Abstract:
OBJECTIVE:To test the hypothesis that nebulized nitroprusside and inhaled nitric oxide would not differ in producing selective pulmonary vasodilation during hypoxia-induced pulmonary hypertension in piglets. SETTING:University laboratory. SUBJECTS:Five piglets. INTERVENTIONS:Piglets (n = 5) were anesthetized and instrumented to monitor systemic arterial pressure, pulmonary artery pressure, and cardiac output continuously. Hypoxia was induced (DeltaFio2 from 0.5 to 0.08), and either nebulized nitroprusside (5 mg/mL at 4 L/min flow; total dose 25 mg) or inhaled nitric oxide (20 ppm) was introduced into the ventilator circuit for 15 mins. Normoxia was then restored, and a repeat cycle of hypoxia followed by the alternate vasodilator treatment was initiated. MEASUREMENTS AND MAIN RESULTS:Hypoxia significantly reduced Pao2 (from 206 to 30 torr) and elevated pulmonary artery pressure (from 18 to 33 torr) while not significantly affecting systemic arterial pressure or cardiac output. During hypoxia, inhaled nitric oxide reduced pulmonary artery pressure from 33 to 21 torr (p <.01), whereas systemic arterial pressure and cardiac output were unchanged. During hypoxia, nebulized nitroprusside also reduced pulmonary artery pressure from 33 to 23 mm Hg (p <.01; p = nonsignificant vs. inhaled nitric oxide), whereas systemic arterial pressure and cardiac output again remained constant. The time course of the reduction in pulmonary artery pressure during inhaled nitric oxide was roughly ten-fold more rapid (<5 secs) than during nebulized nitroprusside ( approximately 1 min). Neither inhaled nitric oxide nor nebulized nitroprusside altered pH, Pao2, or Paco2. CONCLUSION:Both inhaled nitric oxide and nebulized nitroprusside produced prompt, significant, selective reduction of pulmonary artery pressure and pulmonary vascular resistance in piglets with hypoxia-induced pulmonary hypertension, without apparent effects on systemic hemodynamics or pulmonary gas exchange. The equivalence of the two effects in this animal model suggests that cautious extrapolation of the use of nebulized nitroprusside as a convenient bridge to inhaled nitric oxide in selected clinical contexts for human infants may be warranted.
journal_name
Crit Care Medjournal_title
Critical care medicineauthors
Schreiber MD,Dixit R,Rudinsky B,Hipps R,Morgan SE,Keith RRT A,Meadow Wdoi
10.1097/00003246-200211000-00026subject
Has Abstractpub_date
2002-11-01 00:00:00pages
2560-5issue
11eissn
0090-3493issn
1530-0293journal_volume
30pub_type
杂志文章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 ...
journal_title:Critical care medicine
pub_type: 杂志文章,评审
doi:10.1097/00003246-200212000-00023
更新日期:2002-12-01 00:00:00
abstract:OBJECTIVES:Existing handheld glucose meters are glucose oxidase (GO)-based. Oxygen side reactions can introduce oxygen dependency, increase potential error, and limit clinical use. Our primary objectives were to: a) introduce a new glucose dehydrogenase (GD)-based electrochemical biosensor for point-of-care testing; b)...
journal_title:Critical care medicine
pub_type: 杂志文章,多中心研究
doi:10.1097/00003246-199803000-00036
更新日期:1998-03-01 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:Neurologic damage following cardiac arrest remains a major burden for modern resuscitation medicine. Cardiopulmonary resuscitation with extracorporeal circulatory support holds the potential to reduce morbidity and mortality. Furthermore, the endogenous gasotransmitter carbon monoxide attracts attention in r...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/CCM.0000000000004242
更新日期:2020-04-01 00:00:00
abstract:OBJECTIVE:To examine the role of platelets, fibrin, and adhesion molecules in mediating neutrophil-endothelial cell interactions in septic shock. DESIGN:Controlled experiments using phase contrast microscopy to examine neutrophil, platelet, and endothelial cell interactions in flowing cell suspensions under simulated ...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/01.ccm.0000139918.80602.57
更新日期:2004-09-01 00:00:00
abstract:OBJECTIVE:Acute aneurysmal subarachnoid hemorrhage (SAH) is a complex multifaceted disorder that plays out over days to weeks. Many patients with SAH are seriously ill and require a prolonged intensive care unit stay. Cardiopulmonary complications are common. The management of patients with SAH focuses on the anticipat...
