Abstract:
OBJECTIVE:To examine the effect of hypertonic saline on bacterial translocation and the number and function of natural killer and T cells in controlled hemorrhagic shock. DESIGN:Randomized controlled study. Duration of follow-up was 24 hrs. SETTING:University research laboratory. SUBJECTS:Adult male Sprague-Dawley rats, weighing 310-390 g. INTERVENTIONS:Controlled hemorrhagic shock was induced by blood withdrawal (mean arterial pressure, 30-40 mm Hg) and maintained for 30 mins. The animals were randomly divided into three groups: group 1 (n = 10) was sham-operated, group 2 (n = 10) was untreated, and group 3 was treated with 5 mL/kg hypertonic saline (n = 10). The rats were killed after 24 hrs. MEASUREMENTS AND MAIN RESULTS:Infusion of hypertonic saline in group 3 was followed by reduced bacterial translocation rate (5.0 +/- 2.2% vs. 18.3 +/- 5.3%, p <.033). The total mass of bacteria isolated from hypertonic saline-treated animals with bacterial translocation was 7.8- to 10.4-fold less than that from untreated rats. Controlled hemorrhagic shock resulted in a low percentage of CD4+ cells in blood (35.2 +/- 3.9%, p <.05) and lymph nodes (44.4 +/- 4.5%, p <.05) and depressed CD4 expression on blood (82 +/- 13 arbitrary units, p <.005) and lymph node (168 +/- 24 arbitrary units, p <.03) cells. A compensatory mobilization of NKR-P1+ cells from lymph nodes (8.6 +/- 2.3%, p <.05) to blood (21.2 +/- 5.2%, p <.01) with down-regulated NKR-P1 expression on blood cells (59 +/- 10 arbitrary units, p <.005) was observed. Natural killer cell-mediated cytotoxicity was decreased (67.9 +/- 9.7%, p <.05). Hypertonic saline treatment greatly stimulated CD4 expression on blood (419 +/- 113 arbitrary units, p <.005) and lymph node (553 +/- 115 arbitrary units, p <.03) cells. Also, normalization of NKR-P1 expression (160 +/- 19 arbitrary units, p <.005) and restoration of natural killer cell-mediated cytotoxicity to near normal values (88.6 +/- 7.4%, p <.05) were demonstrated. CONCLUSION:Controlled hemorrhagic shock was accompanied by CD4+ cells suppression and excessive recruitment of natural killer cells with abnormally low NKR-P1 expression and suppressed cytolytic activity into circulation. Infusion of hypertonic saline reversed these changes and reduced bacterial translocation.
journal_name
Crit Care Medjournal_title
Critical care medicineauthors
Hirsh M,Dyugovskaya L,Bashenko Y,Krausz MMdoi
10.1097/00003246-200204000-00025subject
Has Abstractpub_date
2002-04-01 00:00:00pages
861-7issue
4eissn
0090-3493issn
1530-0293journal_volume
30pub_type
杂志文章abstract:OBJECTIVE:The Cardiac Arrhythmia Suppression Trial II showed that moricizine acutely increases the occurrence of sudden cardiac death. Thus the objective of this investigation was to evaluate the antifibrillatory properties of moricizine (a new antiarrhythmic agent) alone and in combination with lidocaine (an establish...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/00003246-199310000-00029
更新日期:1993-10-01 00:00:00
abstract:OBJECTIVE:Liquid lung ventilation has been demonstrated to improve cardiorespiratory function after cardiopulmonary bypass. We hypothesized that liquid lung ventilation (LLV) would decrease the pulmonary inflammatory response after cardiopulmonary bypass (CPB). DESIGN:Prospective, randomized, experimental, controlled,...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/00003246-200104000-00021
更新日期:2001-04-01 00:00:00
abstract:OBJECTIVES:To perform a complete immunological characterization of compensatory anti-inflammatory response syndrome in patients with sepsis and to explore the relationship between these changes and clinical outcomes of 28-day mortality and secondary infections. DESIGN:Prospective single-center study conducted between ...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/CCM.0000000000000100
更新日期:2014-04-01 00:00:00
abstract::Pentoxifylline has been shown to increase red blood cell malleability, thus increasing capillary blood flow in a number of disease states. The present study was undertaken to determine whether pentoxifylline might improve tissue oxygenation after anesthesia and during an operation in rats. Rats were anesthetized and d...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/00003246-198702000-00001
更新日期:1987-02-01 00:00:00
abstract:OBJECTIVES:To describe the effectiveness of a comprehensive, interdisciplinary sepsis treatment protocol with regard to both implementation and outcomes and to compare the mortality rates and therapies of patients with septic shock with similar historical controls. DESIGN:Prospective, interventional cohort study with ...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/01.CCM.0000206104.18647.A8
更新日期:2006-04-01 00:00:00
abstract:OBJECTIVES:In the Acute Respiratory Distress Syndrome Network randomized controlled trial, methylprednisolone treatment was associated with increased return to mechanical ventilation with partial loss of early improvements. We hypothesize a causal relationship between protocol-driven rapid discontinuation of methylpred...
