Abstract:
OBJECTIVE:Exosomes are small, cell-released vesicles (40-100 nm in size) with the potential to transfer proteins, lipids, small RNAs, messenger RNAs, or DNA between cells via interstitial fluids. Due to their role in tissue homeostasis, exosomes have emerged as a new type of therapeutic and diagnostic (theranostic) tool in the noninvasive assessment of organ response to injury or treatment and in the development of reliable organ-protective intensive therapy. Our review provides current insights into the role of exosomes in the personalized management of injury and repair responses in critical illness. DATA SOURCE:Data were obtained from a PubMed search of the most recent medical literature, including the PubMed "related articles" search methodology. STUDY SELECTION:Articles considered include original articles, review articles and conference proceedings. DATA EXTRACTION:A detailed review of scientific, peer-reviewed data was performed. Relevant pre-clinical and clinical studies were included and summarized. DATA SYNTHESIS:Current scientific evidence is focused on the following: 1) Frontiers in the management of critical illness; 2) Biogenesis, characterization, and function of circulating exosomes; 3) The role of exosomes in acute lung injury; 4) The role of exosomes in acute cardiac injury; 5) The role of exosomes in acute kidney injury; 6) The role of exosomes in sepsis; 7) Limitations of exosome isolation protocols; and 8) Perspectives in the theranostic use of exosomes. CONCLUSIONS:Circulating levels of exosomes are associated with the onset and clinical course of critical illness. Exosomes released from cells with different phenotypes exert different functions in order to protect tissue and preserve organ function. Therefore, multifunctional exosomes with combined diagnostic and therapeutic functions show great promise in terms of personalized nanomedicine for patient-specific diagnosis and treatment of critical illness.
journal_name
Crit Care Medjournal_title
Critical care medicineauthors
Terrasini N,Lionetti Vdoi
10.1097/CCM.0000000000002328subject
Has Abstractpub_date
2017-06-01 00:00:00pages
1054-1060issue
6eissn
0090-3493issn
1530-0293journal_volume
45pub_type
杂志文章,评审abstract:OBJECTIVE:The adrenal gland is the endocrine organ most commonly involved in patients infected with human immunodeficiency virus (HIV). It is important to recognize patients with adrenal insufficiency, because this disorder may be fatal if untreated. The incidence of adrenal insufficiency in critically ill HIV-infected...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/00003246-200206000-00018
更新日期:2002-06-01 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:OBJECTIVE:During pressure support ventilation, ventilator inspiration ends when inspiratory flow drops to a given percentage of the peak inspiratory flow cycling-off criteria. This study evaluated the effect of two different cycling-off criteria on breathing pattern, respiratory effort, and gas exchange in patients wit...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/01.CCM.0000287594.80110.34
更新日期:2007-11-01 00:00:00
abstract:OBJECTIVE:An increasing number of ICU patients survive and develop mental, cognitive, or physical impairments. Various interventions support recovery from this postintensive care syndrome. Physicians in charge of post-ICU patients need to know which interventions are effective. DATA SOURCES:Systematic literature searc...
journal_title:Critical care medicine
pub_type: 杂志文章,评审
doi:10.1097/CCM.0000000000000148
更新日期:2014-05-01 00:00:00
abstract:OBJECTIVES:Evaluate clinicians' sentiments about participating in cardiac arrest resuscitations and identify factors associated with confidence in resuscitation of cardiac arrest. DESIGN:Electronic survey. SETTING:Twenty-one hospitals in Utah and Idaho. SUBJECTS:All attending physicians, residents, and nurses in a m...
journal_title:Critical care medicine
pub_type: 杂志文章,多中心研究
doi:10.1097/CCM.0000000000003612
更新日期:2019-03-01 00:00:00
abstract:OBJECTIVES:Lung CT is the reference imaging technique for acute respiratory distress syndrome, but requires transportation outside the intensive care and x-ray exposure. Lung ultrasound is a promising, inexpensive, radiation-free, tool for bedside imaging. Aim of the present study was to compare the global and regional...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/CCM.0000000000003971
更新日期:2019-11-01 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
abstract:OBJECTIVES:To determine the point prevalence of medication errors at the time of transition of care from an ICU to non-ICU location and assess error types and risk factors for medication errors during transition of care. DESIGN:This was a multicenter, retrospective, 7-day point prevalence study. SETTING:Fifty-eight I...
