Abstract:
OBJECTIVE:To determine the relative distribution of fluid within the extracellular fluid volume (ECFV) and the effect on oxygen delivery after infusing either normal saline or 5% albumin in cardiac surgical patients. DESIGN:Prospective, randomized, unblinded, interventional study. SETTING:Cardiac surgical intensive care unit in a 450-bed teaching hospital. PATIENTS:Postoperative cardiac surgical patients (n = 40). INTERVENTIONS:Infusion of either normal saline or 5% albumin to a hemodynamic end point determined by the patient's clinician. MEASUREMENTS AND MAIN RESULTS:Plasma volume (PV), ECFV, cardiac index, and arterial oxygen content were measured immediately before (baseline) and after each fluid infusion. PV and ECFV were measured by dilution of (131)I-albumin and [(35)S]sodium sulfate, respectively. Interstitial fluid volume (ISFV) was calculated as ECFV - PV. Baseline values for PV, ISFV, ECFV, and oxygen delivery index did not differ between treatment groups. Infusion of normal saline and 5% albumin increased PV by 9 +/- 23% and 52 +/- 84% of the volume infused, respectively (p <.05), whereas there was no significant difference between saline and albumin in the change in ISFV per volume infused. Only 5% albumin significantly increased cardiac index, although oxygen delivery did not change significantly after either infusion. CONCLUSIONS:In postoperative cardiac surgical patients, infusion of 5% albumin is approximately five times as efficient as a PV expander but has comparable effects on changes in ISFV and oxygen delivery relative to normal saline.
journal_name
Crit Care Medjournal_title
Critical care medicineauthors
Ernest D,Belzberg AS,Dodek PMdoi
10.1097/00003246-200112000-00011subject
Has Abstractpub_date
2001-12-01 00:00:00pages
2299-302issue
12eissn
0090-3493issn
1530-0293journal_volume
29pub_type
临床试验,杂志文章,随机对照试验abstract:OBJECTIVE:The elevation of the percentage of regulatory CD4+CD25+ T lymphocytes (Treg) has been recently described during septic shock. The objective of the present study was to investigate whether this increased percentage was due to Treg proliferation. DESIGN:Observational study. SETTING:Adult intensive care units ...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/01.ccm.0000145999.42971.4b
更新日期:2004-11-01 00:00:00
abstract:OBJECTIVE:To assess clinician perceptions of a machine learning-based early warning system to predict severe sepsis and septic shock (Early Warning System 2.0). DESIGN:Prospective observational study. SETTING:Tertiary teaching hospital in Philadelphia, PA. PATIENTS:Non-ICU admissions November-December 2016. INTERVE...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/CCM.0000000000003803
更新日期:2019-11-01 00:00:00
abstract:OBJECTIVE:To describe a case of hepatic subcapsular hematoma causing an acute Budd-Chiari-like syndrome, leading to hepatic compartment syndrome, which combines compression of intrahepatic vessels on CT, acute liver failure, and refractory shock. DESIGN:Case report. SETTING:Surgical ICU of a university teaching hospi...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/CCM.0000000000001403
更新日期:2016-03-01 00:00:00
abstract:OBJECTIVE:The first 70 years of critical care can be considered a period of "industrial revolution-like" advancement in terms of progressing the understanding and care of critical illness. Unfortunately, like the industrial revolution's impact on the environment, advancing ICU care of increasingly elderly, immunosuppre...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/CCM.0000000000004783
更新日期:2021-02-01 00:00:00
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 r...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/00003246-200204000-00025
更新日期:2002-04-01 00:00:00
abstract::Three patients under observation in ICUs developed mechanical upper airway obstruction requiring surgical intervention for airway control. One patient was treated by tracheotomy placed through a vertical midline incision and 2 patients were treated by cricothyroidotomy followed by elective tracheostomy and closure of ...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/00003246-198108000-00004
更新日期:1981-08-01 00:00:00
abstract::Cardiac arrest is most commonly encountered as the end result of severe derangements in metabolic homeostasis. These derangements may include toxic, ischemic, or electrophysiological causes of circulatory and/or respiratory arrests. Occasionally, mechanical obstruction or impediment to circulation may cause cardiac ar...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/00003246-198203000-00013
更新日期:1982-03-01 00:00:00
abstract::Right ventricular size and contractility were evaluated using two-dimensional echocardiography during the first days of respiratory support in 23 patients requiring mechanical ventilation for acute respiratory failure. Nine patients had normal echocardiographic right ventricular function, and nine other patients had a...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/00003246-198511000-00035
更新日期:1985-11-01 00:00:00
abstract::Because an acute coronary thrombotic event may be viewed as the main trigger of sudden cardiac arrest, urgent coronary angiography followed by percutaneous coronary intervention appeared as a promising tool in the early postresuscitation phase. Unfortunately, large randomized trials, which have unequivocally demonstra...
