Abstract:
OBJECTIVE:To study the importance of endothelin-1-induced vasoconstriction in a model of acute and maintained low cardiac output, by investigating regional changes within the mesenteric and particularly the intestinal mucosal circulation. DESIGN:Prospective, controlled animal study. SETTING:University-affiliated research laboratory. SUBJECTS:Thirteen fasted, anesthetized, mechanically ventilated landrace pigs. MEASUREMENTS AND MAIN RESULTS:Cardiac output, portal venous blood flow, renal arterial flow, jejunal mucosal microcirculation by laser Doppler flowmetry, jejunal capnotonometry (Pco2 gap), and jejunal mucosal oxygenation (tPo2) were monitored. Cardiac tamponade was established to reduce portal venous blood flow to a preset end point at two thirds of baseline. Measurements were made at baseline, after 90 mins of cardiac tamponade, and 90 mins after the administration of the combined endothelinA/endothelinB antagonist tezosentan at 1 mg.kg-1.hr-1 during tamponade in seven animals. Six animals served as time controls and received only the vehicle. Cardiac tamponade decreased portal venous blood flow, renal arterial flow, and laser Doppler flowmetry, whereas the Pco2 gap increased. The change in tPo2 failed to gain statistical significance (p =.08). Administration of tezosentan during tamponade restored portal venous blood flow and laser Doppler flowmetry to baseline values, increased tPo2 above baseline, and decreased Pco2 gap. No effect on renal arterial flow was observed. Investigated variables remained unchanged in control animals after induction of cardiac tamponade. CONCLUSIONS:Endothelin-1 blockade in acute cardiac failure improves mesenteric, but not renal, perfusion, illustrating the regional importance of endothelin-1-induced vasoconstriction. Importantly, endothelin-1 blockade restored mucosal blood flow and oxygenation, which might be particularly interesting considering the implications for maintenance of mucosal barrier integrity in low output states.
journal_name
Crit Care Medjournal_title
Critical care medicineauthors
Burgener D,Laesser M,Treggiari-Venzi M,Oi Y,Jolliet P,Strasser S,Hadengue A,Aneman Adoi
10.1097/00003246-200108000-00019subject
Has Abstractpub_date
2001-08-01 00:00:00pages
1615-20issue
8eissn
0090-3493issn
1530-0293journal_volume
29pub_type
杂志文章abstract::A new device has been developed to estimate continuously and noninvasively cardiac output from the thoracic electrical bioimpedance (CObi). CObi was compared to cardiac output by thermodilution (COtd) in five anesthetized dogs. Blood pressure, blood volume, and blood flow were manipulated by hemorrhage and infusions o...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/00003246-198603000-00013
更新日期:1986-03-01 00:00:00
abstract:OBJECTIVES:High physical activity levels are associated with wide-ranging health benefits, disease prevention, and longevity. In the present study, we examined the impact of regular physical exercise on the severity of organ injury and survival probability, as well as characteristics of the systemic immune and metaboli...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/CCM.0b013e31828a2ae3
更新日期:2013-10-01 00:00:00
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journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/01.ccm.0000199069.19193.89
更新日期:2006-02-01 00:00:00
abstract:OBJECTIVE:To test the hypothesis that trauma-hemorrhagic shock (T/HS)-induced changes in red blood cells (RBC) contribute to the reduction of blood flow in distant organs. DESIGN:Laboratory study. SETTING:Academic medical center laboratory. SUBJECTS:Specific pathogen-free male Sprague-Dawley rats weighing between 25...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/CCM.0b013e3181962d39
更新日期:2009-03-01 00:00:00
abstract:OBJECTIVE:To examine the association between the performance of a tracheostomy and intensive care unit and postintensive care unit mortality, controlling for treatment selection bias and confounding variables. DESIGN:Prospective, observational, cohort study. SETTING:Twelve French medical or surgical intensive care un...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/01.CCM.0000251134.96055.A6
更新日期:2007-01-01 00:00:00
abstract::Prolonged artificial ventilation may result in worsening gas exchange and pulmonary compliance in patients with otherwise normal lungs. Prolonged hyperinflations to 40 cm H2O can completely reverse deterioration of gas exchange and compliance in such patients. Similar efforts have effectively recruited atelectatic lun...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/00003246-198712000-00001
更新日期:1987-12-01 00:00:00
abstract:OBJECTIVE:To discuss a potential role for endothelial cell apoptosis in the pathogenesis of sepsis. DATA SOURCES:Studies published in biomedical journals and studies from the authors' laboratory. STUDY SELECTION:In vitro and in vivo studies of endothelial cell apoptosis in endotoxin and sepsis models. DATA EXTRACTIO...
