Abstract:
OBJECTIVE:Nondepolarizing neuromuscular blocking agents are commonly used in the intensive care setting, but they have occasionally been associated with development of myopathy. In addition, diaphragmatic atrophy and a reduction in diaphragmatic force were reported after short-term controlled mechanical ventilation in animal models. We hypothesized that infusion of rocuronium, an aminosteroidal neuromuscular blocking agent, during 24 hrs of controlled mechanical ventilation would further alter diaphragm function and would enhance activation of the ubiquitin- proteasome pathway. DESIGN:Randomized, controlled experiment. SETTING:Basic animal science laboratory. SUBJECTS:Male Wistar rats, 14 wks old. INTERVENTIONS:Rats were divided into four groups: a control group, a group of anesthetized rats breathing spontaneously for 24 hrs, and two groups submitted to mechanical ventilation for 24 hrs, receiving a continuous infusion of either 0.9% NaCl or rocuronium. MEASUREMENTS AND MAIN RESULTS:In vitro diaphragm force was decreased more significantly after 24 hrs of mechanical ventilation combined with rocuronium infusion than after mechanical ventilation alone (e.g., tetanic force, -27%; p < .001 vs. mechanical ventilation). Similarly, the decrease in diaphragm type IIx/b fiber dimensions was more pronounced after mechanical ventilation with rocuronium treatment than with saline treatment (-38% and -29%, respectively; p < .001 vs. control). Diaphragm hydroperoxide levels increased similarly in both mechanically ventilated groups. Diaphragm muscle RING-finger protein-1 (MURF-1) messenger RNA expression, an E3 ligase of the ubiquitin-proteasome pathway, increased after mechanical ventilation (+212%, p < .001 vs. control) and increased further with combination of rocuronium (+320%, p < .001 vs. control). Significant correlations were found between expression of MURF-1 messenger RNA, diaphragm force, and type IIx/b fiber dimensions. CONCLUSIONS:Infusion of rocuronium during controlled mechanical ventilation leads to further deterioration of diaphragm function, additional atrophy of type IIx/b fibers, and an increase in MURF-1 messenger RNA in the diaphragm, which suggests an activation of the ubiquitin-proteasome pathway. These findings could be important with regard to weaning failure in patients receiving this drug for prolonged periods in the intensive care unit setting.
journal_name
Crit Care Medjournal_title
Critical care medicineauthors
Testelmans D,Maes K,Wouters P,Gosselin N,Deruisseau K,Powers S,Sciot R,Decramer M,Gayan-Ramirez Gdoi
10.1097/01.CCM.0000245783.28478.ADsubject
Has Abstractpub_date
2006-12-01 00:00:00pages
3018-23issue
12eissn
0090-3493issn
1530-0293journal_volume
34pub_type
杂志文章abstract:OBJECTIVES:Recently, the definition of sepsis has changed from a physiologic derangement (Sepsis-1 and -2) to organ dysfunction (Sepsis-3) based. We sought to determine the concordance between the different sepsis phenotypes and how that affected mortality. DESIGN:Retrospective, multicenter study. SETTING:Three acade...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/CCM.0000000000004449
更新日期:2020-09-01 00:00:00
abstract::The performance of three samples each of six brands of flow-directed pulmonary artery (PA) catheters was evaluated. In vivo studies determined the reproducibility of PA waveforms over a range of controlled heart rates when compared to those obtained from a transducer-tipped catheter. In vitro studies determined their ...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/00003246-198703000-00015
更新日期:1987-03-01 00:00:00
abstract:OBJECTIVE:To determine the cost savings of replacing intravenous midazolam with enterally administered lorazepam in mechanically ventilated children who require long-term continuous sedation. DESIGN:Retrospective review of patients treated according to a preestablished pediatric intensive care unit (ICU) sedation prot...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/00003246-199902000-00052
更新日期:1999-02-01 00:00:00
abstract:OBJECTIVE:The value of different algorithms that estimate cardiac output (CO) by analysis of a peripheral arterial blood pressure (ABP) waveform has not been definitively identified. In this investigation, we developed a testing data set containing a large number of radial ABP waveform segments and contemporaneous refe...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/CCM.0b013e3181930174
更新日期:2009-01-01 00:00:00
abstract:OBJECTIVE:To determine whether naloxone administration after hemorrhagic shock has any beneficial or deleterious effect on immune responses. BACKGROUND DATA:Hemorrhagic shock is known to produce immunodepression in both humans and experimental animals. Although studies suggest that endogenous opioids play a role in im...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/00003246-200001000-00030
更新日期:2000-01-01 00:00:00
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journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/00003246-198206000-00005
更新日期:1982-06-01 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:Increasing evidence, including publication of the Transfusion Requirements in Critical Care trial in 1999, supports a lower hemoglobin threshold for RBC transfusion in ICU patients. However, little is known regarding the influence of this evidence on clinical practice over time in a large population-based coh...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/CCM.0b013e31828e9a49
更新日期:2013-10-01 00:00:00
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journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/00003246-198405000-00008
更新日期:1984-05-01 00:00:00
