Abstract:
OBJECTIVES:Most knowledge related to the pathophysiology of microcirculation in ischemic stroke comes from experimental research. Unfortunately, data on microcirculation in the human brain are limited, partially as a result of the lack of appropriate investigational techniques. The objective of our study was to test the hypothesis that cortical microcirculatory alterations in the brain, in terms of blood flow and vessel density, occur in patients with stroke who require surgical decompression compared with a control group. DESIGN:Prospective and observational study. SETTING:Third-level university hospital. PATIENTS:Six patients who had undergone decompressive surgery as a result of a space-occupying hemispheric infarction. These patients were compared with five patients who had undergone craniotomy for a disease not affecting the cortex. INTERVENTIONS:Cortical microcirculation in the brain was directly observed using sidestream dark-field imaging. All images were analyzed offline. MEASUREMENTS AND MAIN RESULTS:In patients with stroke with a space-occupying hemispheric infarction, 18 good-quality movie images were compared with 25 control group images. In the control group, cortical vessels showed a continuous flow in small, medium, and large vessels compared with patients with stroke who presented intermittent or no flow in all vessels. The proportion of perfused vessels was near 100% in control subjects and 63.44% in patients with stroke. The perfused vessel density index was also higher in control subjects (6.16 1/mm; interquartile range, 5.65-7.56) than in patients with stroke (2.77 1/mm; interquartile range, 1.75-3.86). CONCLUSION:Sidestream dark-field imaging allowed direct visualization of cerebral microcirculatory alterations in the operating room. This technique allowed the documentation of a significant blood flow reduction in the cortical microvascular and a decreased vascular density in patients with stroke compared with control subjects.
journal_name
Crit Care Medjournal_title
Critical care medicineauthors
Pérez-Bárcena J,Goedhart P,Ibáñez J,Brell M,García R,Llinás P,Jiménez C,Ince Cdoi
10.1097/CCM.0b013e31820ead5esubject
Has Abstractpub_date
2011-05-01 00:00:00pages
1126-9issue
5eissn
0090-3493issn
1530-0293journal_volume
39pub_type
杂志文章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...
journal_title:Critical care medicine
pub_type: 临床试验,杂志文章
doi:10.1097/00003246-200006000-00059
更新日期:2000-06-01 00:00:00
abstract::The disadvantages of external ventricular drainage are the threat of sepsis and the nuisance of dislodging a precarious system in routine care. The experience of the authors with nearly 200 cases using a long ventricular catheter demonstrates that a subgaleal tunnel can be easily made for the ventricular catheter usin...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/00003246-197912000-00010
更新日期:1979-12-01 00:00:00
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journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/00003246-198205000-00002
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pub_type: 杂志文章
doi:10.1097/CCM.0000000000004896
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abstract:OBJECTIVES:To determine whether delirium during ICU stay is associated with long-term mental health problems defined as symptoms of anxiety, depression, and posttraumatic stress disorder. DESIGN:Prospective cohort study. SETTING:Survey study, 1 year after discharge from a medical-surgical ICU in the Netherlands. PAT...
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doi:10.1097/CCM.0000000000001861
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abstract:OBJECTIVE:To review current knowledge about the impact of prolonged mechanical ventilation on diaphragmatic function and biology. MEASUREMENTS:Systematic literature review. CONCLUSIONS:Prolonged mechanical ventilation can promote diaphragmatic atrophy and contractile dysfunction. As few as 18 hrs of mechanical ventil...
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更新日期:2009-10-01 00:00:00
abstract:OBJECTIVE:To investigate if prone position delays the progression of experimental ventilator-induced lung injury, possibly due to a more homogeneous distribution of strain within lung parenchyma. DESIGN:Prospective, randomized, controlled trial. SETTING:Animal laboratory of a university hospital. SUBJECTS:Thirty-fiv...
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abstract:OBJECTIVES:The Fragility Index, which represents the number of patients responsible for a statistically significant finding, has been suggested as an aid for interpreting the robustness of results from clinical trials. A small Fragility Index indicates that the statistical significance of a trial depends on only a few ...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/CCM.0000000000003527
更新日期:2019-03-01 00:00:00
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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.0b013e3181b78abe
更新日期:2010-01-01 00:00:00
abstract:OBJECTIVES:Pneumothorax is a frequent complication during mechanical ventilation. Electrical impedance tomography (EIT) is a noninvasive tool that allows real-time imaging of regional ventilation. The purpose of this study was to 1) identify characteristic changes in the EIT signals associated with pneumothoraces; 2) d...
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pub_type: 杂志文章
doi:10.1097/CCM.0b013e31816a0380
更新日期:2008-04-01 00:00:00
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...
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doi:10.1097/00003246-199405000-00027
更新日期:1994-05-01 00:00:00
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doi:10.1097/00003246-198305000-00014
更新日期:1983-05-01 00:00:00
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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: 杂志文章
doi:10.1097/CCM.0B013E318164E3B0
更新日期:2008-03-01 00:00:00
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pub_type: 杂志文章
doi:10.1097/00003246-197507000-00001
更新日期:1975-07-01 00:00:00
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doi:10.1097/CCM.0b013e318211ff3d
更新日期:2011-06-01 00:00:00
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更新日期:2003-04-01 00:00:00
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更新日期:2018-08-01 00:00:00
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doi:10.1097/00003246-200001000-00010
更新日期:2000-01-01 00:00:00
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doi:10.1097/00003246-199208000-00012
更新日期:1992-08-01 00:00:00
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更新日期:2010-10-01 00:00:00
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更新日期:2012-01-01 00:00:00
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更新日期:1986-12-01 00:00:00
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更新日期:1998-12-01 00:00:00
abstract:OBJECTIVE:This report will describe the preparations for and the provision of care of two patients with Ebola virus disease in the biocontainment unit at the University of Nebraska Medical Center. DATA SOURCES:Patient medical records. STUDY SELECTION:Not applicable. DATA EXTRACTION:Not applicable. DATA SYNTHESIS:No...
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更新日期:2015-06-01 00:00:00