Detrimental hemodynamic effects of assisted ventilation in hemorrhagic states.

Abstract:

OBJECTIVE:Our goal was to demonstrate explicitly that lower-frequency positive-pressure ventilation not only preserves adequate oxygenation and acid-base status in hemorrhagic states, but also that "normal" or higher respiratory rates significantly compromise hemodynamics, even with moderate degrees of hemorrhage. DESIGN AND SUBJECTS:Eight intubated pigs (ventilated with 12 mL/kg tidal volume, 28% FIO2, respiratory rate = 12 breaths/min) were hemorrhaged to <65 mm Hg of systolic blood pressure. Respiratory rates were then sequentially changed every 10 mins to 6, 20, 30, and 6 breaths/min. MEASUREMENTS AND MAIN RESULTS:With respiratory rates at 6 breaths/min, all subjects maintained pH of >7.25 and SaO2 of >99% while increasing systolic blood pressure (mean, 65-84 mm Hg; p < .05), time-averaged coronary perfusion pressure (50 +/- 2 to 60 +/- 4 mm Hg; p < .05), and cardiac output (2.4 to 2.8 L/min; p < .05). With respiratory rates of 20 and 30 breaths/min, systolic blood pressure (73 +/- 4 and 66 +/- 5 mm Hg, respectively), coronary perfusion pressure (47 +/- 3 and 42 +/- 4 mm Hg), and cardiac output (2.5 and 2.4 L/min) diminished. When returned to 6 breaths/min, systolic blood pressure (95 mm Hg), coronary perfusion pressure (71 + 6 mm Hg), and cardiac output (3.0 L/min) improved significantly (p < .05 for all comparisons). CONCLUSIONS:After moderate hemorrhage, animals maintain adequate oxygenation and acid-base status with lower-frequency respiratory rates, whereas increasingly higher respiratory rates progressively and significantly impair hemodynamics. Current ventilatory protocols for trauma resuscitation should be re-examined and considered a possible cause of worsened clinical outcomes and unrecognized confounded study results.

journal_name

Crit Care Med

journal_title

Critical care medicine

authors

Pepe PE,Lurie KG,Wigginton JG,Raedler C,Idris AH

doi

10.1097/01.ccm.0000134264.88332.37

subject

Has Abstract

pub_date

2004-09-01 00:00:00

pages

S414-20

issue

9 Suppl

eissn

0090-3493

issn

1530-0293

journal_volume

32

pub_type

杂志文章
  • Critical care checklists, the Keystone Project, and the Office for Human Research Protections: a case for streamlining the approval process in quality-improvement research.

    abstract::Checklists have been recently promulgated as a method to enhance patient safety and improve outcomes for critically ill patients. Specifically, recent work performed by researchers from the Johns Hopkins Medical Institutions has demonstrated that the addition of checklists to usual care in the intensive care unit is a...

    journal_title:Critical care medicine

    pub_type: 杂志文章,评审

    doi:10.1097/CCM.0b013e31819541f8

    authors: Savel RH,Goldstein EB,Gropper MA

    更新日期:2009-02-01 00:00:00

  • Perioperative diabetic and hyperglycemic management issues.

    abstract:OBJECTIVE AND DESIGN:To review and discuss selected literature, expert opinion, and conventional care of the hyperglycemic perioperative or critically ill patient. MAIN POINTS:Diabetes mellitus, the most commonly encountered perioperative endocrinopathy, continues to increase dramatically in prevalence. Diabetes is th...

    journal_title:Critical care medicine

    pub_type: 杂志文章,评审

    doi:10.1097/01.ccm.0000115623.52021.c0

    authors: Coursin DB,Connery LE,Ketzler JT

    更新日期:2004-04-01 00:00:00

  • Continuous monitoring of tissue oxygen tension during hyperoxia and hypoxia: relation of subcutaneous, transcutaneous, and conjunctival oxygen tension to hemodynamic variables.

    abstract::Subcutaneous, transcutaneous, and conjunctival oxygen tensions (PscO2, PtcO2, and PcjO2, respectively) were measured in anesthetized dogs subjected sequentially to normoxia, hyperoxia, and hypoxia. Intravascular pressure, hemodynamic and oxygen transport variables were measured simultaneously. PtcO2 and PcjO2 closely ...

    journal_title:Critical care medicine

    pub_type: 杂志文章

    doi:10.1097/00003246-198812000-00011

    authors: Gottrup F,Gellett S,Kirkegaard L,Hansen ES,Johannsen G

    更新日期:1988-12-01 00:00:00

  • Community-, Healthcare-, and Hospital-Acquired Severe Sepsis Hospitalizations in the University HealthSystem Consortium.

