Allergic and hypersensitivity reactions in the intensive care unit.

Abstract:

:Hypersensitivity reactions are defined as immunologically based adverse reactions to chemicals or medicinal agents. These reactions are common in the intensive care unit and can present as a simple, mildly symptomatic rash or as life-threatening anaphylactic reactions. Hypersensitivity reactions have traditionally been classified as types I to IV reactions based on the underlying immune mechanisms, although the clinical relevance of the classification is unclear, and new subtypes to this system have been recently proposed. Given the immunologic and often unpredictable nature of these reactions, avoidance or prevention is not a feasible option. Therefore, management has primarily consisted of withdrawal of potential offending agents, supportive therapy, symptomatic management, and, in some specific examples, targeted pharmacotherapy. This article outlines the background and types of hypersensitivity reactions and provides descriptions and management strategies when applicable to common types of hypersensitivity reactions encountered in the intensive care unit.

journal_name

Crit Care Med

journal_title

Critical care medicine

authors

Kanji S,Chant C

doi

10.1097/CCM.0b013e3181de0c99

subject

Has Abstract

pub_date

2010-06-01 00:00:00

pages

S162-8

issue

6 Suppl

eissn

0090-3493

issn

1530-0293

pii

00003246-201006001-00010

journal_volume

38

pub_type

杂志文章,评审
  • Predictors of patients who present to the emergency department with sepsis and progress to septic shock between 4 and 48 hours of emergency department arrival.

    abstract:OBJECTIVES:Approximately one in every four patients who present to the emergency department with sepsis progresses to septic shock within 72 hours of arrival. In this study, we describe key patient characteristics present within 4 hours of emergency department arrival that are associated with developing septic shock be...

    journal_title:Critical care medicine

    pub_type: 杂志文章

    doi:10.1097/CCM.0000000000000861

    authors: Capp R,Horton CL,Takhar SS,Ginde AA,Peak DA,Zane R,Marill KA

    更新日期:2015-05-01 00:00:00

  • Efficacy of flow-by during continuous positive airway pressure ventilation.

    abstract::We investigated clinically the differences in respiratory work of patients imposed by three modes of one ventilator: the flow-by system, the demand valve system, and the pressure support system. Inspiratory work using flow-by and pressure support systems was reduced sufficiently when compared to the demand valve syste...

    journal_title:Critical care medicine

    pub_type: 杂志文章

    doi:10.1097/00003246-199006000-00016

    authors: Saito S,Tokioka H,Kosaka F

    更新日期:1990-06-01 00:00:00

  • Therapy of shock based on pathophysiology, monitoring, and outcome prediction.

    abstract::High-risk patients who survived general (noncardiac) surgery were observed to have cardiac index (CI) values averaging 4.5 L/min.m2, oxygen delivery (DO2) greater than 600 ml/min.m2, and oxygen consumption (VO2) 170 ml/min.m2 during the first 2 or three days postoperatively. Patients who subsequently died maintained r...

    journal_title:Critical care medicine

    pub_type: 杂志文章,评审

    doi:

    authors: Shoemaker WC,Kram HB,Appel PL

    更新日期:1990-01-01 00:00:00

  • Effect of classic heatstroke on serum procalcitonin.

    abstract:OBJECTIVE:Procalcitonin, the precursor peptide of calcitonin, has been shown to be a serum marker of the severity and mortality of several systemic inflammatory response syndromes. This study addressed the correlation of serum procalcitonin with the course of classic (nonexertional) heatstroke. DESIGN:Serum samples we...

    journal_title:Critical care medicine

    pub_type: 杂志文章

    doi:10.1097/00003246-199708000-00024

    authors: Nylén ES,Al Arifi A,Becker KL,Snider RH Jr,Alzeer A

    更新日期:1997-08-01 00:00:00

  • Effect of naloxone on immune responses after hemorrhagic shock.

    abstract:OBJECTIVE:To determine whether naloxone administration after hemorrhagic shock has any beneficial or deleterious effect on immune responses. BACKGROUND DATA:Hemorrhagic shock is known to produce immunodepression in both humans and experimental animals. Although studies suggest that endogenous opioids play a role in im...

    journal_title:Critical care medicine

    pub_type: 杂志文章

    doi:10.1097/00003246-200001000-00030

    authors: Wichmann MW,Zellweger R,Ayala A,Chaudry IH

    更新日期:2000-01-01 00:00:00

  • Ventilation requirements during high frequency ventilation.

