Abstract:
OBJECTIVE:Inflammation and immobility are comorbid etiological factors inducing muscle weakness in critically ill patients. This study establishes a rat model to examine the effect of inflammation and immobilization alone and in combination on muscle contraction, histology, and acetylcholine receptor regulation. DESIGN:Prospective, randomized, experimental study. SETTING:Animal laboratory of a university hospital. SUBJECTS:Sprague-Dawley rats. INTERVENTIONS:To produce systemic inflammation, rats (n = 34) received three consecutive intravenous injections of Corynebacterium parvum on days 0, 4, and 8. Control rats (n = 21) received saline. Both groups were further divided to have one hind limb either immobilized by pinning of knee and ankle joints or sham-immobilized (surgical leg). The contralateral nonsurgical leg of each animal served as control (nonsurgical leg). MEASUREMENTS AND MAIN RESULTS:After 12 days, body weight and muscle mass were significantly reduced in all C. parvum animals compared with saline-injected rats. Immobilization led to local muscle atrophy. Normalized to muscle mass, tetanic contraction was reduced in the surgical leg after immobilization (7.64 +/- 1.91 N/g) and after inflammation (8.71 +/- 2.0 N/g; both p < .05 vs. sham immobilization and saline injection, 11.03 +/- 2.26 N/g). Histology showed an increase in inflammatory cells in all C. parvum-injected animals. Immobilization in combination with C. parvum injection had an additive effect on inflammation. Acetylcholine receptors were increased in immobilized muscles and in all muscles of C. parvum-injected animals. CONCLUSIONS:The muscle weakness in critically ill patients can be replicated in our novel rat model. Inflammation and immobilization independently lead to muscle weakness.
journal_name
Crit Care Medjournal_title
Critical care medicineauthors
Fink H,Helming M,Unterbuchner C,Lenz A,Neff F,Martyn JA,Blobner Mdoi
10.1097/CCM.0B013E3181659669subject
Has Abstractpub_date
2008-03-01 00:00:00pages
910-6issue
3eissn
0090-3493issn
1530-0293pii
00003246-200803000-00035journal_volume
36pub_type
杂志文章abstract:OBJECTIVE:To evaluate the comparative efficacy of enteral cisapride, metoclopramide, erythromycin, and placebo for promoting gastric emptying in critically ill patients with intolerance to gastric enteral nutrition (EN). DESIGN:A randomized, crossover study. SETTING:Adult medical intensive care unit at a university-a...
journal_title:Critical care medicine
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1097/00003246-200002000-00025
更新日期:2000-02-01 00:00:00
abstract::Ventricular fibrillation (VF) can masquerade as asystole. We report a 54-yr-old male in cardiac arrest who, on surface ECG, appeared to be in VF or asystole. A bedside intracardiac recording using a transmyocardial pacing wire showed the true rhythm to be atrial fibrillation (AF) with high grade atrioventricular block...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/00003246-198704000-00013
更新日期:1987-04-01 00:00:00
abstract:OBJECTIVES:To determine the proportion of patients with documented bacterial aspiration pneumonia among comatose ICU patients with symptoms suggesting either bacterial aspiration pneumonia or non-bacterial aspiration pneumonitis. DESIGN:Prospective observational study. SETTING:University-affiliated 30-bed ICU. PATIE...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/CCM.0000000000002525
更新日期:2017-08-01 00:00:00
abstract:OBJECTIVE:To define the epidemiology of broad-spectrum cephalosporin-resistant gram-negative bacilli in intensive care units (ICUs) during a nonoutbreak period, including the prevalence, the risk factors for colonization, the frequency of acquisition, and the rate of infection. DESIGN:Prospective cohort study. SETTIN...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/00003246-199906000-00026
更新日期:1999-06-01 00:00:00
abstract:OBJECTIVES:Randomized trials have suggested that hypertonic saline solutions may be superior to mannitol for the treatment of elevated intracranial pressure, but their impact on clinical practice has been limited, partly by their small size. We therefore combined their findings in a meta-analysis. DATA SOURCES:We sear...
