Abstract:
OBJECTIVE:To assess hemodynamic, tissue oxygenation, and tissue perfusion changes by comparing traditional therapy (fluid resuscitation followed by vasopressor treatment) and alternative therapy (early vasopressor treatment) in a hyperkinetic and sedated model of endotoxic shock. DESIGN:Prospective controlled experimental study. SETTING:Animal research laboratory. SUBJECTS:Male Wistar rats. INTERVENTIONS:Rats were anesthetized, mechanically ventilated, paralyzed, and instrumented to measure mean arterial pressure, heart rate, pulse pressure variation, aortic and mesenteric blood flow, muscle and liver tissue oxygen pressure, blood gas, and lactate. Rats were randomly divided into five groups (n = 7): endotoxin alone (Endo), endotoxin plus norepinephrine (Endo/NE), endotoxin plus fluid therapy alone (ENDO/Fl), endotoxin plus fluid therapy plus late catecholamine (Endo/Fl/Late NE), and endotoxin plus fluid therapy plus simultaneous norepinephrine administration (Endo/Fl/Early NE). MEASUREMENTS AND MAIN RESULTS:Mean arterial pressure increased to baseline values only in the catecholamine-treated group (p < .05). In ENDO/Fl, Endo/Fl/Late NE, and Endo/Fl/Early NE, aortic blood flow was maintained. Mesenteric blood flow was maintained at baseline values only in the catecholamine-treated groups. Mesenteric/aortic blood flow ratio was higher in the early catecholamine group (p < .05). Endo and ENDO/Fl were associated with a marked decrease in liver PO2, which was maintained in catecholamine-treated groups (p < .01). Plasma lactate was lower in the Endo/Fl/Early NE group. Volume resuscitation was higher in Endo and Endo/Fl/Late NE groups with 28 +/- 6 and 27 +/- 4 mL, respectively, when compared with the Endo/Fl/Early NE group (19 +/- 3 mL) (p < .05). CONCLUSIONS:The use of norepinephrine was associated with improved mean arterial pressure, sustained aortic and mesenteric blood flow, and better tissue oxygenation when compared with fluid resuscitation alone, irrespective of time of administration. The early use of norepinephrine plus volume expansion was associated with a higher proportion of blood flow redistributed to the mesenteric area, lower lactate levels, and less infused volume. Thus, the early use of norepinephrine is safe and may decrease the need for volume resuscitation.
journal_name
Crit Care Medjournal_title
Critical care medicineauthors
Sennoun N,Montemont C,Gibot S,Lacolley P,Levy Bdoi
10.1097/01.CCM.0000269028.28521.08subject
Has Abstractpub_date
2007-07-01 00:00:00pages
1736-40issue
7eissn
0090-3493issn
1530-0293journal_volume
35pub_type
杂志文章abstract::Mucus plugging of a large airway resulted in the formation of a check-valve mechanism and pulmonary hyperinflation, rather than atelectasis. Fiberoptic bronchoscopy was both diagnostic and curative. The physician should be aware that mucus plugging may have unusual presentations and may mimic other clinical entities. ...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/00003246-198609000-00015
更新日期:1986-09-01 00:00:00
abstract:OBJECTIVES:Existing handheld glucose meters are glucose oxidase (GO)-based. Oxygen side reactions can introduce oxygen dependency, increase potential error, and limit clinical use. Our primary objectives were to: a) introduce a new glucose dehydrogenase (GD)-based electrochemical biosensor for point-of-care testing; b)...
journal_title:Critical care medicine
pub_type: 杂志文章,多中心研究
doi:10.1097/00003246-199803000-00036
更新日期:1998-03-01 00:00:00
abstract:OBJECTIVE:Acute aneurysmal subarachnoid hemorrhage (SAH) is a complex multifaceted disorder that plays out over days to weeks. Many patients with SAH are seriously ill and require a prolonged intensive care unit stay. Cardiopulmonary complications are common. The management of patients with SAH focuses on the anticipat...
