Abstract:
OBJECTIVE:Sepsis and severe trauma result in endothelial activation and damage. The activated endothelium expresses adhesion receptors that control leukocyte trafficking. After activation, some adhesion molecules are also released into plasma as soluble forms. The present study was designed to compare the expression of soluble cell adhesion molecules (sCAMs) in three groups of patients: those with septic shock, severe sepsis, and traumatic-hemorrhagic shock. In addition, the endothelial expression of these adhesive molecules was examined in skin biopsies. DESIGN:Prospective observational study SETTING:Intensive care unit at a university hospital PATIENTS:The study included 15 patients with septic shock (by Bone's definition), 11 patients with severe sepsis (by Bone's definition), and 13 patients with traumatic-hemorrhagic shock. Fifteen healthy blood donors served as controls. MEASUREMENTS AND MAIN RESULTS:Measurements of sCAMs were performed on days 1, 2, and 3 of the disease. On day 1, when compared with controls, sE-selectin, sP-selectin, soluble vascular cell adhesion molecule (sVCAM)-1, and soluble intercellular adhesion molecule (sICAM)-1 were markedly elevated in septic shock patients, whereas these sCAMs, except for sP-selectin, were within normal ranges in traumatic-hemorrhagic shock patients. In patients with severe sepsis, an earlier stage than septic shock in the sepsis continuum, intermediate values of sCAMs were found. In skin biopsies of septic shock patients, the endothelial cells expressed a bright staining of constitutive endothelial molecules (CD146, CD144, CD131). Inducible molecules (ICAM-1, VCAM-1, and E-selectin) were positively expressed with bright staining. The biopsies from traumatic-hemorrhagic shock patients showed a similar positive expression of endothelial molecules. CONCLUSION:The patterns of sCAMs indicate that the systemic activation of the endothelium is different in the three clinical entities, maximum in septic shock, intermediate in severe sepsis, and not different from controls in traumatic-hemorrhagic shock. Comparable endothelial activation as evidenced by skin biopsies suggests that caution is required in the interpretation of CAMs in plasma, which does not necessarily reflect the in situ activation state of endothelium.
journal_name
Crit Care Medjournal_title
Critical care medicineauthors
Leone M,Boutière B,Camoin-Jau L,Albanèse J,Horschowsky N,Mège JL,Martin C,Dignat-George Fdoi
10.1097/00003246-200204000-00015subject
Has Abstractpub_date
2002-04-01 00:00:00pages
808-14issue
4eissn
0090-3493issn
1530-0293journal_volume
30pub_type
杂志文章abstract:OBJECTIVE:To describe opioid use after ICU admission, identify factors associated with chronic opioid use after critical care, and determine if chronic opioid use is associated with an increased risk of death. DESIGN:Retrospective cohort study. SETTING:Sweden including all registered ICU admissions between 2010 and 2...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/CCM.0000000000004896
更新日期:2021-01-28 00:00:00
abstract:OBJECTIVE:To determine whether low-dose dopamine administration reduces the incidence or severity of acute renal failure, need for dialysis, or mortality in patients with critical illness. DATA SOURCES AND STUDY SELECTION:We performed a MEDLINE search of literature published from 1966 to 2000 for studies addressing th...
journal_title:Critical care medicine
pub_type: 杂志文章,meta分析
doi:10.1097/00003246-200108000-00005
更新日期:2001-08-01 00:00:00
abstract::In the last three decades, numerous articles on plasma catecholamine concentrations in various settings have been published in the medical literature. Despite this abundance of information, no summary article has analyzed the species variations in circulating catecholamine concentrations. In this paper, the plasma cat...
