Abstract:
:The effects of PEEP and subsequent augmentation of cardiac output by sodium nitroprusside (SNP) were examined in a canine model of asymmetric oleic acid injury to the right lung. PEEP (9.2 +/- 0.5 cm H2O) was added to six animals to decrease venous admixture (Qsp/Qt) from 50.6 +/- 4.4% to 16.0 +/- 1.3% (p less than .05). With PEEP, intrapulmonary blood flow distribution (assessed by radioactive microspheres) decreased significantly to nondependent lung regions while increasing to dependent regions. In six other animals, zero end-expiratory pressure (ZEEP) did not alter intrapulmonary blood flow distribution. SNP was then administered to increase cardiac output by 40% (to 2.60 +/- 0.21 L/min in the ZEEP group and to 1.75 +/- 0.27 L/min in the PEEP group). SNP produced no adverse effects on Qsp/Qt or intrapulmonary blood flow distribution. Specifically, SNP did not preferentially dilate pulmonary vessels injured by oleic acid with or without end-expiratory pressure. Thus, administration of a vasodilator drug in asymmetric pulmonary edema appears well tolerated.
journal_name
Crit Care Medjournal_title
Critical care medicineauthors
Johnston WE,Vinten-Johansen J,Tommasi Edoi
10.1097/00003246-198903000-00008subject
Has Abstractpub_date
1989-03-01 00:00:00pages
241-6issue
3eissn
0090-3493issn
1530-0293journal_volume
17pub_type
杂志文章abstract:OBJECTIVE:To determine alterations in intestinal epithelial permeability to solutes in burn injured rats with and without Enterococcus faecalis infection and the role of neutrophils in the intestinal permeability changes. DESIGN:Prospective sham-controlled animal study. SETTING:University research laboratory. SUBJEC...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/01.ccm.0000145579.66001.05
更新日期:2004-11-01 00:00:00
abstract::We previously reported increased lipid peroxide and decreased alpha-tocopherol levels in the blood of critically ill septic patients. To clarify these results, we investigated lipid peroxidation in experimental septic rats and severely traumatized rats. In septic rats, both platelet count and plasma alpha-tocopherol d...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/00003246-198608000-00010
更新日期:1986-08-01 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
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:OBJECTIVES:Studies have shown that endothelium-dependent relaxation (mediated by endothelium-derived nitric oxide) is depressed during the early, hyperdynamic stage of sepsis. Although it is known that ATP-MgCl2 produces beneficial effects following various adverse circulatory conditions, it remains unknown whether thi...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/00003246-199905000-00035
更新日期:1999-05-01 00:00:00
abstract::To evaluate the effect of meconium on pulmonary surface tension properties, the mechanics of 30 excised, separated canine pulmonary lobes were studied. Meconia were blended in normal saline to produce solutions of 10% and 20%. Solutions were filtered to remove large particles and instilled endobronchially into the can...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/00003246-198504000-00005
更新日期:1985-04-01 00:00:00
abstract:OBJECTIVES:To review mechanisms underlying sepsis-induced cardiac dysfunction in general and intrinsic myocardial depression in particular. DATA SOURCE:MEDLINE database. DATA SYNTHESIS:Myocardial depression is a well-recognized manifestation of organ dysfunction in sepsis. Due to the lack of a generally accepted defi...
journal_title:Critical care medicine
pub_type: 杂志文章,评审
doi:10.1097/01.CCM.0000266683.64081.02
更新日期:2007-06-01 00:00:00
abstract::Vecuronium's short half-life and minimal cardiopulmonary side-effects make it a suitable drug for continuous infusion. Vecuronium is used frequently in critically ill patients to increase their total compliance and to minimize the adverse effects of mechanical ventilation. This crossover, prospective study evaluates t...