journal_title:Critical care medicine
pub_type: 杂志文章,评审
doi:10.1097/CCM.0b013e318195865a
更新日期:2009-02-01 00:00:00
abstract:OBJECTIVE:Procalcitonin has been advocated as a specific biomarker for bacterial infection. We performed this study to determine whether accuracy of procalcitonin for diagnosis of postoperative bacterial infection is affected by renal function after aortic surgery. DESIGN:Single-center prospective study. SETTING:Univ...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/CCM.0b013e3181692966
更新日期:2008-04-01 00:00:00
abstract:OBJECTIVES:To assess the variability in short-term sepsis mortality by hospital among Centers for Medicare and Medicaid Services beneficiaries in the United States during 2013-2014. DESIGN:A retrospective cohort design. SETTING:Hospitalizations from 3,068 acute care hospitals that participated in the Centers for Medi...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/CCM.0000000000003324
更新日期:2018-11-01 00:00:00
abstract:OBJECTIVE:To evaluate the safety of human albumin administered for therapeutic purposes. DESIGN:Retrospective compilation of spontaneously reported serious adverse events. SETTING:Records of serious adverse event reports received from 1990 through 1997 by nine major suppliers of therapeutic human albumin worldwide. ...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/00003246-200105000-00021
更新日期:2001-05-01 00:00:00
abstract:OBJECTIVES:Although pentoxifylline produces various beneficial effects following adverse circulatory conditions, it is not known whether this agent has any effects on gut lipid metabolism after trauma-hemorrhage and resuscitation. The aim of this study, therefore, was to determine whether or not administration of pento...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/00003246-199801000-00023
更新日期:1998-01-01 00:00:00
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
更新日期:1990-12-01 00:00:00
abstract:OBJECTIVES:Carbon monoxide poisoning affects 50,000 per year in the United States alone. Mortality is approximately 3%, and up to 40% of survivors suffer from permanent neurocognitive and affective deficits. Hyperbaric oxygen therapy has shown benefit on reducing the long-term neurologic sequelae of carbon monoxide poi...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/CCM.0000000000003135
更新日期:2018-07-01 00:00:00
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
更新日期:2014-04-01 00:00:00
abstract:OBJECTIVE:To determine the ability of somatosensory evoked potentials (SEP) compared with clinical findings to monitor and predict recovery in patients suffering from closed head injury with predominantly diffuse axonal injury (DAI). DESIGN:Prospective cohort study. SETTING:Neurologic intensive care unit (ICU) of a u...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/00003246-200103000-00005
更新日期:2001-03-01 00:00:00
abstract:OBJECTIVES:There has long-been controversy about the possible superiority of norepinephrine compared to dopamine in the treatment of shock. The objective was to evaluate the effects of norepinephrine and dopamine on outcome and adverse events in patients with septic shock. DATA SOURCES:A systematic search of the MEDLI...
journal_title:Critical care medicine
pub_type: 杂志文章,meta分析
doi:10.1097/CCM.0b013e31823778ee
更新日期:2012-03-01 00:00:00
abstract:OBJECTIVES:Survivors of critical illness in early life are at risk of long-term-memory and attention impairments. However, their neurobiologic substrates remain largely unknown. DESIGN:A prospective follow-up study. SETTING:Erasmus MC-Sophia Children's Hospital, Rotterdam, the Netherlands. PATIENTS:Thirty-eight scho...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/CCM.0000000000002553
更新日期:2017-10-01 00:00:00
abstract:OBJECTIVES:The American College of Critical Care Medicine provided 2002 and 2007 guidelines for hemodynamic support of newborn and pediatric septic shock. Provide the 2014 update of the 2007 American College of Critical Care Medicine "Clinical Guidelines for Hemodynamic Support of Neonates and Children with Septic Shoc...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/CCM.0000000000002425
更新日期:2017-06-01 00:00:00
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
更新日期:2018-02-01 00:00:00
abstract:OBJECTIVE:The Cardiac Arrhythmia Suppression Trial II showed that moricizine acutely increases the occurrence of sudden cardiac death. Thus the objective of this investigation was to evaluate the antifibrillatory properties of moricizine (a new antiarrhythmic agent) alone and in combination with lidocaine (an establish...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/00003246-199310000-00029
更新日期:1993-10-01 00:00:00
abstract:OBJECTIVE:To examine the accuracy of brain multimodal monitoring-consisting of intracranial pressure, brain tissue PO2, and cerebral microdialysis--in detecting cerebral hypoperfusion in patients with severe traumatic brain injury. DESIGN:Prospective single-center study. PATIENTS:Patients with severe traumatic brain ...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/CCM.0000000000000720
