Hemodynamic resuscitation with fluids bolus and norepinephrine increases severity of lung damage in an experimental model of septic shock.

Abstract:

OBJECTIVE:Hemodynamic resuscitation is considered a cornerstone of the initial treatment of septic shock. However, there is growing concern about its side effects. Our objective was to assess the relationship between fluid administration and norepinephrine infusion and the development of lung injury. DESIGN:Randomized in vivo study in rabbits. SETTING:University animal research laboratory. PATIENTS:Eighteen New Zealand rabbits. Control group (SHAM, n=6), Sepsis group with or without hemodynamic resuscitation (ETX-R, n=6; ETX-NR, n=6). INTERVENTIONS:Sepsis was induced by intravenous lipopolysaccharide administration and animals were followed-up for 4h. Hemodynamic resuscitation with Ringer lactate (20mL·kg-1) was administered and later norepinephrine was initiated 3h after sepsis induction. At the end, the left lung was excised. MAIN VARIABLES OF INTEREST:An indwelling arterial catheter and an esophageal Doppler were placed. Lung mechanics were monitored with side stream spirometry. Lung damage was analyzed by histopathological examination. RESULTS:The SHAM group did not show hemodynamic or respiratory changes. Lipopolysaccharide administration aimed an increase in cardiac output and arterial hypotension. In the ETX-NR group, animals remained hypotensive until the end of the experiment. Resuscitation with fluids and norepinephrine reversed arterial hypotension. Compared to the ETX-NR group, the remaining lung of the ETX-R group showed greater accumulation of neutrophils and reactive type-II pneumocytes, thicker alveolar wall, alveolar hemorrhage and non-aerated pulmonary areas. Lung injury score was larger in the ETX-R group. CONCLUSIONS:In our experimental study, following a strategy with bolus fluids and late norepinephrine used in the early phase of endotoxic septic shock has a negative influence on the development of lung injury.

journal_name

Med Intensiva

journal_title

Medicina intensiva

authors

Guijo Gonzalez P,Gracia Romero MA,Gil Cano A,Garcia Rojo M,Cecconi M,Monge Garcia IM

doi

10.1016/j.medin.2020.05.011

subject

Has Abstract

pub_date

2020-07-24 00:00:00

eissn

0210-5691

issn

1578-6749

pii

S0210-5691(20)30178-9

pub_type

杂志文章
  • New clinical practice guidelines of the surviving sepsis campaign: a critical appraisal.

    abstract::In 2004 was published the first edition of the "Surviving sepsis campaign" guidelines for the management of severe sepsis and septic shock, opening a new era in the treatment of this syndrome. The paradox is that guidelines application have produced positive results despite including in some cases treatments proven in...

    journal_title:Medicina intensiva

    pub_type: 杂志文章

    doi:10.1016/j.medin.2013.07.008

    authors: Palencia Herrejón E,Bueno García B

    更新日期:2013-12-01 00:00:00

  • Comparison of values in critically ill patients for global end-diastolic volume and extravascular lung water measured by transcardiopulmonary thermodilution: a meta-analysis of the literature.

    abstract:INTRODUCTION:Hemodynamic parameters such as the global end-diastolic volume index (GEDVI) and extravascular lung water index (EVLWI), derived by transpulmonary thermodilution, have gained increasing interest for guiding fluid therapy in critically ill patients. The proposed normal values (680-800ml/m(2) for GEDVI and 3...

    journal_title:Medicina intensiva

    pub_type: 杂志文章,meta分析

    doi:10.1016/j.medin.2011.11.014

    authors: Eichhorn V,Goepfert MS,Eulenburg C,Malbrain ML,Reuter DA

    更新日期:2012-10-01 00:00:00

  • Quality of anthropometric measurements in Spanish Intensive Care Units (The CAMIES Study).

