Abstract:
OBJECTIVE:To determine whether clinically relevant airspace concentrations of beta2-adrenergic agonists stimulated maximal alveolar fluid clearance rates and to determine whether beta2 agonist therapy decreased pulmonary edema in experimental acute lung injury. DESIGN:Prospective randomized laboratory investigation. SETTING:University-affiliated laboratory. SUBJECTS:Sprague Dawley rats. INTERVENTIONS:Dibutyryl cyclic adenosine monophosphate (cAMP), salmeterol, albuterol, and isoproterenol in normal rat lung. Salmeterol in a rat model of acid-induced lung injury. MEASUREMENTS AND MAIN RESULTS:Basal alveolar fluid clearance was 7.6 +/- 2.2 %/hr. Maximal cAMP-dependent alveolar fluid clearance rate was 32.9 +/- 10.9 %/hr (p <.05). Racemic albuterol 10(-5) M, salmeterol 10(-6) M, and isoproterenol 10(-6) M each stimulated alveolar fluid clearance to a level comparable to maximal cAMP-dependent alveolar fluid clearance. Compared with basal rates, alveolar fluid clearance was increased by both racemic albuterol 10(-6) M (14.5 +/- 3.0%, p <.05) and R-enantiomer 10(-6) M (15.0 +/- 4.6%, p <.05), but there was no difference between the two groups. Intra-alveolar salmeterol 10 (-6) M attenuated the degree of pulmonary edema following acid-induced lung injury. Extravascular lung water increased to only 180 +/- 30 microL with salmeterol treatment, compared with 296 +/- 65 microL in saline-treated rats 4 hrs after acid injury (p <.05). This decrease in lung water was accompanied by a 2.4-fold increase in the rate of alveolar fluid clearance at 4 hrs in the salmeterol-treated group. Lung endothelial permeability, expressed as extravascular plasma equivalents, was reduced to 64 +/- 9 microL with salmeterol compared with 119 +/- 51 microL in saline-treated rats 4 hrs after acid injury (p <.05). CONCLUSIONS:Clinically relevant airspace concentrations of beta2-adrenergic agonists a) stimulate maximal cAMP-dependent airspace fluid clearance in normal lungs and b) reduce pulmonary edema in acid aspiration-induced lung injury by increasing alveolar fluid clearance and decreasing endothelial permeability. Clinical studies are required to determine whether beta2-adrenergic agonists improve outcome in patients with acute lung injury.
journal_name
Crit Care Medjournal_title
Critical care medicineauthors
McAuley DF,Frank JA,Fang X,Matthay MAdoi
10.1097/01.ccm.0000129489.34416.0esubject
Has Abstractpub_date
2004-07-01 00:00:00pages
1470-6issue
7eissn
0090-3493issn
1530-0293pii
00003246-200407000-00003journal_volume
32pub_type
杂志文章abstract:OBJECTIVES:To determine nuclear factor kappa B (NF-kappa B) activation in mononuclear and neutrophils from critically ill patients and to compare NF-kappa B activation with circulating concentrations of interleukin (IL)-6, IL-8, and soluble intercellular adhesion molecule (sICAM)-1. DESIGN:Observational study. SETTIN...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/00003246-200004000-00022
更新日期:2000-04-01 00:00:00
abstract:BACKGROUND:Endotoxin (lipopolysaccharide [LPS]) has been associated with sepsis and the high mortality rate seen in septic shock. The administration of a small amount of LPS to healthy subjects produces a mild syndrome qualitatively similar to that seen in clinical sepsis. We used this model to test the efficacy of an ...
journal_title:Critical care medicine
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1097/00003246-200008000-00005
更新日期:2000-08-01 00:00:00
abstract:OBJECTIVE:Mannitol is widely used in hospitals worldwide to treat patients with high intracranial pressure and/or cerebral edema. One of the mechanisms by which mannitol is thought to affect intracranial pressure is by increasing the patient's serum osmolarity, but not the osmolarity in the brain or cerebrospinal fluid...
