Abstract:
OBJECTIVE:To assess the effect of diisopropyl phenol (propofol), with and without Intralipid, on the cardiopulmonary system and on thromboxane production in endotoxic pigs. DESIGN:Prospective, randomized animal study. SETTING:Animal research laboratory at a major teaching hospital. SUBJECTS:Twenty-four pigs, divided into three groups (n = 8). INTERVENTIONS:Pulmonary arterial catheters and arterial cannulas were inserted into all pigs. Each pig received a 30 ng/kg bolus of endotoxin at 1 hr, followed by a continuous infusion of endotoxin at 24 ng x kg-1 x hr-1. Diisopropyl phenol at 25, 75, and 200 microg x kg-1 x min-1 was administered to all pigs, beginning at 1, 2, and 3 hrs, respectively. The pigs were divided into three groups to receive 0.25 g x kg-1 x hr-1, 0.08 g x kg-1 x hr-1, or no Intralipid, starting at time t = 0. Heart rate and mean arterial, central venous, and pulmonary arterial pressures were recorded continuously. Core temperature, arterial blood gases, mixed venous oxygen saturation, pulmonary arterial occlusion pressure, and cardiac output were measured intermittently. Thromboxane B(2) concentrations were measured at baseline and at 60, 75, 120, 135, 180, 195, and 240 mins. Data are expressed as mean +/- sd. Groups were compared by using repeated analysis of variance, with p <.05 used for statistical significance. MEASUREMENTS AND MAIN RESULTS:All pigs completed the 4-hr study. Marked variabilities were noted for individual pigs. Following the infusion of endotoxin, compared with baseline, there was a significant increase in pulmonary vascular resistance and a decrease in Pao(2) (p <.001 and p <.008, respectively). This response was not affected by the increasing dose of diisopropyl phenol, nor were there differences between the Intralipid and control groups. Pao(2) remained significantly lower in all groups, compared with the baseline measurements (p <.001) over the 4 hrs of the experiment. Thromboxane B(2) concentrations remained elevated compared with baseline and were significantly higher (p <.05) in the high-dose Intralipid group, compared with the low-dose and the control groups, during the last hour of the experiment. CONCLUSIONS:Small doses of endotoxin, when given to pigs, induce major perturbations of cardiopulmonary function. Neither Intralipid, high vs. low dose, nor diisopropyl phenol, at sedating vs. anesthetizing doses, worsened the physiologic derangement associated with the stress of low-dose endotoxemia.
journal_name
Crit Care Medjournal_title
Critical care medicineauthors
Ziser A,Strickland RA,Murray MJdoi
10.1097/01.CCM.0000070445.76287.6Esubject
Has Abstractpub_date
2003-07-01 00:00:00pages
2029-33issue
7eissn
0090-3493issn
1530-0293journal_volume
31pub_type
杂志文章abstract:OBJECTIVE:To determine daily amino acid and total protein losses in patients with acute renal failure receiving total parenteral nutrition (TPN) during treatment by continuous arteriovenous hemofiltration with hemodialysis (CAVHD). DESIGN:Prospective, nonrandomized study. SETTING:Patients in the ICU of a regional nep...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/00003246-199112000-00012
更新日期:1991-12-01 00:00:00
abstract:OBJECTIVE:Cytokines and adhesion molecules have a decisive role in the development of early inflammatory response as well as the late sequelae of sepsis. Because L-selectin-deficient mice are protected from lethal endotoxemia, blockade of L-selectin may provide a useful therapeutic option in human sepsis. Heparin has i...
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.0000059441.70680.DC
更新日期:2003-04-01 00:00:00
abstract::Right ventricular size and contractility were evaluated using two-dimensional echocardiography during the first days of respiratory support in 23 patients requiring mechanical ventilation for acute respiratory failure. Nine patients had normal echocardiographic right ventricular function, and nine other patients had a...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/00003246-198511000-00035
更新日期:1985-11-01 00:00:00
abstract:OBJECTIVES:To review the reports of prolonged neuromuscular blockade secondary to vecuronium and atracurium administration. To propose mechanisms for prolonged blockade, as well as methods to avoid prolonged blockade. DATA SOURCES:A literature search was conducted of articles published from 1980 to 1993. Articles pert...
journal_title:Critical care medicine
pub_type: 杂志文章,评审
doi:10.1097/00003246-199405000-00028
更新日期:1994-05-01 00:00:00
abstract:OBJECTIVE:Acute respiratory distress syndrome is an abrupt inflammatory illness that involves damage from reactive oxygen species. We examined the efficacy and safety of oxothiazolidine-4-carboxylic acid (OTZ), a free radical scavenger, in treating acute respiratory distress syndrome. DESIGN:Double-blind, placebo-cont...
