Oxygen saturation determined from deep muscle, not thenar tissue, is an early indicator of central hypovolemia in humans.

Abstract:

OBJECTIVE:To compare the responses of noninvasively measured tissue oxygen saturation (StO2) and calculated muscle oxygen tension (PmO2) to standard hemodynamic variables for early detection of imminent hemodynamic instability during progressive central hypovolemia in humans. DESIGN:Prospective study. SETTING:Research laboratory. SUBJECTS:Sixteen healthy human volunteers. INTERVENTIONS:Progressive lower body negative pressure (LBNP) to onset of cardiovascular collapse. MEASUREMENTS AND MAIN RESULTS:Noninvasive measurements of blood pressures, heart rate, and stroke volume were obtained during progressive LBNP with simultaneous assessments of StO2, PmO2, and muscle oxygen saturation (SmO2). Forearm SmO2 and PmO2 were determined with a novel near infrared spectroscopic measurement device (UMMS) and compared with thenar StO2 measured by a commercial device (HT). All values were normalized to the duration of LBNP exposure required for cardiovascular collapse in each subject (i.e., LBNP maximum). Stroke volume was significantly decreased at 25% of LBNP maximum, whereas blood pressure was a late indicator of imminent cardiovascular collapse. PmO2 (UMMS) was significantly decreased at 50% of maximum LBNP while SmO2 (UMMS) decreased at 75% of maximum LBNP. Thenar StO2 (HT) showed no statistical change throughout the entire LBNP protocol. CONCLUSIONS:Spectroscopic assessment of forearm muscle PO2 and SmO2 provides noninvasive and continuous measures that are early indicators of impending cardiovascular collapse resulting from progressive reductions in central blood volume.

journal_name

Crit Care Med

journal_title

Critical care medicine

authors

Soller BR,Ryan KL,Rickards CA,Cooke WH,Yang Y,Soyemi OO,Crookes BA,Heard SO,Convertino VA

doi

10.1097/01.CCM.0000295586.83787.7E

subject

Has Abstract

pub_date

2008-01-01 00:00:00

pages

176-82

issue

1

eissn

0090-3493

issn

1530-0293

journal_volume

36

pub_type

杂志文章
  • Relationship between neopterin and granulocyte elastase plasma levels and the severity of multiple organ failure.

    abstract::In a series of 56 patients (24 uncomplicated postoperative and 32 septic patients), neopterin and elastase alpha 1 protease inhibitor complex (E-alpha 1 PI) plasma levels were measured daily. The clinical course of each patient was evaluated with the Multiple Organ Failure (MOF) score according to Goris. Neopterin cou...

    journal_title:Critical care medicine

    pub_type: 杂志文章

    doi:10.1097/00003246-198903000-00004

    authors: Pacher R,Redl H,Frass M,Petzl DH,Schuster E,Woloszczuk W

    更新日期:1989-03-01 00:00:00

  • The impact of a neurointensivist-led team on a semiclosed neurosciences intensive care unit.

    abstract:OBJECTIVE:To evaluate the impact of a newly appointed neurointensivist on neurosciences intensive care unit (NICU) patient outcomes and quality of care variables. DESIGN:Observational cohort with historical controls. SETTING:Ten-bed neurointensive care unit in tertiary university hospital. PATIENTS:Mortality, length...

    journal_title:Critical care medicine

    pub_type: 杂志文章

    doi:10.1097/01.ccm.0000146131.03578.21

    authors: Varelas PN,Conti MM,Spanaki MV,Potts E,Bradford D,Sunstrom C,Fedder W,Hacein Bey L,Jaradeh S,Gennarelli TA

    更新日期:2004-11-01 00:00:00

  • Difficulties in predicting outcome in cardiac surgery patients.

    abstract:OBJECTIVE:To evaluate a novel combination of preoperative, intraoperative, and postoperative variables (including the Parsonnet, and the Acute Physiology and Chronic Health Evaluation II and III [APACHE II and III] scores) in cardiac surgery patients in order to predict hospital outcome, complications, and length of st...

    journal_title:Critical care medicine

    pub_type: 临床试验,杂志文章

    doi:10.1097/00003246-199511000-00010

    authors: Turner JS,Morgan CJ,Thakrar B,Pepper JR

    更新日期:1995-11-01 00:00:00

  • Indirect calorimetry in mechanically ventilated infants and children: measurement accuracy with absence of audible airleak.

