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 250 and 350 g. INTERVENTIONS:Rats were transfused with trauma-sham shock (T/SS), or T/HS whole blood, or RBC-depleted blood (blood with the RBC removed and consisting of white blood cells and plasma). MEASUREMENTS AND MAIN RESULTS:Cardiac output and organ blood flow were measured by the radioactive microsphere technique. RBC tissue trapping, deformability, and RBC aggregation and adhesion were studied. Measurements of RBC adenosine triphosphate (ATP) and plasma fibrinogen were performed. Exchange transfusion with T/SS blood did not alter cardiac output or organ blood flow. However, cardiac output and blood flow in several organs were decreased when T/HS whole blood was used and RBCs were trapped in the organs that evidenced decreased blood flow. T/HS also increased RBC aggregation and adhesion, and decreased deformability. The ability of T/HS exchange transfusion to decrease microcirculatory blood flow did not appear to be due to plasma factors or non-RBC elements (i.e., white blood cell), because organ blood flow was not reduced after exchange transfusion with T/HS RBC-depleted blood. Likewise, neither decreased RBC ATP nor increased plasma fibrinogen explained the T/HS-induced changes that were observed. There was no change in fibrinogen levels during or after shock. Although there was a transient decrease in T/HS erythrocyte ATP levels during the early shock period, in contrast to RBC function, the ATP levels had returned to normal with resuscitation. CONCLUSIONS:T/HS induces significant changes in RBC functions and the injection of T/HS, but not T/SS, RBC leads to decreased organ blood flow. These findings confirm the hypothesis that T/HS-induced RBC alterations will directly cause organ hypoperfusion and suggest that T/HS-induced RBC damage contributes to this process. Thus, T/HS-induced changes in RBC function may contribute to the development of shock-induced multiple organ failure.

journal_name

Crit Care Med

journal_title

Critical care medicine

authors

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

doi

10.1097/CCM.0b013e3181962d39

subject

Has Abstract

pub_date

2009-03-01 00:00:00

pages

1000-10

issue

3

eissn

0090-3493

issn

1530-0293

pii

00003246-200903000-00030

journal_volume

37

pub_type

杂志文章
  • Heparin-binding protein: a diagnostic marker of acute bacterial meningitis.

    abstract:BACKGROUND:The early detection of bacterial meningitis is crucial for successful outcome. Heparin-binding protein, a potent inducer of increased vascular permeability, is released from activated neutrophils in severe sepsis. OBJECTIVE:In this study we investigated whether heparin-binding protein levels in cerebrospina...

    journal_title:Critical care medicine

    pub_type: 杂志文章

    doi:10.1097/CCM.0b013e318206c396

    authors: Linder A,Akesson P,Brink M,Studahl M,Björck L,Christensson B

    更新日期:2011-04-01 00:00:00

  • Exacerbation by granulocyte colony-stimulating factor of prior acute lung injury: implication of neutrophils.

    abstract:OBJECTIVE:Granulocyte colony-stimulating factor is widely prescribed to hasten recovery from cancer chemotherapy-induced neutropenia and has been reported to induce pulmonary toxicity. However, circumstances and mechanisms of this toxicity remain poorly known. DESIGN:To reproduce a routine situation in cancer patients...

    journal_title:Critical care medicine

    pub_type: 杂志文章

    doi:10.1097/00003246-200209000-00027

    authors: Azoulay E,Attalah H,Yang K,Jouault H,Schlemmer B,Brun-Buisson C,Brochard L,Harf A,Delclaux C

    更新日期:2002-09-01 00:00:00

  • Conflict Management Strategies in the ICU Differ Between Palliative Care Specialists and Intensivists.

    abstract:OBJECTIVES:Conflict is common between physicians and surrogate decision makers around end-of-life care in ICU. Involving experts in conflict management improve outcomes, but little is known about what differences in conflict management styles may explain the benefit. We used simulation to examine potential differences ...

    journal_title:Critical care medicine

    pub_type: 杂志文章

    doi:10.1097/CCM.0000000000001583

    authors: Chiarchiaro J,White DB,Ernecoff NC,Buddadhumaruk P,Schuster RA,Arnold RM