journal_title:Critical care medicine
pub_type: 杂志文章,评审
doi:10.1097/00003246-200205001-00009
更新日期:2002-05-01 00:00:00
abstract:OBJECTIVE:Acute renal tubular injury is a serious complication in the postoperative period, which is associated with high mortality and increased ICU stay. We aimed to demonstrate the protective effect of rhEPO against acute tubular injury induced by ischemia-reperfusion and to explore the mechanism of canonical transi...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/CCM.0000000000000542
更新日期:2014-10-01 00:00:00
abstract:OBJECTIVE:To determine the risk factors for development of severe hypoglycemia (defined as glucose <40 mg/dL) in critically ill patients and define the outcomes of this complication. DESIGN:Retrospective database review, including a case-control analysis that matched each patient with severe hypoglycemia with three co...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/01.CCM.0000282073.98414.4B
更新日期:2007-10-01 00:00:00
abstract:OBJECTIVE:The emergency department (ED) often serves as the first site for the recognition and treatment of patients with suspected severe sepsis. However, few evaluations of the national epidemiology and distribution of severe sepsis in the ED exist. We sought to determine national estimates of the number, timing, ED ...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/01.CCM.0000277043.85378.C1
更新日期:2007-08-01 00:00:00
abstract:OBJECTIVE:To review recent advances in the use of transforming growth factor (TGF)-beta in acute lung injury and to apply this knowledge to understanding the pathophysiology of this syndrome. DATA SOURCES AND STUDY SELECTION:Published research and review articles in the English language related to the role of TGF-beta...
journal_title:Critical care medicine
pub_type: 杂志文章,评审
doi:10.1097/01.CCM.0000057901.92381.75
更新日期:2003-04-01 00:00:00
abstract::Doppler ultrasound has been used extensively in assessing adequacy of circulation. We have found it to be convenient in the identification of blood flow, particularly in hypotensive states where percutaneous radial artery cannulation of the vessel is tedious and difficult to perform. The technique is simple, atraumati...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/00003246-197611000-00011
更新日期:1976-11-01 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:OBJECTIVE:To evaluate the frequency and clinical correlates of ultrafilterable hypomagnesemia in neonates admitted to the neonatal intensive care unit (ICU). DESIGN:Prospective, observational study. SETTING:Massachusetts General Hospital and Mount Auburn Hospital. PATIENTS:A total of 117 patients (84 neonatal ICU pa...
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pub_type: 杂志文章
doi:10.1097/00003246-199405000-00017
更新日期:1994-05-01 00:00:00
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journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/00003246-199712000-00017
更新日期:1997-12-01 00:00:00
abstract:OBJECTIVE:Early assessment of neurologic recovery is often challenging in survivors of cardiac arrest. Further, little is known about when to assess neurologic status in comatose, postarrest patients receiving therapeutic hypothermia. We sought to evaluate timing of prognostication in cardiac arrest survivors who recei...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/CCM.0b013e3182372f93
更新日期:2012-03-01 00:00:00
abstract:OBJECTIVES:Although the mortality of severe sepsis is easily quantified, the actual cause and timing of death from severe sepsis are less defined. We used the INDEPTH (International Integrated Database for the Evaluation of Severe Sepsis and Drotrecogin alfa activated) database to investigate the reported cause of deat...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/CCM.0b013e31820eda29
更新日期:2011-05-01 00:00:00
abstract:OBJECTIVE:To describe blood conservation strategies for critically ill patients. DATA SOURCES:By using a predefined strategy, we searched the electronic databases of Medline, EMBASE, CINAHL, the Cochrane database of systematic reviews, Cochrane central register of controlled trials, ACP Journal Club, Database of abstr...