journal_title:Critical care medicine
pub_type: 临床试验,杂志文章
doi:10.1097/01.CCM.0000050287.68977.84
更新日期:2003-02-01 00:00:00
abstract:OBJECTIVE:Neutropenia recovery may be associated with an increased risk of respiratory function deterioration. A history of pneumonia complicating neutropenia has been identified as the leading cause of adult respiratory distress syndrome during neutropenia recovery in patients receiving anticancer chemotherapy, sugges...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/00003246-200301000-00025
更新日期:2003-01-01 00:00:00
abstract:OBJECTIVE:As the Surviving Sepsis Campaign was assessing patient-level data over multiple countries, we sought to evaluate the use of a pragmatic and parsimonious severity-of-illness scoring system for patients with sepsis in an attempt to provide appropriate comparisons with practical application. DESIGN:Prospective,...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/CCM.0000000000000416
更新日期:2014-09-01 00:00:00
abstract:OBJECTIVE:To investigate the cardiorespiratory effects of graded bilateral pleural effusions in the anesthetized pig. DESIGN:Prospective, randomized, controlled, laboratory study. SETTING:Animal laboratory. SUBJECTS:Eleven male Yorkshire pigs. INTERVENTIONS:Animals were anesthetized using inhaled isoflurane. Orotra...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/00003246-199903000-00040
更新日期:1999-03-01 00:00:00
abstract:OBJECTIVE:The objective of the present study was to determine whether selective inflammatory cytokine concentrations within cerebrospinal fluid are useful markers for the differential diagnosis of aseptic and bacterial meningitis within neurosurgical patients. DESIGN:Prospective, open-label, observational, cohort stud...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/CCM.0000000000001188
更新日期:2015-11-01 00:00:00
abstract:OBJECTIVE:Sepsis and severe trauma result in endothelial activation and damage. The activated endothelium expresses adhesion receptors that control leukocyte trafficking. After activation, some adhesion molecules are also released into plasma as soluble forms. The present study was designed to compare the expression of...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/00003246-200204000-00015
更新日期:2002-04-01 00:00:00
abstract::In a prospective 30-month study of nosocomial infections in a pediatric ICU (PICU), the incidence, sites, and causes of infection were determined. Factors associated with increased risk of infection were investigated. In 1,388 patients who remained in the PICU for a minimum of 72 h, 116 infections occurred (6.1 infect...
journal_title:Critical care medicine
pub_type: 杂志文章,评审
doi:10.1097/00003246-198803000-00005
更新日期:1988-03-01 00:00:00
abstract:OBJECTIVE:Liquid lung ventilation has been demonstrated to improve cardiorespiratory function after cardiopulmonary bypass. We hypothesized that liquid lung ventilation (LLV) would decrease the pulmonary inflammatory response after cardiopulmonary bypass (CPB). DESIGN:Prospective, randomized, experimental, controlled,...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/00003246-200104000-00021
更新日期:2001-04-01 00:00:00
abstract:OBJECTIVE:Head-to-head comparison of the success rate of jejunal placement of a new electromagnetically visualized jejunal tube with that of the endoscopic technique in critically ill patients. DESIGN:: Prospective, randomized clinical trial. SETTING:Two intensive care units at a university hospital. PATIENTS:: A to...
journal_title:Critical care medicine
pub_type: 杂志文章,随机对照试验
doi:10.1097/CCM.0b013e3181fb7b5f
更新日期:2011-01-01 00:00:00
abstract:OBJECTIVES:To measure energy expenditure in critically ill children and compare it with the energy expenditure predicted by recommended formulas, and relate the measured energy expenditure to nutritional and clinical indices. DESIGN:A prospective, clinical study. SETTING:Tertiary care pediatric intensive care unit in...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/00003246-200004000-00042
更新日期:2000-04-01 00:00:00
abstract:OBJECTIVE:Most intensive care deaths beyond the first few days of critical illness are attributable to nonresolving organ failure, either due to or coinciding with sepsis. One of the mechanisms that is thought to contribute to the pathogenesis of organ failure is microvascular thrombosis. Recently, we reported signific...