    abstract:OBJECTIVES:Severe sepsis poses a major burden on the U.S. healthcare system. Previous epidemiologic studies have not differentiated community-acquired severe sepsis from healthcare-associated severe sepsis or hospital-acquired severe sepsis hospitalizations. We sought to compare and contrast community-acquired severe s...

    journal_title:Critical care medicine

    pub_type: 杂志文章

    doi:10.1097/CCM.0000000000001164

    authors: Page DB,Donnelly JP,Wang HE

    更新日期:2015-09-01 00:00:00

  • Postextubation hypoxemia treated with a continuous positive airway pressure mask.

    abstract::Twenty-seven surgical patients who developed post-extubation hypoxemia unresponsive to routine respiration therapy (incentive spirometry and chest physical therapy) received continuous positive airway pressure (CPAP) delivered through a mask at an inspired oxygen fraction (FIO2) of 0.45. All patients responded with an...

    journal_title:Critical care medicine

    pub_type: 杂志文章

    doi:10.1097/00003246-198501000-00012

    authors: Dehaven CB Jr,Hurst JM,Branson RD

    更新日期:1985-01-01 00:00:00

  • Steroid controversy in sepsis and septic shock: a meta-analysis.

    abstract:OBJECTIVE:The use of corticosteroids in patients with sepsis or septic shock has been controversial for many decades. Clinical studies have reported beneficial, as well as negative results. We conducted a meta-analysis to assess the clinical evidence and to evaluate treatment effects in specific subgroups of patients. ...

    journal_title:Critical care medicine

    pub_type: 杂志文章,meta分析

    doi:10.1097/00003246-199507000-00021

    authors: Lefering R,Neugebauer EA

    更新日期:1995-07-01 00:00:00

  • Lactated Ringer Is Associated With Reduced Mortality and Less Acute Kidney Injury in Critically Ill Patients: A Retrospective Cohort Analysis.

    abstract:OBJECTIVES:To assess the impact of the percentage of fluid infused as Lactated Ringer (%LR) during the first 2 days of ICU admission in hospital mortality and occurrence of acute kidney injury. DESIGN:Retrospective cohort. SETTING:Analysis of a large public database (Multiparameter Intelligent Monitoring in Intensive...

    journal_title:Critical care medicine

    pub_type: 杂志文章

    doi:10.1097/CCM.0000000000001948

    authors: Zampieri FG,Ranzani OT,Azevedo LC,Martins ID,Kellum JA,Libório AB

    更新日期:2016-12-01 00:00:00

  • Dose-related hemodynamic and renal effects of dopamine in septic shock.

    abstract::offstudied hemodynamic and renal effects of increasing the dosage of dopamine (DP) by 5 micrograms/kg X min, in 7 patients with peritonitis and clinical findings of septic shock, all of whom were already receiving variable dosages of DP. Stroke index (SI) (p less than .01), except in 3 cases, and mean arterial pressur...

    journal_title:Critical care medicine

    pub_type: 杂志文章

    doi:10.1097/00003246-198401000-00006

    authors: de la Cal MA,Miravalles E,Pascual T,Esteban A,Ruiz-Santana S

    更新日期:1984-01-01 00:00:00

  • Recombinant human erythropoietin pretreatment attenuates acute renal tubular injury against ischemia-reperfusion by restoring transient receptor potential channel-6 expression and function in collecting ducts.

    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

    authors: Shen S,Jin Y,Li W,Liu X,Zhang T,Xia W,Wang Y,Ma K

    更新日期:2014-10-01 00:00:00

  • Endotracheal intubation and mechanical ventilation in severe asthma.

    abstract:OBJECTIVE:To determine the occurrence rate of complications and mortality in patients with severe asthma requiring endotracheal intubation and mechanical ventilation. DESIGN:Retrospective review of medical records from September 1982 to July 1988. SETTING:Urban, teaching hospital serving primarily indigent patients. ...

    journal_title:Critical care medicine

    pub_type: 杂志文章

    doi:10.1097/00003246-199311000-00023

    authors: Zimmerman JL,Dellinger RP,Shah AN,Taylor RW

    更新日期:1993-11-01 00:00:00

  • The risk of nosocomial pneumonia is not increased during partial liquid ventilation.

