Calcium administration increases the mortality of endotoxic shock in rats.

Abstract:

:Calcium chloride is administered frequently to critically ill patients to improve cardiac output and BP. However, Ca has been implicated in the pathophysiology of shock and ischemic disorders. To test the hypothesis that Ca may be deleterious to shock outcome, we studied the effects of CaCl and Ca chelator (EGTA) infusions on mean arterial pressure (MAP) responses to endotoxin and 24-h survival in rats. Increasing ionized Ca from 4.1 +/- 0.06 to 4.9 +/- 0.20 and 8.5 +/- 0.52 mg/dl progressively increased endotoxin lethality from 20% to 37% and 80%, respectively. This occurred despite slight improvements in MAP in hypercalcemic rats. Conversely, hypocalcemia (3.6 +/- 0.08 mg/dl) lowered endotoxin-induced mortality to 0 without significant effects on MAP. Ca and EGTA infusions alone were not associated with any mortality. Although Ca administration may improve MAP, it significantly increases mortality associated with endotoxic shock in rats. Based on these observations, we advise caution when using Ca in patients with sepsis.

journal_name

Crit Care Med

journal_title

Critical care medicine

authors

Malcolm DS,Zaloga GP,Holaday JW

doi

10.1097/00003246-198909000-00012

subject

Has Abstract

pub_date

1989-09-01 00:00:00

pages

900-3

issue

9

eissn

0090-3493

issn

1530-0293

journal_volume

17

pub_type

杂志文章
  • Humane terminal extubation reconsidered: the role for preemptive analgesia and sedation.

    abstract::Patient comfort is not assured by common practices for terminal extubation. Treatment guidelines suggest minimizing dosage of opioids and sedatives. Multiple lines of evidence indicate that clinicians are limited in their ability to recognize distress in such patients and tend to undermedicate patients in distress. Ye...

    journal_title:Critical care medicine

    pub_type: 杂志文章,评审

    doi:10.1097/CCM.0b013e318228235d

    authors: Billings JA

    更新日期:2012-02-01 00:00:00

  • Old Mice Demonstrate Organ Dysfunction as well as Prolonged Inflammation, Immunosuppression, and Weight Loss in a Modified Surgical Sepsis Model.

    abstract:OBJECTIVES:Our goal was to "reverse translate" the human response to surgical sepsis into the mouse by modifying a widely adopted murine intra-abdominal sepsis model to engender a phenotype that conforms to current sepsis definitions and follows the most recent expert recommendations for animal preclinical sepsis resea...

    journal_title:Critical care medicine

    pub_type: 杂志文章

    doi:10.1097/CCM.0000000000003926

    authors: Stortz JA,Hollen MK,Nacionales DC,Horiguchi H,Ungaro R,Dirain ML,Wang Z,Wu Q,Wu KK,Kumar A,Foster TC,Stewart BD,Ross JA,Segal M,Bihorac A,Brakenridge S,Moore FA,Wohlgemuth SE,Leeuwenburgh C,Mohr AM,Moldawer LL,E

    更新日期:2019-11-01 00:00:00

  • Procalcitonin release patterns in a baboon model of trauma and sepsis: relationship to cytokines and neopterin.

    abstract:OBJECTIVES:Procalcitonin (PCT) has been described as an early, discriminating marker of bacteria-associated sepsis in patients. However, little is known of its source and actions, in part because no appropriate animal models have been available. We tested the hypothesis that plasma PCT increases during various pathophy...

    journal_title:Critical care medicine

    pub_type: 杂志文章

    doi:10.1097/00003246-200011000-00021

    authors: Redl H,Schlag G,Tögel E,Assicot M,Bohuon C

    更新日期:2000-11-01 00:00:00

  • Dopexamine increases splanchnic blood flow but decreases gastric mucosal pH in severe septic patients treated with dobutamine.

