Abstract:
:We previously reported that small volume infusions of 7.5% NaCl in 6% dextran-70 (HSD) are superior to equal volumes of normal saline (NS) or 7.5% NaCl in the ability to resuscitate animals from an otherwise lethal hemorrhage. In the present experiment, we evaluated organ blood flow in unanesthetized swine bled 46 ml/kg in 15 min and subsequently infused with a volume of HSD (n = 5) or NS (n = 5) equal to 25% of the shed blood. Radiomicrospheres were injected before hemorrhage, immediately after hemorrhage, and 5 and 30 min after treatment. At the end of hemorrhage, cardiac output had fallen to one-third of baseline values. Five minutes after the infusion of HSD, cardiac output had returned to baseline levels, while cardiac output in the NS-treated controls had increased to only one-half of prehemorrhage values. Blood flows to the brain, diaphragm, skin, muscle, and fat were not different between the two groups. Infusion with HSD, however, produced flows to the myocardium, kidneys, liver, small intestine, and pancreas that were significantly greater than post-hemorrhage and NS-treated control values. NS was unable to increase these flows significantly above post-hemorrhage levels. We conclude that small volumes of HSD can significantly improve organ blood flow after hemorrhagic shock. This improvement in flow may explain the increased survival observed with this solution and may attenuate some of the later complications of hemorrhagic shock.
journal_name
Crit Care Medjournal_title
Critical care medicineauthors
Maningas PAdoi
10.1097/00003246-198712000-00009subject
Has Abstractpub_date
1987-12-01 00:00:00pages
1121-6issue
12eissn
0090-3493issn
1530-0293journal_volume
15pub_type
杂志文章abstract:OBJECTIVE:Acute renal failure can be treated with continuous renal replacement therapy (CRRT) or intermittent hemodialysis. There is no difference in mortality, although patients treated with CRRT may have a higher rate of renal recovery. Given these considerations, an estimate of the costs by modality may help in choo...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/01.CCM.0000045182.90302.B3
更新日期:2003-02-01 00:00:00
abstract:CONTEXT:Reducing aspiration of gastric contents by placing mechanically ventilated patients in a semirecumbent position has been associated with lower incidences of ventilator-associated pneumonia (VAP). The feasibility and efficacy of this intervention in a larger patient population, however, are unknown. OBJECTIVE:A...
journal_title:Critical care medicine
pub_type: 杂志文章,多中心研究,随机对照试验
doi:10.1097/01.ccm.0000198529.76602.5e
更新日期:2006-02-01 00:00:00
abstract:OBJECTIVE:Exposure of neutrophils to low doses of bacterial lipopolysaccharides enhances their readiness to respond with inflammatory mediator generation including oxygen radical formation to a subsequently applied inflammatory stimulus ("priming"). In the present study, we investigated the role of lipid mediator synth...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/00003246-200210000-00020
更新日期:2002-10-01 00:00:00
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
更新日期:2017-06-01 00:00:00
abstract:OBJECTIVE:To define the relative needs of the staffs of rural, community hospitals for training in advanced cardiac life support (ACLS), identify weaknesses, and modify a standard ACLS course to meet these needs. DESIGN:Prospective assessment of knowledge and skills relating to the practice of ACLS. SETTING:Rural, co...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/00003246-199405000-00006
更新日期:1994-05-01 00:00:00
abstract:OBJECTIVE:The successful management of an influenza pandemic will be reliant on the expertise of healthcare workers at high risk for occupationally acquired influenza. Recommended infection control measures for healthcare workers include surgical masks to protect against droplet-spread respiratory transmissible infecti...
journal_title:Critical care medicine
pub_type: 杂志文章,评审
doi:10.1097/ccm.0b013e3181b9e8b3
更新日期:2010-02-01 00:00:00
abstract:OBJECTIVE:Intensive care unit (ICU) length of stay (LOS) and hospital LOS are common indices used to compare performance of hospitals and are yardsticks used in efforts to contain costs, yet there is no standardized method of quantitating this outcome variable. Attempts have been made to correct LOS according to diseas...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/00003246-200006000-00071
更新日期:2000-06-01 00:00:00
abstract:OBJECTIVE:Spread of multidrug-resistant organisms within the intensive care unit (ICU) results in substantial morbidity and mortality. Novel strategies are needed to reduce transmission. This study sought to determine if the use of daily chlorhexidine bathing would decrease the incidence of colonization and bloodstream...
