Abstract:
OBJECTIVE:Although hepatic cytochrome P-450 protein concentrations are altered following endotoxin shock, changes in P-450 isoforms in sepsis have not been fully investigated. The aim of this study was to determine whether the major P-450 isoform in rat liver (i.e., CYP1A2) is down-regulated during the progression of sepsis and, if so, whether reduction of P-450 enzyme system plays an important role in the inflammatory response. DESIGN:Prospective, controlled, and randomized animal study. SETTING:A university/institute research laboratory. SUBJECTS:Male adult Sprague-Dawley rats were subjected either to polymicrobial sepsis by cecal ligation and puncture (CLP) or to sham operation followed by the administration of normal saline solution (i.e., fluid resuscitation). INTERVENTIONS:P-450 isoforms in the liver (i.e., CYP1A2 and 4A1) were determined using reverse transcription polymerase chain reaction and Western blot analysis at various time points after CLP. MEASUREMENTS AND MAIN RESULTS:The results indicate that CYP1A2 messenger RNA expression decreased significantly at 10 and 20 hrs whereas its protein concentrations decreased at 20 hrs after the induction of sepsis. In contrast, CYP4A1 messenger RNA and protein concentrations were not altered even at 20 hrs after CLP. In an additional experiment, all P-450 isoforms were inhibited by pretreatment with 1-aminobenzotriazole to determine the effect of cytochrome P-450 blockade on inflammatory responses by assessing proinflammatory cytokines. The results show further increases in serum concentrations of tumor necrosis factor-alpha, interleukin-1beta, and interleukin-6 in aminobenzotriazole-treated animals at 10 hrs after CLP, which was associated with elevated concentrations of circulating lactate and severe morphologic alterations in the liver. These results suggest that the integrity of the cytochrome P-450 enzyme system plays an important role in septic inflammatory response. CONCLUSION:The major hepatic P-450 isoform CYP1A2 is down-regulated and inhibition of P-450 enzyme system is associated with an exacerbated inflammatory response in sepsis. Treatment with pharmaceutical agents that regulate or are metabolized by P-450 enzymes might be approached cautiously in the septic patient if this holds true in a clinical setting.
journal_name
Crit Care Medjournal_title
Critical care medicineauthors
Crawford JH,Yang S,Zhou M,Simms HH,Wang Pdoi
10.1097/01.CCM.0000109453.57709.E2subject
Has Abstractpub_date
2004-02-01 00:00:00pages
502-8issue
2eissn
0090-3493issn
1530-0293journal_volume
32pub_type
杂志文章abstract:OBJECTIVES:Vascular beds vary in their responses to atrial natriuretic peptide and sodium nitroprusside. Both of these agents dilate blood vessels by increasing intracellular guanosine 3',5'-cyclic monophosphate (cyclic-GMP) but activate different enzymes in the vascular smooth muscle cell. We aimed to determine if the...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/00003246-199409000-00017
更新日期:1994-09-01 00:00:00
abstract:OBJECTIVE:To provide a conceptual and clinical review of the physiology of the venous system as it is relates to cardiac function in health and disease. DATA:An integration of venous and cardiac physiology under normal conditions, critical illness, and resuscitation. SUMMARY:The usual teaching of cardiac physiology f...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/CCM.0b013e3182772ab6
更新日期:2013-01-01 00:00:00
abstract::The effects of hypertonic mannitol on postischemic cerebral circulation were studied in 20 dogs. Mannitol, 2 g/kg iv, was infused into ten dogs during a 2-h period starting 1.5 h after 6 min of complete cerebral ischemia. One hour postischemia, regional cerebral blood flow (rCBF) was 36% in the control group (ten dogs...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/00003246-198607000-00010
更新日期:1986-07-01 00:00:00
abstract::This study evaluates the recall of 100 patients after ICU admission. There was a wide spectrum of race, religion, occupation, and educational levels. The more common diagnoses included asthma, pneumonia, trauma, and adult respiratory distress syndrome. The average Acute Physiology and Chronic Health Evaluation (APACHE...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/00003246-199009000-00012
更新日期:1990-09-01 00:00:00
abstract:OBJECTIVE:To describe a case of hepatic subcapsular hematoma causing an acute Budd-Chiari-like syndrome, leading to hepatic compartment syndrome, which combines compression of intrahepatic vessels on CT, acute liver failure, and refractory shock. DESIGN:Case report. SETTING:Surgical ICU of a university teaching hospi...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/CCM.0000000000001403
更新日期:2016-03-01 00:00:00
abstract::The fractional elimination rate of exogenous fat, and fat-mobilizing lipolysis in relation to plasma catecholamine (CA) levels were studied in seven ventilator-treated ICU patients. Blood levels of CA, triglycerides, cholesterol and free fatty acids (FFA) were also analyzed before and during constant infusion of a soy...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/00003246-198411000-00006