journal_title:Critical care medicine
pub_type: 杂志文章,评审
doi:10.1097/01.CCM.0000099350.50651.46
更新日期:2003-12-01 00:00:00
abstract:OBJECTIVES:The Fragility Index, which represents the number of patients responsible for a statistically significant finding, has been suggested as an aid for interpreting the robustness of results from clinical trials. A small Fragility Index indicates that the statistical significance of a trial depends on only a few ...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/CCM.0000000000003527
更新日期:2019-03-01 00:00:00
abstract:OBJECTIVE:To compare the classification performance of the Revised Atlanta Classification, the Determinant-Based Classification, and a new modified Determinant-Based Classification according to observed mortality and morbidity. DESIGN:A prospective multicenter observational study conducted in 1-year period. SETTING:F...
journal_title:Critical care medicine
pub_type: 杂志文章,多中心研究
doi:10.1097/CCM.0000000000001565
更新日期:2016-05-01 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
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journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/00003246-199509000-00018
更新日期:1995-09-01 00:00:00
abstract:OBJECTIVE:Mitochondrial damage and dysfunction are thought to play an important role in the pathogenesis of sepsis-induced organ failures. Unfortunately, specific markers of mitochondrial damage in vital organs do not currently exist. Recently, carbomyl phosphate synthase (CPS)-1, a protein primarily localized to liver...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/01.CCM.0000230240.02216.21
更新日期:2006-09-01 00:00:00
abstract:OBJECTIVE:To appraise the literature on the effect of initial renal replacement therapy (RRT) modality on clinical outcomes. DESIGN:Systematic review and meta-analysis. SETTING:Academic medical center. PATIENTS AND PARTICIPANTS:Adult critically ill patients with acute kidney injury. INTERVENTIONS:Continuous vs. int...
journal_title:Critical care medicine
pub_type: 杂志文章,meta分析,评审
doi:10.1097/01.CCM.0B013E3181611F552
更新日期:2008-02-01 00:00:00
abstract::Comparative hemodynamic measurements recorded in 19 cases of septic shock associated with Neisseria meningitidis bacteremia and in 20 shock cases associated with bacteremia due to other Gram-negative bacilli showed a significantly higher incidence of early myocardial depression in the cases with meningococcal infectio...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/00003246-198412000-00003
更新日期:1984-12-01 00:00:00
abstract:BACKGROUND:Although survival is traditionally modeled using Cox proportional hazards modeling, this approach may be inappropriate in sepsis, in which the proportional hazards assumption does not hold. Newer, more flexible models, such as Gray's model, may be more appropriate. OBJECTIVES:To construct and compare Gray's...
journal_title:Critical care medicine
pub_type: 杂志文章,多中心研究
doi:10.1097/01.ccm.0000114819.37569.4b
更新日期:2004-03-01 00:00:00
abstract:OBJECTIVE:To measure exhaled nitric oxide (NO) and compare it with lung function after cardiopulmonary bypass (CPB) in adult patients. Pulmonary dysfunction is sometimes observed after CPB. Impaired production of NO may account for this dysfunction. DESIGN:Prospective, single-center, observational study. SETTING:Univ...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/00003246-200012000-00012
更新日期:2000-12-01 00:00:00
abstract:OBJECTIVE:This study determines whether acid-base data obtained in the emergency department correlate with outcome from major vascular injury. DESIGN:Observational, retrospective record review of trauma patients requiring vascular repair (torso or extremity, January 1988 to December 1997). Data included age, Injury Se...
journal_title:Critical care medicine
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doi:10.1097/01.ccm.0000125517.28517.74
更新日期:2004-05-01 00:00:00
abstract:OBJECTIVE:Delayed surfactant treatment (>2 hrs after birth) is less effective than early treatment in conventionally ventilated preterm infants with respiratory distress syndrome. The objective of this study was to evaluate if this time-dependent efficacy of surfactant treatment is also present during open lung ventila...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/01.CCM.0000243794.09377.96
更新日期:2006-11-01 00:00:00
abstract:OBJECTIVES:Cognitive deficits after traumatic brain injury are a leading cause of disability worldwide, yet no effective pharmacologic treatments exist to improve cognition. Traumatic brain injury increases proinflammatory cytokines, which trigger excess function of α5 subunit-containing γ-aminobutyric acid type A rece...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/CCM.0000000000004161
更新日期:2020-04-01 00:00:00