Abstract:
OBJECTIVE:To evaluate the early myocardial biochemical inflammatory response with the microdialysis technique during porcine endotoxemia and to simultaneously monitor systemic hemodynamics. DESIGN:Prospective, randomized, placebo-controlled trial with parallel groups. SETTING:Animal research laboratory at the University Hospital of Uppsala, Sweden. SUBJECTS:Thirteen piglets aged 12-14 wks receiving general anesthesia. INTERVENTIONS:After thoracotomy and the insertion of microdialysis probes in standardized locations in the left ventricle of the heart and in the quadriceps muscle, seven pigs received a continuous infusion of endotoxin, initiating a severe endotoxemic shock. Six pigs received saline instead of endotoxin. MEASUREMENTS AND MAIN RESULTS:Endotoxemia caused a rapid and pronounced elevation of a metabolite obtained from prostaglandin degradation, 15-keto-dihydro-PGF(2alpha), in myocardial microdialysate fluid being specific of cyclooxygenase (COX)-mediated inflammation (p <.001 vs. saline-infused controls). Simultaneously, we observed a decrease in left ventricular stroke work index in the endotoxemic pigs (p <.01 vs. saline-infused controls). Endotoxemia did not alter 15-keto-dihydro-PGF(2alpha) levels in quadriceps muscle. Endotoxemia caused increases in taurine, hypoxanthine, and magnesium in myocardial microdialysate (p <.05 vs. saline-infused controls), whereas the contents of pyruvate, lactate, inosine, adenosine, and calcium were not significantly changed. CONCLUSION:Endotoxemia induced a myocardial COX-mediated inflammation without signs of ischemia. In parallel, a depletion of myocardial energy substrates and a deterioration in myocardial performance were seen.
journal_name
Crit Care Medjournal_title
Critical care medicineauthors
Mutschler DK,Eriksson MB,Wikström BG,Lind L,Larsson A,Bergren-Kiiski R,Lagrange A,Nordgren A,Basu Sdoi
10.1097/01.CCM.0000075740.61294.a6subject
Has Abstractpub_date
2003-06-01 00:00:00pages
1780-5issue
6eissn
0090-3493issn
1530-0293journal_volume
31pub_type
杂志文章abstract::Hemodynamic effects of controlled mechanical ventilation (CMV), intermittent mandatory ventilation (IMV), and intermittent mandatory ventilation with 5 cm H20 PEEP (IMV 5 peep) were studied in 20 patients after aortocoronary bypass surgery. Significant increases in cardiac index (CI) and stroke volume index (SI) (p le...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/00003246-198207000-00001
更新日期:1982-07-01 00:00:00
abstract:OBJECTIVE:To study the pharmacokinetics of dopamine in hemodynamically stable adult patients. DESIGN:Prospective clinical study. SETTING:University hospital intensive care unit. PATIENTS:Fourteen patients (aged 43 to 73 yrs) recovering from esophageal surgery. INTERVENTION:Dopamine was infused and blood samples wer...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/00003246-199311000-00013
更新日期:1993-11-01 00:00:00
abstract:OBJECTIVE:Patients with severe sepsis have high mortality that is improved by timely, often expensive, treatments. Patients without insurance are more likely to delay seeking care; they may also receive less intense care. DESIGN:We performed a retrospective analysis of administrative database-Healthcare Costs and Util...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/01.ccm.0000435667.15070.9c
更新日期:2014-03-01 00:00:00
abstract:OBJECTIVES:Mechanical ventilation can cause ventilator-induced brain injury via afferent vagal signaling and hippocampal neurotransmitter imbalances. The triggering mechanisms for vagal signaling during mechanical ventilation are unknown. The objective of this study was to assess whether pulmonary transient receptor po...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/CCM.0000000000003977
更新日期:2019-11-01 00:00:00
abstract:OBJECTIVES:The Accreditation Council for Graduate Medical Education recently released new standards for supervision and duty hours for residency programs. These new standards, which will affect over 100,000 residents, take effect in July 2011. In response to these new guidelines, the Society of Critical Care Medicine c...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/CCM.0b013e318225776f
更新日期:2011-11-01 00:00:00
abstract:OBJECTIVES:Preliminary studies have suggested that low doses of corticosteroids might rapidly improve hemodynamics in late septic shock treated with catecholamines. We examined the effect of hydrocortisone on shock reversal, hemodynamics, and survival in this particular setting. DESIGN:Prospective, randomized, double-...
