Abstract:
OBJECTIVE:To describe the effects of inhaled prostacyclin administered after cardiopulmonary bypass (CPB) to a patient with severe pulmonary hypertension. DESIGN:Case report and literature review. SETTING:Cardiac surgical operating rooms and postoperative recovery unit. PATIENTS:A 63-yr-old female who had undergone mitral and aortic valve replacement for rheumatic heart disease. INTERVENTIONS:Administration of inhaled prostacyclin to decrease pulmonary artery pressures and to permit discontinuation of CPB. MEASUREMENTS AND MAIN RESULTS:The patient was unable to be removed from CPB because of severe pulmonary hypertension precipitating acute right heart failure, despite administration of milrinone, norepinephrine, and nitroglycerin infusions. Inhaled prostacyclin was started at a dosage of 50 ng/kg/min, and the patient was able to be weaned from CPB. The inhaled prostacyclin was continued for 4 days postoperatively, with no signs of tolerance or systemic effects. CONCLUSION:Inhaled prostacyclin is an effective and selective pulmonary vasodilator at the dosage given in this report. Prolonged use is not associated with tolerance or systemic effects. The apparatus required for the delivery of inhaled prostacyclin is simple, inexpensive, and readily available in most hospitals. A review of the literature suggests that inhaled prostacyclin is effective in a number of clinical settings and displays comparable efficacy and hemodynamic effects to inhaled nitric oxide.
journal_name
Crit Care Medjournal_title
Critical care medicineauthors
Lowson SM,Doctor A,Walsh BK,Doorley PAdoi
10.1097/00003246-200212000-00023subject
Has Abstractpub_date
2002-12-01 00:00:00pages
2762-4issue
12eissn
0090-3493issn
1530-0293journal_volume
30pub_type
杂志文章,评审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:OBJECTIVES:Cardiac arrest etiology may be an important source of between-patient heterogeneity, but the impact of etiology on organ injury is unknown. We tested the hypothesis that asphyxial cardiac arrest results in greater neurologic injury than cardiac etiology cardiac arrest (ventricular fibrillation cardiac arrest...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/CCM.0000000000003070
更新日期:2018-06-01 00:00:00
abstract:OBJECTIVES:To evaluate the preload dependence of femoral maximal change in pressure over time (dP/dtmax) during volume expansion in preload dependent and independent critically ill patients. DESIGN:Retrospective database analysis. SETTING:Two adult polyvalent ICUs. PATIENTS:Twenty-five critically ill patients with a...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/CCM.0000000000004515
更新日期:2020-10-01 00:00:00
abstract:OBJECTIVES:In patients with acute hypoxemic respiratory failure, noninvasive ventilation and high-flow nasal cannula oxygen are alternative strategies to conventional oxygen therapy. Endotracheal intubation is frequently needed in these patients with a risk of delay, and early predictors of failure may help clinicians ...
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.0000000000002818
更新日期:2018-02-01 00:00:00
abstract:SUBJECT:After transient global cerebral ischemia, selective vulnerable brain areas show delayed neurodegeneration with characteristics of apoptosis. Recent data demonstrate potent neuroprotective effects of the application of endogenous growth hormones such as brain-derived neurotrophic factor (BDNF) after focal cerebr...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/01.ccm.0000134223.09056.fc
更新日期:2004-09-01 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
abstract:OBJECTIVE:The Acute Respiratory Distress Syndrome Network protocol recommends limiting tidal volume and plateau pressure; it also recommends increasing respiratory rate to prevent hypercapnia. We tested a strategy that combines the low tidal volume with lower respiratory rates and minimally invasive CO2 removal. SUBJE...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/CCM.0000000000000312
更新日期:2014-06-01 00:00:00
abstract:OBJECTIVE:The aim of this study was to investigate whether hyperglycemia enhances the systemic inflammatory response and oxidative stress induced by endotoxin. DESIGN:Laboratory investigation. SETTING:University medical school. SUBJECTS:Forty-one male Sprague-Dawley rats. INTERVENTIONS:A hyperglycemic condition was...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/01.ccm.0000163225.88827.63
更新日期:2005-05-01 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:To present electron micrographs of lung tissue obtained from a patient exposed to high ventilatory pressures in the context of pulmonary dysfunction and pulmonary hypertension. DESIGN:Case report. SETTING:Adult intensive care unit of a university-affiliated teaching hospital. PATIENTS:A patient exposed to ...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/00003246-200210000-00030
更新日期:2002-10-01 00:00:00
abstract:OBJECTIVE:To investigate, in restrictive patients, the influence of pressure ramp slope values on the efficacy of pressure support ventilation. DESIGN:Prospective study. SETTING:A university hospital medical intensive care unit. PATIENTS:Twelve intubated restrictive patients. INTERVENTIONS:Patients were randomly as...
journal_title:Critical care medicine
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1097/00003246-199904000-00023
更新日期:1999-04-01 00:00:00
abstract:OBJECTIVE:During cardiopulmonary bypass, inflammation and immunosuppression is present. We measured circulating mediators and monocyte-based functions and tested the hypothesis that these variables are influenced by methylprednisolone (MP) or tirilazad mesylate (TM) treatment. DESIGN:Randomized, controlled, double-bli...
