Abstract:
OBJECTIVE:Opioids are frequently used during mechanical ventilation for severe viral infection in infancy. Opioid receptors have immunomodulatory properties, but nothing is known about their antiviral effects. We therefore aimed to investigate the role of opioid receptors in virus-induced airway inflammation. PATIENTS AND INTERVENTIONS:Two single nucleotide polymorphisms in OPRM1 and OPRD1 were genotyped in 465 infants with severe respiratory syncytial virus infection and 930 control subjects. Subsequently, the mechanism by which opioid receptors affect clinical outcome in respiratory syncytial virus bronchiolitis was studied in BALB/c mice. Animals were injected daily with nalmefene, a nonselective opioid receptor antagonist, and infected by intranasal inoculation of respiratory syncytial virus 24 hrs after the first dose of nalmefene. The potential therapeutic effect of pharmaceutical opioids was studied using µ (DAMGO), κ (U50488), and Δ (DPDPE) opioid receptor agonists 48 hrs after infection. MEASUREMENTS AND MAIN RESULTS:In our human study, the A118G single nucleotide polymorphism rs1799971 was associated with respiratory syncytial virus disease severity (p = 0.015). In mice, nalmefene treatment increased viral titers and was associated with more pronounced weight loss. Increased viral replication was associated with increased levels of cytokines and chemokines in the bronchoalveolar lavage fluid, enhanced bronchoalveolar cellular influx, and exaggerated lung pathology. Pharmaceutical opioids, in particular DPDPE, did not affect viral replication. They did induce a decreased influx of neutrophils, but an increased influx of lymphocytes and monocytes into the bronchoalveolar lumen during respiratory syncytial virus infection. CONCLUSIONS:Using a human study and an experimental model, we show that opioid receptor signaling has a potential beneficial role in the outcome of respiratory viral disease. We show that opioid receptor signaling is required to control respiratory syncytial virus replication and thereby to control disease severity. However, we also show that caution is required before using pharmaceutical opioids as anti-inflammatory or antiviral treatment of patients with viral respiratory infection.
journal_name
Crit Care Medjournal_title
Critical care medicineauthors
Salimi V,Hennus MP,Mokhtari-Azad T,Shokri F,Janssen R,Hodemaekers HM,Rygiel TP,Coenjaerts FE,Meyaard L,Bont Ldoi
10.1097/CCM.0b013e31826767a8subject
Has Abstractpub_date
2013-01-01 00:00:00pages
205-14issue
1eissn
0090-3493issn
1530-0293journal_volume
41pub_type
杂志文章abstract:OBJECTIVE:Our knowledge of the molecular mechanisms of sepsis has attained exponential growth. Yet, the pillars of its care remain antibiotics, fluid resuscitation, and physiologic support of failing organ systems. The inability to bring biologic breakthroughs to the bedside is not for lack of effort. Over 60 clinical ...
journal_title:Critical care medicine
pub_type: 杂志文章,评审
doi:10.1097/CCM.0000000000003271
更新日期:2018-09-01 00:00:00
abstract:OBJECTIVES:a) To quantify the use of do-not-resuscitate orders in a tertiary care children's hospital; and b) to characterize the circumstances in which such orders are written. DESIGN:Retrospective chart review. SETTING:University teaching hospital. PATIENTS:All inpatients who died in an urban children's hospital o...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/00003246-199301000-00012
更新日期:1993-01-01 00:00:00
abstract:OBJECTIVE:To evaluate the efficacy and tolerability of intravenous empiric treatment with meropenem compared with ceftazidime-tobramycin in patients with hospital-acquired lower respiratory tract infections. DESIGN:Prospective, nonblind, randomized trial. SETTING:Multicenter trial conducted at 22 centers. PATIENTS:T...
journal_title:Critical care medicine
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1097/00003246-199710000-00015
更新日期:1997-10-01 00:00:00
abstract:OBJECTIVE:To study whether noninvasive pressure support ventilation (NIPSV) with helium/oxygen (He/oxygen), which can reduce dyspnea, PaCO2, and work of breathing more than NIPSV with air/oxygen in decompensated chronic obstructive pulmonary disease, could have beneficial consequences on outcome and hospitalization cos...