journal_title:Critical care medicine
pub_type: 杂志文章,多中心研究
doi:10.1097/CCM.0b013e31819ffe6d
更新日期:2009-06-01 00:00:00
abstract:OBJECTIVE:Trauma induces a state of immunosuppression, which is responsible for the development of nosocomial infections. Hydrocortisone reduces the rate of pneumonia in patients with trauma. Because alterations of dendritic cells and natural killer cells play a central role in trauma-induced immunosuppression, we inve...
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.0000000000000658
更新日期:2014-12-01 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:Radial artery pressure is known to differ from central arterial pressure in normal patients (distal pulse amplification) and in the early postcardiopulmonary bypass period. The adequacy of the radial artery as a site for blood pressure monitoring in critically ill patients receiving high-dose vasopressors ha...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/00003246-199810000-00014
更新日期:1998-10-01 00:00:00
abstract::The educational objectives in use in our Pediatric ICU are described. These have importance for educational programs in critical care medicine, in particular, where patient care needs can easily overwhelm educational needs. It is important not to overlook our role as teachers in the development of proper attitudes and...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/00003246-197705000-00008
更新日期:1977-05-01 00:00:00
abstract:OBJECTIVE:To examine the frequency with which quality of life and treatment limitation were discussed in formal family meetings for long-stay intensive care unit patients with high risk for mortality and morbidity. DESIGN:Descriptive observational study. SETTING:Five intensive care units. PATIENTS:One hundred sixtee...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/CCM.0b013e318232d8c4
更新日期:2012-02-01 00:00:00
abstract:OBJECTIVE:To determine whether extreme obesity (morbid obesity; body mass index > or =40 kg/m(2)) is an independent risk factor for death among critically ill patients; this objective is most salient in the subset of patients who sustain a prolonged intensive care unit stay during which the burdens of care imposed by o...
journal_title:Critical care medicine
pub_type: 评论,杂志文章
doi:10.1097/01.CCM.0000205758.18891.70
更新日期:2006-04-01 00:00:00
abstract:OBJECTIVES:Formal guidelines recommend that therapeutic hypothermia be considered after in-hospital cardiac arrest. The rate of therapeutic hypothermia use after in-hospital cardiac arrest and details about its implementation are unknown. We aimed to determine the use of therapeutic hypothermia for adult in-hospital ca...
journal_title:Critical care medicine
pub_type: 杂志文章,多中心研究
doi:10.1097/CCM.0b013e318287f2c4
更新日期:2013-06-01 00:00:00
abstract:OBJECTIVES:To review the immunologic role of the cytokines and the specific role that tumor necrosis factor (TNF) plays in response to infection. The influence of bacterial lipopolysaccharide on TNF, the cytokine cascade, and resultant pathologies are also reviewed. DATA SOURCES:A MEDLINE search of the international E...