    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

    authors: Colgan FJ,TenEyck LG,Sawa T

    更新日期:1983-03-01 00:00:00

  • Hepcidin and Anemia in Surgical Critical Care: A Prospective Cohort Study.

    abstract:OBJECTIVE:Because anemia of inflammation is common in ICU patients and hepcidin is the key regulator of iron homeostasis, we examined time-dependent changes in hepcidin, erythropoietin, iron, and inflammatory markers in surgical ICU patients with anemia. DESIGN:Prospective single-center clinical noninterventional stud...

    journal_title:Critical care medicine

    pub_type: 杂志文章

    doi:10.1097/CCM.0000000000003089

    authors: Cherry-Bukowiec JR,Engoren M,Wiktor A,Raghavendran K,Napolitano LM

    更新日期:2018-06-01 00:00:00

  • Protection of Brain Injury by Amniotic Mesenchymal Stromal Cell-Secreted Metabolites.

    abstract:OBJECTIVES:To define the features of human amniotic mesenchymal stromal cell secretome and its protective properties in experimental models of acute brain injury. DESIGN:Prospective experimental study. SETTING:Laboratory research. SUBJECTS:C57Bl/6 mice. INTERVENTIONS:Mice subjected to sham or traumatic brain injury...

    journal_title:Critical care medicine

    pub_type: 杂志文章

    doi:10.1097/CCM.0000000000001864

    authors: Pischiutta F,Brunelli L,Romele P,Silini A,Sammali E,Paracchini L,Marchini S,Talamini L,Bigini P,Boncoraglio GB,Pastorelli R,De Simoni MG,Parolini O,Zanier ER

    更新日期:2016-11-01 00:00:00

  • Restoration of hormonal action and muscle protein.

    abstract::This review focuses on the effects of restoring hormonal levels and/or influence on muscle protein metabolism in the stressed state. We have highlighted our clinical experience in the administration of anabolic and anticatabolic agents in stressed clinical populations, primarily adult and pediatric burn injury, as wel...

    journal_title:Critical care medicine

    pub_type: 杂志文章,评审

    doi:10.1097/01.CCM.0000278529.44899.57

    authors: Ferrando AA,Wolfe RR

    更新日期:2007-09-01 00:00:00

  • Real-Time Risk Prediction on the Wards: A Feasibility Study.

    abstract:OBJECTIVE:Failure to detect clinical deterioration in the hospital is common and associated with poor patient outcomes and increased healthcare costs. Our objective was to evaluate the feasibility and accuracy of real-time risk stratification using the electronic Cardiac Arrest Risk Triage score, an electronic health r...

    journal_title:Critical care medicine

    pub_type: 杂志文章

    doi:10.1097/CCM.0000000000001716

    authors: Kang MA,Churpek MM,Zadravecz FJ,Adhikari R,Twu NM,Edelson DP

    更新日期:2016-08-01 00:00:00

  • Preclinical evaluation of epinephrine nebulization to reduce airway hyperemia and improve oxygenation after smoke inhalation injury.

    abstract:OBJECTIVE:Acute lung injury secondary to smoke inhalation is a major source of morbidity and mortality in burn patients. We tested the hypothesis that nebulized epinephrine would ameliorate pulmonary dysfunction secondary to acute lung injury by reducing airway hyperemia and edema formation and mediating bronchodilatat...

    journal_title:Critical care medicine

    pub_type: 杂志文章

    doi:10.1097/CCM.0b013e318207ec52

    authors: Lange M,Hamahata A,Traber DL,Cox RA,Kulp GA,Nakano Y,Traber LD,Herndon DN,Enkhbaatar P

    更新日期:2011-04-01 00:00:00

  • Elevated Mean Airway Pressure and Central Venous Pressure in the First Day of Mechanical Ventilation Indicated Poor Outcome.

    abstract:OBJECTIVES:The relationship between respiratory mechanical parameters and hemodynamic variables remains unclear. This study was performed to determine whether mean airway pressure and central venous pressure in the first day of mechanical ventilation are associated with patient outcomes. DESIGN:Retrospective first 24-...