journal_title:Critical care medicine
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1097/00003246-198910000-00004
更新日期:1989-10-01 00:00:00
abstract:OBJECTIVE:Transfusion of red blood cells has been linked to disappointing clinical outcomes in the critically ill, but specific mechanisms of organ dysfunction after transfusion remain poorly understood. We tested the hypothesis that red blood cell storage impairs the ability of red blood cells to release adenosine-5'-...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/CCM.0b013e318225754f
更新日期:2011-11-01 00:00:00
abstract:OBJECTIVE:To study the effects of high-dose epinephrine, compared with standard-dose epinephrine, on the dynamics of superficial cortical cerebral blood flow as well as global cerebral oxygenation during experimental cardiopulmonary resuscitation. We hypothesized that high-dose epinephrine might be unable to improve ce...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/00003246-200005000-00028
更新日期:2000-05-01 00:00:00
abstract:OBJECTIVE:To evaluate premorbid conditions and sociodemographic characteristics associated with differences in hospitalization and mortality rates of sepsis in blacks and whites. DESIGN:Secondary data analysis of the publicly available New Jersey State Inpatient Database for 2002. SETTING:Acute care hospitals in New ...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/01.CCM.0000256726.80998.BF
更新日期:2007-03-01 00:00:00
abstract:OBJECTIVE:To review trial design issues related to control groups. DESIGN:Review of the literature with specific reference to critical care trials. MAIN RESULTS AND CONCLUSIONS:Performing randomized controlled trials in the critical care setting presents specific problems: studies include patients with rapidly lethal...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/CCM.0b013e3181922bf4
更新日期:2009-01-01 00:00:00
abstract:OBJECTIVES:To develop a predictive equation to estimate the frequency of blood drawing for intensive care unit (ICU) laboratory tests and to evaluate variations in ICU blood sampling practices after adjusting for patient and institutional factors. DESIGN:Prospective, inception, cohort study. SETTING:Forty-two ICUs in...
journal_title:Critical care medicine
pub_type: 杂志文章,多中心研究
doi:10.1097/00003246-199705000-00006
更新日期:1997-05-01 00:00:00
abstract:OBJECTIVE:To test the hypothesis that the effects of intravenous injection of latex particles would demonstrate the contribution of phagocytosis by mononuclear phagocytes to the development of Escherichia coli-induced acute lung injury in neutropenic guinea pigs. DESIGN:Prospective, controlled, experimental study. Int...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/00003246-199606000-00025
更新日期:1996-06-01 00:00:00
abstract:OBJECTIVES:Mechanical ventilation can cause ventilator-induced brain injury via afferent vagal signaling and hippocampal neurotransmitter imbalances. The triggering mechanisms for vagal signaling during mechanical ventilation are unknown. The objective of this study was to assess whether pulmonary transient receptor po...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/CCM.0000000000003977
更新日期:2019-11-01 00:00:00
abstract:OBJECTIVE:Very elderly persons admitted to ICUs are at high risk of death. To document life-sustaining interventions (mechanical ventilation, vasopressors, renal replacement therapy) provided in the ICU and outcomes of care. DESIGN:Multicenter, prospective cohort study. SETTING:ICUs of 24 Canadian hospitals. PARTICI...
journal_title:Critical care medicine
pub_type: 杂志文章,多中心研究
doi:10.1097/CCM.0000000000001024
更新日期:2015-07-01 00:00:00
abstract:OBJECTIVES:To describe the effectiveness of a comprehensive, interdisciplinary sepsis treatment protocol with regard to both implementation and outcomes and to compare the mortality rates and therapies of patients with septic shock with similar historical controls. DESIGN:Prospective, interventional cohort study with ...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/01.CCM.0000206104.18647.A8
更新日期:2006-04-01 00:00:00
abstract:OBJECTIVES:: To determine the relationship between intra-abdominal sepsis-induced high mobility group-box 1 and diaphragm contractile performance and to determine the inhibitory effects of antibodies for high mobility group-box 1 and receptor for advanced glycation end-products on septic peritonitis-induced diaphragmat...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/CCM.0b013e3181a930f7
更新日期:2009-09-01 00:00:00
abstract:OBJECTIVE:To determine whether continuous modes of renal replacement therapy result in improved cardiovascular stability compared with standard daily intermittent treatment in critically ill patients. DESIGN:Prospective, randomized controlled trial. SETTING:Intensive care unit in a quaternary referral center for live...