journal_title:Critical care medicine
pub_type: 杂志文章,评审
doi:10.1097/CCM.0b013e318195865a
更新日期:2009-02-01 00:00:00
abstract:OBJECTIVES:To investigate attitudes and practices regarding oxygen therapy in intensive care units (ICUs) and to devise quantitative descriptive indices. SETTING:Canadian university-affiliated adult ICUs. PARTICIPANTS:Fifty-two medical directors of ICUs in 48 institutions. INTERVENTION:Structured postal questionnair...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/00003246-199912000-00033
更新日期:1999-12-01 00:00:00
abstract:OBJECTIVE:Spread of multidrug-resistant organisms within the intensive care unit (ICU) results in substantial morbidity and mortality. Novel strategies are needed to reduce transmission. This study sought to determine if the use of daily chlorhexidine bathing would decrease the incidence of colonization and bloodstream...
journal_title:Critical care medicine
pub_type: 杂志文章,多中心研究
doi:10.1097/CCM.0b013e31819ffe6d
更新日期:2009-06-01 00:00:00
abstract::It was found that, during 1974, it cost an average of $8842 ($12,909 in 1979) to care for a survivor of severe respiratory distress syndrome (RDS) who required mechanical ventilation in this ICU compared to $2448 ($3574 in 1979) for nonsurvivors. Death in 15 out of the 16 nonsurvivors was accompanied by grade III-IV i...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/00003246-198102000-00005
更新日期:1981-02-01 00:00:00
abstract:OBJECTIVE:In children, like in adults, tracheal intubation is a painful procedure that may induce hypertension, tachycardia, and other undesirable hemodynamic disorders. Although premature neonates are very sensitive to pain and vulnerable to its long-term effects, the need for sedation before tracheal intubation is st...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/01.CCM.0000108883.58081.E3
更新日期:2004-02-01 00:00:00
abstract:OBJECTIVE:To develop a pharmacokinetic-pharmacogenomic population model of morphine in critically ill children with acute respiratory failure. DESIGN:Prospective pharmacokinetic-pharmacogenomic observational study. SETTING:Thirteen PICUs across the United States. PATIENTS:Pediatric subjects (n = 66) mechanically ven...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/CCM.0000000000003741
更新日期:2019-06-01 00:00:00
abstract:OBJECTIVE:To test the hypothesis that therapeutic hypercapnia enhances the proinflammatory responses to endotoxemia in the lung and spleen of rats. DESIGN:Prospective randomized study. SETTINGS:Hospital research institute. SUBJECTS:Forty-eight adult male rats. INTERVENTIONS:Rats were randomly assigned for a 24-hr p...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/CCM.0b013e31820ee1f2
更新日期:2011-06-01 00:00:00
abstract:OBJECTIVES:To evaluate the ability of central venous-to-arterial carbon dioxide pressure difference, central venous oxygen saturation, and the combination of these two parameters to detect extubation failure in critically ill patients. DESIGN:Multicentric, prospective, observational study. SETTING:Three ICUs. PATIEN...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/CCM.0000000000004446
更新日期:2020-10-01 00:00:00
abstract:OBJECTIVE:To determine the number of adult or pediatric intensive care unit patients without documented invasive fungal infection who receive systemic antifungal therapy. DESIGN:A 1-day cross-sectional cohort study. SETTING:One hundred sixty-nine intensive care units in France and Belgium. PATIENTS:All patients stay...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/CCM.0b013e318236f297
更新日期:2012-03-01 00:00:00
abstract:OBJECTIVES:Randomized trials have suggested that hypertonic saline solutions may be superior to mannitol for the treatment of elevated intracranial pressure, but their impact on clinical practice has been limited, partly by their small size. We therefore combined their findings in a meta-analysis. DATA SOURCES:We sear...