更新日期:1984-11-01 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:OBJECTIVE:To assess the accuracy of mixed venous hemoglobin oxygen saturation estimated, using in vivo pulmonary artery reflectance oximetry with ranging concentrations of carboxyhemoglobin. DESIGN:Criterion standard, a comparison of an alternative test to the "gold standard." SETTING:Laboratory animal facility of a ...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/00003246-199407000-00022
更新日期:1994-07-01 00:00:00
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
更新日期:2007-10-01 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: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:OBJECTIVE:Life-threatening conditions cause severe changes in the organization and conformation of macromolecules, creating urgent requirements for protein repair to ensure survival. As molecular chaperones, heat shock proteins (HSP) that have specialized functions in protein folding are now well established to restore...
journal_title:Critical care medicine
pub_type: 杂志文章,评审
doi:
更新日期:2002-01-01 00:00:00
abstract:OBJECTIVES:a) To quantify the use of do-not-resuscitate orders in a tertiary care children's hospital; and b) to characterize the circumstances in which such orders are written. DESIGN:Retrospective chart review. SETTING:University teaching hospital. PATIENTS:All inpatients who died in an urban children's hospital o...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/00003246-199301000-00012
更新日期:1993-01-01 00:00:00
abstract:OBJECTIVE:To investigate the concentrations of reduced and total glutathione in relation to the muscle free amino acid pattern in critically ill patients and matched healthy controls. DESIGN:Prospective case control. SETTING:University hospital intensive care unit (ICU). PATIENTS:Eleven critically ill patients in th...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/00003246-199701000-00016
更新日期:1997-01-01 00:00:00
abstract:OBJECTIVES:To assess in-hospital neurologic (CNS) complications in adult patients undergoing veno-venous extracorporeal membrane oxygenation for respiratory failure. DESIGN:Retrospective analysis of the Extracorporeal Life Support Organization's data registry. SETTING:Data reported to Extracorporeal Life Support Orga...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/CCM.0000000000002502
更新日期:2017-08-01 00:00:00
abstract:OBJECTIVES:To assess the relations between anemia, serum erythropoietin (EPO), iron status, and inflammatory mediators in multiply traumatized patients. DESIGN:Prospective observational study. SETTING:Intensive care unit. PATIENTS:Twenty-three patients suffering from severe trauma (injury severity score > or =30). ...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/00003246-200104000-00009
更新日期:2001-04-01 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 compare urea nitrogen removal by continuous hemodiafiltration vs. functional native kidneys in critically ill, septic patients receiving > 2 g of amino acids/kg body weight per day. DESIGN:Prospective, comparative, unblinded study. SETTING:Trauma critical care units of a Level I adult trauma hospital. P...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/00003246-199403000-00009
更新日期:1994-03-01 00:00:00
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:OBJECTIVE:To review trial design issues related to control groups. DESIGN:Review of the literature with specific reference to critical care trials. MAIN RESULTS AND CONCLUSIONS:Performing randomized controlled trials in the critical care setting presents specific problems: studies include patients with rapidly lethal...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/CCM.0b013e3181922bf4
更新日期:2009-01-01 00:00:00
abstract:OBJECTIVE:The genetic background of hypertensive crisis is unknown. We examined the association of polymorphisms in genes involved in the renin-angiotensin-aldosterone-system with hypertensive crisis. DESIGN:Population-based case-control study. SETTING:Emergency department at a tertiary care university hospital. PAT...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/00003246-200210000-00010
更新日期:2002-10-01 00:00:00
abstract:OBJECTIVE:A 3-yr study funded by the U.S. Department of Health and Human Services was conducted to identify potential barriers to and opportunities for increasing the number hospitals with donation after cardiac death (DCD) protocols, the support of DCD by individuals involved in the donation request process, and the n...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/CCM.0b013e3181691b2b
更新日期:2008-04-01 00:00:00
abstract:OBJECTIVE:The Sequential Organ Failure Assessment (SOFA) score was developed to quantify the severity of patients' illness, based on the degree of organ dysfunction. This study aimed to evaluate the accuracy and the reliability of SOFA scoring. DESIGN:Prospective study. SETTING:Adult intensive care unit (ICU) in a te...
