Mild hypothermia attenuates circulatory and pulmonary dysfunction during experimental endotoxemia.


OBJECTIVE:We tested whether mild hypothermia impacts on circulatory and respiratory dysfunction during experimental endotoxemia. DESIGN:Randomized controlled prospective experimental study. SETTING:Large animal facility, Medical University of Graz, Austria. SUBJECTS:Thirteen anesthetized and mechanically ventilated pigs. INTERVENTIONS:Lipopolysaccharide was administered for 4 hours. With the beginning of lipopolysaccharide infusion, animals were assigned to either normothermia (38°C, n = 7) or mild hypothermia (33°C, n = 6, intravascular cooling) and followed for 8 hours in total. MEASUREMENTS AND MAIN RESULTS:At the end of the protocol, cardiac output was lower in mild hypothermia than in normothermia (4.5 ± 0.4 L/min vs 6.6 ± 0.4 L/min, p < 0.05), but systemic vascular resistance (885 ± 77 dyn·s/cm vs 531 ± 29 dyn·s/cm, p < 0.05) and (Equation is included in full-text article.)(77% ± 6% vs 54% ± 3%, p < 0.05) were higher. Indices of left ventricular contractility in vivo were not different between groups. The high-frequency band in spectral analysis of heart rate variability indicated a better preserved vagal autonomic modulation of sinuatrial node activity in mild hypothermia versus normothermia (87 ± 5 vs 47 ± 5, normalized units, p < 0.05). Plasma norepinephrine levels were elevated compared with baseline in normothermia (2.13 ± 0.27 log pg/mL vs 0.27 ± 0.17 log pg/mL, p < 0.05) but not in mild hypothermia (1.02 ± 0.31 vs 0.55 ± 0.26, p = not significant). At 38°C in vitro, left ventricular muscle strips isolated from the mild hypothermia group had a higher force response to isoproterenol. SaO2 (100% ± 0% vs 92% ± 3%, p < 0.05) and the oxygenation index (PO2/FIO2, 386 ± 52 mm Hg vs 132 ± 32 mm Hg, p < 0.05) were substantially higher in mild hypothermia versus normothermia. Plasma cytokine levels were not consistently different between groups (interleukin 10) or higher (tumor necrosis factor-α and interleukin 6 and 8) during mild hypothermia versus normothermia. CONCLUSION:The induction of mild hypothermia attenuates cardiac and respiratory dysfunction and counteracts sympathetic activation during experimental endotoxemia. This was not associated with lower plasma cytokine levels, indicating a reduction of cytokine responsiveness by mild hypothermia.


Crit Care Med


Critical care medicine


Schwarzl M,Seiler S,Wallner M,von Lewinski D,Huber S,Maechler H,Steendijk P,Zelzer S,Truschnig-Wilders M,Obermayer-Pietsch B,Lueger A,Pieske BM,Post H




Has Abstract


2013-12-01 00:00:00












  • The Impella 2.5 and 5.0 devices for ST-elevation myocardial infarction patients presenting with severe and profound cardiogenic shock: the Academic Medical Center intensive care unit experience.

    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


    authors: Engström AE,Cocchieri R,Driessen AH,Sjauw KD,Vis MM,Baan J,de Jong M,Lagrand WK,van der Sloot JA,Tijssen JG,de Winter RJ,de Mol BA,Piek JJ,Henriques JP

    更新日期:2011-09-01 00:00:00

  • The role of ω-3 fatty acid supplemented parenteral nutrition in critical illness in adults: a systematic review and meta-analysis.

    abstract:OBJECTIVE:To determine whether the supplementation of parenteral nutrition with ω-3 fatty acids confers treatment benefits to critically ill adult patients. DATA SOURCE:We performed computerized searches for relevant articles from 1996 to June 2011 on MEDLINE, EMBASE, and the Cochrane register of controlled trials and...

    journal_title:Critical care medicine

    pub_type: 杂志文章,meta分析,评审


    authors: Palmer AJ,Ho CK,Ajibola O,Avenell A

    更新日期:2013-01-01 00:00:00

  • Arterial versus venous potassium: clinical implications.