    更新日期:2016-05-01 00:00:00

  • The impact of adding 1 month of intensive care unit training in a categorical internal medicine residency program.

    abstract:OBJECTIVE:To determine the impact of adding a month of critical care training in the postgraduate year (PGY)-2 on the critical care skills of PGY-3 residents. DESIGN:Prospective, nonrandomized. SETTING:The internal medicine (IM) residency program of a tertiary care medical center. STUDY SUBJECTS:The study subjects i...

    journal_title:Critical care medicine

    pub_type: 杂志文章

    doi:10.1097/CCM.0b013e31819cc170

    authors: Mullon JJ,Gajic O,Gali B,Ficalora RD,Kolars JC,Afessa B

    更新日期:2009-04-01 00:00:00

  • Sepsis-related cardiogenic shock.

    abstract::To further define cardiovascular abnormalities in patients with septic shock, serial conventional hemodynamic measurements combined with two-dimensional echocardiographic studies were performed at the bedside in 21 patients admitted for an acute episode of sepsis-related circulatory failure. Measurements obtained duri...

    journal_title:Critical care medicine

    pub_type: 杂志文章

    doi:10.1097/00003246-199010000-00001

    authors: Jardin F,Brun-Ney D,Auvert B,Beauchet A,Bourdarias JP

    更新日期:1990-10-01 00:00:00

  • Evaluation of an emergency cricothyrotomy instrument.

    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

    authors: Bjoraker DG,Kumar NB,Brown AC

    更新日期:1987-02-01 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

  • Experience with percutaneous venoarterial cardiopulmonary bypass for emergency circulatory support.

    abstract:OBJECTIVE:Mechanical circulatory support can maintain vital organ perfusion in patients with cardiac failure unresponsive to standard pharmacologic treatment. The purpose of the current study was to report complication and survival rates in patients supported with emergency percutaneous venoarterial cardiopulmonary byp...

    journal_title:Critical care medicine

    pub_type: 杂志文章

    doi:10.1097/01.CCM.0000053522.55711.E3

    authors: Schwarz B,Mair P,Margreiter J,Pomaroli A,Hoermann C,Bonatti J,Lindner KH

    更新日期:2003-03-01 00:00:00

  • Long-term mortality and quality of life after prolonged mechanical ventilation.

    abstract:OBJECTIVE:To describe and identify factors associated with mortality rate and quality of life 1 yr after prolonged mechanical ventilation. DESIGN:Prospective, observational cohort study with patient recruitment over 26 months and follow-up for 1 yr. SETTING:Intensive care units at a tertiary care university hospital....

    journal_title:Critical care medicine

    pub_type: 杂志文章

    doi:10.1097/01.CCM.0000098029.65347.F9

    authors: Chelluri L,Im KA,Belle SH,Schulz R,Rotondi AJ,Donahoe MP,Sirio CA,Mendelsohn AB,Pinsky MR

    更新日期:2004-01-01 00:00:00

  • Mortality-adjusted duration of mechanical ventilation in critically ill children with symptomatic central venous line-related deep venous thrombosis.

    abstract:OBJECTIVE:To determine the association between symptomatic central venous line-related deep venous thrombosis and a mortality-adjusted measure of duration of mechanical ventilation in critically ill children with central venous lines. DESIGN:Retrospective matched cohort study. SETTING:Eleven pediatric intensive care ...

    journal_title:Critical care medicine

    pub_type: 杂志文章

    doi:10.1097/CCM.0b013e31820eb8a1

    authors: Faustino EV,Lawson KA,Northrup V,Higgerson RA

    更新日期:2011-05-01 00:00:00

  • Hemoptysis and pneumothorax after removal of a persistently wedged pulmonary artery catheter.

    abstract::Significant resistance was encountered when an attempt was made to withdraw a persistently wedged pulmonary artery catheter. A small amount of air was injected into the balloon lumen with great difficulty. This injection freed the catheter which was removed, but produced significant sudden hemoptysis and a pneumothora...