    journal_title:Critical care medicine

    pub_type: 杂志文章

    doi:10.1097/CCM.0000000000002290

    authors: Long Y,Su L,Zhang Q,Zhou X,Wang H,Cui N,Chai W,Wang X,Rui X,Liu D

    更新日期:2017-05-01 00:00:00

  • The Stability and Workload Index for Transfer score predicts unplanned intensive care unit patient readmission: initial development and validation.

    abstract:OBJECTIVE:Unplanned readmission of hospitalized patients to an intensive care unit (ICU) is associated with a worse outcome, but our ability to identify who is likely to deteriorate after ICU dismissal is limited. The objective of this study is to develop and validate a numerical index, named the Stability and Workload...

    journal_title:Critical care medicine

    pub_type: 杂志文章

    doi:10.1097/CCM.0B013E318164E3B0

    authors: Gajic O,Malinchoc M,Comfere TB,Harris MR,Achouiti A,Yilmaz M,Schultz MJ,Hubmayr RD,Afessa B,Farmer JC

    更新日期:2008-03-01 00:00:00

  • Assessment of hyperglycemia after calcium channel blocker overdoses involving diltiazem or verapamil.

    abstract:BACKGROUND:Overdoses of calcium channel blocker agents result in hyperglycemia, primarily due to the blockade of pancreatic L-type calcium channels and insulin resistance on the cellular level. The clinical significance of the hyperglycemia in this setting has not previously been described. METHODS:This study is a ret...

    journal_title:Critical care medicine

    pub_type: 杂志文章

    doi:10.1097/01.ccm.0000278916.04569.23

    authors: Levine M,Boyer EW,Pozner CN,Geib AJ,Thomsen T,Mick N,Thomas SH

    更新日期:2007-09-01 00:00:00

  • Improving code team performance and survival outcomes: implementation of pediatric resuscitation team training.

    abstract:OBJECTIVE:To determine whether implementation of Composite Resuscitation Team Training is associated with improvement in survival to discharge and code team performance after pediatric in-hospital cardiopulmonary arrest. DESIGN, SETTING, AND SUBJECTS:We conducted a prospective observational study with historical contr...

    journal_title:Critical care medicine

    pub_type: 杂志文章

    doi:10.1097/CCM.0b013e3182a6439d

    authors: Knight LJ,Gabhart JM,Earnest KS,Leong KM,Anglemyer A,Franzon D

    更新日期:2014-02-01 00:00:00

  • Antibiotic-Associated Apoptotic Enterocolitis in the Absence of a Defined Pathogen: The Role of Intestinal Microbiota Depletion.

    abstract:OBJECTIVE:Antibiotic therapy is a major risk factor for the development of diarrhea and colitis with varying severity. Often the origin of antibiotic-associated gastrointestinal deterioration remains elusive and no specific infectious agents could be discerned. PATIENTS:We represent three cases of intractable high-vol...

    journal_title:Critical care medicine

    pub_type: 杂志文章

    doi:10.1097/CCM.0000000000002310

    authors: Wurm P,Spindelboeck W,Krause R,Plank J,Fuchs G,Bashir M,Petritsch W,Halwachs B,Langner C,Högenauer C,Gorkiewicz G

    更新日期:2017-06-01 00:00:00

  • Evaluation of an "in vivo" PaO2 and PaCO2 monitor in the management of respiratory failure.

    abstract::A commercially available gas-chromatograph (Sentorr Gas Analyzer, Ohio Medical Products, Madison, WI) was tested, featuring continuous measurement of in vivo PaO2 and PaCO2 by means of a thin, heparin-coated catheter, inserted through an indwelling arterial line. Gas tensions are displayed every 4 min. The probes had ...

    journal_title:Critical care medicine

    pub_type: 杂志文章

    doi:10.1097/00003246-198007000-00011

    authors: Carlon GC,Kahn RC,Ray C Jr,Howland WS

    更新日期:1980-07-01 00:00:00

  • Antagonism of the Neurokinin-1 Receptor Improves Survival in a Mouse Model of Sepsis by Decreasing Inflammation and Increasing Early Cardiovascular Function.

    abstract:OBJECTIVES:Sepsis remains a serious clinical problem despite intensive research efforts and numerous attempts to improve outcome by modifying the inflammatory response. Substance P, the principal ligand for the neurokinin-1 receptor, is a potent proinflammatory mediator that exacerbates inflammatory responses and cardi...