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.0000055369.37620.EE
更新日期:2003-03-01 00:00:00
abstract:OBJECTIVES:There is controversy regarding the benefits of N-acetylcysteine in acute kidney injury. This study was to compare three commonly used regimens and explore which regimen is best for the protection of acute kidney injury. DESIGN:Prospective experimental study. SETTING:University research laboratory. INTERVE...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/CCM.0b013e31822575fc
更新日期:2011-11-01 00:00:00
abstract:OBJECTIVE:To assess the possibility that acute respiratory distress syndrome (ARDS) of pulmonary and nonpulmonary origins represent two distinct syndromes. DESIGN:Analysis of data collected prospectively from an inception cohort of 117 patients with ARDS. SETTING:Adult intensive care unit (ICU), university/postgradua...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/00003246-200103000-00016
更新日期:2001-03-01 00:00:00
abstract::An emergency cricothyrotomy device was placed in 11 anesthetized dogs in order to assess airway damage and problems in placement, ventilation, and design. Posterior airway perforation without esophageal damage occurred in three animals. Submucosal hematomas or cricoid cartilage injury occurred in seven animals. As pla...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/00003246-198702000-00016
更新日期:1987-02-01 00:00:00
abstract:OBJECTIVES:To determine whether mean arterial blood pressure excursions below the lower limit of cerebral blood flow autoregulation during cardiopulmonary bypass are associated with acute kidney injury after surgery. SETTING:Tertiary care medical center. PATIENTS:Four hundred ten patients undergoing cardiac surgery w...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/CCM.0b013e31826ab3a1
更新日期:2013-02-01 00:00:00
abstract:OBJECTIVE:Although hepatic cytochrome P-450 protein concentrations are altered following endotoxin shock, changes in P-450 isoforms in sepsis have not been fully investigated. The aim of this study was to determine whether the major P-450 isoform in rat liver (i.e., CYP1A2) is down-regulated during the progression of s...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/01.CCM.0000109453.57709.E2
更新日期:2004-02-01 00:00:00
abstract:OBJECTIVE:Conventional outcomes research provides only percentage risk of such end points as mortality rate, utilization of resources, and/or broad groupings of multiple organ system dysfunction. These prognostications generally are not applicable to individual patients. The purpose of the present study was to determin...
journal_title:Critical care medicine
pub_type: 临床试验,杂志文章
doi:10.1097/00003246-200205000-00014
更新日期:2002-05-01 00:00:00
abstract::In order to determine and analyze the complication rate of the insertion and maintenance of the balloon-tipped, flow-directed pulmonary artery catheter (PAC), the authors prospectively studied the use of 320 catheters in 219 critically ill patients. Mean patient age was 53 +/- 1 years, and 36% had a history of cardiov...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/00003246-198104000-00006
更新日期:1981-04-01 00:00:00
abstract::A safe, simple, reliable technique for sampling uncontaminated peripheral bronchial secretions in patients with endotracheal tubes has been developed. It is easily performed and requires no special training or equipment. This report summarizes the techniques's usefulness in providing diagnostic samples of peripheral a...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/00003246-197703000-00003
更新日期:1977-03-01 00:00:00
abstract:OBJECTIVE:To evaluate the safety of human albumin administered for therapeutic purposes. DESIGN:Retrospective compilation of spontaneously reported serious adverse events. SETTING:Records of serious adverse event reports received from 1990 through 1997 by nine major suppliers of therapeutic human albumin worldwide. ...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/00003246-200105000-00021
更新日期:2001-05-01 00:00:00
abstract::Standard cardiopulmonary-cerebral resuscitation fails to achieve restoration of spontaneous circulation in approximately 50% of normovolemic sudden cardiac arrests outside hospitals and in essentially all victims of penetrating truncal trauma who exsanguinate rapidly to cardiac arrest. Among cardiopulmonary-cerebral r...
journal_title:Critical care medicine
pub_type: 杂志文章,评审
doi:10.1097/00003246-200011001-00012
更新日期:2000-11-01 00:00:00
abstract::This study was undertaken to investigate ventilatory requirements during high frequency ventilation (HFV). Six anesthetized dogs were ventilated with bird M-2 or Emerson 2-V ventilators at respiratory rates (RRs) ranging from 13-1300 breath/min. PaCO2 was maintained within normal range at all rates by tidal volume (VT...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/00003246-198303000-00005
更新日期:1983-03-01 00:00:00
abstract:OBJECTIVES:To compare the frequency and preventability of adverse drug events and potential adverse drug events in intensive care units (ICUs) and non-ICUs. To evaluate systems factors involving the individual caregivers, care unit teams, and patients involved in each adverse drug event by comparing ICUs with non-ICUs ...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/00003246-199708000-00014
更新日期:1997-08-01 00:00:00
abstract:OBJECTIVE:To appraise the literature on the effect of initial renal replacement therapy (RRT) modality on clinical outcomes. DESIGN:Systematic review and meta-analysis. SETTING:Academic medical center. PATIENTS AND PARTICIPANTS:Adult critically ill patients with acute kidney injury. INTERVENTIONS:Continuous vs. int...