    abstract:INTRODUCTION:Real body weight and height are essential data to be obtained in all critically ill patients (CIP), due to their influence in the designing of therapies and monitoring. Visual estimation is a very inaccurate practice. No precise descriptions of anthropometric measurements among CIP are available in the cli...

    journal_title:Medicina intensiva

    pub_type: 杂志文章,多中心研究

    doi:10.1016/j.medin.2017.09.008

    authors: García-Martínez MA,Cherednichenko T,Hidalgo Encinas Y,Catalá Espinosa AI,Arrascaeta Llanes A,Acosta Escribano JA

    更新日期:2018-01-01 00:00:00

  • Occupancy of the Departments of Intensive Care Medicine in Catalonia (Spain): A prospective, analytical cohort study.

    abstract:BACKGROUND:Before deciding increases in the number or capacitance of Intensive Care Units (ICUs), or the regionalization of Units, it is essential to know their present effectiveness. OBJECTIVE:To analyze the daily occupancy rate of ICUs in Catalonia (Spain) and the frequency of denied admission due to lack of capacit...

    journal_title:Medicina intensiva

    pub_type: 杂志文章,多中心研究

    doi:10.1016/j.medin.2014.11.002

    authors: Fernandez R,Clinical Management Working Group of the Societat Catalana de Medicina Intensiva i Crítica.

    更新日期:2015-12-01 00:00:00

  • Innovation and technology transfer in the health sciences: a cross-sectional perspective.

    abstract::This article is based on the strategic reflection and discussion that took place on occasion of the first conference on innovation and technology transfer in the health sciences organized by the REGIC-ENS-FENIN-SEMICYUC and held in Madrid in the Instituto de Salud Carlos III on May 7th, 2013, with the aim of promoting...

    journal_title:Medicina intensiva

    pub_type:

    doi:10.1016/j.medin.2014.04.012

    authors: Blanch L,Guerra L,Lanuza A,Palomar G

    更新日期:2014-11-01 00:00:00

  • [Organ preservation].

    abstract::Maintaining organ viability from extraction to transplantation is crucial to ensure the function and survival of the graft. In recent years, maintaining organ viability has become more challenging because the shortage of donors has led to broader criteria for donor acceptability and consequently to organs with greater...

    journal_title:Medicina intensiva

    pub_type: 杂志文章

    doi:10.1016/S0210-5691(09)72196-5

    authors: Cobo JL,Del Río Gallegos F

    更新日期:2009-08-01 00:00:00

  • [Differential characteristics of patients with acute coronary syndrome without ST-segment elevation compared to those with transient ST-segment elevation].

    abstract:OBJECTIVE:To evaluate different characteristics of patients with acute coronary syndrome (ACS) without ST-segment elevation compared with transient St-segment elevation. DESIGN:An observational, prospective study. SETTING:A 12-bed coronary care unit. PATIENTS:Consecutive patients of ACS without persistent ST-segment...

    journal_title:Medicina intensiva

    pub_type: 杂志文章

    doi:10.1016/j.medin.2011.01.007

    authors: Arroyo Úcar E,Domínguez-Rodríguez A,Juárez Prera R,Blanco Palacios G,Hernández García C,Carrillo-Pérez Tome M,Abreu-González P

    更新日期:2011-06-01 00:00:00

  • [Guidelines for specialized nutritional and metabolic support in the critically ill-patient. Update. Consensus of the Spanish Society of Intensive Care Medicine and Coronary Units-Spanish Society of Parenteral and Enteral Nutrition (SEMICYUC-SENPE): sever

    abstract::Severe acute pancreatitis (SAP) causes local and systemic complications leading to high catabolic, hypermetabolic and hyperdynamic stress states with marked morbidity and mortality. In the last decade, nutritional support has become a key element in the treatment of SAP. Thus, specialized nutrition is indicated from a...

    journal_title:Medicina intensiva

    pub_type: 共识发展会议,杂志文章,实务指引

    doi:10.1016/S0210-5691(11)70007-9

    authors: Bordejé Laguna L,Lorencio Cárdenas C,Acosta Escribano J,Spanish Society of Intensive Care Medicine and Coronary Units-Spanish Society of Parenteral and Enteral Nutrition (SEMICYUC-SENPE).