journal_title:Critical care medicine
pub_type: 杂志文章,多中心研究,随机对照试验
doi:10.1097/CCM.0B013E318164E7E4
更新日期:2008-03-01 00:00:00
abstract:OBJECTIVES:To compare 1-year all-cause mortality and major adverse cardiovascular events in cardiac arrest survivors with and without posttraumatic stress disorder symptomatology at hospital discharge. DESIGN:Prospective, observational cohort. SETTING:ICUs at a tertiary-care center. PATIENTS:Adults with return of sp...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/CCM.0000000000003713
更新日期:2019-06-01 00:00:00
abstract:OBJECTIVES:We recently reported that bacterial lipopolysaccharide stimulates release of tumor necrosis factor (TNF)-alpha from both human vascular tissue and cultured smooth muscle cells. In the current study, we tested the hypothesis that increased intracellular cyclic adenosine 3',5'-monophosphate (cAMP) could inhibi...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/00003246-199711000-00025
更新日期:1997-11-01 00:00:00
abstract:OBJECTIVES:Explosive traumatic injury to an extremity may lead to both local and distant organ injury. Regional traumatic tissue hypothermia has been reported to offer systemic protection; here we investigated the protective effects of regional limb hypothermia on local tissue trauma and the lungs. Furthermore, the opt...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/CCM.0b013e3182a84daa
更新日期:2014-01-01 00:00:00
abstract:OBJECTIVE:To describe and identify factors associated with mortality rate and quality of life 1 yr after prolonged mechanical ventilation. DESIGN:Prospective, observational cohort study with patient recruitment over 26 months and follow-up for 1 yr. SETTING:Intensive care units at a tertiary care university hospital....
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/01.CCM.0000098029.65347.F9
更新日期:2004-01-01 00:00:00
abstract:OBJECTIVE:Anesthetic preconditioning appears to be a viable strategy to treat ischemic cerebral injury. Here we investigated 1) whether the protection conferred by sevoflurane preconditioning sustains in time; 2) whether sevoflurane preconditioning diminishes mitochondrial dysfunction following cerebral ischemia; and 3...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/CCM.0b013e318258fb90
更新日期:2012-09-01 00:00:00
abstract:OBJECTIVE:Families and other surrogate decisionmakers for chronically critically ill patients often lack information about patient prognosis or options for care. This study describes an approach to develop and validate a printed information brochure about chronic critical illness aimed at improving comprehension of the...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/CCM.0b013e31822d7901
更新日期:2012-01-01 00:00:00
abstract::The conjunctival oxygen monitor reflects oxygen tension of the internal carotid artery without introducing the heating artifact characteristic of transcutaneous monitors. It is now being used in the ICU and the operating room to measure accurately and continuously Po2 and temperature of conjunctival tissue. We examine...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/00003246-198508000-00016
更新日期:1985-08-01 00:00:00
abstract:OBJECTIVE:Carbon monoxide (CO), an endogenous byproduct of heme metabolism, is produced at high levels in injured tissue via induction of heme-oxygenase-1 activity, where it contributes to the modulation of proinflammatory processes. Alone, CO has potent anti-inflammatory effects in models of acute and chronic inflamma...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/01.ccm.0000166349.76514.40
更新日期:2005-06-01 00:00:00
abstract:OBJECTIVE:Acute-phase proteins, such as C-reactive protein and albumin, may be related with course and outcome in status epilepticus, as changes of cytokine levels and blood-brain barrier breakdown during status epilepticus have been demonstrated. The aim of this study was to elucidate the association of C-reactive pro...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/CCM.0b013e318287f2ac
更新日期:2013-06-01 00:00:00
abstract::We developed a method to measure accurately pressures at the airway opening (Pao) and in the trachea (Ptr) in neonates during high frequency oscillatory ventilation (HFOV) from 15-30 Hz. All component parts of the pressure-measuring system were tested as a unit against a reference transducer in a closed chamber in whi...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/00003246-198401000-00011
更新日期:1984-01-01 00:00:00
abstract:BACKGROUND:Nutritional support is an essential component of the management of critically ill and injured ICU patients. Optimal provision of calories and protein has been demonstrated to reduce morbidity, mortally, and length of ICU and hospital stay. Yet, a large proportion of ICU patients receive inadequate nutrition....
journal_title:Critical care medicine
pub_type: 杂志文章,评审
doi:10.1097/CCM.0000000000000051
更新日期:2014-04-01 00:00:00
abstract:OBJECTIVE:To examine the isolated and combined effects of positive end-expiratory pressure (PEEP) and partial liquid ventilation (PLV) on the development of ventilator-induced lung injury in an ovine model. DESIGN:Prospective controlled animal study. SETTING:University-based cardiovascular animal physiology laborator...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/00003246-200201000-00026
更新日期:2002-01-01 00:00:00
abstract:OBJECTIVE:The purpose of this study is to: 1) describe a newly mechanism of blood flow to the brain during cardiopulmonary resuscitation using the impedance threshold device in a piglet model of cardiac arrest, and 2) describe the survival benefits in humans of applying all of the highly recommended changes in the 2005...