    abstract:OBJECTIVE:To determine whether partial liquid ventilation (PLV) affects the risk of nosocomial pneumonia. STUDY DESIGN:To assess in vitro bacterial adhesion and viability after liquid perfluorocarbon exposure and to assess bacterial recovery after partial liquid ventilation in vivo in rabbits. SETTING:University anim...

    journal_title:Critical care medicine

    pub_type: 杂志文章

    doi:10.1097/00003246-199912000-00023

    authors: Sajan I,Scannapieco FA,Fuhrman BP,Steinhorn DM

    更新日期:1999-12-01 00:00:00

  • Inhibition of exhaled nitric oxide production during sepsis does not prevent lung inflammation.

    abstract:OBJECTIVES:Increases in exhaled nitric oxide have been demonstrated to originate from the lungs of rats after septic lung injury. The aim of this study was to investigate whether treatment with the nitric oxide synthase inhibitor N-nitro-L-arginine methyl ester (L-NAME) would prevent lipopolysaccharide (LPS)-induced in...

    journal_title:Critical care medicine

    pub_type: 杂志文章

    doi:10.1097/00003246-199802000-00033

    authors: Aaron SD,Valenza F,Volgyesi G,Mullen JB,Slutsky AS,Stewart TE

    更新日期:1998-02-01 00:00:00

  • Noninvasive PtcO2 initial slope index and invasive PtcO2 arterial index as diagnostic criterion of the state of peripheral circulation.

    abstract::Transcutaneous PO2 (PtcO2), PaO2, PtcO2 arterial index (ARI; PtcO2/PaO2), and the initial slope index (ISI; [delta PO2/min]/starting PtcO2) were measured in 42 healthy volunteers, 12 patients with stable circulation and respiratory insufficiency, and ten patients with insufficient peripheral circulation in cardiogenic...

    journal_title:Critical care medicine

    pub_type: 杂志文章

    doi:10.1097/00003246-198804000-00009

    authors: Lemke R,Klaus D,Lübbers DW,Oevermann G

    更新日期:1988-04-01 00:00:00

  • Cognitive, Psychiatric, and Quality of Life Outcomes in Adult Survivors of Extracorporeal Membrane Oxygenation Therapy: A Scoping Review of the Literature.

    abstract:OBJECTIVES:To perform a scoping literature review of cognitive, psychiatric, and quality of life outcomes in adults undergoing extracorporeal membrane oxygenation for any indication. DATA SOURCES:We searched PubMed, EMBASE, Cochrane Library, Web of Science, CINAHL, and PsycINFO from inception to June 2019. STUDY SELE...

    journal_title:Critical care medicine

    pub_type: 杂志文章

    doi:10.1097/CCM.0000000000004488

    authors: Khan IR,Saulle M,Oldham MA,Weber MT,Schifitto G,Lee HB

    更新日期:2020-10-01 00:00:00

  • Comparison of dopamine, dobutamine, and epinephrine in CPR.

    abstract::Two new catecholamines, dopamine and dobutamine, have found widespread use for cardiovascular support. The relative efficacy of these drugs in aiding resuscitation from cardiopulmonary arrest is unknown. Dogs were subjected to either asphyxial or fibrillatory cardiac arrest. Resuscitation was attempted with artificial...

    journal_title:Critical care medicine

    pub_type: 杂志文章

    doi:10.1097/00003246-198109000-00005

    authors: Otto CW,Yakaitis RW,Redding JS,Blitt CD

    更新日期:1981-09-01 00:00:00

  • Probability of survival as a prognostic and severity of illness score in critically ill surgical patients.

    abstract::A new quantitative method for measuring the prognosis and severity of illness in terms of probability of survival was developed from 224 studies in an index population of 220 critically ill surgical patients. Patients were selected preoperatively to eliminate pre-existing cardiac disease, cirrhosis, nutritional debili...

    journal_title:Critical care medicine

    pub_type: 杂志文章

    doi:10.1097/00003246-198502000-00007

    authors: Bland RD,Shoemaker WC

    更新日期:1985-02-01 00:00:00

  • ICU Utilization for Patients With Acute Exacerbation of Chronic Obstructive Pulmonary Disease Receiving Noninvasive Ventilation.

    abstract:OBJECTIVES:We investigated whether patients with chronic obstructive pulmonary disease could safely receive noninvasive ventilation outside of the ICU. DESIGN:Retrospective cohort study. SETTING:Twelve states with ICU utilization flag from the State Inpatient Database from 2014. PATIENTS:Patients greater than or equ...