    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

    authors: Meier-Hellmann A,Bredle DL,Specht M,Hannemann L,Reinhart K

    更新日期:1999-10-01 00:00:00

  • A Quasi-Experimental, Before-After Trial Examining the Impact of an Emergency Department Mechanical Ventilator Protocol on Clinical Outcomes and Lung-Protective Ventilation in Acute Respiratory Distress Syndrome.

    abstract:OBJECTIVES:To evaluate the impact of an emergency department mechanical ventilation protocol on clinical outcomes and adherence to lung-protective ventilation in patients with acute respiratory distress syndrome. DESIGN:Quasi-experimental, before-after trial. SETTING:Emergency department and ICUs of an academic cente...

    journal_title:Critical care medicine

    pub_type: 杂志文章

    doi:10.1097/CCM.0000000000002268

    authors: Fuller BM,Ferguson IT,Mohr NM,Drewry AM,Palmer C,Wessman BT,Ablordeppey E,Keeperman J,Stephens RJ,Briscoe CC,Kolomiets AA,Hotchkiss RS,Kollef MH

    更新日期:2017-04-01 00:00:00

  • Intestinal nitric oxide output during reduced mucosal blood flow in healthy volunteers.

    abstract:OBJECTIVE:Nitric oxide regulates epithelial permeability and other properties of the intestinal mucosal barrier. It previously has been shown in animals that intestinal mucosal nitric oxide production is impaired during gut hypoperfusion. The study was performed to confirm the presence of intestinal mucosal nitric oxid...

    journal_title:Critical care medicine

    pub_type: 杂志文章

    doi:10.1097/01.CCM.0000080489.67211.1F

    authors: Snygg J,Aneman A,Pettersson A,Fändriks L

    更新日期:2003-08-01 00:00:00

  • Intra-aortic balloon pump effects on macrocirculation and microcirculation in cardiogenic shock patients supported by venoarterial extracorporeal membrane oxygenation*.

    abstract:OBJECTIVES:This study was designed to assess the effects on macrocirculation and microcirculation of adding an intra-aortic balloon pump to peripheral venoarterial extracorporeal membrane oxygenation in patients with severe cardiogenic shock and little/no residual left ventricular ejection. DESIGN:A prospective, singl...

    journal_title:Critical care medicine

    pub_type: 杂志文章

    doi:10.1097/CCM.0000000000000410

    authors: Petroni T,Harrois A,Amour J,Lebreton G,Brechot N,Tanaka S,Luyt CE,Trouillet JL,Chastre J,Leprince P,Duranteau J,Combes A

    更新日期:2014-09-01 00:00:00

  • Endotoxin increases plasma leptin and ghrelin levels in dogs.

    abstract:OBJECTIVE:Evaluations of plasma leptin and ghrelin levels and their relations with circulating levels of proinflammatory mediators, stress hormones, and biochemical markers of hepatorenal injury during experimental endotoxemia in dogs. SETTING:Uludag University. DESIGN:Placebo-controlled animal study. ANIMALS:Adult ...

    journal_title:Critical care medicine

    pub_type: 杂志文章

    doi:10.1097/01.CCM.0B013E3181611F5AA

    authors: Yilmaz Z,Ilcol YO,Ulus IH

    更新日期:2008-03-01 00:00:00

  • From laboratory science to six emergency medical services systems: New understanding of the physiology of cardiopulmonary resuscitation increases survival rates after cardiac arrest.

    abstract:OBJECTIVE:The purpose of this study is to: 1) describe a newly mechanism of blood flow to the brain during cardiopulmonary resuscitation using the impedance threshold device in a piglet model of cardiac arrest, and 2) describe the survival benefits in humans of applying all of the highly recommended changes in the 2005...

    journal_title:Critical care medicine

    pub_type: 杂志文章,多中心研究

    doi:10.1097/ccm.0b013e31818a7e56

    authors: Aufderheide TP,Alexander C,Lick C,Myers B,Romig L,Vartanian L,Stothert J,McKnite S,Matsuura T,Yannopoulos D,Lurie K

    更新日期:2008-11-01 00:00:00

  • Predictors of noninvasive ventilation failure in patients with hematologic malignancy and acute respiratory failure.

    abstract:OBJECTIVES:The current trend to manage critically ill hematologic patients admitted with acute respiratory failure is to perform noninvasive ventilation to avoid endotracheal intubation. However, failure of noninvasive ventilation may lead to an increased mortality. DESIGN:Retrospective study to determine the frequenc...

    journal_title:Critical care medicine

    pub_type: 杂志文章

    doi:10.1097/CCM.0b013e31818699f6

    authors: Adda M,Coquet I,Darmon M,Thiery G,Schlemmer B,Azoulay E

    更新日期:2008-10-01 00:00:00

  • System for umbilical artery monitoring.

    abstract::A simple, safe, and effective system for umbilical artery monitoring controls continuous fluid infusion to prevent fluid overinfusion and keep the catheter from clotting. Accurate and continuous pressure measurements can be recorded simultaneously with fluid infusion. A convenient method for checking dynamic response ...