journal_title:Critical care medicine
pub_type: 杂志文章,评审
doi:10.1097/ccm.0b013e31818a8ae6
更新日期:2008-11-01 00:00:00
abstract:OBJECTIVE:Pulmonary air embolism, causing vessel obstruction and primary or secondary reactions of blood, can lead to acute lung injury. In addition, nitric oxide has been known to play a key role in various causes of lung injury. In this study we employed the isolated rat lung model to investigate the effects of l-arg...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/01.ccm.0000178175.54354.ea
更新日期:2005-09-01 00:00:00
abstract:OBJECTIVE:To evaluate a new technique for pressure-volume curve tracing. DESIGN:Prospective experimental study. SETTING:Animal research laboratory. SUBJECTS:Six anesthetized rats. INTERVENTIONS:Two pressure-volume curves were obtained by means of the super-syringe method (gold standard) and the continuous positive ...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/01.CCM.0000090003.87219.AA
更新日期:2003-10-01 00:00:00
abstract::Twenty-seven surgical patients who developed post-extubation hypoxemia unresponsive to routine respiration therapy (incentive spirometry and chest physical therapy) received continuous positive airway pressure (CPAP) delivered through a mask at an inspired oxygen fraction (FIO2) of 0.45. All patients responded with an...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/00003246-198501000-00012
更新日期:1985-01-01 00:00:00
abstract:OBJECTIVE:To develop definitions of infection that can be used in clinical trials in patients with sepsis. CONTEXT:Infection is a key component of the definition of sepsis, yet there is currently no agreement on the definitions that should be used to identify specific infections in patients with sepsis. Agreeing on a ...
journal_title:Critical care medicine
pub_type: 共识发展会议,杂志文章,评审
doi:10.1097/01.ccm.0000168253.91200.83
更新日期:2005-07-01 00:00:00
abstract:OBJECTIVE:To determine the effectiveness of increasing the preoxygenation period with 100% oxygen in the critically ill patient from 4 to 8 mins in preparation for emergency tracheal intubation. DESIGN:Nonrandomized, controlled trial. SETTING:Large, level one trauma center, tertiary care intensive care unit. PATIENT...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/CCM.0b013e318192845e
更新日期:2009-01-01 00:00:00
abstract::Critical care clinicians no longer consider family members as visitors in the intensive care unit. Family-centered care has emerged from the results of qualitative and quantitative studies evaluating the specific needs of families of patients dying in the intensive care unit. In addition, interventional studies have e...
journal_title:Critical care medicine
pub_type: 杂志文章,评审
doi:10.1097/01.CCM.0000237049.44246.8C
更新日期:2006-11-01 00:00:00
abstract::In the pathogenesis of sepsis, inflammation and coagulation play a pivotal role. Increasing evidence points to an extensive cross-talk between these two systems, whereby inflammation leads to activation of coagulation, and coagulation also considerably affects inflammatory activity. Molecular pathways that contribute ...
journal_title:Critical care medicine
pub_type: 杂志文章,评审
doi:10.1097/CCM.0b013e3181c98d21
更新日期:2010-02-01 00:00:00
abstract:OBJECTIVE:Catheter-associated infections are common, costly, and potentially lethal. The impact of catheter insertion site on infection risk remains controversial. We aimed to establish whether nontunneled central venous catheters inserted in the subclavian vein are associated with lower risk of catheter-associated inf...