journal_title:Critical care medicine
pub_type: 杂志文章,评审
doi:
更新日期:1989-11-01 00:00:00
abstract:OBJECTIVES:Racial/ethnic differences in palliative care resource use after stroke have been recognized, but it is unclear whether patient or hospital characteristics drive this disparity. We sought to determine whether palliative care use after intracerebral hemorrhage and ischemic stroke differs between hospitals serv...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/CCM.0000000000002762
更新日期:2017-12-01 00:00:00
abstract:OBJECTIVE:To describe the management of patients in an ICU during failure of both primary and backup electrical systems, resulting in nonfunctioning monitors, mechanical ventilators, and other life-support equipment. DESIGN:Case report of power outage and discussion. SETTING:A 45-bed cardiothoracic surgical ICU in a ...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/00003246-199206000-00023
更新日期:1992-06-01 00:00:00
abstract::Transfusion-associated circulatory overload is the most frequent serious adverse transfusion reaction, with an incidence close to 1% of transfused patients in the general adult population. Patients in ICUs are probably more at risk of transfusion-associated circulatory overload as they are more frequently transfused a...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/CCM.0000000000003743
更新日期:2019-06-01 00:00:00
abstract:OBJECTIVE:To provide a conceptual and clinical review of the physiology of the venous system as it is relates to cardiac function in health and disease. DATA:An integration of venous and cardiac physiology under normal conditions, critical illness, and resuscitation. SUMMARY:The usual teaching of cardiac physiology f...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/CCM.0b013e3182772ab6
更新日期:2013-01-01 00:00:00
abstract::To further define cardiovascular abnormalities in patients with septic shock, serial conventional hemodynamic measurements combined with two-dimensional echocardiographic studies were performed at the bedside in 21 patients admitted for an acute episode of sepsis-related circulatory failure. Measurements obtained duri...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/00003246-199010000-00001
更新日期:1990-10-01 00:00:00
abstract:OBJECTIVE:Addressing the quality gap in ICU-based palliative care is limited by uncertainty about acceptable models of collaborative specialist and generalist care. Therefore, we characterized the attitudes of physicians and nurses about palliative care delivery in an ICU environment. DESIGN:Mixed-methods study. SETT...
journal_title:Critical care medicine
pub_type: 杂志文章,多中心研究
doi:10.1097/CCM.0000000000002099
更新日期:2017-04-01 00:00:00
abstract:BACKGROUND:Noninvasive positive-pressure ventilation (NPPV) has been shown to be effective in select patients enrolled in clinical trials. However, few data are available on the use of NPPV as routine standard medical care for patients with respiratory failure outside of controlled trials. MEASUREMENTS AND MAIN RESULT...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/01.CCM.0000300084.67277.90
更新日期:2008-02-01 00:00:00
abstract::The heart rate variability (HRV) of 82 patients exhibiting sinus rhythm and admitted for possible myocardial infarction (MI) was evaluated. Using a simple information entropy measure to quantify the HRV, patients subsequently diagnosed with MI or experiencing significant dysrhythmia (n = 35) exhibited less entropy (0....
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/00003246-198801000-00014
更新日期:1988-01-01 00:00:00
abstract:OBJECTIVE:To determine if inhibition of nitric oxide synthase with NG-nitro-L-arginine-methyl-ester (L-NAME) potentiates endotoxin-induced cardiopulmonary dysfunction and release of cyclooxygenase products in a porcine model of endotoxemia. DESIGN:Prospective, multiple group, controlled experimental study. SETTING:Ph...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/00003246-199706000-00024
更新日期:1997-06-01 00:00:00
abstract:OBJECTIVE:To review the anti-inflammatory and anti-apoptotic properties of drotrecogin alfa (activated) (recombinant human activated protein C), emphasizing its modulatory effects on endothelial nuclear factor-kappaB. We propose a broad anti-inflammatory effect of drotrecogin alfa (activated), acting on both endotheliu...
journal_title:Critical care medicine
pub_type: 杂志文章,评审
doi:10.1097/00003246-200205001-00019
更新日期:2002-05-01 00:00:00
abstract:OBJECTIVES:Most knowledge related to the pathophysiology of microcirculation in ischemic stroke comes from experimental research. Unfortunately, data on microcirculation in the human brain are limited, partially as a result of the lack of appropriate investigational techniques. The objective of our study was to test th...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/CCM.0b013e31820ead5e
更新日期:2011-05-01 00:00:00
abstract::Nine previously untrained health professionals learned to measure cardiac output (Qt) by suprasternal continuous-wave Doppler ultrasound (QtDopp) and by thoracic bioimpedance (Qtbi). Each received standardized written, videotaped, and individual instruction. First the novice, then the reference examiner, measured QtDo...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/00003246-198911000-00019
更新日期:1989-11-01 00:00:00
abstract:OBJECTIVE:To study whether noninvasive pressure support ventilation (NIPSV) with helium/oxygen (He/oxygen), which can reduce dyspnea, PaCO2, and work of breathing more than NIPSV with air/oxygen in decompensated chronic obstructive pulmonary disease, could have beneficial consequences on outcome and hospitalization cos...