journal_title:Critical care medicine
pub_type: 杂志文章,多中心研究
doi:10.1097/CCM.0000000000003633
更新日期:2019-04-01 00:00:00
abstract:OBJECTIVE:Our goal was to demonstrate explicitly that lower-frequency positive-pressure ventilation not only preserves adequate oxygenation and acid-base status in hemorrhagic states, but also that "normal" or higher respiratory rates significantly compromise hemodynamics, even with moderate degrees of hemorrhage. DES...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/01.ccm.0000134264.88332.37
更新日期:2004-09-01 00:00:00
abstract:OBJECTIVE:The objectives of this study were to evaluate safety (primary) and clinical efficacy (secondary) of the humanized monoclonal anti-L-selectin antibody aselizumab in severely injured patients. DESIGN:Prospective phase II, parallel group, double-blind, randomized, placebo-controlled clinical trial. SETTING:Fou...
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.0000142396.59236.f3
更新日期:2004-10-01 00:00:00
abstract:OBJECTIVE:Fibrotic changes are initiated early in acute respiratory distress syndrome. This may involve overproliferation of alveolar type II cells. In an animal model of acute respiratory distress syndrome, we have shown that the administration of an adenoviral vector overexpressing the 70-kd heat shock protein (AdHSP...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/01.CCM.0000295473.56522.EF
更新日期:2008-01-01 00:00:00
abstract:OBJECTIVE:To determine the frequency, etiology, and risk factors of ventilator-associated pneumonia (VAP) and purulent tracheobronchitis (TBX) in patients who have undergone heart surgery. To study the predictive role of systematic surveillance cultures. DESIGN:Prospective study. SETTING:Heart surgery intensive care ...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/01.ccm.0000084807.15352.93
更新日期:2003-07-01 00:00:00
abstract:OBJECTIVES:To investigate the frequency, types, and implications of complications during intensive care in patients after status epilepticus has been successfully terminated. DESIGN:Retrospective study. SETTING:ICUs at a Swiss tertiary academic medical care center. PATIENTS:Data were collected from the digital patie...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/CCM.0000000000004642
更新日期:2020-12-01 00:00:00
abstract:OBJECTIVE:Anesthetic preconditioning appears to be a viable strategy to treat ischemic cerebral injury. Here we investigated 1) whether the protection conferred by sevoflurane preconditioning sustains in time; 2) whether sevoflurane preconditioning diminishes mitochondrial dysfunction following cerebral ischemia; and 3...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/CCM.0b013e318258fb90
更新日期:2012-09-01 00:00:00
abstract:OBJECTIVE:Our objective was to quantify the association between intensive care unit-acquired dysglycemia (hyperglycemia, hypoglycemia, and high variability) and in-hospital mortality. DESIGN:Retrospective, observational study. SETTING:eICU Research Institute participating hospitals with an active tele-ICU program bet...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/CCM.0b013e3182656ae5
更新日期:2012-12-01 00:00:00
abstract::A meta-analysis was performed of 15 randomized studies on the prophylaxis with cimetidine and/or ant-acids of upper GI bleeding acquired in the ICU. There were eight comparisons of a group receiving cimetidine with a control group, nine comparisons of a group receiving antacids with a control group, and ten comparison...