    journal_title:Critical care medicine

    pub_type: 杂志文章

    doi:10.1097/00003246-198106000-00013

    authors: Farber DL,Rose DM,Bassell GM,Eugene J

    更新日期:1981-06-01 00:00:00

  • Understanding the antecedents of the acceptance of donation after cardiac death by healthcare professionals.

    abstract:OBJECTIVE:A 3-yr study funded by the U.S. Department of Health and Human Services was conducted to identify potential barriers to and opportunities for increasing the number hospitals with donation after cardiac death (DCD) protocols, the support of DCD by individuals involved in the donation request process, and the n...

    journal_title:Critical care medicine

    pub_type: 杂志文章

    doi:10.1097/CCM.0b013e3181691b2b

    authors: D'Alessandro AM,Peltier JW,Phelps JE

    更新日期:2008-04-01 00:00:00

  • The effects of a fluctuating Fio2 on metabolic measurements in mechanically ventilated patients.

    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

    authors: Browning JA,Linberg SE,Turney SZ,Chodoff P

    更新日期:1982-02-01 00:00:00

  • Hypercortisolism in septic shock is not suppressible by dexamethasone infusion.

    abstract:OBJECTIVE:To explore the feedback regulation of glucocorticoids on corticotropin secretion in patients with septic and nonseptic circulatory shock. DESIGN:Prospective study. SETTING:An intensive care unit of a general hospital. PATIENTS:Two groups of patients with septic shock (n = 11) or nonseptic shock (n = 7). A ...

    journal_title:Critical care medicine

    pub_type: 杂志文章

    doi:10.1097/00003246-199303000-00018

    authors: Perrot D,Bonneton A,Dechaud H,Motin J,Pugeat M

    更新日期:1993-03-01 00:00:00

  • A direct relationship between ionized calcium and arterial pressure among patients in an intensive care unit.

    abstract::Serum ionized calcium (Ca+2), creatinine, magnesium, phosphate, and arterial pH were measured in patients on admission to the medical ICU (MICU). Patients were classified into three groups: a) hypotensive (n = 38), those who received vasopressor support for frank hypotension; b) hypertensive (n = 21), those who requir...

    journal_title:Critical care medicine

    pub_type: 杂志文章

    doi:10.1097/00003246-198806000-00002

    authors: Desai TK,Carlson RW,Thill-Baharozian M,Geheb MA

    更新日期:1988-06-01 00:00:00

  • Pediatric risk of mortality (PRISM) score.

    abstract::The Pediatric Risk of Mortality (PRISM) score was developed from the Physiologic Stability Index (PSI) to reduce the number of physiologic variables required for pediatric ICU (PICU) mortality risk assessment and to obtain an objective weighting of the remaining variables. Univariate and multivariate statistical techn...

    journal_title:Critical care medicine

    pub_type: 临床试验,杂志文章,多中心研究

    doi:10.1097/00003246-198811000-00006

    authors: Pollack MM,Ruttimann UE,Getson PR

    更新日期:1988-11-01 00:00:00

  • Dimethyl-prostaglandin E2 prevents stress ulceration with minimal complications.

    abstract::Gastric mucosal damage produced by topical application of necrotizing agents is diminished by topical or systemic pretreatment with a variety of E and F prostaglandins. The rat restraint model of gastric mucosal injury is more analogous to clinical stress ulceration than are models using intragastric application of to...

    journal_title:Critical care medicine

    pub_type: 杂志文章

    doi:10.1097/00003246-198901000-00011

    authors: Ephgrave KS,Horton J,Burns D

    更新日期:1989-01-01 00:00:00

  • Reliability of electrocardiogram interpretation in critically ill patients.

    abstract:OBJECTIVE:To assess the intrarater and interrater reliability of electrocardiogram (ECG) interpretation in critically ill patients and to assess the effect of knowledge of cardiac troponin values on these reliability estimates. DESIGN:Prospective cohort study. SETTING:Fifteen-bed medical-surgical intensive care unit....