journal_title:Critical care medicine
pub_type: 杂志文章,meta分析,评审
doi:10.1097/01.CCM.0B013E3181611F552
更新日期:2008-02-01 00:00:00
abstract:OBJECTIVES:Thrombotic microangiopathy syndromes are a heterogeneous group of severe diseases that often require ICU admission. Prompt initiation of targeted therapies is required for atypical hemolytic uremic syndrome and thrombotic thrombocytopenic purpura, whereas there is no specific consensus therapy for Shiga toxi...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/CCM.0000000000003292
更新日期:2018-09-01 00:00:00
abstract:BACKGROUND:Endotoxin (lipopolysaccharide [LPS]) has been associated with sepsis and the high mortality rate seen in septic shock. The administration of a small amount of LPS to healthy subjects produces a mild syndrome qualitatively similar to that seen in clinical sepsis. We used this model to test the efficacy of an ...
journal_title:Critical care medicine
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1097/00003246-200008000-00005
更新日期:2000-08-01 00:00:00
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
doi:10.1097/CCM.0000000000004667
更新日期:2020-12-01 00:00:00
abstract:OBJECTIVE:To evaluate the safety and physiologic actions of ibuprofen in patients with severe sepsis. DESIGN:Randomized, double-blind, placebo-controlled trial. SETTING:Three university hospital medical ICUs. PATIENTS:Twenty-nine patients with clinical evidence of sepsis and the need for hemodynamic monitoring with ...
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:10.1097/00003246-199111000-00006
更新日期:1991-11-01 00:00:00
abstract:OBJECTIVE:To simultaneously determine perceived vs. practiced adherence to recommended interventions for the treatment of severe sepsis or septic shock. DESIGN:One-day cross-sectional survey. SETTING:Representative sample of German intensive care units stratified by hospital size. PATIENTS:Adult patients with severe...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/CCM.0b013e318186b6f3
更新日期:2008-10-01 00:00:00
abstract:OBJECTIVE:To evaluate the ability of two prognostic systems to predict hospital mortality in adult intensive care patients. DESIGN:Prospective cohort study. SETTING:A mixed medical and surgical intensive care unit (ICU) in the United Kingdom. PATIENTS:A total of 1,144 patients consecutively admitted to the study. I...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/00003246-199701000-00006
更新日期:1997-01-01 00:00:00
abstract:OBJECTIVE:Addressing the quality gap in ICU-based palliative care is limited by uncertainty about acceptable models of collaborative specialist and generalist care. Therefore, we characterized the attitudes of physicians and nurses about palliative care delivery in an ICU environment. DESIGN:Mixed-methods study. SETT...
journal_title:Critical care medicine
pub_type: 杂志文章,多中心研究
doi:10.1097/CCM.0000000000002099
更新日期:2017-04-01 00:00:00
abstract::Two new catecholamines, dopamine and dobutamine, have found widespread use for cardiovascular support. The relative efficacy of these drugs in aiding resuscitation from cardiopulmonary arrest is unknown. Dogs were subjected to either asphyxial or fibrillatory cardiac arrest. Resuscitation was attempted with artificial...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/00003246-198109000-00005
更新日期:1981-09-01 00:00:00
abstract:OBJECTIVE:In rodent models, enhanced formation of nitric oxide and formation of peroxynitrite have been implicated in the pathogenesis of various forms of shock. Here we examined the effect of mercaptoethylguanidine (MEG), an inducible nitric oxide synthase inhibitor and peroxynitrite scavenger, in a severe hemorrhagic...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/00003246-199907000-00027
更新日期:1999-07-01 00:00:00
abstract:OBJECTIVE:After a stay in the intensive care unit, patients risk experiencing delusional memories, memory loss, and symptoms of posttraumatic stress. Since the 1990s, diaries have been kept for intensive care unit patients to help fill in memory gaps, aid psychosocial recovery, and improve health-related quality of lif...
journal_title:Critical care medicine
pub_type: 杂志文章,多中心研究
doi:10.1097/CCM.0b013e31821e89c8
更新日期:2011-08-01 00:00:00
abstract::The determination of minute oxygen consumption (VO2) for metabolic studies on patients using either the Beckman Metabolic Cart (MMC) or the Respiratory Monitoring System (RMS) requires a stable fractional inspired oxygen concentration (FIO2). Measurement of VO2 on mechanically ventilated patients using the Bourns BEAR...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/00003246-198202000-00003
更新日期:1982-02-01 00:00:00
abstract:OBJECTIVES:During cardiopulmonary resuscitation (CPR), elimination of CO2 was shown to be limited by low tissue perfusion, especially when very low perfusion pressures were generated. It has therefore been suggested that sodium bicarbonate (NaHCO3), by producing CO2, might aggravate the hypercarbic component of the exi...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/00003246-199808000-00027
更新日期:1998-08-01 00:00:00
abstract:OBJECTIVE:To evaluate a novel combination of preoperative, intraoperative, and postoperative variables (including the Parsonnet, and the Acute Physiology and Chronic Health Evaluation II and III [APACHE II and III] scores) in cardiac surgery patients in order to predict hospital outcome, complications, and length of st...
journal_title:Critical care medicine
pub_type: 临床试验,杂志文章
doi:10.1097/00003246-199511000-00010
更新日期:1995-11-01 00:00:00