Abstract:
OBJECTIVE:Recent studies have demonstrated the therapeutic effectiveness and pharmacologic mechanisms of hyperbaric oxygen therapy (HBOT) in the treatment of a systemic shock state. To elucidate the in vivo role of HBOT during sepsis, we evaluated the effects of HBOT on intestinal mucosal injury and bacterial translocation after lipopolysaccharide challenge. DESIGN:Experimental study. SETTING:First Department of Surgery and Division of Emergency Care, Kagoshima University School of Medicine, Kagoshima, Japan. SUBJECTS:: Male rats were treated with lipopolysaccharide by an intraperitoneal route or with lipopolysaccharide and HBOT. INTERVENTIONS:The survival rate, small intestinal tissue damage, and bacterial translocation in the HBOT-treated group were compared with those in the untreated group. Moreover, plasma tumor necrosis factor-alpha and nitrite/nitrate concentrations, inducible nitric oxide synthase and myeloperoxidase activities, and nuclear factor-kappaB in ileal mucosa were investigated. HBOT was initiated 3 hrs after lipopolysaccharide challenge and administered as 100% oxygen, at 2.53 x 10 kPa (2.5 atm absolute), for 60 mins. MEASUREMENTS AND MAIN RESULTS:When a sublethal dose of lipopolysaccharide (24 mg/kg) was given, the survival rate was much better in the HBOT-treated group (75%) than in the untreated group (33%). HBOT given 3 hrs after lipopolysaccharide injection (10 mg/kg) also lessened the histologic tissue damage of the terminal ileum and the incidence and magnitude of bacterial translocation to mesenteric lymph nodes at 24 hrs after the lipopolysaccharide injection. Moreover, HBOT was able to reduce mucosal inducible nitric oxide synthase and myeloperoxidase activities and plasma nitrite/nitrate concentrations but not serum tumor necrosis factor-alpha concentrations. Immunohistochemical examination revealed that HBOT specifically modified the mucosal nuclear factor-kappaB activation within 4-6 hrs after the injection. CONCLUSIONS:HBOT performed 3 hrs after lipopolysaccharide challenge alleviates intestinal barrier dysfunction and improves survival rates. Herein, we propose one possible mechanism for these beneficial effects: HBOT can modify the nuclear factor-kappaB activation in the intestinal mucosa and attenuate the sequential nitric oxide overproduction and myeloperoxidase activation. Consequently, bacterial translocation could be potentially decreased. We believe that the present study should lead to an improved understanding of HBOT's potential role in sepsis.
journal_name
Crit Care Medjournal_title
Critical care medicineauthors
Sakoda M,Ueno S,Kihara K,Arikawa K,Dogomori H,Nuruki K,Takao S,Aikou Tdoi
10.1097/01.ccm.0000132898.27101.6csubject
Has Abstractpub_date
2004-08-01 00:00:00pages
1722-9issue
8eissn
0090-3493issn
1530-0293pii
00003246-200408000-00014journal_volume
32pub_type
杂志文章abstract:OBJECTIVE:Chronic diabetes mellitus (DM) is a known cause of multisystem injury. The effect of DM in acute critical illness may also be detrimental, but is not specifically known. We hypothesized that the preexisting diagnosis of DM is an independent risk factor for mortality in critically ill patients. DESIGN:Paralle...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/CCM.0b013e3181b9eaa5
更新日期:2010-01-01 00:00:00
abstract:OBJECTIVE:This survey was designed to study current practices in the monitoring and treatment of patients with severe head injury in the United States. DATA SOURCES:The collected data represent answers to telephone interviews of nurse managers, clinical specialists, and staff nurses specializing in neurotrauma care at...
journal_title:Critical care medicine
pub_type: 杂志文章,多中心研究
doi:10.1097/00003246-199503000-00023
更新日期:1995-03-01 00:00:00
abstract::A patient with brainstem infarction met the clinical criteria for brain death but had persistent EEG activity, complicating our decision to withdraw life support. We evaluated cerebral blood flow with xenon-enhanced computed tomography (Xe/CT), which documented the absence of posterior circulation flow and persistent,...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/00003246-198705000-00014
更新日期:1987-05-01 00:00:00
abstract:OBJECTIVE:To evaluate diagnostic and prognostic values of C-reactive protein (CRP) dosage in critically ill patients. DESIGN:Prospective, observational study. SETTING:Medical intensive care unit (ICU) in a university hospital. PATIENTS:A consecutive series of 74 patients admitted to the ICU. INTERVENTION:CRP measur...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/00003246-200203000-00006
更新日期:2002-03-01 00:00:00
abstract:OBJECTIVE:To examine the pulmonary and cardiac function of children who survived an episode of acute hypoxemic respiratory failure. DESIGN:Descriptive cohort analysis. SETTING:Pediatric clinical research center of a university hospital. PATIENTS:Utilizing the criteria of PaO2 < 75 torr (< 10 kPa) with an FIO2 of > 0...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/00003246-199601000-00024
更新日期:1996-01-01 00:00:00
abstract::Twenty preterm infants in respiratory distress, each with an umbilical catheter in place, were studied during their first 24 h of hospitalization, to determine the effects of continuous transcutaneous oxygen (PtcO2) monitoring on the frequency of arterial blood gas (ABG) determinations and on the incidence of hypoxia ...