journal_title:Critical care medicine
pub_type: 临床试验,杂志文章
doi:10.1097/00003246-198909000-00003
更新日期:1989-09-01 00:00:00
abstract:OBJECTIVES:To assess the specific host responses to systemic endotoxemia and tumor necrosis factor (TNF) activation after abdominal aortic aneurysm surgery by measuring antiendotoxin core antibodies (EndoCab) immunoglobulin (Ig)G and IgM, and soluble p55TNF receptor concentrations. The role of the gut in initiating the...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/00003246-199709000-00013
更新日期:1997-09-01 00:00:00
abstract:OBJECTIVE:The purpose of this study was to evaluate the long-term cardiopulmonary outcome at ages 10-15 yrs following neonatal extracorporeal membrane oxygenation (ECMO). The specific aims of the study were to assess baseline aerobic capacity, cardiac function, and pulmonary function in neonatal ECMO survivors using gr...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/01.CCM.0000084856.00372.CE
更新日期:2003-09-01 00:00:00
abstract:BACKGROUND:Noncuffed, percutaneously inserted central venous catheters (CVCs) are widely used and cause at least 250,000 bloodstream infections (BSIs) in U.S. hospitals each year. We report a prospective study to determine whether inflammation at the insertion site is predictive of CVC-related BSI. METHODS:Percutaneou...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/00003246-200212000-00003
更新日期:2002-12-01 00:00:00
abstract::One hundred six early features were retrospectively collected on 44 patients with acute pancreatitis and stored in a database programmed on a microcomputer. Intraoperative/autopsy findings or clinical course categorized patients as having severe (n = 16) or mild (n = 28) pancreatitis. The frequency of 88 early availab...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/00003246-198904000-00004
更新日期:1989-04-01 00:00:00
abstract::The care of critically ill children has become more complex and demanding. This document establishes recommendations for developing regionalized integration of the care of these children into the emergency medical services system. These recommendations were developed by pediatricians with expertise in pediatric critic...
journal_title:Critical care medicine
pub_type: 共识发展会议,杂志文章,评审
doi:10.1097/00003246-200001000-00040
更新日期:2000-01-01 00:00:00
abstract:OBJECTIVE:To test whether spectral indices derived from the electroencephalogram (EEG), and especially the bispectral index (BIS), can be used as measures of neurologic status in unsedated, critically ill patients. DESIGN:Prospective, observational study. SETTING:Medical intensive care unit (ICU) of a university-affi...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/00003246-200110000-00024
更新日期:2001-10-01 00:00:00
abstract:OBJECTIVE:To evaluate the safety and diagnostic yield of transbronchial biopsy performed in mechanically ventilated patients. DESIGN:Retrospective, cohort analysis. SETTING:A university-affiliated teaching hospital. PATIENTS:Seventy-one consecutive, mechanically ventilated patients requiring lung tissue examination....
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/00003246-199703000-00012
更新日期:1997-03-01 00:00:00
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
更新日期:1990-02-01 00:00:00
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
doi:10.1097/01.ccm.0000159193.42628.e8
更新日期:2005-04-01 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:OBJECTIVE:The acute respiratory distress syndrome may complicate postpartum hemorrhagic shock and resuscitation, but its mechanisms are not yet well defined. We studied the lung inflammatory response to postpartum hemorrhagic shock and resuscitation in a rabbit model and the role of the nuclear factor-κB pathway. DESI...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/CCM.0b013e3182451c17
更新日期:2012-05-01 00:00:00
abstract:OBJECTIVES:In this systematic review and meta-analysis, we assessed whether a high CO2 gap predicts mortality in adult critically ill patients with circulatory shock. DATA SOURCES:A systematic search of MEDLINE and EMBASE electronic databases from inception to October 2019. STUDY SELECTION:Studies from adult (age ≥ 1...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/CCM.0000000000004578
更新日期:2020-12-01 00:00:00
abstract::A polarographic conjunctival oxygen sensor was used to measure oxygen tension in a tissue bed supplied by the internal carotid artery. The shared vascular source of the conjunctiva and brain suggests that conjunctival PO2 monitoring may provide an index of cerebral perfusion. We studied the effects of hyperventilation...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/00003246-198601000-00003
更新日期:1986-01-01 00:00:00
abstract:BACKGROUND:Pneumonia accounts for almost half of intensive care unit (ICU) infections and nearly 60% of deaths from nosocomial infections. It increases hospital stay by 7-9 days, crude mortality by 70% and attributable mortality by 30%. OBJECTIVE:Our purpose was to assess the impact of standard operating procedures ad...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/CCM.0b013e3181934f1b
更新日期:2009-01-01 00:00:00