journal_title:Critical care medicine
pub_type: 杂志文章,meta分析
doi:10.1097/CCM.0b013e31823e99cb
更新日期:2012-05-01 00:00:00
abstract:BACKGROUND:Procalcitonin (PCT), a marker of bacterial sepsis, may also act as a mediator of the inflammatory response to infection, and thus influence outcome. OBJECTIVE:To investigate the relationship between PCT, interleukin (IL)-10, tumor necrosis factor (TNF), organ failure, and mortality in pediatric septic shock...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/00003246-200007000-00068
更新日期:2000-07-01 00:00:00
abstract:OBJECTIVES:Peripherally inserted central catheters are increasingly used in ICU as an alternative to centrally inserted central catheters for IV infusion. However, their reliability for hemodynamic measurements with transpulmonary thermodilution is currently unknown. We investigated the agreement between transpulmonary...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/CCM.0000000000003917
更新日期:2019-10-01 00:00:00
abstract:OBJECTIVE:To determine whether mortality rates among intensive care unit (ICU) patients differ according to the time of ICU admission, we compared the death rates for patients admitted during weekday day shifts and off hours (from 6:30 pm to 8:29 am the next day for night shifts, from Saturday 1:00 pm to Monday 8:29 am...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/01.CCM.0000249832.36518.11
更新日期:2007-01-01 00:00:00
abstract:OBJECTIVES:Secretoneurin is associated with cardiomyocyte Ca handling and improves risk prediction in patients with acute myocardial dysfunction. Whether secretoneurin improves risk assessment on top of established cardiac biomarkers and European System for Cardiac Operative Risk Evaluation II in patients undergoing ca...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/CCM.0000000000003670
更新日期:2019-05-01 00:00:00
abstract:OBJECTIVE:Pump-driven extracorporeal gas exchange systems have been advocated in patients suffering from severe acute respiratory distress syndrome who are at risk for life-threatening hypoxemia and/or hypercapnia. This requires extended technical and staff support. DESIGN:We report retrospectively our experience with...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/01.CCM.0000215111.85483.BD
更新日期:2006-05-01 00:00:00
abstract:OBJECTIVES:To assess the reversibility of acute kidney injury-induced neutrophil dysfunction and to identify involved mechanisms. DESIGN:Controlled laboratory experiment and prospective observational clinical study. SETTING:University laboratory and hospital. SUBJECTS:C57BL/6 wild-type mice. PATIENTS:Patients with ...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/CCM.0000000000001472
更新日期:2016-07-01 00:00:00
abstract::Patient comfort is not assured by common practices for terminal extubation. Treatment guidelines suggest minimizing dosage of opioids and sedatives. Multiple lines of evidence indicate that clinicians are limited in their ability to recognize distress in such patients and tend to undermedicate patients in distress. Ye...
journal_title:Critical care medicine
pub_type: 杂志文章,评审
doi:10.1097/CCM.0b013e318228235d
更新日期:2012-02-01 00:00:00
abstract:OBJECTIVE:Very elderly persons admitted to ICUs are at high risk of death. To document life-sustaining interventions (mechanical ventilation, vasopressors, renal replacement therapy) provided in the ICU and outcomes of care. DESIGN:Multicenter, prospective cohort study. SETTING:ICUs of 24 Canadian hospitals. PARTICI...
journal_title:Critical care medicine
pub_type: 杂志文章,多中心研究
doi:10.1097/CCM.0000000000001024
更新日期:2015-07-01 00:00:00
abstract::A portable video image-processor unit used to evaluate bedside digital subtraction angiography yields sufficient information on the major arterial vessels and the heart, using standard x-ray equipment at fluoroscopic energy levels. This unit should contribute to the evaluation of the critically ill patient in the ICU....
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/00003246-198412000-00014
更新日期:1984-12-01 00:00:00
abstract:OBJECTIVES:Vital organ hypoperfusion significantly contributes to the dismal survival rates observed with manual cardiopulmonary resuscitation after cardiac arrest. The impedance threshold device is a valve which reduces air entry into lungs during chest recoil between chest compressions, producing a potentially benefi...
journal_title:Critical care medicine
pub_type: 杂志文章,meta分析
doi:10.1097/CCM.0b013e318170ba80
更新日期:2008-05-01 00:00:00
abstract:BACKGROUND AND METHODS:Calcium-channel blockers may attenuate vasospasm after transient ischemia and improve organ blood flow after resuscitation. Our aim was to assess the effect of diltiazem on systemic oxygen delivery and consumption, hemodynamics, electroencephalogram (EEG), and organ blood flow after restoration o...
journal_title:Critical care medicine
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1097/00003246-199205000-00018
更新日期:1992-05-01 00:00:00
abstract:OBJECTIVES:To compare usual care with a proactive case-finding approach for critically ill patients with terminal dementia using an inpatient palliative care service. DESIGN:Prospective comparison to historical control. SETTING:Urban, university-affiliated hospital. PATIENTS:Total of 52 men and women with end-stage ...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/01.ccm.0000138560.56577.88
更新日期:2004-09-01 00:00:00
abstract:OBJECTIVE:Clinical predictors for acute respiratory distress syndrome (ARDS) have been studied in few prospective studies. Although transfusions are common in the intensive care unit, the role of submassive transfusion in non-trauma-related ARDS has not been studied. We describe here the clinical predictors of ARDS ris...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/01.ccm.0000165566.82925.14
更新日期:2005-06-01 00:00:00