    abstract::A difference between potassium concentrations in arterial plasma and venous serum was evaluated. The difference was 0.5 mM/litre, with a range of 0.1 to 1.1 mM/liter. Multiple factors operating primarily upon the venous sample are responsible for this difference. The value for arterial plasma potassium is stable and p...

    journal_title:Critical care medicine

    pub_type: 杂志文章


    authors: Ward CF,Arkin DB,Benumof JL,Saidman LJ

    更新日期:1978-09-01 00:00:00

  • The impact of adding 1 month of intensive care unit training in a categorical internal medicine residency program.

    abstract:OBJECTIVE:To determine the impact of adding a month of critical care training in the postgraduate year (PGY)-2 on the critical care skills of PGY-3 residents. DESIGN:Prospective, nonrandomized. SETTING:The internal medicine (IM) residency program of a tertiary care medical center. STUDY SUBJECTS:The study subjects i...

    journal_title:Critical care medicine

    pub_type: 杂志文章


    authors: Mullon JJ,Gajic O,Gali B,Ficalora RD,Kolars JC,Afessa B

    更新日期:2009-04-01 00:00:00

  • Recombinant human erythropoietin pretreatment attenuates acute renal tubular injury against ischemia-reperfusion by restoring transient receptor potential channel-6 expression and function in collecting ducts.

    abstract:OBJECTIVE:Acute renal tubular injury is a serious complication in the postoperative period, which is associated with high mortality and increased ICU stay. We aimed to demonstrate the protective effect of rhEPO against acute tubular injury induced by ischemia-reperfusion and to explore the mechanism of canonical transi...

    journal_title:Critical care medicine

    pub_type: 杂志文章


    authors: Shen S,Jin Y,Li W,Liu X,Zhang T,Xia W,Wang Y,Ma K

    更新日期:2014-10-01 00:00:00

  • Incidence and Mortality of Acute Respiratory Distress Syndrome in Children: A Systematic Review and Meta-Analysis.

    abstract:OBJECTIVES:Our understanding of the acute respiratory distress syndrome in children is limited, and literature is dominated by investigations in adult patients. Recent preclinical studies suggest that the susceptibility to and severity of acute respiratory distress syndrome in children could differ from that in adults....

    journal_title:Critical care medicine

    pub_type: 杂志文章,meta分析,评审


    authors: Schouten LR,Veltkamp F,Bos AP,van Woensel JB,Serpa Neto A,Schultz MJ,Wösten-van Asperen RM

    更新日期:2016-04-01 00:00:00

  • Experiencing the pediatric intensive care unit: perspective from parents of children with severe antecedent disabilities.

    abstract:OBJECTIVE:To describe the experience of pediatric intensive care hospitalization from the perspective of a parents of children with severe, antecedent disability. DESIGN:Qualitative analysis of data obtained through semistructured interviews. SETTING:Pediatric intensive care unit (PICU) in a children's hospital. SUB...

    journal_title:Critical care medicine

    pub_type: 杂志文章


    authors: Graham RJ,Pemstein DM,Curley MA

    更新日期:2009-06-01 00:00:00

  • Validity of urinary urea nitrogen as a measure of total urinary nitrogen in adult patients requiring parenteral nutrition.

    abstract::The validity of the urinary urea nitrogen (UUN) estimate of total urinary nitrogen (TUN) was tested in patients who required iv nutrition. UUN and TUN were determined in 120 urine collections from ten preoperative, 13 postoperative, and 11 stressed patients. The relationship between TUN and UUN was examined by linear ...

    journal_title:Critical care medicine

    pub_type: 杂志文章


    authors: Loder PB,Kee AJ,Horsburgh R,Jones M,Smith RC

    更新日期:1989-04-01 00:00:00

  • Development and External Validation of an Online Clinical Prediction Model for Augmented Renal Clearance in Adult Mixed Critically Ill Patients: The Augmented Renal Clearance Predictor.

    abstract:OBJECTIVES:Augmented renal clearance might lead to subtherapeutic plasma levels of drugs with predominant renal clearance. Early identification of augmented renal clearance remains challenging for the ICU physician. We developed and validated our augmented renal clearance predictor, a clinical prediction model for augm...

    journal_title:Critical care medicine

    pub_type: 杂志文章


    authors: Gijsen M,Huang CY,Flechet M,Van Daele R,Declercq P,Debaveye Y,Meersseman P,Meyfroidt G,Wauters J,Spriet I