journal_title:Critical care medicine
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1097/01.ccm.0000178178.02574.ab
更新日期:2005-09-01 00:00:00
abstract:OBJECTIVES:Over 2,500 children undergo hematopoietic stem cell transplantation in the United States each year, and up to 35% require PICU support for life-threatening complications. PICU mortality has dropped from 85% to 44%, but interpretation is confounded by significant cohort heterogeneity. Reports conflict regardi...
journal_title:Critical care medicine
pub_type: 杂志文章,多中心研究
doi:10.1097/CCM.0000000000001085
更新日期:2015-09-01 00:00:00
abstract:OBJECTIVE:To test the hypothesis that the effects of intravenous injection of latex particles would demonstrate the contribution of phagocytosis by mononuclear phagocytes to the development of Escherichia coli-induced acute lung injury in neutropenic guinea pigs. DESIGN:Prospective, controlled, experimental study. Int...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/00003246-199606000-00025
更新日期:1996-06-01 00:00:00
abstract:OBJECTIVE:To examine the effects of mechanical ventilation with a tidal volume of 6 mL/kg compared with 12 mL/kg predicted body weight on hemodynamics, vasopressor use, fluid balance, diuretics, sedation, and neuromuscular blockade within 48 hrs in patients with acute lung injury and acute respiratory distress syndrome...
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:10.1097/01.ccm.0000149836.76063.71
更新日期:2005-01-01 00:00:00
abstract:INTRODUCTION:The difficult airway is a common problem in adult critical care patients. However, the challenge is not just the establishment of a safe airway, but also maintaining that safety over days, weeks, or longer. AIMS:This review considers the management of the difficult airway in the adult critical care enviro...
journal_title:Critical care medicine
pub_type: 杂志文章,评审
doi:10.1097/CCM.0b013e31817d7ae1
更新日期:2008-07-01 00:00:00
abstract:OBJECTIVES:The objectives of the present study were to evaluate, in patients with persistent arterial hypotension in the immediate postcardiac surgery period, the effects of norepinephrine infusion on ventriculo-arterial coupling, its determinants: arterial elastance and end-systolic ventricular elastance, and to test ...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/CCM.0000000000002772
更新日期:2018-01-01 00:00:00
abstract:OBJECTIVE:To evaluate the physiology and pharmacokinetics of a novel hemoglobin-based oxygen carrier of bovine origin. DESIGN:Randomized, single-blind, placebo-controlled, dose-escalation study. SETTING:The Upjohn Research Clinics (Kalamazoo, MI). SUBJECTS:Normal healthy adult men between the ages of 18 and 45 yrs. ...
journal_title:Critical care medicine
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1097/00003246-199605000-00006
更新日期:1996-05-01 00:00:00
abstract:OBJECTIVES:Muscle weakness associated with critical illness can be due to the illness itself, immobilization associated with it, and/or to concomitant use of drugs that affect neuromuscular transmission. This study investigated the contribution of immobilization per se to the muscle dysfunction, as well as the associat...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/00003246-199902000-00031
更新日期:1999-02-01 00:00:00