    abstract:OBJECTIVE:To establish the effect of an audible airleak (around an endotracheal tube) on oxygen consumption (VO2) measurements in pediatric ICU patients. DESIGN:Prospective trial comparing VO2 measurements before and after deflation of the endotracheal tube cuff. SETTING:Pediatric ICU in a large pediatric tertiary ca...

    journal_title:Critical care medicine

    pub_type: 杂志文章

    doi:10.1097/00003246-199206000-00012

    authors: Chwals WJ,Lally KP,Woolley MM

    更新日期:1992-06-01 00:00:00

  • Potassium concentrations and ventricular ectopy: a prospective, observational study in post-cardiac surgery patients.

    abstract:OBJECTIVE:To determine whether a correlation exists between concentrations of intracellular and extracellular potassium and to determine the frequency of ventricular ectopy in patients after cardiac operations. DESIGN:Prospective, observational clinical evaluation. SETTING:Surgical-respiratory intensive care unit of ...

    journal_title:Critical care medicine

    pub_type: 杂志文章

    doi:10.1097/00003246-199911000-00018

    authors: Johnson RG,Shafique T,Sirois C,Weintraub RM,Comunale ME

    更新日期:1999-11-01 00:00:00

  • Mild hypothermia attenuates circulatory and pulmonary dysfunction during experimental endotoxemia.

    abstract:OBJECTIVE:We tested whether mild hypothermia impacts on circulatory and respiratory dysfunction during experimental endotoxemia. DESIGN:Randomized controlled prospective experimental study. SETTING:Large animal facility, Medical University of Graz, Austria. SUBJECTS:Thirteen anesthetized and mechanically ventilated ...

    journal_title:Critical care medicine

    pub_type: 杂志文章

    doi:10.1097/CCM.0b013e31829791da

    authors: Schwarzl M,Seiler S,Wallner M,von Lewinski D,Huber S,Maechler H,Steendijk P,Zelzer S,Truschnig-Wilders M,Obermayer-Pietsch B,Lueger A,Pieske BM,Post H

    更新日期:2013-12-01 00:00:00

  • Swan-Ganz catheterization in the critically ill newborn.

    abstract::The authors placed Swan-Ganz catheters in 11 preterm and 2 term infants with severe cardiopulmonary distress. The infants ranged in weight from 1100-4000 g. The procedure was performed in the neonatal ICU by jugular venous cutdown. Intracardiac pressures and oxygen saturations were measured in each chamber entered. Th...

    journal_title:Critical care medicine

    pub_type: 杂志文章

    doi:10.1097/00003246-197908000-00002

    authors: Todres ID,Crone RK,Rogers MC,Shannon DC

    更新日期:1979-08-01 00:00:00

  • Influence of aminosteroid and glucocorticoid treatment on inflammation and immune function during cardiopulmonary bypass.

    abstract:OBJECTIVE:During cardiopulmonary bypass, inflammation and immunosuppression is present. We measured circulating mediators and monocyte-based functions and tested the hypothesis that these variables are influenced by methylprednisolone (MP) or tirilazad mesylate (TM) treatment. DESIGN:Randomized, controlled, double-bli...

    journal_title:Critical care medicine

    pub_type: 临床试验,杂志文章,随机对照试验

    doi:10.1097/00003246-200111000-00015

    authors: Volk T,Schmutzler M,Engelhardt L,Döcke WD,Volk HD,Konertz W,Kox WJ

    更新日期:2001-11-01 00:00:00

  • Association of Driving Pressure With Mortality Among Ventilated Patients With Acute Respiratory Distress Syndrome: A Systematic Review and Meta-Analysis.

    abstract:OBJECTIVES:A recent post hoc analysis suggested that driving pressure may be more important than traditional ventilatory variables in determining outcome in mechanically ventilated patients with acute respiratory distress syndrome. We conducted a systematic review and meta-analysis to summarize the risk of mortality fo...

    journal_title:Critical care medicine

    pub_type: 杂志文章,meta分析

    doi:10.1097/CCM.0000000000002838

    authors: Aoyama H,Pettenuzzo T,Aoyama K,Pinto R,Englesakis M,Fan E

    更新日期:2018-02-01 00:00:00

  • Endocardial and transcutaneous cardiac pacing, calcium chloride, and epinephrine in postcountershock asystole and bradycardias.