    更新日期:2011-11-01 00:00:00

  • [Mitochondrial dysfunction during sepsis, impact and possible regulating role of hypoxia-inducible factor-1alpha].

    abstract::There is a direct correlation between the development of the multiple organ dysfunction syndrome (MODS) and the elevated mortality associated with sepsis. The mechanisms responsible for MODS development are being studied, however, the main efforts regarding MODS evaluation have focused on oxygen delivery optimization ...

    journal_title:Medicina intensiva

    pub_type: 杂志文章,评审

    doi:10.1016/j.medin.2008.10.002

    authors: Regueira T,Andresen M,Djafarzadeh S

    更新日期:2009-11-01 00:00:00

  • TLR2-TLR4/CD14 polymorphisms and predisposition to severe invasive infections by Neisseria meningitidis and Streptococcus pneumoniae.

    abstract:PURPOSE:Streptococcus pneumoniae and Neisseria meningitidis are major causes of severe invasive bacterial infections in some individuals. Apparently the genetic is a major susceptibility determinant to these infectious diseases. We study if the functional polymorphisms within genes of the innate immune system (TLR2-TLR...

    journal_title:Medicina intensiva

    pub_type: 杂志文章

    doi:10.1016/j.medin.2013.08.006

    authors: Tellería-Orriols JJ,García-Salido A,Varillas D,Serrano-González A,Casado-Flores J

    更新日期:2014-08-01 00:00:00

  • [Acute renal function deterioration in a Coronary Unit in Spain].

    abstract:OBJECTIVE:To assess the incidence and prognostic value of acute renal function deterioration (ARFD) in patients with acute heart disease. SETTING:Coronary Care Unit in a tertiary university hospital. DESIGN:Retrospective study. PARTICIPANTS:One hundred consecutive patients admitted during 2004. INTERVENTIONS:No ran...

    journal_title:Medicina intensiva

    pub_type: 杂志文章

    doi:10.1016/s0210-5691(08)70932-x

    authors: Martí D,Escobar C,Dedieu N,Liaño F,Jiménez Mena M,Asín E

    更新日期:2008-05-01 00:00:00

  • [Clinical consensus recommendations regarding non-invasive respiratory support in the adult patient with acute respiratory failure secondary to SARS-CoV-2 infection].

    abstract::Coronavirus disease 2019 (COVID-19) is a respiratory tract infection caused by a newly emergent coronavirus, that was first recognized in Wuhan, China, in December 2019. Currently, the World Health Organization (WHO) has defined the infection as a global pandemic and there is a health and social emergency for the mana...

    journal_title:Medicina intensiva

    pub_type: 共识发展会议,杂志文章,实务指引

    doi:10.1016/j.medin.2020.03.005

    authors: Cinesi Gómez C,Peñuelas Rodríguez Ó,Luján Torné M,Egea Santaolalla C,Masa Jiménez JF,García Fernández J,Carratalá Perales JM,Heili-Frades SB,Ferrer Monreal M,de Andrés Nilsson JM,Lista Arias E,Sánchez Rocamora JL,Garrote JI,Zam

    更新日期:2020-10-01 00:00:00

  • [Incidence, characteristics and outcome of barotrauma during open lung ventilation].

    abstract:OBJECTIVE:To describe the incidence and main clinical characteristics of barotrauma during open lung ventilation (OLV). DESIGN:A retrospective, observational, descriptive study was made of 100 patients with acute respiratory failure and bilateral pulmonary infiltrates. INTERVENTIONS:1) A lung recruitment maneuver (LR...