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.0000000000003021
更新日期:2018-06-01 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:OBJECTIVE:To determine the accuracy and reproducibility of four thermodilution indicators (5-mL room temperature, 10-mL room temperature, 5-mL iced, and 10-mL iced injectates) at clinically relevant flow rates. DESIGN:Quasi-experimental study. SETTING:Animal research laboratory of a health sciences university. SUBJE...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/00003246-199304000-00021
更新日期:1993-04-01 00:00:00
abstract::The current definition of sepsis is life-threatening, acute organ dysfunction secondary to a dysregulated host response to infection. Criteria to operationalize this definition can be judged by six domains of usefulness (reliability, content, construct and criterion validity, measurement burden, and timeliness). The r...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/CCM.0000000000001724
更新日期:2016-03-01 00:00:00
abstract:OBJECTIVE:Information booklets have not been assessed by the families of intensive care unit (ICU) patients. This study explored the information that the relatives of adult ICU patients wanted to find in the information booklets. DESIGN:Multicenter survey. SETTING:Twenty-three French ICUs. SUBJECTS:One close relativ...
journal_title:Critical care medicine
pub_type: 杂志文章,多中心研究
doi:10.1097/CCM.0b013e3181a03063
更新日期:2009-07-01 00:00:00
abstract:OBJECTIVE:We hypothesized that deficiency in 25-hydroxyvitamin D before hospital admission would be associated with all-cause mortality in the critically ill. DESIGN:Multicenter observational study of patients treated in medical and surgical intensive care units. SETTING:A total of 209 medical and surgical intensive ...
journal_title:Critical care medicine
pub_type: 杂志文章,多中心研究
doi:10.1097/CCM.0b013e318206ccdf
更新日期:2011-04-01 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:OBJECTIVES:We examined recommendations within critical care guidelines to describe the pairing patterns for strength of recommendation and quality of evidence. We further identified recommendations where the reported strength of recommendation was strong while the reported quality of evidence was not high/moderate and ...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/CCM.0000000000003467
更新日期:2019-01-01 00:00:00
abstract:OBJECTIVE:Expert task forces have proposed that adult critical care medicine services should be regionalized in order to improve outcomes. However, it is currently unknown if high intensive care unit (ICU) patient volumes are associated with reduced mortality rate. The objective was to investigate whether high-volume I...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/01.CCM.0000226415.93237.84
更新日期:2006-07-01 00:00:00
abstract:OBJECTIVE:To test whether intensive care unit (ICU) nasal screening for methicillin-resistant Staphylococcus aureus (MRSA) predicts the presence or absence of MRSA infections requiring antimicrobial treatment. DESIGN:A prospective cohort study. SETTING:Medical ICU at Barnes-Jewish Hospital, a 1252-bed urban teaching ...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/CCM.0b013e3181eeda3f
更新日期:2010-10-01 00:00:00
abstract:OBJECTIVE:To evaluate a novel combination of preoperative, intraoperative, and postoperative variables (including the Parsonnet, and the Acute Physiology and Chronic Health Evaluation II and III [APACHE II and III] scores) in cardiac surgery patients in order to predict hospital outcome, complications, and length of st...
journal_title:Critical care medicine
pub_type: 临床试验,杂志文章
doi:10.1097/00003246-199511000-00010
更新日期:1995-11-01 00:00:00
abstract:OBJECTIVES:To determine nuclear factor kappa B (NF-kappa B) activation in mononuclear and neutrophils from critically ill patients and to compare NF-kappa B activation with circulating concentrations of interleukin (IL)-6, IL-8, and soluble intercellular adhesion molecule (sICAM)-1. DESIGN:Observational study. SETTIN...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/00003246-200004000-00022
更新日期:2000-04-01 00:00:00
abstract:OBJECTIVE:To describe the current status and the clinical data related to the effects of tight glucose control by intensive insulin therapy in critically ill patients. DESIGN:Review article. SETTING:University hospital. PATIENTS:Medical and surgical critically ill patients in whom a correlation between blood glucose...