    更新日期:2020-12-01 00:00:00

  • Catecholamines: study of interspecies variation.

    abstract::In the last three decades, numerous articles on plasma catecholamine concentrations in various settings have been published in the medical literature. Despite this abundance of information, no summary article has analyzed the species variations in circulating catecholamine concentrations. In this paper, the plasma cat...

    journal_title:Critical care medicine

    pub_type: 杂志文章,评审


    authors: Hart BB,Stanford GG,Ziegler MG,Lake CR,Chernow B

    更新日期:1989-11-01 00:00:00

  • Comparison of noninvasive measurements of carbon dioxide tension during withdrawal from mechanical ventilation.

    abstract::End tidal CO2 tension (PetCO2) and transcutaneous CO2 tension (PtcCO2) were compared with arterial CO2 (PaCO2) before and after withdrawal of mechanical ventilation in 20 patients predisposed to hypercarbia. With stable PaCO2 during mechanical ventilation, the correlation coefficient (r) between PaCO2 and PetCO2 was ....

    journal_title:Critical care medicine

    pub_type: 杂志文章


    authors: Healey CJ,Fedullo AJ,Swinburne AJ,Wahl GW

    更新日期:1987-08-01 00:00:00

  • 1,25-Dihydroxyvitamin D fluctuations in cardiac surgery are related to age and clinical outcome*.

    abstract:OBJECTIVE:To investigate the interrelationship between cardiac surgery, age, circulating concentrations of the vitamin D hormone 1,25-dihydroxyvitamin D, and clinical outcome. DESIGN:Prospective, monocentric, two-arm parallel study. SETTING:Tertiary Heart and Diabetes Center in the Federal State of North Rhine-Westph...

    journal_title:Critical care medicine

    pub_type: 临床试验,杂志文章


    authors: Börgermann J,Lazouski K,Kuhn J,Dreier J,Schmidt M,Gilis-Januszewski T,Knabbe C,Gummert JF,Zittermann A

    更新日期:2012-07-01 00:00:00

  • The international sepsis forum consensus conference on definitions of infection in the intensive care unit.

    abstract:OBJECTIVE:To develop definitions of infection that can be used in clinical trials in patients with sepsis. CONTEXT:Infection is a key component of the definition of sepsis, yet there is currently no agreement on the definitions that should be used to identify specific infections in patients with sepsis. Agreeing on a ...

    journal_title:Critical care medicine

    pub_type: 共识发展会议,杂志文章,评审


    authors: Calandra T,Cohen J,International Sepsis Forum Definition of Infection in the ICU Consensus Conference.

    更新日期:2005-07-01 00:00:00

  • Safety of intravenous nitroglycerin after administration of sildenafil citrate to men with coronary artery disease: a double-blind, placebo-controlled, randomized, crossover trial.

    abstract:OBJECTIVE:Although contraindicated, there are situations when a patient who has recently taken a phosphodiesterase 5 inhibitor (e.g., sildenafil) might need intravenous nitroglycerin (NTG) treatment. This study determined if, and at what dose, intravenous NTG could be administered safely to men with coronary artery dis...

    journal_title:Critical care medicine

    pub_type: 杂志文章,多中心研究,随机对照试验


    authors: Parker JD,Bart BA,Webb DJ,Koren MJ,Siegel RL,Wang H,Malhotra B,Jen F,Glue P

    更新日期:2007-08-01 00:00:00

  • Reactive hemophagocytic syndrome presenting as a component of multiple organ dysfunction syndrome.

    abstract:OBJECTIVE:To report two cases of severe reactive hemophagocytic syndrome (RHS), to discuss their impact, and to present evidence that RHS may be a constitutive part of multiple organ dysfunction syndrome (MODS). DESIGN:Case-report. SETTING:Pediatric intensive care unit (PICU). PATIENTS:Two patients with RHS and MODS...

    journal_title:Critical care medicine

    pub_type: 杂志文章


    authors: Gauvin F,Toledano B,Champagne J,Lacroix J

    更新日期:2000-09-01 00:00:00

  • Pentoxifylline increases gut ketogenesis following trauma and hemorrhagic shock.