journal_title:Critical care medicine
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1097/00003246-198402000-00009
更新日期:1984-02-01 00:00:00
abstract:BACKGROUND:Subcutaneously administered low-molecular-weight heparins are widely used for prevention of venous thromboembolism. The appropriateness of the subcutaneous route in critically ill patients has never been established. OBJECTIVE:To determine anti-Xa activities in critically ill patients and in noncritically i...
journal_title:Critical care medicine
pub_type: 临床试验,杂志文章
doi:10.1097/01.CCM.0000059725.60509.A0
更新日期:2003-05-01 00:00:00
abstract:OBJECTIVES:Radial artery pressure is known to differ from central arterial pressure in normal patients (distal pulse amplification) and in the early postcardiopulmonary bypass period. The adequacy of the radial artery as a site for blood pressure monitoring in critically ill patients receiving high-dose vasopressors ha...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/00003246-199810000-00014
更新日期:1998-10-01 00:00:00
abstract:OBJECTIVE:To comparatively evaluate cerebral metabolic rate of oxygen consumption and a modification of it, cerebral consumption of oxygen, in patients with acute brain injury with acute anemia. DESIGN:Prospective, observational study. SETTING:Neuroscience intensive care unit (ICU) of a university hospital. PATIENTS...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/00003246-199308000-00024
更新日期:1993-08-01 00:00:00
abstract:OBJECTIVE:Rapid fluid loading is standard treatment for hypovolemia. Because volume expansion does not always improve hemodynamic status, predictive parameters of fluid responsiveness are needed. Passive leg raising is a reversible maneuver that mimics rapid volume expansion. Passive leg raising-induced changes in stro...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/CCM.0b013e3181c8fe7a
更新日期:2010-03-01 00:00:00
abstract:OBJECTIVES:To identify the prevalence, risk factors, and outcomes of intra-abdominal hypertension in a mixed multicenter ICU population. DESIGN:Prospective observational study. SETTING:Fifteen ICUs worldwide. PATIENTS:Consecutive adult ICU patients with a bladder catheter. INTERVENTIONS:None. MEASUREMENTS AND MAIN...
journal_title:Critical care medicine
pub_type: 杂志文章,多中心研究
doi:10.1097/CCM.0000000000003623
更新日期:2019-04-01 00:00:00
abstract::The determination of minute oxygen consumption (VO2) for metabolic studies on patients using either the Beckman Metabolic Cart (MMC) or the Respiratory Monitoring System (RMS) requires a stable fractional inspired oxygen concentration (FIO2). Measurement of VO2 on mechanically ventilated patients using the Bourns BEAR...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/00003246-198202000-00003
更新日期:1982-02-01 00:00:00
abstract:OBJECTIVES:To determine the incidence of enteral feed intolerance, identify factors associated with enteral feed intolerance, and assess the relationship between enteral feed intolerance and key nutritional and clinical outcomes in critically ill patients. DESIGN:Analysis of International Nutrition Survey database col...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/CCM.0000000000004712
更新日期:2021-01-01 00:00:00
abstract:BACKGROUND:Early excision with autograft-allograft closure is standard in severe burn management. Cadaver skin is associated with risks such as antigenicity, infection, and limited availability and shelf life. Previous studies have shown that Integra is safe to use in burns of <20% total body surface area. However, the...
journal_title:Critical care medicine
pub_type: 杂志文章,随机对照试验
doi:10.1097/01.CCM.0000285991.36698.E2
更新日期:2007-11-01 00:00:00
abstract::The relationship between oxygen uptake (Vo2) and delivery (Do2) was examined in 64 patients immediately after cardiopulmonary bypass. In 44 patients with lactate levels below 2.5 mmol/L, Vo2 decreased proportionally when Do2 decreased below 300 ml/min X m2. At a Do2 over this level, Vo2 plateaued at 105 +/- 13 (SD) ml...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/00003246-198703000-00002
更新日期:1987-03-01 00:00:00
abstract:OBJECTIVES:To characterize the landscape of process of care and safety outcomes for tracheal intubation across pediatric intensive care units BACKGROUND:Procedural process of care and safety outcomes of tracheal intubation across pediatric intensive care units has not been described. We hypothesize that the novel Nati...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/CCM.0b013e3182746736
更新日期:2013-03-01 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::We investigated clinically the differences in respiratory work of patients imposed by three modes of one ventilator: the flow-by system, the demand valve system, and the pressure support system. Inspiratory work using flow-by and pressure support systems was reduced sufficiently when compared to the demand valve syste...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/00003246-199006000-00016
更新日期:1990-06-01 00:00:00
abstract:OBJECTIVES:Extracorporeal membrane oxygenation is used to stabilize severe cardiocirculatory and/or respiratory failure. However, extracorporeal membrane oxygenation is associated with a coagulopathy characterized by thromboembolic and hemorrhagic complications. This study aimed to characterize the pathomechanism of th...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/CCM.0000000000004286
更新日期:2020-05-01 00:00:00
abstract::A small, double-blind crossover study compared the efficacy of aminophylline and doxapram in ventilator weaning of eight premature infants recovering from respiratory distress syndrome (RDS). Although neither drug was significantly better than the other, four infants were weaned from mechanical ventilation after drug ...