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:10.1097/01.CCM.0000055369.37620.EE
更新日期:2003-03-01 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:The results from the recent Targeted Temperature Management trial raised the question whether cooling or merely the avoidance of fever mediates better neurologic outcome in resuscitated patients. As temperature per se is a major determinant of cardiac function, we characterized the effects of hyperthermia (4...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/CCM.0000000000001358
更新日期:2016-03-01 00:00:00
abstract:OBJECTIVES:There is controversy regarding the benefits of N-acetylcysteine in acute kidney injury. This study was to compare three commonly used regimens and explore which regimen is best for the protection of acute kidney injury. DESIGN:Prospective experimental study. SETTING:University research laboratory. INTERVE...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/CCM.0b013e31822575fc
更新日期:2011-11-01 00:00:00
abstract:OBJECTIVE:When a patient is incompetent, the family is often considered to be a natural surrogate. The doctors' responsiveness to family wishes may vary. We explored if doctors' personal characteristics were associated with responsiveness to the relatives' wishes when admission to the intensive care unit (ICU) is consi...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/CCM.0b013e3181958409
更新日期:2009-02-01 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:OBJECTIVE:To determine whether neutrophil depletion could eradicate intestinal bacterial translocation in bum-injured rats. DESIGN:Prospective, randomized, controlled study. SETTING:University research laboratory. SUBJECTS:Adult male Sprague-Dawley rats. INTERVENTIONS:The rats were intravenously administered a rabb...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/00003246-200005000-00048
更新日期:2000-05-01 00:00:00
abstract:OBJECTIVE:Most intensive care deaths beyond the first few days of critical illness are attributable to nonresolving organ failure, either due to or coinciding with sepsis. One of the mechanisms that is thought to contribute to the pathogenesis of organ failure is microvascular thrombosis. Recently, we reported signific...
journal_title:Critical care medicine
pub_type: 杂志文章,随机对照试验
doi:10.1097/CCM.0b013e31816f7bae
更新日期:2008-05-01 00:00:00
abstract:OBJECTIVES:To assess the variability in short-term sepsis mortality by hospital among Centers for Medicare and Medicaid Services beneficiaries in the United States during 2013-2014. DESIGN:A retrospective cohort design. SETTING:Hospitalizations from 3,068 acute care hospitals that participated in the Centers for Medi...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/CCM.0000000000003324
更新日期:2018-11-01 00:00:00
abstract::A closed system device with teflon needle, sideholes, and attached stopcock was designed and evaluated for diagnosis and evacuation of neonatal pneumothoraces. Experience with this device has demonstrated specific advantages over existing needles and techniques. Since the system is airtight, diagnosis of pneumothorax ...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/00003246-197811000-00007
更新日期:1978-11-01 00:00:00
abstract:OBJECTIVE:Our aim was to determine the frequency and the clinical and epidemiologic characteristics of sepsis in a hospital-based population in Colombia. DESIGN:Prospective cohort. SETTING:Ten general hospitals in the four main cities of Colombia. PATIENTS:Consecutive patients admitted in emergency rooms, intensive ...
journal_title:Critical care medicine
pub_type: 杂志文章,多中心研究
doi:10.1097/CCM.0b013e318218a35e
更新日期:2011-07-01 00:00:00
abstract:OBJECTIVE:To determine the feasibility of utilizing a scintigraphic technique to differentiate patients with adult respiratory distress syndrome due to sepsis syndrome from control volunteers and patients with congestive heart failure. Gamma scintigraphy was compared with chest roentgenograms to predict mortality rate ...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/00003246-199201000-00012
更新日期:1992-01-01 00:00:00
abstract:OBJECTIVES:Over-utilization of tests, treatments, and procedures is common for hospitalized patients in ICU settings. American Board of Internal Medicine Foundation's Choosing Wisely campaign tasked professional societies to identify sources of overuse in specialty care practice. The purpose of this study was to assess...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/CCM.0000000000003496
更新日期:2019-03-01 00:00:00
abstract::We found that altering aspirating flow rate (ASR) and sample tubing length (STL) affected the response time and capnogram of 2 different side-stream capnometers. Increased flow rate shortened rise time, transit time, and total delay time (TDT), whereas increased STL increased transit and TDTs but not rise time. Increa...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/00003246-198408000-00015
更新日期:1984-08-01 00:00:00
abstract::Although recent clinical reports have noted hypokalemia after resuscitation from cardiac arrest, extensive animal work indicates that potassium is released from cells during ischemia. This study was undertaken to define the changes that occur in serum potassium ion during cardiac arrest and resuscitation in a canine m...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/00003246-198604000-00012
更新日期:1986-04-01 00:00:00