    abstract:OBJECTIVES:Although pentoxifylline produces various beneficial effects following adverse circulatory conditions, it is not known whether this agent has any effects on gut lipid metabolism after trauma-hemorrhage and resuscitation. The aim of this study, therefore, was to determine whether or not administration of pento...

    journal_title:Critical care medicine

    pub_type: 杂志文章


    authors: Wang W,Wang P,Chaudry IH

    更新日期:1998-01-01 00:00:00

  • Spontaneous gasping increases the ability to resuscitate during experimental cardiopulmonary resuscitation.

    abstract:OBJECTIVE:To evaluate the effect of spontaneous gasping on cardiorespiratory functions and the ability to resuscitate during experimental cardiac arrest. DATA SOURCES:Studies in rat and pig models during cardiac arrest and cardiopulmonary resuscitation (CPR). STUDY SELECTION:We retrospectively examined the role of sp...

    journal_title:Critical care medicine

    pub_type: 杂志文章


    authors: Yang L,Weil MH,Noc M,Tang W,Turner T,Gazmuri RJ

    更新日期:1994-05-01 00:00:00

  • Pediatric risk of mortality (PRISM) score.

    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


    authors: Pollack MM,Ruttimann UE,Getson PR

    更新日期:1988-11-01 00:00:00

  • Energy expenditure in critically ill children.

    abstract:OBJECTIVES:To measure energy expenditure in critically ill children and compare it with the energy expenditure predicted by recommended formulas, and relate the measured energy expenditure to nutritional and clinical indices. DESIGN:A prospective, clinical study. SETTING:Tertiary care pediatric intensive care unit in...

    journal_title:Critical care medicine

    pub_type: 杂志文章


    authors: Briassoulis G,Venkataraman S,Thompson AE

    更新日期:2000-04-01 00:00:00

  • Resistance to sodium nitroprusside in hypertensive patients.

    abstract::Eleven patients in hypertensive crisis were treated with iv sodium nitroprusside (SNP). In all cases, rapid clinical improvement was obtained. Nevertheless, 9 patients developed progressive resistance to the hypotensive effect of the drug. For the first 2 h, the mean infusion rate was 1.68 +/- 0.64 micrograms/kg . min...

    journal_title:Critical care medicine

    pub_type: 杂志文章


    authors: Rouby JJ,Gory G,Bourrelli B,Glaser P,Viars P

    更新日期:1982-05-01 00:00:00

  • Impact of adequate empirical antibiotic therapy on the outcome of patients admitted to the intensive care unit with sepsis.

    abstract:OBJECTIVES:Our primary goal was to evaluate the impact on in-hospital mortality rate of adequate empirical antibiotic therapy, after controlling for confounding variables, in a cohort of patients admitted to the intensive care unit (ICU) with sepsis. The impact of adequate empirical antibiotic therapy on early (<3 days...

    journal_title:Critical care medicine

    pub_type: 杂志文章


    authors: Garnacho-Montero J,Garcia-Garmendia JL,Barrero-Almodovar A,Jimenez-Jimenez FJ,Perez-Paredes C,Ortiz-Leyba C

    更新日期:2003-12-01 00:00:00

  • The role of venous return in critical illness and shock-part I: physiology.

    abstract:OBJECTIVE:To provide a conceptual and clinical review of the physiology of the venous system as it is relates to cardiac function in health and disease. DATA:An integration of venous and cardiac physiology under normal conditions, critical illness, and resuscitation. SUMMARY:The usual teaching of cardiac physiology f...

    journal_title:Critical care medicine

    pub_type: 杂志文章


    authors: Funk DJ,Jacobsohn E,Kumar A

    更新日期:2013-01-01 00:00:00

  • Can Concurrent Abnormalities in Free Light Chains and Immunoglobulin Concentrations Identify a Target Population for Immunoglobulin Trials in Sepsis?

    abstract:OBJECTIVES:Light chains κ and λ are immunoglobulin constituents but also circulate independently in blood as free light chains. We investigated whether a concomitant abnormality in free light chain and immunoglobulin levels could identify a high risk of death sepsis subpopulation to inform future IV immunoglobulin tria...

    journal_title:Critical care medicine

    pub_type: 杂志文章


    authors: Shankar-Hari M,Singer M,Spencer J

    更新日期:2017-11-01 00:00:00

  • Clinical Outcomes and Mortality Impact of Hyperbaric Oxygen Therapy in Patients With Carbon Monoxide Poisoning.