    journal_title:Critical care medicine

    pub_type: 杂志文章

    doi:10.1097/00003246-198207000-00009

    authors: Gardner RM,Parker J,Feinauer LR

    更新日期:1982-07-01 00:00:00

  • Glycosylated recombinant human tumor necrosis factor binding protein-1 reduces mortality, shock, and production of tumor necrosis factor in rabbit Escherichia coli sepsis.

    abstract:OBJECTIVE:To examine the effect of glycosylated recombinant human tumor necrosis factor binding protein-1 (r-hTNF binding protein-1), the extracellular domain of the tumor necrosis factor receptor p55 produced in mammalian cells, in a rabbit model of circulatory shock due to Escherichia coli. DESIGN:Prospective, rando...

    journal_title:Critical care medicine

    pub_type: 杂志文章

    doi:10.1097/00003246-199506000-00014

    authors: Porat R,Paddock HN,Schwaitzberg SD,Connolly RJ,Wilkens T,Dasch JR,Gascon MP,Hutchison JS,Ythier A,Wallach D

    更新日期:1995-06-01 00:00:00

  • Association Between Anxiety and New Organ Failure, Independently of Critical Illness Severity and Respiratory Status: A Prospective Multicentric Cohort Study.

    abstract:OBJECTIVES:Anxiety results from the anticipation of a threat and might be associated with poor outcome in the critically ill. This study aims at showing that anxiety at admission in critically ill patients is associated with new organ failure over the first 7 days of ICU hospitalization independently of baseline organ ...

    journal_title:Critical care medicine

    pub_type: 杂志文章

    doi:10.1097/CCM.0000000000004495

    authors: Mazeraud A,Polito A,Sivanandamoorthy S,Porcher R,Heming N,Stoclin A,Hissem T,Antona M,Blot F,Gaillard R,Chrétien F,Annane D,Bozza FAB,Siami S,Sharshar T,Groupe d’Explorations Neurologiques en Réanimation (GENER).

    更新日期:2020-10-01 00:00:00

  • Therapy of shock based on pathophysiology, monitoring, and outcome prediction.

    abstract::High-risk patients who survived general (noncardiac) surgery were observed to have cardiac index (CI) values averaging 4.5 L/min.m2, oxygen delivery (DO2) greater than 600 ml/min.m2, and oxygen consumption (VO2) 170 ml/min.m2 during the first 2 or three days postoperatively. Patients who subsequently died maintained r...

    journal_title:Critical care medicine

    pub_type: 杂志文章,评审

    doi:

    authors: Shoemaker WC,Kram HB,Appel PL

    更新日期:1990-01-01 00:00:00

  • Effects of disposable or interchangeable positive end-expiratory pressure valves on work of breathing during the application of continuous positive airway pressure.

    abstract:OBJECTIVE:To determine which of a series of disposable or interchangeable positive end-expiratory pressure (PEEP) devices functions with the least imposition of inspiratory and expiratory work during continuous positive airway pressure. DESIGN:Prospective laboratory evaluation performed on a lung model. SETTING:Resea...

    journal_title:Critical care medicine

    pub_type: 杂志文章

    doi:10.1097/00003246-199408000-00004

    authors: Kacmarek RM,Mang H,Barker N,Cycyk-Chapman MC

    更新日期:1994-08-01 00:00:00

  • Outcomes and complications of intracranial pressure monitoring in acute liver failure: a retrospective cohort study.

    abstract:OBJECTIVE:To determine if intracranial pressure monitor placement in patients with acute liver failure is associated with significant clinical outcomes. DESIGN:Retrospective multicenter cohort study. SETTING:Academic liver transplant centers comprising the U.S. Acute Liver Failure Study Group. PATIENTS:Adult critica...

    journal_title:Critical care medicine

    pub_type: 杂志文章,多中心研究

    doi:10.1097/CCM.0000000000000144

    authors: Karvellas CJ,Fix OK,Battenhouse H,Durkalski V,Sanders C,Lee WM,U S Acute Liver Failure Study Group.