    journal_title:Critical care medicine

    pub_type: 杂志文章

    doi:10.1097/01.CCM.0000214679.23957.90

    authors: Lim W,Qushmaq I,Cook DJ,Devereaux PJ,Heels-Ansdell D,Crowther MA,Tkaczyk A,Meade MO,Cook RJ

    更新日期:2006-05-01 00:00:00

  • Energy expenditure and withdrawal of sedation in severe head-injured patients.

    abstract:OBJECTIVES:To determine the outcome of oxygen consumption (VO2) and energy expenditure after cessation of sedation in severe head-injured patients and to assess its usefulness as a predictor of neurologic severity. DESIGN:Prospective, descriptive study. SETTING:Neurosurgical intensive care unit (ICU) in a university ...

    journal_title:Critical care medicine

    pub_type: 杂志文章

    doi:10.1097/00003246-199407000-00011

    authors: Bruder N,Lassegue D,Pelissier D,Graziani N,François G

    更新日期:1994-07-01 00:00:00

  • Noninvasive positive-pressure ventilation in acute respiratory failure outside clinical trials: experience at the Massachusetts General Hospital.

    abstract:BACKGROUND:Noninvasive positive-pressure ventilation (NPPV) has been shown to be effective in select patients enrolled in clinical trials. However, few data are available on the use of NPPV as routine standard medical care for patients with respiratory failure outside of controlled trials. MEASUREMENTS AND MAIN RESULT...

    journal_title:Critical care medicine

    pub_type: 杂志文章

    doi:10.1097/01.CCM.0000300084.67277.90

    authors: Schettino G,Altobelli N,Kacmarek RM

    更新日期:2008-02-01 00:00:00

  • Longitudinal assessment of Integra in primary burn management: a randomized pediatric clinical trial.

    abstract:BACKGROUND:Early excision with autograft-allograft closure is standard in severe burn management. Cadaver skin is associated with risks such as antigenicity, infection, and limited availability and shelf life. Previous studies have shown that Integra is safe to use in burns of <20% total body surface area. However, the...

    journal_title:Critical care medicine

    pub_type: 杂志文章,随机对照试验

    doi:10.1097/01.CCM.0000285991.36698.E2

    authors: Branski LK,Herndon DN,Pereira C,Mlcak RP,Celis MM,Lee JO,Sanford AP,Norbury WB,Zhang XJ,Jeschke MG

    更新日期:2007-11-01 00:00:00

  • Intrahospital transport of critically ill patients.

    abstract::Severe complications sometimes occur in critically ill patients during intrahospital transport. Possible causes may be inadequate ventilation, insufficient monitoring, interrupted application of vasoactive drugs, or disconnections and accidental extubation. We constructed a transport unit equipped with a respirator; c...

    journal_title:Critical care medicine

    pub_type: 杂志文章

    doi:10.1097/00003246-199012000-00024

    authors: Link J,Krause H,Wagner W,Papadopoulos G

    更新日期:1990-12-01 00:00:00

  • Ligands of the receptor for advanced glycation end products, including high-mobility group box 1, limit bacterial dissemination during Escherichia coli peritonitis.

    abstract:OBJECTIVE:The receptor for advanced glycation end products mediates a variety of inflammatory responses. Soluble receptor for advanced glycation end products has been suggested to function as a decoy abrogating cellular activation. High-mobility group box 1 is a high-affinity binding ligand for the receptor for advance...

    journal_title:Critical care medicine

    pub_type: 杂志文章

    doi:10.1097/CCM.0b013e3181de18bc

    authors: van Zoelen MA,Achouiti A,Schmidt AM,Yang H,Florquin S,Tracey KJ,van der Poll T

    更新日期:2010-06-01 00:00:00

  • Attenuation of hyperoxia-induced diaphragmatic dysfunction with lidocaine in hamsters.

    abstract:OBJECTIVE:Toxic free radicals cause dysfunction of respiratory muscles, probably leading to respiratory distress. Exposure to high concentrations of oxygen generates plenty of free radicals. Lidocaine scavenges the reactive molecules. The purposes of the current study were first to examine whether hyperoxia impairs dia...