    abstract::Clinically, asystole or a bradyarrhythmia may follow countershock of ventricular fibrillation (VF) in up to 40% of attempts. This study evaluated the effects of artificial cardiac pacing, calcium chloride (CaCl2), and epinephrine in postcountershock asystole/bradycardia. Micromanometer catheters were positioned in the...

    journal_title:Critical care medicine

    pub_type: 杂志文章

    doi:10.1097/00003246-198509000-00001

    authors: Niemann JT,Adomian GE,Garner D,Rosborough JP

    更新日期:1985-09-01 00:00:00

  • Levosimendan is superior to milrinone and dobutamine in selectively increasing microvascular gastric mucosal oxygenation in dogs.

    abstract:OBJECTIVE:The effect of levosimendan, a novel inotropic vasodilator (inodilator), on the microvascular gastric mucosal hemoglobin oxygenation (muHbo(2)) is unknown. A possible effect could thereby be selective for the splanchnic region or could primarily reflect changes in systemic oxygen transport (Do(2)) and/or oxyge...

    journal_title:Critical care medicine

    pub_type: 杂志文章

    doi:10.1097/01.ccm.0000150653.89451.6f

    authors: Schwarte LA,Picker O,Bornstein SR,Fournell A,Scheeren TW

    更新日期:2005-01-01 00:00:00

  • Use of bispectral electroencephalogram monitoring to assess neurologic status in unsedated, critically ill patients.

    abstract:OBJECTIVE:To test whether spectral indices derived from the electroencephalogram (EEG), and especially the bispectral index (BIS), can be used as measures of neurologic status in unsedated, critically ill patients. DESIGN:Prospective, observational study. SETTING:Medical intensive care unit (ICU) of a university-affi...

    journal_title:Critical care medicine

    pub_type: 杂志文章

    doi:10.1097/00003246-200110000-00024

    authors: Gilbert TT,Wagner MR,Halukurike V,Paz HL,Garland A

    更新日期:2001-10-01 00:00:00

  • Association of pulmonary artery catheter use with in-hospital mortality.

    abstract:OBJECTIVE:To determine the association of pulmonary artery catheter (PAC) use with in-hospital mortality. DESIGN:Prospective, observational study. SETTING:The medical intensive care units (MICU) of two teaching hospitals. METHODS:The study included 751 adults who were admitted to the MICU, excluding those who stayed...

    journal_title:Critical care medicine

    pub_type: 杂志文章

    doi:10.1097/00003246-200106000-00010

    authors: Afessa B,Spencer S,Khan W,LaGatta M,Bridges L,Freire AX

    更新日期:2001-06-01 00:00:00

  • Cocaine and the critical care challenge.

    abstract:OBJECTIVE:Cocaine, which first made its appearance >1,000 yrs ago, is now widely used throughout the world. The physiologic responses to cocaine may cause severe pathologic effects. This review highlights the many critical care challenges resulting from these effects. DESIGN:Historical vignettes, epidemiologic factors...

    journal_title:Critical care medicine

    pub_type: 杂志文章,评审

    doi:10.1097/01.CCM.0000063258.68159.71

    authors: Shanti CM,Lucas CE

    更新日期:2003-06-01 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

  • Noninvasive ventilation in patients with acute hypercapnic exacerbation of chronic obstructive pulmonary disease who refused endotracheal intubation.

    abstract:OBJECTIVE:To determine the long-term outcome of noninvasive ventilation in chronic obstructive pulmonary disease patients who refused intubation for acute hypercapnic respiratory failure. DESIGN:Prospective, observational study. SETTING:Noninvasive ventilation unit in an acute regional hospital in Hong Kong. METHODS...

    journal_title:Critical care medicine

    pub_type: 杂志文章

    doi:10.1097/01.CCM.0000108879.86838.4F

    authors: Chu CM,Chan VL,Wong IW,Leung WS,Lin AW,Cheung KF

    更新日期:2004-02-01 00:00:00

  • The influence of prehospital systemic corticosteroid use on development of acute respiratory distress syndrome and hospital outcomes.

    abstract:OBJECTIVE:The role of systemic corticosteroids in pathophysiology and treatment of acute respiratory distress syndrome is controversial. Use of prehospital systemic corticosteroid therapy may prevent the development of acute respiratory distress syndrome and improve hospital outcomes. DESIGN:This is a preplanned retro...

    journal_title:Critical care medicine

    pub_type: 杂志文章,多中心研究

    doi:10.1097/CCM.0b013e31828a1fc7

    authors: Karnatovskaia LV,Lee AS,Gajic O,Festic E,U.S. Critical Illness and Injury Trials Group: Lung Injury Prevention Study Investigators (USCIITG–LIPS).