journal_title:Critical care medicine
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1097/00003246-200111000-00015
更新日期:2001-11-01 00:00:00
abstract:OBJECTIVE:The association between cigarette smoke exposure and the acute respiratory distress syndrome in patients with the most common acute respiratory distress syndrome risk factors of sepsis, pneumonia, and aspiration has not been well studied. The goal of this study was to test the association between biomarker-co...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/CCM.0000000000001089
更新日期:2015-09-01 00:00:00
abstract::We report a case of an amniotic fluid embolism (AFE) causing a cardiorespiratory arrest associated temporally with ingestion of castor oil in a full-term normal pregnancy. Risk factors usually associated with AFE were not found in this patient. ...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/00003246-198806000-00016
更新日期:1988-06-01 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:OBJECTIVE:To investigate the association of collaboration between intensive care unit (ICU) physicians and nurses and patient outcome. DESIGN:Prospective, descriptive, correlational study using self-report instruments. SETTINGS:A community teaching hospital medical ICU, a university teaching hospital surgical ICU, an...
journal_title:Critical care medicine
pub_type: 杂志文章,多中心研究
doi:10.1097/00003246-199909000-00045
更新日期:1999-09-01 00:00:00
abstract:OBJECTIVES:Sepsis, a life-threatening organ dysfunction caused by a dysregulated host response to infection, is a leading cause of death and disability among children worldwide. Identifying sepsis in pediatric patients is difficult and can lead to treatment delay. Our objective was to assess the host proteomic response...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/CCM.0000000000004083
更新日期:2020-01-01 00:00:00
abstract:OBJECTIVE:To evaluate the use of enriched thioglycolate as a transport medium of protected specimen brush samples, in particular its value in direct examination of respiratory specimens and in guiding initial antibiotic prescription. DESIGN:Prospective, randomized, pilot study. SETTING:Medical-surgical teaching inten...
journal_title:Critical care medicine
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1097/00003246-200202000-00008
更新日期:2002-02-01 00:00:00
abstract:OBJECTIVE:To determine the influence of a selective, sterile central nervous system surgery on immune reactivity, particularly whether a decrease of monocytic human leukocyte antigen-DR expression, indicating immunodepression, occurs after neurosurgery and if this measurement is useful for identification of patients wi...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/00003246-199512000-00006
更新日期:1995-12-01 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: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...
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pub_type: 杂志文章
doi:10.1097/CCM.0b013e3182746736
更新日期:2013-03-01 00:00:00
abstract:OBJECTIVE:To investigate the optimal rewarming rate following therapeutic hypothermia in a rate model of cardiopulmonary resuscitation. Both clinical and laboratory studies have demonstrated that mild therapeutic hypothermia following cardiopulmonary resuscitation improves myocardial and neurologic outcomes of cardiac ...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/CCM.0b013e3182a63fff
更新日期:2014-02-01 00:00:00
abstract:OBJECTIVES:Clinical applications of inhaled nitric oxide (NO) therapy resulted in the development of delivery systems and monitoring devices applicable to routine clinical care. This article presents the various components necessary for an adequate clinical use of inhaled NO, and discusses the NO gas mixture cylinders,...
journal_title:Critical care medicine
pub_type: 杂志文章,评审
doi:10.1097/00003246-199804000-00033
更新日期:1998-04-01 00:00:00
abstract:OBJECTIVE:To determine whether continuous gas flow in the breathing circuit or an airleak around the tracheal tube cuff will introduce errors into the measurement of oxygen consumption (VO2) with indirect calorimetry. DESIGN:Nonrandomized, controlled trial. SETTING:Experimental laboratory. SUBJECTS:Ten healthy, anes...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/00003246-199209000-00023
更新日期:1992-09-01 00:00:00
abstract::The care of critically ill children has become more complex and demanding. This document establishes recommendations for developing regionalized integration of the care of these children into the emergency medical services system. These recommendations were developed by pediatricians with expertise in pediatric critic...
journal_title:Critical care medicine
pub_type: 共识发展会议,杂志文章,评审
doi:10.1097/00003246-200001000-00040
更新日期:2000-01-01 00:00:00
abstract:OBJECTIVE:Fibrotic changes are initiated early in acute respiratory distress syndrome. This may involve overproliferation of alveolar type II cells. In an animal model of acute respiratory distress syndrome, we have shown that the administration of an adenoviral vector overexpressing the 70-kd heat shock protein (AdHSP...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/01.CCM.0000295473.56522.EF
更新日期:2008-01-01 00:00:00
abstract:OBJECTIVE:To determine the effects of accidental injury of varying severity on interleukin (IL)-1 alpha, IL-6, IL-8, tumor necrosis factor-alpha (TNF-alpha), and endotoxin release. DESIGN:Prospective, multi-unit, longitudinal study. SETTING:Emergency Departments and intensive care units of two university hospitals. ...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/00003246-199306000-00010
更新日期:1993-06-01 00:00:00
abstract:OBJECTIVE:Anecdotal reports suggest that propofol (Diprivan) may stimulate mucus hypersecretion in patients without pulmonary disease. The purpose of this study was to evaluate the effect of methohexital or propofol anesthesia on the physical and transport properties of airway mucus in spontaneously breathing dogs. DE...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/00003246-200105000-00035
更新日期:2001-05-01 00:00:00
abstract::One hundred six early features were retrospectively collected on 44 patients with acute pancreatitis and stored in a database programmed on a microcomputer. Intraoperative/autopsy findings or clinical course categorized patients as having severe (n = 16) or mild (n = 28) pancreatitis. The frequency of 88 early availab...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/00003246-198904000-00004
更新日期:1989-04-01 00:00:00
abstract:BACKGROUND AND METHODS:A study was performed to examine the effects of the calcium-channel blocker levemopamil on neurologic outcome and neuropathology in a clinically relevant model of complete global cerebral ischemia (ventricular fibrillation in cats). Levemopamil was administered to cats starting 5 mins after resus...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/00003246-199201000-00025
更新日期:1992-01-01 00:00:00