    journal_title:Critical care medicine

    pub_type: 杂志文章

    doi:10.1097/CCM.0000000000003660

    authors: Myers LC,Faridi MK,Currier P,Camargo CA Jr

    更新日期:2019-05-01 00:00:00

  • Delivery of metered dose inhaler aerosols to paralyzed and nonparalyzed rabbits.

    abstract:OBJECTIVE:To assess whether paralysis alters pulmonary deposition of albuterol delivered by metered dose inhaler and spacer to small animals. DESIGN:A parallel group study of intubated and ventilated rabbits. INTERVENTIONS:Animals in group 1 (n = 7) were paralyzed with intravenous pancuronium, and ventilated at a rat...

    journal_title:Critical care medicine

    pub_type: 杂志文章

    doi:10.1097/00003246-199701000-00026

    authors: Fok TF,al-Essa M,Monkman S,Dolovich M,Girard L,Coates G,Kirpalani H

    更新日期:1997-01-01 00:00:00

  • Combined neuronal and inducible nitric oxide synthase inhibition in ovine acute lung injury.

    abstract:OBJECTIVE:Acute lung injury with subsequent pneumonia and sepsis represents a major cause of morbidity and mortality in thermally injured patients. Production of nitric oxide by the neuronal and inducible nitric oxide synthase may be critically involved in the pathophysiology of the disease process at different time po...

    journal_title:Critical care medicine

    pub_type: 杂志文章

    doi:10.1097/CCM.0b013e3181926104

    authors: Lange M,Connelly R,Traber DL,Hamahata A,Cox RA,Nakano Y,Bansal K,Esechie A,von Borzyskowski S,Jonkam C,Traber LD,Hawkins HK,Herndon DN,Enkhbaatar P

    更新日期:2009-01-01 00:00:00

  • Resolution of Cardiogenic Shock Using Echocardiography-Guided Pacing Optimization in Intensive Care: A Case Series.

    abstract:OBJECTIVE:Inotropic and vasopressor drugs are routinely used in critically ill patients to maintain adequate blood pressure and cardiac output in patients with cardiogenic shock although potentially at the expense of increasing myocardial oxygen demand. Pacing optimization has been demonstrated as effective in reducing...

    journal_title:Critical care medicine

    pub_type: 杂志文章

    doi:10.1097/CCM.0000000000001655

    authors: Tavazzi G,Kontogeorgis A,Bergsland NP,Price S

    更新日期:2016-08-01 00:00:00

  • Hemodynamic effects of digoxin during acute cardiac failure: a comparison in patients with and without acute myocardial infarction.

    abstract::The hemodynamic effects of digitalis were examined in ten patients with acute cardiac failure. Administration of 10 micrograms/kg of digoxin iv resulted in significant increases in cardiac index, stroke volume index, and left ventricular stroke work index within one hour in five patients with acute myocardial infarcti...

    journal_title:Critical care medicine

    pub_type: 杂志文章

    doi:10.1097/00003246-198711000-00002

    authors: Rackow EC,Packman MI,Weil MH

    更新日期:1987-11-01 00:00:00

  • Caspase-dependent protein phosphatase 2A activation contributes to endotoxin-induced cardiomyocyte contractile dysfunction.

    abstract:OBJECTIVE:Several studies report calcium mishandling, sarcomere disarray, and caspase activation during heart failure. Although active caspases have been shown to cleave myofibrillar proteins, little is known regarding their effects on calcium handling proteins. Therefore, we aimed to explore how endotoxin-induced casp...

    journal_title:Critical care medicine

    pub_type: 杂志文章

    doi:10.1097/CCM.0b013e3181eedafb

    authors: Neviere R,Hassoun SM,Decoster B,Bouazza Y,Montaigne D,Maréchal X,Marciniak C,Marchetti P,Lancel S

    更新日期:2010-10-01 00:00:00

  • Association of hypomagnesemia and mortality in acutely ill medical patients.

    abstract:OBJECTIVE:To test the hypothesis that the mortality rate of acutely ill patients admitted to a medical ward or medical ICU is higher for those patients who present with hypomagnesemia than for those patients who do not present with hypomagnesemia. DESIGN:Prospective, observational study. SETTING:Emergency Department ...

    journal_title:Critical care medicine

    pub_type: 杂志文章

    doi:10.1097/00003246-199302000-00010

    authors: Rubeiz GJ,Thill-Baharozian M,Hardie D,Carlson RW

    更新日期:1993-02-01 00:00:00

  • Interventions to Improve Hand Hygiene Compliance in the ICU: A Systematic Review.