    abstract:OBJECTIVES:Carbon monoxide poisoning affects 50,000 per year in the United States alone. Mortality is approximately 3%, and up to 40% of survivors suffer from permanent neurocognitive and affective deficits. Hyperbaric oxygen therapy has shown benefit on reducing the long-term neurologic sequelae of carbon monoxide poi...

    journal_title:Critical care medicine

    pub_type: 杂志文章


    authors: Rose JJ,Nouraie M,Gauthier MC,Pizon AF,Saul MI,Donahoe MP,Gladwin MT

    更新日期:2018-07-01 00:00:00

  • Assessment of the development of choked flow during total liquid ventilation.

    abstract:OBJECTIVE:The flow rate of a liquid drainage from the lungs is limited because of the elastic nature of the airways. This study was designed to clarify the relationship between intrapulmonary liquid volume and the development of the flow limitation or choked flow phenomenon as a function of expiratory flow rate during ...

    journal_title:Critical care medicine

    pub_type: 杂志文章


    authors: Baba Y,Brant D,Brah SS,Grotberg J,Bartlett RH,Hirschl RB

    更新日期:2004-01-01 00:00:00

  • Therapeutic potential of intraluminal oxygenation.

    abstract:OBJECTIVE:To discuss the potential therapeutic value of intraluminal oxygenation of the gut in critical illness. DATA SOURCES:Relevant articles published in the English language literature. STUDY SELECTION:No special study has been carried out for the present presentation. DATA EXTRACTION:Information from the litera...

    journal_title:Critical care medicine

    pub_type: 杂志文章,评审


    authors: Haglund U

    更新日期:1993-02-01 00:00:00

  • Mechanical ventilation in fiberoptic-bronchoscopy: comparison between high frequency positive pressure ventilation and normal frequency positive pressure ventilation.

    abstract::High frequency positive pressure ventilation (HFPPV) was compared with normal frequency positive pressure ventilation (NFPPV) during diagnostic fiberoptic-bronchoscopy. HFPPV was achieved by a simple modification of the Minivent, and gave satisfactory alveolar ventilation and oxygenation. In all 11 patients and over p...

    journal_title:Critical care medicine

    pub_type: 杂志文章


    authors: Flatau E,Lewinsohn G,Konichezky S,Lev A,Barzilay E

    更新日期:1982-11-01 00:00:00

  • Noninvasive ventilation in patients with acute hypercapnic exacerbation of chronic obstructive pulmonary disease who refused endotracheal intubation.

    abstract:OBJECTIVE:To determine the long-term outcome of noninvasive ventilation in chronic obstructive pulmonary disease patients who refused intubation for acute hypercapnic respiratory failure. DESIGN:Prospective, observational study. SETTING:Noninvasive ventilation unit in an acute regional hospital in Hong Kong. METHODS...

    journal_title:Critical care medicine

    pub_type: 杂志文章


    authors: Chu CM,Chan VL,Wong IW,Leung WS,Lin AW,Cheung KF

    更新日期:2004-02-01 00:00:00

  • Mechanical influences on the capnogram.

    abstract::We found that altering aspirating flow rate (ASR) and sample tubing length (STL) affected the response time and capnogram of 2 different side-stream capnometers. Increased flow rate shortened rise time, transit time, and total delay time (TDT), whereas increased STL increased transit and TDTs but not rise time. Increa...

    journal_title:Critical care medicine

    pub_type: 杂志文章


    authors: Schena J,Thompson J,Crone RK

    更新日期:1984-08-01 00:00:00

  • Sucralfate does not reduce the risk of acid aspiration pneumonitis.

    abstract:OBJECTIVE:To study the pulmonary effects of aspirating a mixture of sucralfate in water and sucralfate in hydrochloric acid in an animal model of aspiration pneumonia. DESIGN:Prospective, randomized, controlled study with repeated measures. SETTING:University research laboratory. SUBJECTS:Thirty-two in situ, isolate...

    journal_title:Critical care medicine

    pub_type: 杂志文章


    authors: Toung TJ,Rosenfeld BA,Yoshiki A,Grayson RF,Traystman RJ

    更新日期:1993-09-01 00:00:00