更新日期:2015-02-01 00:00:00
abstract::The hospital records of 7 patients with severe bronchopulmonary dysplasia (BPD) were reviewed. All patients were ventilator dependent for prolonged periods (mean duration intermittent mandatory ventilation (IMV) 14.3 +/- 3.5 months) but eventually were successfully weaned from mechanical ventilation and sent home. The...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/00003246-198112000-00001
更新日期:1981-12-01 00:00:00
abstract::Sequential assessment of renal function in 50 critically ill postoperative patients was done by simultaneous determinants of osmolar, free water, creatinine and sodium clearances, and fractional excretion of sodium. The traumatic and nontraumatic critically ill surgical patients had a characteristic pattern of creatin...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/00003246-198002000-00004
更新日期:1980-02-01 00:00:00
abstract:OBJECTIVE:To describe the long-term health-related quality of life (HRQL) of survivors of sepsis and to evaluate the reliability and validity of the medical outcomes study Short Form-36 (SF-36) in this population. STUDY DESIGN:Cross-sectional survey. SETTING:University intensive care unit. PATIENTS:Surviving patient...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/00003246-200011000-00006
更新日期:2000-11-01 00:00:00
abstract:OBJECTIVES:To examine perceptions of nurses and physicians in regard to ethical decision-making climate in the ICU and to test the hypothesis that the worse the ethical decision-making climate, the greater the discordance between nurses' and physicians' rating of ethical decision-making climate with physicians hypothes...
journal_title:Critical care medicine
pub_type: 杂志文章,多中心研究
doi:10.1097/CCM.0000000000004017
更新日期:2019-12-01 00:00:00
abstract:OBJECTIVE:Fibrotic changes are initiated early in acute respiratory distress syndrome. This may involve overproliferation of alveolar type II cells. In an animal model of acute respiratory distress syndrome, we have shown that the administration of an adenoviral vector overexpressing the 70-kd heat shock protein (AdHSP...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/01.CCM.0000295473.56522.EF
更新日期:2008-01-01 00:00:00
abstract:OBJECTIVE:Limited data are available on the influence of sedation for critical care therapy with the widely used anesthetic propofol on recovery from acute traumatic brain injury. To establish the influence of propofol on endogenous neurogenesis and functional recovery after traumatic brain injury, rats were sedated wi...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/CCM.0b013e3182a639fd
更新日期:2014-01-01 00:00:00
abstract:OBJECTIVE:The aim of this study was to quantify the effect of hypertonic saline solution on contused and noncontused brain tissue in patients with traumatic brain injury. We hypothesize that hypertonic saline would increase the volume of brain contusion while decreasing the volume of noncontused hemispheric areas. DES...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/01.CCM.0000243797.42346.64
更新日期:2006-12-01 00:00:00
abstract:OBJECTIVES:There is substantial variation in use of life sustaining technologies in patients near the end of life but little is known about variation in physicians' initial ICU admission and intubation decision making processes. Our objective is to describe variation in hospital-based physicians' communication behavior...
journal_title:Critical care medicine
pub_type: 杂志文章,多中心研究
doi:10.1097/CCM.0b013e318287f0dd
更新日期:2013-06-01 00:00:00
abstract:OBJECTIVE:Information booklets have not been assessed by the families of intensive care unit (ICU) patients. This study explored the information that the relatives of adult ICU patients wanted to find in the information booklets. DESIGN:Multicenter survey. SETTING:Twenty-three French ICUs. SUBJECTS:One close relativ...
journal_title:Critical care medicine
pub_type: 杂志文章,多中心研究
doi:10.1097/CCM.0b013e3181a03063
更新日期:2009-07-01 00:00:00
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
更新日期:2014-02-01 00:00:00
abstract::Comparative hemodynamic measurements recorded in 19 cases of septic shock associated with Neisseria meningitidis bacteremia and in 20 shock cases associated with bacteremia due to other Gram-negative bacilli showed a significantly higher incidence of early myocardial depression in the cases with meningococcal infectio...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/00003246-198412000-00003
更新日期:1984-12-01 00:00:00
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
更新日期:2014-02-01 00:00:00
abstract:OBJECTIVE:To examine the isolated and combined effects of positive end-expiratory pressure (PEEP) and partial liquid ventilation (PLV) on the development of ventilator-induced lung injury in an ovine model. DESIGN:Prospective controlled animal study. SETTING:University-based cardiovascular animal physiology laborator...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/00003246-200201000-00026
更新日期:2002-01-01 00:00:00