    更新日期:2014-05-01 00:00:00

  • Patterns of prescribing and administering drugs for agitation and pain in patients in a surgical intensive care unit.

    abstract:OBJECTIVES:To describe the variety of medications prescribed along with the doses administered and routes of administration, and to delineate the clarity of orders written and the accuracy of transcription of drugs used for sedation, anxiety, pain, and neuromuscular blockade in a surgical intensive care unit (ICU). DE...

    journal_title:Critical care medicine

    pub_type: 杂志文章

    doi:10.1097/00003246-199406000-00016

    authors: Dasta JF,Fuhrman TM,McCandles C

    更新日期:1994-06-01 00:00:00

  • Liquid lung ventilation reduces neutrophil sequestration in a neonatal swine model of cardiopulmonary bypass.

    abstract:OBJECTIVE:Liquid lung ventilation has been demonstrated to improve cardiorespiratory function after cardiopulmonary bypass. We hypothesized that liquid lung ventilation (LLV) would decrease the pulmonary inflammatory response after cardiopulmonary bypass (CPB). DESIGN:Prospective, randomized, experimental, controlled,...

    journal_title:Critical care medicine

    pub_type: 杂志文章

    doi:10.1097/00003246-200104000-00021

    authors: Williams EA,Welty SE,Geske RS,Hubble CL,Craig DM,Quick G,Meliones JN,Cheifetz IM

    更新日期:2001-04-01 00:00:00

  • A double-blind placebo-controlled study to evaluate the safety and efficacy of L-2-oxothiazolidine-4-carboxylic acid in the treatment of patients with acute respiratory distress syndrome.

    abstract:OBJECTIVE:Acute respiratory distress syndrome is an abrupt inflammatory illness that involves damage from reactive oxygen species. We examined the efficacy and safety of oxothiazolidine-4-carboxylic acid (OTZ), a free radical scavenger, in treating acute respiratory distress syndrome. DESIGN:Double-blind, placebo-cont...

    journal_title:Critical care medicine

    pub_type: 杂志文章,多中心研究,随机对照试验

    doi:10.1097/CCM.0B013E318164E7E4

    authors: Morris PE,Papadakos P,Russell JA,Wunderink R,Schuster DP,Truwit JD,Vincent JL,Bernard GR

    更新日期:2008-03-01 00:00:00

  • Exhaled tidal volume overestimation in mechanically ventilated patients with large cardiogenic oscillation.

    abstract:OBJECTIVES:In postcardiac surgery patients, we often noticed that monitored tidal volumes exceeded the ventilator settings. We investigated whether cardiogenic oscillation causes overestimation of tidal volume. DESIGN:Prospective, observational, clinical study. SETTING:Surgical intensive care unit in a national heart...

    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.0000129487.25203.1f

    authors: Imanaka H,Takeuchi M,Tachibana K,Nishimura M

    更新日期:2004-07-01 00:00:00

  • Fiber atrophy, but not changes in acetylcholine receptor expression, contributes to the muscle dysfunction after immobilization.

    abstract:OBJECTIVES:Muscle weakness associated with critical illness can be due to the illness itself, immobilization associated with it, and/or to concomitant use of drugs that affect neuromuscular transmission. This study investigated the contribution of immobilization per se to the muscle dysfunction, as well as the associat...

    journal_title:Critical care medicine

    pub_type: 杂志文章

    doi:10.1097/00003246-199902000-00031

    authors: Ibebunjo C,Martyn JA

    更新日期:1999-02-01 00:00:00

  • Determining pulmonary resistance to gas flow during sinusoidal pressure wave mechanical ventilation.

    abstract::Standard techniques for measuring pulmonary resistance (RP) to gas flow in newborn infants yield results that are widely dispersed and difficult to interpret. The purpose of this study is to describe and evaluate a new improved method for determining RP which utilizes a sinusoidal pressure wave generator. Measurements...

    journal_title:Critical care medicine

    pub_type: 杂志文章

    doi:10.1097/00003246-198307000-00015

    authors: Richardson P,Carlstrom JR

    更新日期:1983-07-01 00:00:00

  • Aminophylline versus doxapram in weaning premature infants from mechanical ventilation: preliminary report.

    abstract::A small, double-blind crossover study compared the efficacy of aminophylline and doxapram in ventilator weaning of eight premature infants recovering from respiratory distress syndrome (RDS). Although neither drug was significantly better than the other, four infants were weaned from mechanical ventilation after drug ...

    journal_title:Critical care medicine

    pub_type: 临床试验,杂志文章

    doi:10.1097/00003246-198502000-00016

    authors: Eyal FG,Sagi EF,Alpan G,Glick B,Arad I

    更新日期:1985-02-01 00:00:00

  • Effect of corticosteroid prophylaxis on lipopolysaccharide levels associated with intestinal ischemia in cats.