journal_title:Critical care medicine
pub_type: 杂志文章,评审
doi:10.1097/01.CCM.0000278046.24345.C7
更新日期:2007-09-01 00:00:00
abstract:OBJECTIVE:To analyze the effects of an extracorporeal bioartificial liver containing alginate bead-entrapped hepatocytes on pigs with ischemia-induced acute hepatic failure. DESIGN:Prospective animal study. SETTING:University and INSERM laboratory. SUBJECTS:Fifteen Large White/Pietrin female pigs weighing 20-30 kg. ...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/00003246-200203000-00027
更新日期:2002-03-01 00:00:00
abstract:OBJECTIVE:To determine the limits of agreement between the cardiac output and volumetric data estimated by impedance cardiography with the cardiac output determined by thermodilution and the left ventricular ejection fraction and end-diastolic volume estimated from left ventriculography. DESIGN:A prospective study. S...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/00003246-199709000-00023
更新日期:1997-09-01 00:00:00
abstract:OBJECTIVES:To provide an overview of key elements of the Affordable Care Act. To evaluate ways in which the Affordable Care Act will likely impact the practice of critical care medicine. To describe strategies that may help health systems and providers effectively adapt to changes brought about by the Affordable Care A...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/CCM.0000000000001431
更新日期:2016-03-01 00:00:00
abstract:OBJECTIVES:Corticosteroid therapy is frequently used in septic patients given the rationale that there is an increased demand for corticosteroid in sepsis, and up to 60% of severe septic patients experience adrenal insufficiency. However, the efficacy of corticosteroid therapy and whether the therapy should be based on...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/CCM.0000000000001264
更新日期:2015-11-01 00:00:00
abstract::The venous-arterial PCO2 gradient may increase in certain low-flow states, such as CPR and canine endotoxemia. To determine whether venous hypercarbia also occurs in hemorrhagic shock, we studied 12 anesthetized, mechanically ventilated dogs. We performed laparotomies on the animals, inserting catheters into their ren...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/00003246-198705000-00013
更新日期:1987-05-01 00:00:00
abstract:OBJECTIVE:Artery puncture and hematoma formation are the most common immediate complications during internal jugular vein catheterization. This study was performed to assess whether the bevel-down approach of the puncture needle decreases the incidence of posterior venous wall damage and hematoma formation during inter...
journal_title:Critical care medicine
pub_type: 杂志文章,随机对照试验
doi:10.1097/CCM.0b013e318232da48
更新日期:2012-02-01 00:00:00
abstract:OBJECTIVE:Tea has been around for centuries, and its medicinal properties have been purported in the literature but never fully confirmed. Interleukin-8 is a principle neutrophil chemoattractant and activator in humans. We determined the effects of theaflavin, a black tea-derived polyphenol, on tumor necrosis factor-al...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/01.ccm.0000142661.73633.15
更新日期:2004-10-01 00:00:00
abstract:OBJECTIVE:To establish the effect of an audible airleak (around an endotracheal tube) on oxygen consumption (VO2) measurements in pediatric ICU patients. DESIGN:Prospective trial comparing VO2 measurements before and after deflation of the endotracheal tube cuff. SETTING:Pediatric ICU in a large pediatric tertiary ca...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/00003246-199206000-00012
更新日期:1992-06-01 00:00:00
abstract:OBJECTIVE:Evaluations of plasma leptin and ghrelin levels and their relations with circulating levels of proinflammatory mediators, stress hormones, and biochemical markers of hepatorenal injury during experimental endotoxemia in dogs. SETTING:Uludag University. DESIGN:Placebo-controlled animal study. ANIMALS:Adult ...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/01.CCM.0B013E3181611F5AA
更新日期:2008-03-01 00:00:00
abstract:OBJECTIVES:Although pentoxifylline produces various beneficial effects following adverse circulatory conditions, it is not known whether this agent has any effects on gut lipid metabolism after trauma-hemorrhage and resuscitation. The aim of this study, therefore, was to determine whether or not administration of pento...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/00003246-199801000-00023
更新日期:1998-01-01 00:00:00
abstract:OBJECTIVES:The American College of Critical Care Medicine provided 2002 and 2007 guidelines for hemodynamic support of newborn and pediatric septic shock. Provide the 2014 update of the 2007 American College of Critical Care Medicine "Clinical Guidelines for Hemodynamic Support of Neonates and Children with Septic Shoc...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/CCM.0000000000002425
更新日期:2017-06-01 00:00:00
abstract:OBJECTIVE:Nitric oxide regulates epithelial permeability and other properties of the intestinal mucosal barrier. It previously has been shown in animals that intestinal mucosal nitric oxide production is impaired during gut hypoperfusion. The study was performed to confirm the presence of intestinal mucosal nitric oxid...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/01.CCM.0000080489.67211.1F
更新日期:2003-08-01 00:00:00