    journal_title:Critical care medicine

    pub_type: 杂志文章

    doi:10.1097/CCM.0000000000002075

    authors: Mella JR,Chiswick E,Stepien D,Moitra R,Duffy ER,Stucchi A,Remick D

    更新日期:2017-02-01 00:00:00

  • Endotoxemia reduces cerebral perfusion but enhances dynamic cerebrovascular autoregulation at reduced arterial carbon dioxide tension.

    abstract:OBJECTIVE:The administration of endotoxin to healthy humans reduces cerebral blood flow but its influence on dynamic cerebral autoregulation remains unknown. We considered that a reduction in arterial carbon dioxide tension would attenuate cerebral perfusion and improve dynamic cerebral autoregulation in healthy subjec...

    journal_title:Critical care medicine

    pub_type: 杂志文章

    doi:10.1097/CCM.0b013e3182474ca7

    authors: Brassard P,Kim YS,van Lieshout J,Secher NH,Rosenmeier JB

    更新日期:2012-06-01 00:00:00

  • Inhaled prostacyclin for the treatment of pulmonary hypertension after cardiac surgery.

    abstract:OBJECTIVE:To describe the effects of inhaled prostacyclin administered after cardiopulmonary bypass (CPB) to a patient with severe pulmonary hypertension. DESIGN:Case report and literature review. SETTING:Cardiac surgical operating rooms and postoperative recovery unit. PATIENTS:A 63-yr-old female who had undergone ...

    journal_title:Critical care medicine

    pub_type: 杂志文章,评审

    doi:10.1097/00003246-200212000-00023

    authors: Lowson SM,Doctor A,Walsh BK,Doorley PA

    更新日期:2002-12-01 00:00:00

  • Importance of the infusion rate for the plasma expanding effect of 5% albumin, 6% HES 130/0.4, 4% gelatin, and 0.9% NaCl in the septic rat.

    abstract:OBJECTIVES:To compare the plasma volume (PV) expanding effect of a fast infusion rate with that of a slow infusion rate of a fixed volume of 5% albumin, of the synthetic colloids, 6% hydroxyethyl starch 130/0.4 and 4% gelatin, and of 0.9% NaCl in a rat sepsis model and to compare the plasma-expanding effect among these...

    journal_title:Critical care medicine

    pub_type: 杂志文章

    doi:10.1097/CCM.0b013e318274157e

    authors: Bark BP,Persson J,Grände PO

    更新日期:2013-03-01 00:00:00

  • Thrombocytopenia impairs host defense during murine Streptococcus pneumoniae pneumonia.

    abstract:OBJECTIVES:Streptococcus pneumoniae is the most common causative pathogen in community-acquired pneumonia. In patients, thrombocytopenia is correlated with an adverse outcome of pneumonia. Platelets can modulate the host response to infection in several ways, that is, by facilitating clot formation, production of antim...

    journal_title:Critical care medicine

    pub_type: 杂志文章

    doi:10.1097/CCM.0000000000000853

    authors: van den Boogaard FE,Schouten M,de Stoppelaar SF,Roelofs JJ,Brands X,Schultz MJ,van't Veer C,van der Poll T

    更新日期:2015-03-01 00:00:00

  • Efficacy of albumin supplementation in the surgical intensive care unit: a prospective, randomized study.

    abstract:OBJECTIVE:To determine the efficacy of supplemental 25% albumin in reducing morbidity and mortality rates in the surgical intensive care unit (ICU). DESIGN:Prospective, randomized, unblinded clinical study. SETTING:Surgical ICU in a community hospital. PATIENTS:Two hundred nineteen patients with admission circulatin...

    journal_title:Critical care medicine

    pub_type: 临床试验,杂志文章,随机对照试验

    doi:10.1097/00003246-199404000-00017

    authors: Golub R,Sorrento JJ Jr,Cantu R Jr,Nierman DM,Moideen A,Stein HD

    更新日期:1994-04-01 00:00:00

  • Coping Strategies and Posttraumatic Stress Symptoms in Post-ICU Family Decision Makers.

    abstract:OBJECTIVE:To assess the coping strategies used by family decision makers of adult critical care patients during and after the critical care experience and the relationship of coping strategies to posttraumatic stress symptoms experienced 60 days after hospitalization. DESIGN:A single-group descriptive longitudinal cor...