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:10.1097/00003246-199804000-00010
更新日期:1998-04-01 00:00:00
abstract::A system of instrumentation for continuous measurement of oxygen consumption (VO2), carbon dioxide production (VCO2) and minute ventilation (V1) in human newborns on assisted ventilation is described. VO2 and VCO2 are measured by open-circuit indirect calorimetry utilizing a Servomex OA 184 differential paramagnetic o...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/00003246-198311000-00011
更新日期:1983-11-01 00:00:00
abstract:OBJECTIVE:To determine whether blood lactate, base deficit, or oxygen-derived hemodynamic variables correlate with morbidity and mortality rates in a clinically-relevant LD50 model of penetrating trauma. DESIGN:Prospective, controlled study. SETTING:University research laboratory. SUBJECTS:Anesthetized, mechanically...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/00003246-199901000-00044
更新日期:1999-01-01 00:00:00
abstract:OBJECTIVES:Radial artery applanation tonometry allows completely noninvasive continuous cardiac output estimation. The aim of the present study was to compare cardiac output measurements obtained with applanation tonometry (AT-CO) using the T-Line system (Tensys Medical, San Diego, CA) with cardiac output measured by i...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/CCM.0000000000000979
更新日期:2015-07-01 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:OBJECTIVE:Circulating serum levels of procalcitonin rise significantly during bacterial infection. Because calcitonin is known to be a monocyte chemoattractant, we investigated whether procalcitonin, a prohormone of calcitonin, also affects leukocyte migration. DESIGN:Prospective, controlled in vitro study. SETTING:U...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/00003246-200205000-00025
更新日期:2002-05-01 00:00:00
abstract::Given the limitations of high-dose diuretics and vasodilators and the increasing literature showing that inotropes, regardless of the dose used, have a detrimental effect on mortality, a variety of new agents are under investigation for the treatment of pulmonary and systemic congestion and restoration of cardiac outp...
journal_title:Critical care medicine
pub_type: 杂志文章,评审
doi:10.1097/01.CCM.0000296810.74724.8D
更新日期:2008-01-01 00:00:00
abstract::To evaluate the effect of meconium on pulmonary surface tension properties, the mechanics of 30 excised, separated canine pulmonary lobes were studied. Meconia were blended in normal saline to produce solutions of 10% and 20%. Solutions were filtered to remove large particles and instilled endobronchially into the can...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/00003246-198504000-00005
更新日期:1985-04-01 00:00:00
abstract:OBJECTIVE:To alert health professionals to the need for early detection and prevention of shock in critically ill patients. By describing the associations between intramucosal acidosis in the gut and multiple system organ failure, the author demonstrates how noninvasive measurement of gut intramucosal pH can be used to...
journal_title:Critical care medicine
pub_type: 杂志文章,评审
doi:10.1097/00003246-199302001-00017
更新日期:1993-02-01 00:00:00
abstract:OBJECTIVE:To determine if exogenous interleukin (IL)-10 will decrease the morbidity or mortality of sepsis induced by cecal ligation and puncture. DESIGN:Prospective, randomized, controlled study. SETTING:University research laboratory. SUBJECTS:Adult, female, Balb¿c mice. INTERVENTIONS:Balb¿c mice were subjected t...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/00003246-199805000-00025
更新日期:1998-05-01 00:00:00
abstract:OBJECTIVE:To directly compare the cerebrovascular effects of norepinephrine and dopamine in patients with acute traumatic brain injury. DESIGN:Prospective randomized crossover trial. SETTING:Neurosciences critical care unit of a university hospital. PATIENTS:Ten acutely head-injured patients requiring vasoactive dru...
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.0000120054.32845.a6
更新日期:2004-04-01 00:00:00
abstract::Computers are commonly used to serve many functions in today's modern intensive care unit. One of the most intriguing and perhaps most challenging applications of computers has been to attempt to improve medical education. With the introduction of the first computer, medical educators began looking for ways to incorpo...
journal_title:Critical care medicine
pub_type: 杂志文章,评审
doi:10.1097/00003246-200108001-00006
更新日期:2001-08-01 00:00:00
abstract::Seven dogs with electromagnetic flow probes implanted on their main (QT) and left (QL) pulmonary arteries, had catheters placed in their left atria and pulmonary artery, and were ventilated via Carlen's double-lumen endotracheal tubes. The effect of high-frequency oscillation (HFO) on the redistribution of pulmonary b...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/00003246-198405000-00008
更新日期:1984-05-01 00:00:00
abstract:OBJECTIVE:Trauma induces a state of immunosuppression, which is responsible for the development of nosocomial infections. Hydrocortisone reduces the rate of pneumonia in patients with trauma. Because alterations of dendritic cells and natural killer cells play a central role in trauma-induced immunosuppression, we inve...