    更新日期:2013-07-01 00:00:00

  • Heat stress increases survival rates in lipopolysaccharide-stimulated rats.

    abstract:OBJECTIVE:To examine the hypothesis that heat stress applied after the administration of bacterial endotoxin is protective. DESIGN:Prospective, randomized, laboratory study. SETTING:University research laboratory. SUBJECTS:One hundred eleven adult male Sprague-Dawley rats (weight range 250 to 400 g). INTERVENTIONS:...

    journal_title:Critical care medicine

    pub_type: 杂志文章

    doi:10.1097/00003246-199710000-00025

    authors: Chu EK,Ribeiro SP,Slutsky AS

    更新日期:1997-10-01 00:00:00

  • Consensus report for regionalization of services for critically ill or injured children. Council of the Society of Critical Care Medicine.

    abstract::The care of critically ill children has become more complex and demanding. This document establishes recommendations for developing regionalized integration of the care of these children into the emergency medical services system. These recommendations were developed by pediatricians with expertise in pediatric critic...

    journal_title:Critical care medicine

    pub_type: 共识发展会议,杂志文章,评审

    doi:10.1097/00003246-200001000-00040

    authors:

    更新日期:2000-01-01 00:00:00

  • Are autopsy findings still relevant to the management of critically ill patients in the modern era?

    abstract:OBJECTIVES:The purpose of this study was to determine the accuracy of clinical diagnoses compared to autopsy findings in critically ill patients in the current medical era. DESIGN:We conducted a retrospective, blinded review of matched medical records and postmortem findings in patients who died between June 2006 and ...

    journal_title:Critical care medicine

    pub_type: 杂志文章

    doi:10.1097/CCM.0b013e3182a275b1

    authors: Fröhlich S,Ryan O,Murphy N,McCauley N,Crotty T,Ryan D

    更新日期:2014-02-01 00:00:00

  • Citrate pharmacokinetics and metabolism in cirrhotic and noncirrhotic critically ill patients.

    abstract:OBJECTIVES:To investigate pharmacokinetics and metabolism of sodium citrate in critically ill patients. To determine the risk of citrate accumulation in the setting of liver dysfunction (cirrhosis, hepatorenal syndrome). DESIGN:Prospective cohort study. SETTING:Intensive Care Unit, Department of Medicine IV, Universi...

    journal_title:Critical care medicine

    pub_type: 杂志文章

    doi:10.1097/01.CCM.0000084871.76568.E6

    authors: Kramer L,Bauer E,Joukhadar C,Strobl W,Gendo A,Madl C,Gangl A

    更新日期:2003-10-01 00:00:00

  • How to use articles about diagnostic technology: gastric tonometry.

    abstract:PURPOSE:Periodic diagnostic tests and continuous and intermittent monitoring are integral to critical care medicine. The focus of this article is understanding the impact of existing diagnostic technology, as well as that of new diagnostic technology. DATA SYNTHESIS:We use literature about gastric tonometry to illustr...

    journal_title:Critical care medicine

    pub_type: 杂志文章,评审

    doi:10.1097/00003246-199909000-00005

    authors: Keenan SP,Guyatt GH,Sibbald WJ,Cook DJ,Heyland DK,Jaeschke RZ

    更新日期:1999-09-01 00:00:00

  • High-frequency jet ventilation in weaning the ventilator-dependent patient.

    abstract::Nine ventilator-dependent patients were successfully weaned from mechanical ventilatory support by high-frequency jet ventilation. All patients had been on ventilatory support for at least 2 wk, and had not responded to attempts at weaning by intermittent mandatory ventilation. ...