    journal_title:Medicina intensiva

    pub_type: 杂志文章

    doi:10.1016/j.medin.2011.10.011

    authors: Gil Cano A,Monge García MI,Gracia Romero M,Díaz Monrové JC

    更新日期:2012-06-01 00:00:00

  • Management of accidental hypothermia: A narrative review.

    abstract::A narrative review is presented on the diagnosis, treatment and management of accidental hypothermia. Although all these processes form a continuum, for descriptive purposes in this manuscript the recommendations are organized into the prehospital and in-hospital settings. At prehospital level, it is advised to: a) pe...

    journal_title:Medicina intensiva

    pub_type: 杂志文章,评审

    doi:10.1016/j.medin.2018.11.008

    authors: Avellanas Chavala ML,Ayala Gallardo M,Soteras Martínez Í,Subirats Bayego E

    更新日期:2019-12-01 00:00:00

  • [Results of an artificial airway management protocol in critical patients subjected to mechanical ventilation].

    abstract:OBJECTIVE:To determine the results of the implementation of a protocol in an intensive care unit (ICU) referred to critically ill patients requiring a prolonged artificial airway. DESIGN:A prospective, observational cohort study was carried out. INTERVENTION:Management strategies were established on the airway by end...

    journal_title:Medicina intensiva

    pub_type: 杂志文章

    doi:10.1016/j.medin.2012.07.003

    authors: Prieto-González M,López-Messa JB,Moradillo-González S,Franzón-Laz ZM,Ortega-Sáez M,Poncela-Blanco M,Alonso-Castañeira I,Andrés-de Llano J

    更新日期:2013-08-01 00:00:00

  • [Intermittent versus continuous renal replacement techniques: pro intermittent].

    abstract::After an introduction that summarizes the new definitions and risk classification of acute kidney injury, along with the consequences on its epidemiology, available evidence in the literature is reviewed in order to compare intermittent and continuous renal replacement therapy in terms of survival, renal function reco...

    journal_title:Medicina intensiva

    pub_type: 杂志文章,评审

    doi:10.1016/s0210-5691(09)70688-6

    authors: Barrio V

    更新日期:2009-03-01 00:00:00

  • Advances in immunosuppression after lung transplantation.

    abstract::Immunosuppression in transplantation has experienced changes in recent years as a result of the introduction of new drugs that act upon the different pathways of the host immune response with the purpose of securing more individualized immune suppression, with fewer side effects. Although following in the steps of oth...

    journal_title:Medicina intensiva

    pub_type: 杂志文章

    doi:10.1016/j.medin.2012.05.011

    authors: Borro JM

    更新日期:2013-01-01 00:00:00

  • Physician staffing needs in critical care departments.

    abstract::Departments of Critical Care Medicine are characterized by high medical assistance costs and great complexity. Published recommendations on determining the needs of medical staff in the DCCM are based on low levels of evidence and attribute excessive significance to the structural/welfare approach (physician-to-beds r...

    journal_title:Medicina intensiva

    pub_type: 杂志文章

    doi:10.1016/j.medin.2017.09.013

    authors: Gómez Tello V,Ruiz Moreno J,Weiss M,González Marín E,Merino de Cos P,Franco Garrobo N,Alonso Ovies A,Montejo González JC,Iber T,Marx G,Córcoles González V,Gordo Vidal F,Palencia Herrejón E,Roca Guiseris J,en nombre de la Soci

    更新日期:2018-01-01 00:00:00

  • Blood caspase-8 concentrations and mortality among septic patients.

    abstract:OBJECTIVE:No data are available on blood caspase-8 concentrations (the initiator caspase in the extrinsic apoptosis pathway) in septic patients. The present study thus describes the blood caspase-8 concentrations in survivors and non-survivors, and examines the possible association between blood caspase-8 concentration...

    journal_title:Medicina intensiva

    pub_type: 杂志文章

    doi:10.1016/j.medin.2020.06.016

    authors: Lorente L,Martín MM,Ortiz-López R,González-Rivero AF,Pérez-Cejas A,Martín M,Gonzalez V,Pérez A,Rodin M,Jiménez A