journal_title:Critical care medicine
pub_type: 临床试验,杂志文章
doi:10.1097/00003246-198502000-00016
更新日期:1985-02-01 00:00:00
abstract::Hypophosphatemia may occur in Reye's syndrome. We retrospectively studied 42 patients with Reye's syndrome to determine the frequency and degree of hypophosphatemia, to identify possible causes, and to determine whether hypophosphatemia was related to the severity of disease or mortality. Nineteen (46%) patients were ...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/00003246-198506000-00008
更新日期:1985-06-01 00:00:00
abstract:OBJECTIVE:To evaluate the safety and diagnostic yield of transbronchial biopsy performed in mechanically ventilated patients. DESIGN:Retrospective, cohort analysis. SETTING:A university-affiliated teaching hospital. PATIENTS:Seventy-one consecutive, mechanically ventilated patients requiring lung tissue examination....
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/00003246-199703000-00012
更新日期:1997-03-01 00:00:00
abstract:OBJECTIVE:To examine the effects of hypertonic (7.5%) saline-6% dextran 70 (HSD) and isotonic (0.9%) saline-6% dextran 70 (ISD) on cardiovascular function and intestinal perfusion in experimental endotoxin shock. DESIGN:Experimental, randomized, unblinded, interventional study. SETTING:University experimental animal ...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/00003246-200008000-00027
更新日期:2000-08-01 00:00:00
abstract:OBJECTIVE:To study the rate of elimination of ethanol after a major burn trauma. DESIGN:Prospective, controlled study. SETTING:National burns unit in a Swedish university hospital. PATIENTS AND SUBJECTS:Eight consecutive patients suffering from 18%-72% total burned surface area and nine healthy male control subjects...
journal_title:Critical care medicine
pub_type: 临床试验,杂志文章
doi:10.1097/00003246-199912000-00003
更新日期:1999-12-01 00:00:00
abstract:OBJECTIVE:This study tested the hypothesis that intra-coronary transfusion of circulation-derived autologous CD34+ cells can improve ischemia-related left ventricular dysfunction in patients with severe diffuse coronary artery disease refractory to medication and unsuitable for coronary intervention. DESIGN:A prospect...
journal_title:Critical care medicine
pub_type: 杂志文章,随机对照试验
doi:10.1097/CCM.0000000000001138
更新日期:2015-10-01 00:00:00
abstract:OBJECTIVE:To determine alterations in intestinal epithelial permeability to solutes in burn injured rats with and without Enterococcus faecalis infection and the role of neutrophils in the intestinal permeability changes. DESIGN:Prospective sham-controlled animal study. SETTING:University research laboratory. SUBJEC...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/01.ccm.0000145579.66001.05
更新日期:2004-11-01 00:00:00
abstract:OBJECTIVES:Previous workers have demonstrated that controlled mechanical ventilation results in diaphragm inactivity and elicits a rapid development of diaphragm weakness as a result of both contractile dysfunction and fiber atrophy. Limited data exist regarding the impact of pressure support ventilation, a commonly us...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/CCM.0b013e31823c8cc9
更新日期:2012-04-01 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::Gastric mucosal damage occurs in critically ill patients in intensive care units and develops in the setting of severe physiologic stress. Within 24 hrs of admission to the intensive care unit, 75% to 100% of critically ill patients demonstrate evidence of stress-related mucosal disease. Stress ulcers present a risk o...
journal_title:Critical care medicine
pub_type: 杂志文章,评审
doi:10.1097/00003246-200206001-00002
更新日期:2002-06-01 00:00:00
abstract:OBJECTIVE:Although it is established that septic shock induces immunosuppression, the mechanisms for this phenomenon remain poorly understood. Human leukocyte antigen-G exerts strong inhibitory effects that are directed at different arms of the immune system. The main objective of the current study was to measure human...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/01.CCM.0000277039.84372.1C
更新日期:2007-08-01 00:00:00