journal_title:Critical care medicine
pub_type: 杂志文章,meta分析
doi:10.1097/CCM.0b013e318206b9be
更新日期:2011-03-01 00:00:00
abstract:OBJECTIVE:The aim of this study was to determine whether changing heat and moisture exchangers (HMEs) every 96 hrs rather than 24 hrs would affect their efficacy to preserve the heat and moisture of inspiratory gases. The impact of a prolonged use of the HME on its microbial colonization was also assessed. DESIGN:Pros...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/00003246-200003000-00019
更新日期:2000-03-01 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::A survey of acute care/blood gas laboratories was conducted through the memberships of the Society of Critical Care Medicine ( SCCM ) and the National Association of Medical Directors of Respiratory Care ( NAMDRC ). Data were obtained from 227 laboratories and analyzed for operational characteristics, personnel, analy...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/00003246-198406000-00014
更新日期:1984-06-01 00:00:00
abstract:OBJECTIVE:To determine whether activation of the nuclear enzyme poly(adenosine 5'-diphosphate [ADP]-ribose) synthetase (PARS) contributes to mortality rate, myocardial dysfunction, and cardiovascular collapse in a porcine model of sepsis induced by implantation of an infected clot. DESIGN:Prospective, random animal st...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/00003246-200205000-00004
更新日期:2002-05-01 00:00:00
abstract:OBJECTIVE:The high incidence of lower lobe collapse in adult intensive care patients is well described. We aimed to document the incidence and distribution of acute lobar collapse in the pediatric intensive care setting. The influence of anatomical and pathophysiological differences between the adult and pediatric resp...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/00003246-199908000-00035
更新日期:1999-08-01 00:00:00
abstract:OBJECTIVE:To describe the symptom experiences of family members of patients at high risk for dying in the intensive care unit and to assess risk factors associated with higher symptom burden. DESIGN:Prospective, cross-sectional study. SETTING:Three intensive care units at a large academic medical center. PARTICIPANT...
journal_title:Critical care medicine
pub_type: 杂志文章,多中心研究
doi:10.1097/CCM.0b013e3181cf6d94
更新日期:2010-04-01 00:00:00
abstract:OBJECTIVE:To assess the statistical association of the Acute Physiology and Chronic Health Evaluation (APACHE II) score with multiple intervention and outcome variables in surgical ICU patients. DESIGN:Continuous data collection on every patient admitted to the surgical ICU for a 21-month period. MATERIALS AND METHOD...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/00003246-199108000-00013
更新日期:1991-08-01 00:00:00
abstract::With the thermodilution technique, repeated determination of cardiac index (CI) has become a rapid, easily accomplished, safe procedure. We paired 77 CI determinations measured by direct Fick and thermodilution techniques in 21 patients who underwent myocardial revascularization. Commercially available thermistor-tipp...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/00003246-197509000-00002
更新日期:1975-09-01 00:00:00
abstract:OBJECTIVES:A growing number of patients survive sepsis hospitalizations each year and are at high risk for readmission. However, little is known about temporal trends in hospital-based acute care (emergency department treat-and-release visits and hospital readmission) after sepsis. Our primary objective was to measure ...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/CCM.0000000000002872
更新日期:2018-03-01 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:OBJECTIVES:Ethicists advise that life-sustaining treatment decisions should be made in keeping with patient preferences. Until recently, there has been little systematic study of the impact of patient preferences on the use of various life-sustaining treatments or the consequent cost of hospital care. This prospective ...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/00003246-199611000-00009
更新日期:1996-11-01 00:00:00
abstract:OBJECTIVE:To evaluate premorbid conditions and sociodemographic characteristics associated with differences in hospitalization and mortality rates of sepsis in blacks and whites. DESIGN:Secondary data analysis of the publicly available New Jersey State Inpatient Database for 2002. SETTING:Acute care hospitals in New ...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/01.CCM.0000256726.80998.BF
更新日期:2007-03-01 00:00:00
abstract::To determine whether end-tidal carbon dioxide tension (PETCO2) accurately reflects PaCO2 during high-frequency jet ventilation (HFJV), 43 studies were performed on eight mongrel dogs with normal lungs. During HFJV, minute volume was modified to obtain a range of PaCO2 values from 15.5 to 74.5 torr. When PETCO2 was mea...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/00003246-198610000-00014
更新日期:1986-10-01 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 determine the pharmacokinetics of fentanyl when used as a long-term continuous infusion for sedation/analgesia in mechanically ventilated critically ill infants and children. DESIGN:Prospective, case series. SETTING:A university hospital pediatric intensive care unit (ICU). PATIENTS:Nineteen mechanicall...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/00003246-199307000-00012
更新日期:1993-07-01 00:00:00