    abstract:OBJECTIVES:To synthesize the literature describing interventions to improve hand hygiene in ICUs, to evaluate the quality of the extant research, and to outline the type, and efficacy, of interventions described. DATA SOURCES:Systematic searches were conducted in November 2016 using five electronic databases: Medline,...

    journal_title:Critical care medicine

    pub_type: 杂志文章,评审

    doi:10.1097/CCM.0000000000002691

    authors: Lydon S,Power M,McSharry J,Byrne M,Madden C,Squires JE,O'Connor P

    更新日期:2017-11-01 00:00:00

  • Investigating conflict in ICUs-is the clinicians' perspective enough?

    abstract:OBJECTIVE:Most studies have assessed conflict between clinicians and surrogate decision makers in ICUs from only clinicians' perspectives. It is unknown if surrogates' perceptions differ from clinicians'. We sought to determine the degree of agreement between physicians and surrogates about conflict and to identify pre...

    journal_title:Critical care medicine

    pub_type: 杂志文章

    doi:10.1097/CCM.0b013e3182a27598

    authors: Schuster RA,Hong SY,Arnold RM,White DB

    更新日期:2014-02-01 00:00:00

  • Endothelium as an organ system.

    abstract::The endothelium is a highly dynamic cell layer that is involved in a multitude of physiologic functions, including the control of vasomotor tone, the trafficking of cells and nutrients, the maintenance of blood fluidity, and the growth of new blood vessels. Over the past several decades, advances in basic research of ...

    journal_title:Critical care medicine

    pub_type: 杂志文章,评审

    doi:10.1097/01.ccm.0000129669.21649.40

    authors: Aird WC

    更新日期:2004-05-01 00:00:00

  • Diffusive vs. convective therapy: effects on mediators of inflammation in patient with severe systemic inflammatory response syndrome.

    abstract:OBJECTIVE:To compare two forms of continuous renal replacement therapy, continuous venovenous hemofiltration (CVVH) vs. continuous venovenous hemodialysis (CVVHD), in terms of the removal of inflammatory mediators from the blood of patients with systemic inflammatory response syndrome and acute renal failure. DESIGN:R...

    journal_title:Critical care medicine

    pub_type: 临床试验,杂志文章,随机对照试验

    doi:10.1097/00003246-199812000-00027

    authors: Kellum JA,Johnson JP,Kramer D,Palevsky P,Brady JJ,Pinsky MR

    更新日期:1998-12-01 00:00:00

  • Old age does not negate good cerebral outcome after cardiopulmonary resuscitation: analyses from the brain resuscitation clinical trials. The Brain Resuscitation Clinical Trial I and II Study Groups.

    abstract:OBJECTIVE:To assess survival after cardiac arrest and to determine whether age is an independent determinant of late mortality or poor neurologic outcome. DESIGN:Analyses using results of Brain Resuscitation Clinical Trial I (1979 to 1984) and Brain Resuscitation Clinical Trial II (1984 to 1989), two randomized, doubl...

    journal_title:Critical care medicine

    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

    authors: Rogove HJ,Safar P,Sutton-Tyrrell K,Abramson NS

    更新日期:1995-01-01 00:00:00

  • Severe hypoglycemia in critically ill patients: risk factors and outcomes.

    abstract:OBJECTIVE:To determine the risk factors for development of severe hypoglycemia (defined as glucose <40 mg/dL) in critically ill patients and define the outcomes of this complication. DESIGN:Retrospective database review, including a case-control analysis that matched each patient with severe hypoglycemia with three co...

    journal_title:Critical care medicine

    pub_type: 杂志文章

    doi:10.1097/01.CCM.0000282073.98414.4B

    authors: Krinsley JS,Grover A

    更新日期:2007-10-01 00:00:00

  • Determinants of tidal volume during high-frequency oscillation.

    abstract:OBJECTIVE:High-frequency oscillation has been proposed for use in adult acute respiratory distress syndrome. However, limited data are available on the effect of pressure amplitude and rate (Hz) on tidal volumes delivered during high-frequency oscillation in adults. DESIGN:Prospective, animal model, lung injury study....

    journal_title:Critical care medicine

    pub_type: 杂志文章

    doi:10.1097/00003246-200301000-00035

    authors: Sedeek KA,Takeuchi M,Suchodolski K,Kacmarek RM

    更新日期:2003-01-01 00:00:00