journal_title:Critical care medicine
pub_type: 杂志文章,多中心研究
doi:10.1097/ccm.0b013e31818a7e56
更新日期:2008-11-01 00:00:00
abstract:OBJECTIVE:To investigate whether inhibition of cyclooxygenase-2, a critical component of the inflammatory pathway, is neuroprotective in a neonatal rat model of cerebral hypoxia-ischemia. The development of brain inflammation largely contributes to neonatal brain injury that may lead to a lifetime of neurologic deficit...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/CCM.0b013e3181cb1158
更新日期:2010-02-01 00:00:00
abstract::Little is known about the structure and objectives of various hospital ethics committees due to their need to preserve confidentiality, their reluctance to reveal internal hospital problems, and their concern about becoming involved in the developing debate about the appropriate role and value of such committees. The ...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/00003246-198211000-00018
更新日期:1982-11-01 00:00:00
abstract:OBJECTIVE:To investigate the interrelationship between cardiac surgery, age, circulating concentrations of the vitamin D hormone 1,25-dihydroxyvitamin D, and clinical outcome. DESIGN:Prospective, monocentric, two-arm parallel study. SETTING:Tertiary Heart and Diabetes Center in the Federal State of North Rhine-Westph...
journal_title:Critical care medicine
pub_type: 临床试验,杂志文章
doi:10.1097/CCM.0b013e31824e8c42
更新日期:2012-07-01 00:00:00
abstract:OBJECTIVES:To determine whether delirium during ICU stay is associated with long-term mental health problems defined as symptoms of anxiety, depression, and posttraumatic stress disorder. DESIGN:Prospective cohort study. SETTING:Survey study, 1 year after discharge from a medical-surgical ICU in the Netherlands. PAT...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/CCM.0000000000001861
更新日期:2016-10-01 00:00:00
abstract:OBJECTIVE:To document the effects of propofol on the hemodynamic and inflammatory responses to endotoxemia in an animal model. DESIGN:Randomized, prospective laboratory study. SETTING:University experimental laboratory. SUBJECTS:Thirty-two male rats. INTERVENTIONS:The animals were randomly assigned to one of four g...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/00003246-200004000-00032
更新日期:2000-04-01 00:00:00
abstract:OBJECTIVES:To determine the effects of sustained, 3-day endotoxin infusion on early steps of the insulin-signaling pathway in rat liver and skeletal muscle in vivo; to examine insulin signaling in well-established acute endotoxin models of insulin resistance. DESIGN:Prospective, controlled animal study. SETTING:Unive...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/00003246-200104000-00032
更新日期:2001-04-01 00:00:00
abstract:OBJECTIVE:Initial success with chimeric antigen receptor-modified T cell therapy for relapsed/refractory acute lymphoblastic leukemia is leading to expanded use through multicenter trials. Cytokine release syndrome, the most severe toxicity, presents a novel critical illness syndrome with limited data regarding diagnos...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/CCM.0000000000002053
更新日期:2017-02-01 00:00:00
abstract:OBJECTIVES:Lung contusion is a major risk factor for the development of acute respiratory distress syndrome. We set to determine the role of toll-like receptor 3 and the binding of double-stranded RNA in the pathogenesis of sterile injury following lung contusion. DESIGN:Toll-like receptor 3 expression was analyzed in...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/CCM.0000000000001879
更新日期:2016-11-01 00:00:00
abstract:OBJECTIVES:Chronic subdural hematoma is a commonly encountered disease in neurosurgic practice, whereas its increasing prevalence is compatible with the ageing population. Recommendations concerning postoperative thrombosis prophylaxis after burr-hole drainage of chronic subdural hematoma are lacking. The aim of this s...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/CCM.0000000000002804
更新日期:2018-01-01 00:00:00
abstract:OBJECTIVE:To determine the effectiveness of increasing the preoxygenation period with 100% oxygen in the critically ill patient from 4 to 8 mins in preparation for emergency tracheal intubation. DESIGN:Nonrandomized, controlled trial. SETTING:Large, level one trauma center, tertiary care intensive care unit. PATIENT...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/CCM.0b013e318192845e
更新日期:2009-01-01 00:00:00
abstract::Although systolic dysfunction of the left ventricle has been characterized in septic shock (SS) and sepsis without shock (SWS), diastolic abnormalities are less well characterized. Diastolic filling was determined using pulsed Doppler transmitral spectral tracings in 13 patients with SS, ten patients with SWS, and 33 ...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/00003246-199007000-00005
更新日期:1990-07-01 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