    更新日期:2020-08-22 00:00:00

  • [Prolonged mechanical ventilation probability model].

    abstract:OBJECTIVE:To design a probability model for prolonged mechanical ventilation (PMV) using variables obtained during the first 24 hours of the start of MV. DESIGN:An observational, prospective, multicenter cohort study. SCOPE:Thirteen Spanish medical-surgical intensive care units. PATIENTS:Adult patients requiring mec...

    journal_title:Medicina intensiva

    pub_type: 杂志文章,多中心研究

    doi:10.1016/j.medin.2012.01.003

    authors: Añón JM,Gómez-Tello V,González-Higueras E,Oñoro JJ,Córcoles V,Quintana M,López-Martínez J,Marina L,Choperena G,García-Fernández AM,Martín-Delgado C,Gordo F,Díaz-Alersi R,Montejo JC,Lorenzo AG,Pérez-Arriaga M,Madero R

    更新日期:2012-10-01 00:00:00

  • [Liver transplantation: influence of donor-related factors].

    abstract:OBJECTIVE:To detect donor characteristics related to graft function after orthotopic liver transplantation (OLT). DESIGN:Retrospective cohort study. CONTEXT:Polyvalent intensive care unit. PATIENTS:145 liver transplant recipients and their respective donors. INTERVENTIONS:None. MAIN VARIABLES OF INTEREST:In donors...

    journal_title:Medicina intensiva

    pub_type: 杂志文章

    doi:10.1016/s0210-5691(08)75708-5

    authors: Seller-Pérez G,Herrera-Gutiérrez ME,Lebrón-Gallardo M,Moreno-Quintana J,Banderas-Bravo E,Quesada-García G

    更新日期:2008-11-01 00:00:00

  • Weaning from mechanical ventilation: why are we still looking for alternative methods?

    abstract::Most patients who require mechanical ventilation for longer than 24 hours, and who improve the condition leading to the indication of ventilatory support, can be weaned after passing a first spontaneous breathing test. The challenge is to improve the weaning of patients who fail that first test. We have methods that c...

    journal_title:Medicina intensiva

    pub_type: 杂志文章,评审

    doi:10.1016/j.medin.2012.08.008

    authors: Frutos-Vivar F,Esteban A

    更新日期:2013-12-01 00:00:00

  • [Brain death diagnosis].

    abstract::Brain death has been recognized by the scientific community as the person's death, and accepted in the legislation of different countries. Brain death is defined as the irreversible ending of the functions of all the intracranial neurological structure in both the brain and brain stem. This clinical situation appears ...

    journal_title:Medicina intensiva

    pub_type: 杂志文章,评审

    doi:10.1016/s0210-5691(09)71215-x

    authors: Escudero D

    更新日期:2009-05-01 00:00:00

  • [Electrical impedance tomography in acute lung injury].

    abstract::Electrical impedance tomography has been described as a new method of monitoring critically ill patients on mechanical ventilation. It has recently gained special interest because of its applicability for monitoring ventilation and pulmonary perfusion. Its bedside and continuous implementation, and the fact that it is...

    journal_title:Medicina intensiva

    pub_type: 杂志文章,评审

    doi:10.1016/j.medin.2011.05.005

    authors: Riera J,Riu PJ,Casan P,Masclans JR

    更新日期:2011-11-01 00:00:00

  • Cranioplasty with bandaging. New forms of limitation of life support and organ donation.

    abstract::Most of transplanted organs are obtained from brain death (BD) donors. In neurocritical patients with catastrophic injuries and decompressive craniectomy (DC), which show a dreadful development in spite of this treatment, DC could be a futile tool to avoid natural progress to BD. We propose if cranial compressive band...