    journal_title:Critical care medicine

    pub_type: 杂志文章

    doi:10.1097/00003246-198409000-00021

    authors: Klain M,Kalla R,Sladen A,Guntupalli K

    更新日期:1984-09-01 00:00:00

  • Implementation of the Smart Use of Antibiotics Program to Reduce Unnecessary Antibiotic Use in a Neonatal ICU: A Prospective Interrupted Time-Series Study in a Developing Country.

    abstract:OBJECTIVES:We aimed to implement our Smart Use of Antibiotics Program to ensure the proper use of antimicrobials, improve patient care and outcomes, and reduce the risks of adverse effects and antimicrobial resistance. DESIGN:We compared the time periods before (baseline) and after (intervention) the implementation of...

    journal_title:Critical care medicine

    pub_type: 杂志文章

    doi:10.1097/CCM.0000000000003463

    authors: Lu C,Liu Q,Yuan H,Wang L

    更新日期:2019-01-01 00:00:00

  • Effects of norepinephrine on static and dynamic preload indicators in experimental hemorrhagic shock.

    abstract:OBJECTIVE:To investigate the effect of norepinephrine on static (right atrial pressure, pulmonary artery occlusion pressure ) and dynamic (pulse pressure variation and arterial systolic pressure variation) preload indicators in experimental hemorrhagic shock. DESIGN:Prospective controlled experimental study. SETTING:...

    journal_title:Critical care medicine

    pub_type: 杂志文章

    doi:10.1097/01.ccm.0000182801.48137.13

    authors: Nouira S,Elatrous S,Dimassi S,Besbes L,Boukef R,Mohamed B,Abroug F

    更新日期:2005-10-01 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

  • One-lung high-frequency ventilation in the management of traumatic tear of bronchus in a child.

    abstract::An 8-yr-old child suffered traumatic bilateral pneumothoraces and a ruptured right main bronchus. Surgical repair of the bronchus was postponed for 18 h after a definite diagnosis was established due to severe hypoxemia and hypercarbia. Only left endobronchial high-frequency ventilation with muscle relaxation correcte...

    journal_title:Critical care medicine

    pub_type: 杂志文章

    doi:10.1097/00003246-198712000-00019

    authors: Pizov R,Shir Y,Eimerl D,Uretzky G,Milgalter E,Cotev S

    更新日期:1987-12-01 00:00:00

  • Carbamoyl phosphate synthase-1: a marker of mitochondrial damage and depletion in the liver during sepsis.

    abstract:OBJECTIVE:Mitochondrial damage and dysfunction are thought to play an important role in the pathogenesis of sepsis-induced organ failures. Unfortunately, specific markers of mitochondrial damage in vital organs do not currently exist. Recently, carbomyl phosphate synthase (CPS)-1, a protein primarily localized to liver...

    journal_title:Critical care medicine

    pub_type: 杂志文章

    doi:10.1097/01.CCM.0000230240.02216.21

    authors: Crouser ED,Julian MW,Huff JE,Struck J,Cook CH

    更新日期:2006-09-01 00:00:00

  • Adrenal insufficiency during the late stage of polymicrobial sepsis.

    abstract:OBJECTIVES:Although studies have indicated that adrenal insufficiency occurs after severe trauma and hemorrhagic shock, it remains controversial whether adrenal function is depressed during the late stage of polymicrobial sepsis. DESIGN:Prospective, controlled animal study. SETTING:A university research laboratory. ...

    journal_title:Critical care medicine

    pub_type: 杂志文章

    doi:10.1097/00003246-200103000-00026

    authors: Koo DJ,Jackman D,Chaudry IH,Wang P

    更新日期:2001-03-01 00:00:00

  • Role of protein kinase C and phosphatases in the pulmonary vasculature of neonatal piglets.

    abstract:OBJECTIVE:Persistent pulmonary hypertension of the newborn is characterized by the presence of intense vasoconstriction and vascular remodeling. Protein tyrosine phosphorylation has been recognized as a critical regulatory element in signal transduction, because it is dynamically regulated by the opposing actions of pr...

    journal_title:Critical care medicine

    pub_type: 临床试验,杂志文章,随机对照试验

    doi:10.1097/00003246-200106000-00030

    authors: Berkenbosch JW,Baribeau J,Ferretti E,Perreault T

    更新日期:2001-06-01 00:00:00