    journal_title:Critical care medicine

    pub_type: 杂志文章

    doi:10.1097/CCM.0000000000000934

    authors: Petrinec AB,Mazanec PM,Burant CJ,Hoffer A,Daly BJ

    更新日期:2015-06-01 00:00:00

  • Amino acid alterations and encephalopathy in the sepsis syndrome.

    abstract:OBJECTIVE:To evaluate the role of amino acid profiles in septic encephalopathy. DESIGN:Retrospective analysis. SETTING:Medical wards and medical ICU of a university hospital. PATIENTS:Patients with infections and normal mental status were compared with patients with septic shock and altered sensorium. INTERVENTIONS...

    journal_title:Critical care medicine

    pub_type: 杂志文章

    doi:10.1097/00003246-199106000-00004

    authors: Sprung CL,Cerra FB,Freund HR,Schein RM,Konstantinides FN,Marcial EH,Pena M

    更新日期:1991-06-01 00:00:00

  • Detecting life-threatening lactic acidosis related to nucleoside-analog treatment of human immunodeficiency virus-infected patients, and treatment with L-carnitine.

    abstract:OBJECTIVE:Our first objective was to determine a blood lactate threshold predictive of survival in human immunodeficiency virus patients experiencing lactic acidosis related to nucleoside analogs, and second, to test l-carnitine for the treatment of patients exceeding that threshold. DESIGN:a) Retrospective study usin...

    journal_title:Critical care medicine

    pub_type: 临床试验,杂志文章,多中心研究

    doi:10.1097/01.CCM.0000053649.69377.08

    authors: Claessens YE,Cariou A,Monchi M,Soufir L,Azoulay E,Rouges P,Goldgran-Toledano D,Branche F,Dhainaut JF

    更新日期:2003-04-01 00:00:00

  • Trauma-hemorrhagic shock-induced red blood cell damage leads to decreased microcirculatory blood flow.

    abstract:OBJECTIVE:To test the hypothesis that trauma-hemorrhagic shock (T/HS)-induced changes in red blood cells (RBC) contribute to the reduction of blood flow in distant organs. DESIGN:Laboratory study. SETTING:Academic medical center laboratory. SUBJECTS:Specific pathogen-free male Sprague-Dawley rats weighing between 25...

    journal_title:Critical care medicine

    pub_type: 杂志文章

    doi:10.1097/CCM.0b013e3181962d39

    authors: Machiedo GW,Zaets SB,Berezina TL,Xu DZ,Feketova E,Spolarics Z,Deitch EA

    更新日期:2009-03-01 00:00:00

  • Quality of life among long-term survivors of intensive care.

    abstract::Quality of life was examined in 717 individuals 1 yr after their admission to a multidisciplinary ICU. Of these, 87% were able to live at home 6 months after their admission. Of patients 65 yr and older, 90% had been living independently before admission compared to 80% 1 yr afterward. Of those younger than 65 yr, mos...

    journal_title:Critical care medicine

    pub_type: 杂志文章

    doi:10.1097/00003246-198708000-00006

    authors: Zarén B,Hedstrand U

    更新日期:1987-08-01 00:00:00

  • Endothelial cell apoptosis in sepsis.

    abstract:OBJECTIVE:To discuss a potential role for endothelial cell apoptosis in the pathogenesis of sepsis. DATA SOURCES:Studies published in biomedical journals and studies from the authors' laboratory. STUDY SELECTION:In vitro and in vivo studies of endothelial cell apoptosis in endotoxin and sepsis models. DATA EXTRACTIO...

    journal_title:Critical care medicine

    pub_type: 杂志文章,评审

    doi:10.1097/00003246-200205001-00009

    authors: Hotchkiss RS,Tinsley KW,Swanson PE,Karl IE

    更新日期:2002-05-01 00:00:00

  • Enteral nutrition in the critically ill: myths and misconceptions.

    abstract:BACKGROUND:Nutritional support is an essential component of the management of critically ill and injured ICU patients. Optimal provision of calories and protein has been demonstrated to reduce morbidity, mortally, and length of ICU and hospital stay. Yet, a large proportion of ICU patients receive inadequate nutrition....

    journal_title:Critical care medicine

    pub_type: 杂志文章,评审

    doi:10.1097/CCM.0000000000000051

    authors: Marik PE

    更新日期:2014-04-01 00:00:00