Abstract:
OBJECTIVES:Previous workers have demonstrated that controlled mechanical ventilation results in diaphragm inactivity and elicits a rapid development of diaphragm weakness as a result of both contractile dysfunction and fiber atrophy. Limited data exist regarding the impact of pressure support ventilation, a commonly used mode of mechanical ventilation-that permits partial mechanical activity of the diaphragm-on diaphragm structure and function. We carried out the present study to test the hypothesis that high-level pressure support ventilation decreases the diaphragm pathology associated with CMV. METHODS:Sprague-Dawley rats were randomly assigned to one of the following five groups:1) control (no mechanical ventilation); 2) 12 hrs of controlled mechanical ventilation (12CMV); 3) 18 hrs of controlled mechanical ventilation (18CMV); 4) 12 hrs of pressure support ventilation (12PSV); or 5) 18 hrs of pressure support ventilation (18PSV). MEASUREMENTS AND MAIN RESULTS:We carried out the following measurements on diaphragm specimens: 4-hydroxynonenal-a marker of oxidative stress, active caspase-3 (casp-3), active calpain-1 (calp-1), fiber type cross-sectional area, and specific force (sp F). Compared with the control, both 12PSV and 18PSV promoted a significant decrement in diaphragmatic specific force production, but to a lesser degree than 12CMV and 18CMV. Furthermore, 12CMV, 18PSV, and 18CMV resulted in significant atrophy in all diaphragm fiber types as well as significant increases in a biomarker of oxidative stress (4-hydroxynonenal) and increased proteolytic activity (20S proteasome, calpain-1, and caspase-3). Furthermore, although no inspiratory effort occurs during controlled mechanical ventilation, it was observed that pressure support ventilation resulted in large decrement, approximately 96%, in inspiratory effort compared with spontaneously breathing animals. CONCLUSIONS:High levels of prolonged pressure support ventilation promote diaphragmatic atrophy and contractile dysfunction. Furthermore, similar to controlled mechanical ventilation, pressure support ventilation-induced diaphragmatic atrophy and weakness are associated with both diaphragmatic oxidative stress and protease activation.
journal_name
Crit Care Medjournal_title
Critical care medicineauthors
Hudson MB,Smuder AJ,Nelson WB,Bruells CS,Levine S,Powers SKdoi
10.1097/CCM.0b013e31823c8cc9subject
Has Abstractpub_date
2012-04-01 00:00:00pages
1254-60issue
4eissn
0090-3493issn
1530-0293pii
00003246-201204000-00028journal_volume
40pub_type
杂志文章abstract:OBJECTIVE:To compare the effectiveness and safety of the hemoglobin-based nitric oxide scavenger, pyridoxalated hemoglobin polyoxyethylene, against placebo in patients with vasopressor-dependent distributive shock. DESIGN:Multicenter, randomized, placebo-controlled, open-label study. SETTING:Sixty-one participating I...
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.0000000000000554
更新日期:2015-01-01 00:00:00
abstract:OBJECTIVE:To examine the hypothesis that heat stress applied after the administration of bacterial endotoxin is protective. DESIGN:Prospective, randomized, laboratory study. SETTING:University research laboratory. SUBJECTS:One hundred eleven adult male Sprague-Dawley rats (weight range 250 to 400 g). INTERVENTIONS:...
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doi:10.1097/00003246-199710000-00025
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abstract::Nine previously untrained health professionals learned to measure cardiac output (Qt) by suprasternal continuous-wave Doppler ultrasound (QtDopp) and by thoracic bioimpedance (Qtbi). Each received standardized written, videotaped, and individual instruction. First the novice, then the reference examiner, measured QtDo...
journal_title:Critical care medicine
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abstract:OBJECTIVE:Procalcitonin may be associated with reduced antibiotic usage compared to usual care. However, individual randomized controlled trials testing this hypothesis were too small to rule out harm, and the full cost-benefit of this strategy has not been evaluated. The purpose of this analysis was to evaluate the ef...