    journal_title:Medicina intensiva

    pub_type: 杂志文章

    doi:10.1016/j.medin.2012.12.008

    authors: Escudero D,Cofiño L,Gracia D,Palacios M,Casares M,Cabré L,Simón P,Miranda P,Martínez K,Iribarren S,Saralegui I,Simó RM,de León B,Español V

    更新日期:2013-04-01 00:00:00

  • Enhancing sepsis management through machine learning techniques: A review.

    abstract::Sepsis is a major public health problem and a leading cause of death in the world, where delay in the beginning of treatment, along with clinical guidelines non-adherence have been proved to be associated with higher mortality. Machine Learning is increasingly being adopted in developing innovative Clinical Decision S...

    journal_title:Medicina intensiva

    pub_type: 杂志文章,评审

    doi:10.1016/j.medin.2020.04.003

    authors: Ocampo-Quintero N,Vidal-Cortés P,Del Río Carbajo L,Fdez-Riverola F,Reboiro-Jato M,Glez-Peña D

    更新日期:2020-05-29 00:00:00

  • [ (REgistro de TRAuma grave de la provincia de TOledo): general view and mortality].

    abstract:OBJECTIVE:To analyze the management and progression of the critical trauma patient. DESIGN:A retrospective, descriptive analysis. SETTING:The ICU in the province of Toledo. PATIENTS:All patients with traumatic injury admitted during the 2001-2007 period (7 years). MAIN VARIABLES OF INTEREST:These include the variab...

    journal_title:Medicina intensiva

    pub_type: 杂志文章

    doi:10.1016/j.medin.2010.02.002

    authors: Marina-Martínez L,Sánchez-Casado M,Hortiguela-Martin V,Taberna-Izquierdo MA,Raigal-Caño A,Pedrosa-Guerrero A,Quintana-Díaz M,Rodríguez-Villar S

    更新日期:2010-08-01 00:00:00

  • [Latin American survey on delirium in critical patients].

    abstract:OBJECTIVES:This study has aimed to establish the intensivist physician's concepts and practices in this region regarding the diagnosis, management and prevention of delirium in intensive care units (ICU). DESIGN:A survey was distributed among the FEPIMCTI member societies for distribution among its medical members. R...

    journal_title:Medicina intensiva

    pub_type: 杂志文章

    doi:10.1016/j.medin.2010.04.003

    authors: Ceraso DH,Dueñas-Castel C,Raimondi N,Celis E,Carrillo R,Ugarte Ubiergo S,Rodriguez F

    更新日期:2010-11-01 00:00:00

  • Solid organ transplant training objectives for residents.

    abstract::With the aim of analyzing the current state of the educational objectives in the training of medical residents in solid organ transplantation (SOT), we conducted a review of the status of the official programs of the specialities involved in SOT, focusing particularly on lung transplantation. A survey of medical resid...

    journal_title:Medicina intensiva

    pub_type: 杂志文章

    doi:10.1016/j.medin.2012.03.012

    authors: Masclans JR,Vicente R,Ballesteros MA,Sabater J,Roca O,Rello J,Network PLUTO (Postoperative Lung Transplantantation).

    更新日期:2012-11-01 00:00:00

  • [Early non-invasive diagnosis of posttraumatic carotid-cavernous fistula diagnosed by transcranial color-coded duplex sonography: analysis of 4 patients].

    abstract::Posttraumatic carotid-cavernous fistula (PtCCF) is an uncommon complication after cranioencephalic trauma. It is usually diagnosed with a cerebral arteriography when the clinical symptoms have already appeared. The transcranial color-coded duplex sonography (TCDS) is a non-invasive technique at the patient's bedside t...

    journal_title:Medicina intensiva

    pub_type: 杂志文章

    doi:10.1016/s0210-5691(07)74769-1

    authors: Llompart-Pou JA,Abadal JM,Pérez-Bárcena J,Homar J,Rodríguez A,Ibáñez J

    更新日期:2007-01-01 00:00:00