abstract::Intravenous dobutamine was used in ten patients requiring aggressive therapy for massive pulmonary embolism with circulatory failure. Except in one patient who rapidly died, a 30-min dobutamine infusion (8.3 +/- 2.7 micrograms/kg . min) increased both cardiac index (from 1.7 +/- 0.4 to 2.3 +/- 0.6 L/min . m2, p less t...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/00003246-198512000-00004
更新日期:1985-12-01 00:00:00
abstract:OBJECTIVE:To derive a target range of optimal sedation for the COMFORT Scale and to prospectively test that target range against intensivist assessment of adequacy of sedation. DESIGN:Serial prospective agreement cohort studies. SETTING:Twelve-bed pediatric intensive care unit in an urban academic teaching hospital. ...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/00003246-199401000-00029
更新日期:1994-01-01 00:00:00
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journal_title:Critical care medicine
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doi:10.1097/00003246-200104000-00042
更新日期:2001-04-01 00:00:00
abstract:OBJECTIVES:To establish Department of Veterans Affairs' intensive care unit (ICU) costs from a database and to use this information to validate the Russell equation, the most commonly used method of calculating ICU costs. To compare and trend Department of Veterans Affairs' and nationwide (USA) ICU and healthcare costs...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:
更新日期:1994-12-01 00:00:00
abstract:OBJECTIVE:Myofibroblasts express alpha-smooth muscle actin (alphaSMA), are important in tissue repair, and are present in the early phase of acute lung injury/acute respiratory distress syndrome (ALI/ARDS). We wished to determine whether bronchoalveolar lavage fluid (BALF) from ALI/ARDS patients can induce myofibroblas...
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pub_type: 杂志文章
doi:10.1097/01.CCM.0000257254.87984.69
更新日期:2007-03-01 00:00:00
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journal_title:Critical care medicine
pub_type: 临床试验,杂志文章,随机对照试验
doi:
更新日期:1994-10-01 00:00:00
abstract:OBJECTIVE:The objective of this study was to test the ability of myoglobin removal of a novel, high-permeability polysulphone dialyzer in acute kidney injury as a result of rhabdomyolysis. SETTING:Intensive care unit of a tertiary care hospital. PATIENTS:Six patients (one female; aged 24, 36, 41, 55, 63, and 65 yrs) ...
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pub_type: 杂志文章
doi:10.1097/CCM.0b013e3181feb7f0
更新日期:2011-01-01 00:00:00
abstract::Traumatic injuries occur in > 20 million children each year and are the leading source of death in children over the age of 1 yr. Mechanisms of injury and subsequent therapies for critically injured children are diverse. This review will focus on resources and management strategies for caring for the severely injured ...
journal_title:Critical care medicine
pub_type: 杂志文章,评审
doi:10.1097/00003246-200211001-00013
更新日期:2002-11-01 00:00:00
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doi:10.1097/CCM.0000000000001655
更新日期:2016-08-01 00:00:00
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更新日期:2010-08-01 00:00:00
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pub_type: 临床试验,杂志文章,多中心研究,随机对照试验
doi:10.1097/00003246-199501000-00007
更新日期:1995-01-01 00:00:00
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pub_type: 杂志文章,meta分析
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更新日期:2012-05-01 00:00:00
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doi:10.1097/CCM.0000000000002314
更新日期:2017-06-01 00:00:00
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journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/00003246-200006000-00005
更新日期:2000-06-01 00:00:00
abstract::It has become accepted that nitric oxide serves important functions in biological systems as a second messenger. Another diatomic gaseous molecule, carbon monoxide (CO), is also rapidly gaining acceptance as a signaling agent. Some of the activities of CO are analogous to those of nitric oxide in the vascular system a...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:
更新日期:2001-01-01 00:00:00
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:
更新日期:1985-08-01 00:00:00
abstract::This report describes an unusual hemolytic transfusion reaction. A group O donor was inadvertently transfused with 100 ml of group A red cells during the course of plasmapheresis. Granulocytopenia, thrombocytopenia, hypofibrinogenemia and low levels of factors V, VIII, and IX developed immediately after the infusion. ...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/00003246-197501000-00003
更新日期:1975-01-01 00:00:00
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journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/CCM.0b013e318275cd75
更新日期:2013-04-01 00:00:00
abstract:OBJECTIVES:The role of nitric oxide in mediating the early phase of hypotension and cardiovascular hyporeactivity in sepsis, and the cellular sources of inducible nitric oxide synthase expression under in vivo conditions, remain unclear. The objective of this study was to elucidate the time course and cellular location...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/00003246-199703000-00022
更新日期:1997-03-01 00:00:00
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doi:10.1097/CCM.0000000000003070
更新日期:2018-06-01 00:00:00
abstract::The hemodynamic response to a dopamine HCl infusion (10 microgram/kg per min) was measured in 25 adult patients with severe sepsis: there were 6 patients with circulatory hyperdynamic states, 9 patients with myocardial failure, and 10 with hypovolemia. Each patient also had acute respiratory failure. Changes of intrap...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/00003246-197906000-00004
更新日期:1979-06-01 00:00:00