    journal_title:Critical care medicine

    pub_type: 杂志文章

    doi:10.1097/00003246-200006000-00048

    authors: Nishina K,Mikawa K,Shiga M,Kodama S,Kagawa T,Maekawa N,Obara H

    更新日期:2000-06-01 00:00:00

  • Magnesium-adenosine triphosphate in the treatment of shock, ischemia, and sepsis.

    abstract:PURPOSE:To review the rationale for adenosine triphosphate-magnesium chloride (ATP-MgCl2) administration in shock, ischemia, and sepsis; the beneficial effects on cellular and organ functions and survival; and possible mechanisms of these effects. DATA SOURCES:Current literature review. STUDY SELECTION:Articles deeme...

    journal_title:Critical care medicine

    pub_type: 杂志文章,评审

    doi:10.1097/00003246-199202000-00015

    authors: Harkema JM,Chaudry IH

    更新日期:1992-02-01 00:00:00

  • Can healthcare providers obtain judicial intervention against surrogates who demand "medically inappropriate" life support for incompetent patients?

    abstract:OBJECTIVE:This article analyzes, from a legal perspective, a recent phenomenon involving a clash between the values of attending medical personnel and the instructions of surrogate decision-makers acting on behalf of incompetent patients. Some hospitals have gone to court to challenge decisions by surrogates to continu...

    journal_title:Critical care medicine

    pub_type: 杂志文章,评审

    doi:10.1097/00003246-199605000-00026

    authors: Cantor NL

    更新日期:1996-05-01 00:00:00

  • Comparison between selective and nonselective nitric oxide synthase inhibition and phenylephrine in normal and endotoxic swine.

    abstract:OBJECTIVE:To compare the cardiopulmonary and peripheral circulatory effects of the nonselective nitric oxide synthase (NOS) inhibitor NG-nitro-L-arginine methyl ester (L-NAME) to the more selective inducible NOS inhibitor S-methylisothiourea (SMT) and to phenylephrine (PE) in endotoxic and normal swine. DESIGN:Prospec...

    journal_title:Critical care medicine

    pub_type: 杂志文章

    doi:10.1097/00003246-200009000-00022

    authors: Cohen RI,Shapir Y,Davis A,Loona R,Scharf SM

    更新日期:2000-09-01 00:00:00

  • Assessing and improving safety climate in a large cohort of intensive care units.

    abstract:OBJECTIVES:To evaluate the impact of a comprehensive unit-based safety program on safety climate in a large cohort of intensive care units participating in the Keystone intensive care unit project. DESIGN/SETTING:A prospective cohort collaborative study to improve quality of care and safety culture by implementing and...

    journal_title:Critical care medicine

    pub_type: 杂志文章,多中心研究

    doi:10.1097/CCM.0b013e318206d26c

    authors: Sexton JB,Berenholtz SM,Goeschel CA,Watson SR,Holzmueller CG,Thompson DA,Hyzy RC,Marsteller JA,Schumacher K,Pronovost PJ

    更新日期:2011-05-01 00:00:00

  • Comparison of arterial and venous blood samples for the diagnosis of bacteremia in critically ill patients.

    abstract::We compared the blood culture results obtained either by venipuncture or through an arterial catheter in 51 critically ill patients with 217 clinically suspected episodes of bacteremia. During each episode, three blood culture samples, two arterial and one venous, were drawn within 1 h. One or more cultures were posit...

    journal_title:Critical care medicine

    pub_type: 杂志文章

    doi:

    authors: Väisänen IT,Michelsen T,Valtonen V,Mäkeläinen A

    更新日期:1985-08-01 00:00:00

  • Optimal release time during airway pressure release ventilation in neonatal sheep.

    abstract:OBJECTIVE:To systematically investigate the effect of altering release time during airway pressure release ventilation in a neonatal animal model before and after oleic acid-induced acute lung injury. DESIGN:Prospective, nonrandomized, controlled study with repeated measures. SETTING:University research laboratory. ...

    journal_title:Critical care medicine

    pub_type: 杂志文章

    doi:10.1097/00003246-199403000-00020

    authors: Martin LD,Wetzel RC

    更新日期:1994-03-01 00:00:00