:2001-06-01 00:00:00
abstract:OBJECTIVE:Pulmonary air embolism, causing vessel obstruction and primary or secondary reactions of blood, can lead to acute lung injury. In addition, nitric oxide has been known to play a key role in various causes of lung injury. In this study we employed the isolated rat lung model to investigate the effects of l-arg...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/01.ccm.0000178175.54354.ea
更新日期:2005-09-01 00:00:00
abstract::The relationship between oxygen uptake (Vo2) and delivery (Do2) was examined in 64 patients immediately after cardiopulmonary bypass. In 44 patients with lactate levels below 2.5 mmol/L, Vo2 decreased proportionally when Do2 decreased below 300 ml/min X m2. At a Do2 over this level, Vo2 plateaued at 105 +/- 13 (SD) ml...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/00003246-198703000-00002
更新日期:1987-03-01 00:00:00
abstract::The hemodynamic response to a dopamine HCl infusion (10 microgram/kg per min) was measured in 25 adult patients with severe sepsis: there were 6 patients with circulatory hyperdynamic states, 9 patients with myocardial failure, and 10 with hypovolemia. Each patient also had acute respiratory failure. Changes of intrap...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/00003246-197906000-00004
更新日期:1979-06-01 00:00:00
abstract:OBJECTIVE:To determine the blood discard volume, as a multiple of deadspace, that is required for accurate arterial blood gas and electrolyte testing from arterial catheters. DESIGN:Prospective, controlled, crossover trial. SETTING:Eighteen-bed intensive care unit of a metropolitan teaching hospital. PATIENTS:A tota...
journal_title:Critical care medicine
pub_type: 临床试验,杂志文章
doi:10.1097/01.CCM.0000063448.98777.EF
更新日期:2003-06-01 00:00:00
abstract::Flow rates and pressure recording accuracy were compared for Argyle 14-, 16-, and 18-ga double-lumen and Edwards 7-Fr triple-lumen CVP catheters. Physiologic saline solution was pressure-infused into dogs through one lumen and CVP was measured via the other lumen. CVP accuracy was unaltered by simultaneous rapid infus...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/00003246-198507000-00017
更新日期:1985-07-01 00:00:00
abstract::Twenty-four pediatric patients undergoing corrective posterior spinal fusion surgery for idiopathic scoliosis were studied to determine the frequency with which the syndrome of inappropriate antidiuretic hormone secretion (SIADH) developed. We measured arterial blood gases, serum and urine electrolytes and osmolalitie...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/00003246-198307000-00009
更新日期:1983-07-01 00:00:00
abstract:OBJECTIVES:Pneumothorax is a frequent complication during mechanical ventilation. Electrical impedance tomography (EIT) is a noninvasive tool that allows real-time imaging of regional ventilation. The purpose of this study was to 1) identify characteristic changes in the EIT signals associated with pneumothoraces; 2) d...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/CCM.0b013e31816a0380
更新日期:2008-04-01 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:OBJECTIVE:Using a modification of the Bohr equation, single-breath carbon dioxide capnography is a noninvasive technology for calculating physiologic dead space (V(D)/V(T)). The objective of this study was to identify a minimal V(D)/V(T) value for predicting successful extubation from mechanical ventilation in pediatri...
journal_title:Critical care medicine
pub_type: 临床试验,杂志文章
doi:10.1097/00003246-200006000-00059
更新日期:2000-06-01 00:00:00
abstract::The recommended rates for closed-chest cardiac compressions during CPR are based on physiologic variations with increasing age rather than experimental data. Using puppies, we compared mean arterial pressure, cardiac index (CI), and cerebral blood flow (CBF) at a slow (40/min, group 1) and a rapid (120/min, group 2) r...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/00003246-198710000-00009
更新日期:1987-10-01 00:00:00
abstract:OBJECTIVE:To determine whether polymorphisms of the surfactant protein B gene may be associated with increased mortality in patients with the acute respiratory distress syndrome. DESIGN:A prospective cohort study. SETTING:Four adult intensive care units at a tertiary academic medical center. PATIENTS:Two hundred fou...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/CCM.0b013e318183f608
更新日期:2008-09-01 00:00:00
abstract:OBJECTIVE:To assess the possible benefits of sympatholytics on uncontrolled hemorrhage in unanesthetized rats. DESIGN:A randomized laboratory study using rats to test the effects of sympatholytics on uncontrolled hemorrhage. SETTING:Research laboratory. SUBJECTS:Forty female Sprague-Dawley rats, randomly assigned in...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/00003246-199909000-00025
更新日期:1999-09-01 00:00:00
abstract:OBJECTIVES:Severe sepsis poses a major burden on the U.S. healthcare system. Previous epidemiologic studies have not differentiated community-acquired severe sepsis from healthcare-associated severe sepsis or hospital-acquired severe sepsis hospitalizations. We sought to compare and contrast community-acquired severe s...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/CCM.0000000000001164
更新日期:2015-09-01 00:00:00
abstract::Standard cardiopulmonary-cerebral resuscitation fails to achieve restoration of spontaneous circulation in approximately 50% of normovolemic sudden cardiac arrests outside hospitals and in essentially all victims of penetrating truncal trauma who exsanguinate rapidly to cardiac arrest. Among cardiopulmonary-cerebral r...
journal_title:Critical care medicine
pub_type: 杂志文章,评审
doi:10.1097/00003246-200011001-00012
更新日期:2000-11-01 00:00:00
abstract:OBJECTIVES:To perform a complete immunological characterization of compensatory anti-inflammatory response syndrome in patients with sepsis and to explore the relationship between these changes and clinical outcomes of 28-day mortality and secondary infections. DESIGN:Prospective single-center study conducted between ...