    abstract::Ischemia of the intestines damages the permeability of the intestinal wall, allowing lipopolysaccharide (LPS) (endotoxin) to leak from the gut lumen into the blood circulation, causing shock and death. We measured LPS levels associated with corticosteroid treatment vs. no treatment in cats whose superior mesenteric ar...

    journal_title:Critical care medicine

    pub_type: 杂志文章

    doi:10.1097/00003246-198610000-00012

    authors: Gaffin SL,Gathiram P,Wells MT,Brock-Utne JG

    更新日期:1986-10-01 00:00:00

  • Ultrafilterable hypomagnesemia in neonates admitted to the neonatal intensive care unit.

    abstract:OBJECTIVE:To evaluate the frequency and clinical correlates of ultrafilterable hypomagnesemia in neonates admitted to the neonatal intensive care unit (ICU). DESIGN:Prospective, observational study. SETTING:Massachusetts General Hospital and Mount Auburn Hospital. PATIENTS:A total of 117 patients (84 neonatal ICU pa...

    journal_title:Critical care medicine

    pub_type: 杂志文章

    doi:10.1097/00003246-199405000-00017

    authors: Munoz R,Khilnani P,Ziegler J,Salem M,Catlin EA,Nussbaum S,Todres ID,Chernow B

    更新日期:1994-05-01 00:00:00

  • Effects of norepinephrine on static and dynamic preload indicators in experimental hemorrhagic shock.

    abstract:OBJECTIVE:To investigate the effect of norepinephrine on static (right atrial pressure, pulmonary artery occlusion pressure ) and dynamic (pulse pressure variation and arterial systolic pressure variation) preload indicators in experimental hemorrhagic shock. DESIGN:Prospective controlled experimental study. SETTING:...

    journal_title:Critical care medicine

    pub_type: 杂志文章

    doi:10.1097/01.ccm.0000182801.48137.13

    authors: Nouira S,Elatrous S,Dimassi S,Besbes L,Boukef R,Mohamed B,Abroug F

    更新日期:2005-10-01 00:00:00

  • Inotropic Effects of Experimental Hyperthermia and Hypothermia on Left Ventricular Function in Pigs-Comparison With Dobutamine.

    abstract:OBJECTIVES:The results from the recent Targeted Temperature Management trial raised the question whether cooling or merely the avoidance of fever mediates better neurologic outcome in resuscitated patients. As temperature per se is a major determinant of cardiac function, we characterized the effects of hyperthermia (4...

    journal_title:Critical care medicine

    pub_type: 杂志文章

    doi:10.1097/CCM.0000000000001358

    authors: Alogna A,Manninger M,Schwarzl M,Zirngast B,Steendijk P,Verderber J,Zweiker D,Maechler H,Pieske BM,Post H

    更新日期:2016-03-01 00:00:00

  • Immunological characterization of compensatory anti-inflammatory response syndrome in patients with severe sepsis: a longitudinal study*.

    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

    authors: Gomez HG,Gonzalez SM,Londoño JM,Hoyos NA,Niño CD,Leon AL,Velilla PA,Rugeles MT,Jaimes FA

    更新日期:2014-04-01 00:00:00

  • Premedication for tracheal intubation: a prospective survey in 75 neonatal and pediatric intensive care units.

    abstract:OBJECTIVE:In children, like in adults, tracheal intubation is a painful procedure that may induce hypertension, tachycardia, and other undesirable hemodynamic disorders. Although premature neonates are very sensitive to pain and vulnerable to its long-term effects, the need for sedation before tracheal intubation is st...

    journal_title:Critical care medicine

    pub_type: 杂志文章

    doi:10.1097/01.CCM.0000108883.58081.E3

    authors: Simon L,Trifa M,Mokhtari M,Hamza J,Treluyer JM

    更新日期:2004-02-01 00:00:00

  • Contextual issues influencing implementation and outcomes associated with an integrated approach to managing pain, agitation, and delirium in adult ICUs.

    abstract:OBJECTIVE:This pilot study was designed to identify which contextual factors facilitate/hinder the implementation of the awakening, breathing, coordination, delirium, and early mobility (ABCDE) bundle for guidance in future studies. DESIGN:The sources of data for this study included document review, planned site visit...

    journal_title:Critical care medicine

    pub_type: 杂志文章

    doi:10.1097/CCM.0b013e3182a2c2b1

    authors: Carrothers KM,Barr J,Spurlock B,Ridgely MS,Damberg CL,Ely EW

    更新日期:2013-09-01 00:00:00