journal_title:Critical care medicine
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1097/00003246-199303000-00007
更新日期:1993-03-01 00:00:00
abstract::Assessment of creatinine clearance (CC) in ICU patients was compared using three methods. The reference method (CC 24 h) used measurements of serum creatinine and urinary creatinine after collection of urine over a 24-h period. The other two methods were predictive methods: the Kampmann nomogram and the formula develo...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/00003246-199011000-00007
更新日期:1990-11-01 00:00:00
abstract:OBJECTIVE:Patients with severe sepsis have high mortality that is improved by timely, often expensive, treatments. Patients without insurance are more likely to delay seeking care; they may also receive less intense care. DESIGN:We performed a retrospective analysis of administrative database-Healthcare Costs and Util...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/01.ccm.0000435667.15070.9c
更新日期:2014-03-01 00:00:00
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
更新日期:2006-03-01 00:00:00
abstract:OBJECTIVE:To determine the effect that acute physiologic derangements have on outcome after subarachnoid hemorrhage (SAH) and to design a composite score summarizing these abnormalities. DESIGN:Prospective observational study. SETTING:Neuroscience intensive care unit in a tertiary care academic center. PATIENTS:Cons...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/01.ccm.0000114830.48833.8a
更新日期:2004-03-01 00:00:00
abstract::A high rate of death from septic shock persists despite general improvements in care. The relative failure of mechanistically based therapies in various clinical trials should also trigger a reconsideration of such mechanistic approaches. Despite reversion of shock by hydrocortisone, the similar death rate compared wi...
journal_title:Critical care medicine
pub_type: 杂志文章,评审
doi:10.1097/CCM.0b013e3181f23dc4
更新日期:2010-10-01 00:00:00
abstract:OBJECTIVE:We hypothesized that deficiency in 25-hydroxyvitamin D before hospital admission would be associated with all-cause mortality in the critically ill. DESIGN:Multicenter observational study of patients treated in medical and surgical intensive care units. SETTING:A total of 209 medical and surgical intensive ...
journal_title:Critical care medicine
pub_type: 杂志文章,多中心研究
doi:10.1097/CCM.0b013e318206ccdf
更新日期:2011-04-01 00:00:00
abstract:OBJECTIVES:The epidemiology of chronic critical illness is not well known. We aimed to estimate the prevalence, mortality, and costs associated with chronic critical illness in Japan. DESIGN:A nationwide inpatient administrative database study in Japan from April 2011 to March 2018. SETTING:Six hundred seventy-nine a...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/CCM.0000000000004723
更新日期:2021-01-01 00:00:00
abstract:PURPOSE:To describe the dark side of pediatric intensive care fellowship training and offer educational approaches for understanding feelings of fallibility, anger, frustration, and loss. DATA SOURCES:Listening and observing fellows in the courses of their pediatric intensive care training and later careers. STUDY SE...
journal_title:Critical care medicine
pub_type: 杂志文章,评审
doi:10.1097/00003246-199305000-00023
更新日期:1993-05-01 00:00:00
abstract:OBJECTIVE:To examine the relationship between aminoglycoside disposition kinetics and hemodynamic response to sepsis, as well as vital support therapy, in critically ill patients with sepsis. DESIGN:Cross-sectional study of critically ill patients with sepsis undergoing physiologic and aminoglycoside pharmacokinetic m...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/00003246-199705000-00016
更新日期:1997-05-01 00:00:00
abstract:OBJECTIVE:Cytokine response after cardiac surgery may be genetically influenced. A study was carried out to investigate the relation between cytokine gene expression in peripheral blood mononuclear cells, genotype, and clinical events after cardiac surgery. DESIGN:A case-control study was performed. SETTING:Cardiac i...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/01.CCM.0000227647.77356.AB
更新日期:2006-08-01 00:00:00
abstract:OBJECTIVE:To assess protective and risk factors for mortality among pediatric patients during initial care after hematopoietic stem cell transplantation (HSCT) and to evaluate changes in hospital mortality. DESIGN:Retrospective cohort using the 1997, 2000, and 2003 Kids Inpatient Database, a probabilistic sample of ch...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/01.CCM.0B013E318161FAC1
更新日期:2008-03-01 00:00:00