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.0000000000000658
更新日期:2014-12-01 00:00:00
abstract:OBJECTIVES:Low tidal volume (= tidal volume ≤ 6 mL/kg, predicted body weight) ventilation using volume control benefits patients with acute respiratory distress syndrome. Airway pressure release ventilation is an alternative to low tidal volume-volume control ventilation, but the release breaths generated are variable ...
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.0000000000003437
更新日期:2018-12-01 00:00:00
abstract:OBJECTIVE:To evaluate the safety of human albumin administered for therapeutic purposes. DESIGN:Retrospective compilation of spontaneously reported serious adverse events. SETTING:Records of serious adverse event reports received from 1990 through 1997 by nine major suppliers of therapeutic human albumin worldwide. ...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/00003246-200105000-00021
更新日期:2001-05-01 00:00:00
abstract:OBJECTIVE:To determine the role of toll-like receptor 2 in cardiac dysfunction during polymicrobial sepsis. DESIGN:Controlled animal study. SETTING:University hospital research laboratory. SUBJECTS:Male C57BL/6, wild-type, toll-like receptor 2-/-. INTERVENTION:Polymicrobial peritonitis, a clinically relevant model ...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/CCM.0b013e3181d99e67
更新日期:2010-05-01 00:00:00
abstract:OBJECTIVES:To describe long-term survival in patients with severe acute respiratory distress syndrome and assess differences in patient characteristics and outcomes among those who receive rescue therapies (prone position ventilation, inhaled nitric oxide, or inhaled epoprostenol) versus conventional treatment. DESIGN...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/CCM.0000000000000322
更新日期:2014-07-01 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:OBJECTIVES:In this study, we evaluated the inflammatory response in patients with severe acute respiratory infection due to the Middle East respiratory syndrome and non-Middle East respiratory syndrome and assessed the presence of distinct inflammatory subphenotypes using latent class analysis. DESIGN:Prospective coho...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/CCM.0000000000004724
更新日期:2021-02-01 00:00:00
abstract:OBJECTIVE:Toxic free radicals cause dysfunction of respiratory muscles, probably leading to respiratory distress. Exposure to high concentrations of oxygen generates plenty of free radicals. Lidocaine scavenges the reactive molecules. The purposes of the current study were first to examine whether hyperoxia impairs dia...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/00003246-200006000-00048
更新日期:2000-06-01 00:00:00
abstract:OBJECTIVES:To determine the amount of spontaneous variability of cardiac output over time in critically ill patients, and to determine the effect of mechanical ventilation on cardiac output variability over time. DESIGN:Case series. SETTING:Medical intensive care unit in a Veterans Affairs Medical Center. PATIENTS:T...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/00003246-199402000-00012
更新日期:1994-02-01 00:00:00
abstract:OBJECTIVE:To explore the potential value of heart rate variability features for automated monitoring of sedation levels in mechanically ventilated ICU patients. DESIGN:Multicenter, pilot study. SETTING:Several ICUs at Massachusetts General Hospital, Boston, MA. PATIENTS:Electrocardiogram recordings from 40 mechanica...
journal_title:Critical care medicine
pub_type: 杂志文章,多中心研究
doi:10.1097/CCM.0000000000001708
更新日期:2016-09-01 00:00:00
abstract:OBJECTIVE:Currently 162-325 mg aspirin is recommended for the treatment of acute coronary syndrome. We tested the effect of an additional loading dose of 250 mg aspirin at the onset of acute coronary syndrome in patients who were already on chronic therapy with 100 mg aspirin. DESIGN:This was a prospective trial in pa...
journal_title:Critical care medicine
pub_type: 杂志文章,随机对照试验
doi:10.1097/CCM.0b013e3181de8b1e
更新日期:2010-06-01 00:00:00
abstract:BACKGROUND AND METHODS:We postulated that low-dose heparin (10 IU/kg.hr) administered as a continuous iv infusion may prevent or ameliorate the induction of thrombin-induced disseminated intravascular coagulation in baboons under general anesthesia. In a nonrandomized experiment lasting 8 hrs, animals were divided into...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/00003246-199109000-00017
更新日期:1991-09-01 00:00:00