journal_title:Critical care medicine
pub_type: 杂志文章,随机对照试验
doi:10.1097/CCM.0b013e31816f7bae
更新日期:2008-05-01 00:00:00
abstract:OBJECTIVE:To determine the impact of the rotation of antimicrobial agents on the rates of infection, intestinal colonization, and acquisition with antimicrobial-resistant Gram-negative bacteria. DESIGN:Pre- and postintervention design. SETTING:A 19-bed, medical intensive care unit. PATIENTS:Individuals admitted to t...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/01.ccm.0000147685.79487.28
更新日期:2004-12-01 00:00:00
abstract:OBJECTIVE:To describe a severe axonal polyneuropathy that follows acute respiratory failure and, in turn, causes continued ventilator dependence and paralysis after resolution of the primary illness. DESIGN:Retrospective chart review of three patients and prospective analysis of two patients. SETTING:Respiratory and ...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/00003246-199302000-00020
更新日期:1993-02-01 00:00:00
abstract:OBJECTIVE:In patients undergoing surgical repair of aortic dissection, false lumen perfusion during cardiopulmonary bypass may produce central nervous system damage, myocardial ischemia, aortic rupture, and death. We describe a method to detect false lumen perfusion at the beginning of retrograde aortic perfusion that ...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/00003246-200006000-00026
更新日期:2000-06-01 00:00:00
abstract:OBJECTIVE:Quality of care for patients admitted with pneumonia varies across hospitals, but causes of this variation are poorly understood. Whether hospitals with high ICU utilization for patients with pneumonia provide better quality care is unknown. We sought to investigate the relationship between a hospital's ICU a...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/CCM.0000000000000925
更新日期:2015-06-01 00:00:00
abstract::This report documents the validity of clinical measurements of oxygen consumption (VO2) and carbon dioxide production (VCO2) made with a new metabolic gas monitor (MGM) suitable for use in critically ill patients receiving mechanical ventilatory support. Paired samples of inspired and expired gases were obtained, and ...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/00003246-198710000-00012
更新日期:1987-10-01 00:00:00
abstract:OBJECTIVES:The potential advantages of lowering core temperature during sepsis are to lower energy requirement and to activate various cell-protecting pathways. We experimentally investigated whether postconditioning temperature modifications influence survival duration during experimental sepsis. DESIGN:A prospective...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/01.CCM.0000240231.76837.DC
更新日期:2006-10-01 00:00:00
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
更新日期:2001-06-01 00:00:00
abstract:OBJECTIVE:To examine the value of laser bronchoscopy in patients with inoperable carcinoma of the lung who required ventilatory assistance for acute respiratory failure. DESIGN:Retrospective review of the medical records of all patients undergoing laser bronchoscopy. SETTING:The Lahey Clinic Medical Center, a tertiar...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/00003246-199303000-00016
更新日期:1993-03-01 00:00:00
abstract::Critical decreases in oxygen delivery (DO2) and mixed venous oxygen saturation (SvO2) are associated with anaerobic metabolism and, therefore, lactic acidosis. We studied 50 consecutive patients with sepsis and 50 consecutive patients with acute myocardial infarction (AMI) in whom the arterial blood lactate was greate...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/00003246-198807000-00001
更新日期:1988-07-01 00:00:00
abstract:OBJECTIVE:To evaluate the tolerance and the efficacy of noninvasive continuous positive airway pressure (CPAP) in severe acute respiratory failure occurring in intensive care unit (ICU) neutropenic patients with hematologic malignancies, and to establish predictive variables of efficacy of this method. DESIGN:Prospect...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/00003246-200009000-00012
更新日期:2000-09-01 00:00:00
abstract:OBJECTIVE:To determine whether four stages of weaning (acute, prewean, wean, and outcome) could be identified by using clinical instruments designed to quantify severity of illness, patient stability, or weaning readiness. The instruments used were the Acute Physiology and Chronic Health Evaluation (APACHE III), the Th...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/00003246-200007000-00013
更新日期:2000-07-01 00:00:00
abstract:OBJECTIVE:Sepsis and acute lung injury continue to be major causes of morbidity and mortality worldwide despite advances in our understanding of pathophysiology and the discovery of new management strategies. Recent investigations show that stem cells may be beneficial as prognostic biomarkers and novel therapeutic str...
journal_title:Critical care medicine
pub_type: 杂志文章,评审
doi:10.1097/CCM.0b013e3181f96f5f
更新日期:2010-12-01 00:00:00
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
更新日期:2020-10-01 00:00:00
abstract:OBJECTIVE:To determine risk factors for nosocomial pneumonia in critically ill trauma patients. DESIGN:Prospective cohort study. SETTING:The trauma intensive care unit (ICU) of a 1500-bed tertiary-care hospital. PATIENTS:All critically ill trauma patients (n = 103) admitted consecutively between November 1995 and Oc...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/00003246-200102000-00015
更新日期:2001-02-01 00:00:00
abstract:OBJECTIVE:To examine the ways in which healthcare professionals work together in the ICU setting, through a consideration of the contextual, organizational, processual, and relational factors that impact their interprofessional collaboration. DESIGN:Data from over 350 hours of ethnographic observation and 35 semistruc...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/CCM.0000000000001136
更新日期:2015-09-01 00:00:00
abstract:OBJECTIVE:Isoflurane, a volatile anesthetic agent, has been recognized for its potential neuroprotective properties and has antiapoptotic effects. We examined whether isoflurane posttreatment is protective against early brain injury after subarachnoid hemorrhage and determined whether this effect needs sphingosine-rela...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/CCM.0b013e3182474bc1
更新日期:2012-06-01 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