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
abstract:OBJECTIVE:To review the anti-inflammatory and anti-apoptotic properties of drotrecogin alfa (activated) (recombinant human activated protein C), emphasizing its modulatory effects on endothelial nuclear factor-kappaB. We propose a broad anti-inflammatory effect of drotrecogin alfa (activated), acting on both endotheliu...
journal_title:Critical care medicine
pub_type: 杂志文章,评审
doi:10.1097/00003246-200205001-00019
更新日期:2002-05-01 00:00:00
abstract::The Pediatric Risk of Mortality (PRISM) score was developed from the Physiologic Stability Index (PSI) to reduce the number of physiologic variables required for pediatric ICU (PICU) mortality risk assessment and to obtain an objective weighting of the remaining variables. Univariate and multivariate statistical techn...
journal_title:Critical care medicine
pub_type: 临床试验,杂志文章,多中心研究
doi:10.1097/00003246-198811000-00006
更新日期:1988-11-01 00:00:00
abstract:OBJECTIVES:To describe the incident fracture rate in survivors of critical illness and to compare fracture risk with population-matched control subjects. DESIGN:Retrospective longitudinal case-cohort study. SETTING:A tertiary adult intensive care unit in Australia. PATIENTS:All patients ventilated admitted to intens...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/CCM.0b013e318211ff3d
更新日期:2011-06-01 00:00:00
abstract:OBJECTIVE:To study whether noninvasive pressure support ventilation (NIPSV) with helium/oxygen (He/oxygen), which can reduce dyspnea, PaCO2, and work of breathing more than NIPSV with air/oxygen in decompensated chronic obstructive pulmonary disease, could have beneficial consequences on outcome and hospitalization cos...
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
doi:10.1097/01.CCM.0000055369.37620.EE
更新日期:2003-03-01 00:00:00
abstract:OBJECTIVES:To compare the assessment of decision-making capacity of ICU patients by attending clinicians (physicians, nurses, and residents) with a capacity score measured by the Mini-Mental Status Examination, completed by Aid to Capacity Evaluation if necessary. The primary outcome was agreement between physicians' a...
journal_title:Critical care medicine
pub_type: 杂志文章,多中心研究
doi:10.1097/CCM.0000000000003550
更新日期:2019-03-01 00:00:00
abstract:OBJECTIVES:Prophylactic levetiracetam is currently used in ~40% of patients with intracerebral hemorrhage, and the potential impact of levetircetam on health-related quality of life is unknown. We tested the hypothesis that prophylactic levetiracetam is independently associated with differences in cognitive function he...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/CCM.0000000000003272
更新日期:2018-09-01 00:00:00
abstract:OBJECTIVES:Vascular beds vary in their responses to atrial natriuretic peptide and sodium nitroprusside. Both of these agents dilate blood vessels by increasing intracellular guanosine 3',5'-cyclic monophosphate (cyclic-GMP) but activate different enzymes in the vascular smooth muscle cell. We aimed to determine if the...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/00003246-199409000-00017
更新日期:1994-09-01 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:Granulocyte transfusions have been used to treat immune cell dysfunction in sepsis. As granulocyte transfusions can trigger tissue injury via local effects of neutrophils, we hypothesized that extracorporeal treatment of plasma using granulocytes would prove beneficial while having less side effects. DESIGN...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/CCM.0b013e318194aa77
更新日期:2009-02-01 00:00:00
abstract:OBJECTIVE:Prognostic information is important to the family members of incapacitated, critically ill patients, yet little is known about what prognostic information physicians provide. Our objectives were to determine the types of prognostic information provided to families of critically ill patients when making major ...
journal_title:Critical care medicine
pub_type: 杂志文章,多中心研究
doi:10.1097/01.CCM.0000254723.28270.14
更新日期:2007-02-01 00:00:00
abstract:OBJECTIVE:One in five Americans dies following treatment in an intensive care unit (ICU), and evidence indicates the need to improve end-of-life care for ICU patients. We conducted this study to elicit the views and experiences of ICU directors regarding barriers to optimal end-of-life care and to identify the type, av...
journal_title:Critical care medicine
pub_type: 杂志文章,多中心研究
doi:10.1097/01.CCM.0000239233.63425.1D
更新日期:2006-10-01 00:00:00
abstract:OBJECTIVES:To investigate the effects of recombinant human erythropoietin on brain oxygenation in a model of diffuse traumatic brain injury. DESIGN:Adult male Wistar rats. SETTING:Neurosciences and physiology laboratories. INTERVENTIONS:Thirty minutes after diffuse traumatic brain injury (impact-acceleration model),...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/CCM.0b013e31827ca64e
更新日期:2013-05-01 00:00:00
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
更新日期:1997-08-01 00:00:00
abstract:OBJECTIVES:To measure pulmonary capillary pressure and pulmonary artery occlusion pressures both during control conditions and during acute lung injury and to evaluate the effects of inotropic therapy and volume loading on these measurements after lung injury. DESIGN:Prospective, randomized, controlled laboratory tria...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/00003246-200202000-00023
更新日期:2002-02-01 00:00:00