journal_title:Critical care medicine
pub_type: 杂志文章,评审
doi:
更新日期:1993-10-01 00:00:00
abstract:OBJECTIVE:To compare the scales and predictive power for hospital mortality of three recent multiple organ dysfunction scores. DESIGN:Prospective, observational, validation cohort study. SETTING:A ten-bed medical-surgical intensive care unit in a Finnish tertiary care hospital. PATIENTS:Among the 591 consecutive pat...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/00003246-200208000-00005
更新日期:2002-08-01 00:00:00
abstract:OBJECTIVES:Extracellular mitochondrial DNA and N-formyl peptides released following tissue damage may contribute to systemic inflammation through stimulation of the innate immune system. In this review, we evaluate existing in vivo human data regarding a role for mitochondrial DNA and N-formyl peptides in producing sys...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/CCM.0000000000003381
更新日期:2018-12-01 00:00:00
abstract:OBJECTIVES:The American College of Critical Care Medicine provided 2002 and 2007 guidelines for hemodynamic support of newborn and pediatric septic shock. Provide the 2014 update of the 2007 American College of Critical Care Medicine "Clinical Guidelines for Hemodynamic Support of Neonates and Children with Septic Shoc...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/CCM.0000000000002425
更新日期:2017-06-01 00:00:00
abstract:OBJECTIVES:Intensive insulin therapy with tight glucose control is known to result in reduced morbidity and mortality in inflammation-related critical illness. Tumor necrosis factor (TNF)-alpha induction in myocardial infarction may trigger inflammation and have detrimental effects on cardiomyocytes. This study was des...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/CCM.0b013e3181782335
更新日期:2008-05-01 00:00:00
abstract:OBJECTIVE:We hypothesized that the extent of injury and release of xanthine oxidase, an oxidant generator, into the circulation would be less in normal-flow hypoxia-reoxygenation than in equal duration no-flow ischemia-reperfusion. DESIGN:Randomized study. SETTING:University-based animal research facility. SUBJECTS:...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/00003246-199806000-00034
更新日期:1998-06-01 00:00:00
abstract:OBJECTIVE:This study was done to assess the effects of temperature on bleeding time and clotting time in normal male and female volunteers. DESIGN:Open study utilizing normal volunteers. SETTING:University research laboratory. SUBJECTS:Fifty-four healthy male and female volunteers, ranging in age from 19 to 35 yrs, ...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/00003246-199504000-00019
更新日期:1995-04-01 00:00:00
abstract:OBJECTIVE:Cardiogenic shock remains an important therapeutic challenge, with high in-hospital mortality rates. Mechanical circulatory support may be beneficial in these patients. Since the efficacy of the intra-aortic balloon pump seems limited, new percutaneously placed mechanical left ventricular support devices, suc...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/CCM.0b013e31821e89b5
更新日期:2011-09-01 00:00:00
abstract:OBJECTIVES:To assess trends in the use of extracorporeal membrane oxygenation for poisoning in the United States. DESIGN:Retrospective cohort study. SETTING:The National Poison Data System, the databased owned and managed by the American Association of Poison Control Centers, the organization that supports and accred...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/CCM.0000000000004401
更新日期:2020-08-01 00:00:00
abstract::The authors have examined cardiopulmonary resuscitation (CPR) skills retention in a police force initially trained to instructor level performance skills as defined by the 1977 American Heart Association Instructor Manual. In 1977, the entire Winnipeg Police Force received a basic 8-h course of CPR training with recor...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/00003246-198011000-00011
更新日期:1980-11-01 00:00:00
abstract::Clonidine may be a source of serious toxicity when ingested by toddlers. We describe 11 cases of clonidine ingestion by toddlers (mean dose 0.15 mg/kg; range 0.01 to 0.57). The source of the clonidine was a grand-parent in six of 11 cases. Symptoms included altered level of consciousness (n = 11), miosis (n = 5), brad...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/00003246-199010000-00014
更新日期:1990-10-01 00:00:00
abstract::Foreign-body aspiration in adults is usually associated with asphyxiation after aspiration of food particles. The present report documents a case of foreign-body aspiration that resulted from poor tracheostomy care in an alcoholic patient, and caused fulminant pneumonitis. ...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/00003246-198408000-00020
更新日期:1984-08-01 00:00:00
abstract:OBJECTIVE:Surgical trauma results in diffuse sympathoadrenal activation which is thought to contribute to perioperative cardiovascular complications in high-risk patients. Regional anesthetic and analgesic techniques can attenuate this "stress response" and reduce the occurrence rate of adverse perioperative events; ho...
journal_title:Critical care medicine
pub_type: 临床试验,杂志文章
doi:10.1097/00003246-199707000-00015
更新日期:1997-07-01 00:00:00
abstract:OBJECTIVE:To study the epidemiology, style of management, and outcome of intensive care patients with acute renal failure requiring replacement therapy in Australia. DESIGN:Prospective epidemiologic study. SETTING:Australian adult intensive care units providing acute renal replacement therapy. PATIENTS:Adult intensi...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/00003246-200110000-00010
更新日期:2001-10-01 00:00:00
abstract::PEEP is the most important therapeutic intervention in the management of acute respiratory failure. Transitory PEEP disconnection to perform clinically relevant maneuvers is often necessary, but its effect upon PaO2 and physiological shunt in patients requiring high-level PEEP is not clear from the literature. Nine ad...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/00003246-197902000-00003
更新日期:1979-02-01 00:00:00