journal_title:Critical care medicine
pub_type: 杂志文章,meta分析
doi:10.1097/CCM.0b013e318206b9be
更新日期:2011-03-01 00:00:00
abstract:OBJECTIVE:To compare three devices that measure core body temperature at the bedside in ICU patients. DESIGN:Prospective, consecutive sample. SETTING:Voluntary community teaching hospital. PATIENTS:Fifteen patients, 78 +/- 6 (SD) yrs of age, admitted to the medical ICU over a 5-month period who had pulmonary artery ...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/00003246-199106000-00015
更新日期:1991-06-01 00:00:00
abstract:OBJECTIVE:Develop a scoring system that can assess the management of septic shock by individuals and teams. DESIGN:Retrospective review of videotapes of critical care house staff managing a standardized simulation of septic shock. SETTING:Academic medical center; videotapes were made in a recreated intensive care uni...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/01.CCM.0000256849.75799.20
更新日期:2007-03-01 00:00:00
abstract::Because of the neonate's susceptibility to pulmonary hypertension (PHN) and his inefficiency in invoking the compensatory mechanisms often used by adults to maintain stable levels of O2 consumption (VO2) in the face of changes in O2 delivery (DO2) and metabolic demand, we have attempted to define the O2 handling capab...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/00003246-198808000-00008
更新日期:1988-08-01 00:00:00
abstract:OBJECTIVE:To investigate the interrelationship between cardiac surgery, age, circulating concentrations of the vitamin D hormone 1,25-dihydroxyvitamin D, and clinical outcome. DESIGN:Prospective, monocentric, two-arm parallel study. SETTING:Tertiary Heart and Diabetes Center in the Federal State of North Rhine-Westph...
journal_title:Critical care medicine
pub_type: 临床试验,杂志文章
doi:10.1097/CCM.0b013e31824e8c42
更新日期:2012-07-01 00:00:00
abstract::Critical Care Medicine encompasses an extremely broad scope. Examination questions were, therefore, chosen to cover a wide variety of critical care topics. A near Gaussian distribution of scores was found for all physician groups studied. We believe the low mean score of 15% reflects the general difficulty of the exam...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/00003246-198305000-00014
更新日期:1983-05-01 00:00:00
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
更新日期:1981-06-01 00:00:00
abstract:OBJECTIVE:To determine whether the supplementation of parenteral nutrition with ω-3 fatty acids confers treatment benefits to critically ill adult patients. DATA SOURCE:We performed computerized searches for relevant articles from 1996 to June 2011 on MEDLINE, EMBASE, and the Cochrane register of controlled trials and...
journal_title:Critical care medicine
pub_type: 杂志文章,meta分析,评审
doi:10.1097/CCM.0b013e3182657578
更新日期:2013-01-01 00:00:00
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
更新日期:2011-05-01 00:00:00
abstract::Accurate assessment and rapid decision-making are essential to save lives and improve performance in critical care medicine. Real-time point-of-care ultrasound has become an invaluable adjunct to the clinical evaluation of critically ill and injured patients both for pre- and in-hospital situations. However, a high le...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/01.CCM.0000260680.16213.26
更新日期:2007-05-01 00:00:00
abstract:OBJECTIVE:The association between cigarette smoke exposure and the acute respiratory distress syndrome in patients with the most common acute respiratory distress syndrome risk factors of sepsis, pneumonia, and aspiration has not been well studied. The goal of this study was to test the association between biomarker-co...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/CCM.0000000000001089
更新日期:2015-09-01 00:00:00
abstract:OBJECTIVES:To determine the reliability of volitional and nonvolitional limb muscle strength assessment in critically ill patients and to provide guidelines for the implementation of limb muscle strength assessment this population. DATA SOURCES:The following computerized bibliographic databases were searched with MeSH...
journal_title:Critical care medicine
pub_type: 杂志文章,meta分析,评审
doi:10.1097/CCM.0000000000000030
更新日期:2014-03-01 00:00:00
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
更新日期:2003-03-01 00:00:00
abstract:OBJECTIVE:Acute renal tubular injury is a serious complication in the postoperative period, which is associated with high mortality and increased ICU stay. We aimed to demonstrate the protective effect of rhEPO against acute tubular injury induced by ischemia-reperfusion and to explore the mechanism of canonical transi...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/CCM.0000000000000542
更新日期:2014-10-01 00:00:00
abstract:OBJECTIVE:Acute respiratory distress syndrome is an abrupt inflammatory illness that involves damage from reactive oxygen species. We examined the efficacy and safety of oxothiazolidine-4-carboxylic acid (OTZ), a free radical scavenger, in treating acute respiratory distress syndrome. DESIGN:Double-blind, placebo-cont...