journal_title:Critical care medicine
pub_type: 杂志文章,meta分析,评审
doi:10.1097/CCM.0b013e31821201a5
更新日期:2011-07-01 00:00:00
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journal_title:Critical care medicine
pub_type: 临床试验,杂志文章,随机对照试验
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更新日期:1989-04-01 00:00:00
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doi:10.1097/CCM.0000000000002310
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doi:10.1097/00003246-199402000-00012
更新日期:1994-02-01 00:00:00
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journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/01.CCM.0000277043.85378.C1
更新日期:2007-08-01 00:00:00
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更新日期:2020-04-01 00:00:00
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journal_title:Critical care medicine
pub_type: 杂志文章
doi:
更新日期:1981-07-01 00:00:00
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pub_type: 杂志文章
doi:10.1097/00003246-200209000-00006
更新日期:2002-09-01 00:00:00
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pub_type: 杂志文章
doi:10.1097/00003246-199505000-00020
更新日期:1995-05-01 00:00:00
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pub_type: 杂志文章
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更新日期:2007-02-01 00:00:00
abstract:OBJECTIVE:To evaluate the relationship between the acute inflammatory response after surgical trauma and changes in hepatic cytochrome P450 3A4 activity, compare changes in cytochrome P450 3A4 activity after procedures with varying degrees of surgical stress, and to explore the time course of any potential drug-cytokin...
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pub_type: 杂志文章
doi:10.1097/01.CCM.0000063040.24541.49
更新日期:2003-05-01 00:00:00
abstract::To understand better the incidence and meaning of hyperamylasemia in the intensive care setting, cellulose acetate membrane electrophoresis was used to measure the isoenzymes of serum amylase in 192 patients with a variety of critical illnesses. Seventy of these patients had elevated serum amylase levels, but none had...
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doi:10.1097/00003246-198507000-00003
更新日期:1985-07-01 00:00:00
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doi:10.1097/CCM.0000000000003670
更新日期:2019-05-01 00:00:00
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journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/00003246-200103000-00026
更新日期:2001-03-01 00:00:00
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pub_type: 临床试验,杂志文章
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更新日期:2005-03-01 00:00:00
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doi:10.1097/CCM.0b013e31825bc92f
更新日期:2012-11-01 00:00:00
abstract:OBJECTIVE:The antimetabolite drug, 5-fluorouracil, inhibits microbial growth. Coating of central venous catheters with 5-fluorouracil may reduce the risk of catheter infection. Our objective was to compare the safety and efficacy of central venous catheters externally coated with 5-fluorouracil with those coated with c...
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pub_type: 杂志文章,多中心研究,随机对照试验
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更新日期:2010-11-01 00:00:00
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pub_type: 评论,杂志文章
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更新日期:2006-04-01 00:00:00
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pub_type: 临床试验,杂志文章,随机对照试验
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更新日期:1993-03-01 00:00:00
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doi:10.1097/00003246-199804000-00021
更新日期:1998-04-01 00:00:00
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doi:10.1097/00003246-199712000-00017
更新日期:1997-12-01 00:00:00
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pub_type: 杂志文章
doi:10.1097/00003246-198011000-00011
更新日期:1980-11-01 00:00:00
abstract:OBJECTIVE:Using a modification of the Bohr equation, single-breath carbon dioxide capnography is a noninvasive technology for calculating physiologic dead space (V(D)/V(T)). The objective of this study was to identify a minimal V(D)/V(T) value for predicting successful extubation from mechanical ventilation in pediatri...
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pub_type: 临床试验,杂志文章
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更新日期:2000-06-01 00:00:00
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更新日期:2008-01-01 00:00:00
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pub_type: 指南,杂志文章,实务指引
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更新日期:2004-01-01 00:00:00
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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
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pub_type: 杂志文章
doi:10.1097/00003246-199705000-00016
更新日期:1997-05-01 00:00:00