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.0B013E318164E7E4
更新日期:2008-03-01 00:00:00
abstract:BACKGROUND:Endotoxin (lipopolysaccharide [LPS]) has been associated with sepsis and the high mortality rate seen in septic shock. The administration of a small amount of LPS to healthy subjects produces a mild syndrome qualitatively similar to that seen in clinical sepsis. We used this model to test the efficacy of an ...
journal_title:Critical care medicine
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1097/00003246-200008000-00005
更新日期:2000-08-01 00:00:00
abstract:OBJECTIVES:To evaluate the frequency of unsuspected posterior vessel wall penetration of the internal jugular vein during ultrasound-guided needle cannulation. DESIGN:Prospective, single-blinded observational study. SETTING:Urban level I emergency department with an annual census of 80,000. PATIENTS:Residents who ha...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/CCM.0b013e3181a067d4
更新日期:2009-08-01 00:00:00
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
abstract:BACKGROUND AND METHODS:This study was designed to explore the effect of mild cerebral and systemic hypothermia (34 degrees C) on outcome after prolonged cardiac arrest in dogs. After ventricular fibrillation with no flow of 10 min, and standard external CPR with epinephrine (low flow) from ventricular fibrillation time...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/00003246-199103000-00017
更新日期:1991-03-01 00:00:00
abstract:OBJECTIVE:To determine the frequency and effects of weaning-related myocardial ischemia on weaning outcomes in patients with coronary artery disease. DESIGN:Prospective cohort study. SETTING:Medical and cardiac intensive care units of a 300-bed teaching community hospital. MEASUREMENTS AND MAIN RESULTS:Three-lead ST...
journal_title:Critical care medicine
pub_type: 临床试验,杂志文章
doi:10.1097/00003246-199910000-00005
更新日期:1999-10-01 00:00:00
abstract:OBJECTIVE:The benefit of continuous on-site presence by a staff academic critical care specialist in the intensive care unit of a teaching hospital is not known. We compared the quality of care and patient/family and provider satisfaction before and after changing the staffing model from on-demand to continuous 24-hr c...
journal_title:Critical care medicine
pub_type: 临床试验,杂志文章
doi:10.1097/01.CCM.0000297887.84347.85
更新日期:2008-01-01 00:00:00
abstract:OBJECTIVES:a) To determine whether pentoxifylline has a preventive effect on the decrease in PaO2 that is caused by oleic acid, and whether pentoxifylline facilitates normalization of PaO2 from the decreased state. b) To examine whether pentoxifylline can attenuate an increase in pulmonary vascular permeability that is...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/00003246-199502000-00023
更新日期:1995-02-01 00:00:00
abstract:OBJECTIVE:To provide a meta-analysis of current literature concerning the validation of thoracic impedance cardiography (TIC) and to explain the variations in the reported results from the differences in the studies. DATA SOURCES:A computer-assisted search of English-language, German, and Dutch literature was performe...
journal_title:Critical care medicine
pub_type: 杂志文章,meta分析
doi:10.1097/00003246-199906000-00053
更新日期:1999-06-01 00:00:00
abstract:OBJECTIVES:To examine the effect of extracorporeal membrane oxygenation (ECMO) therapy on platelet function and number and to determine the in vivo survival of transfused platelets during ECMO. DESIGN:Prospective study of all neonates treated with ECMO during a 6-month period. SETTING:Neonatal intensive care unit in ...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/00003246-199307000-00018
更新日期:1993-07-01 00:00:00
abstract:OBJECTIVE:To compare the outcomes and the short- and long-term complications of percutaneous translaryngeal tracheostomy (TLT) and surgical tracheostomy (ST). DESIGN:Prospective, randomized clinical trial with 1-yr double-blind follow-up. SETTING:A general intensive care unit of a university hospital. PATIENTS:A tot...
journal_title:Critical care medicine
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1097/01.ccm.0000163401.77581.86
更新日期:2005-05-01 00:00:00
abstract::To achieve synchronized differential pulmonary ventilation, an Ohio 560 ventilator was modified through separation of the outputs of the deep breath bellows and the tidal volume bellows and providing independent volume, flow rate, PEEP, oxygen-humidification, and alarm systems. The described ventilator modification is...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/00003246-198106000-00012
更新日期:1981-06-01 00:00:00