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, nonblinded study. SETTING:Animal research laboratory at a university setting. SUBJECTS:A total of 24 neonatal piglets. INTERVENTIONS:After intubation with a cuffed endotracheal tube, swine were conventionally ventilated. After surgical cannulation, each piglet was placed on conventional nonpulsatile CPB and cooled to 18 degrees C (64.4 degrees F). Subsequently, the animals were exposed to 90 mins of low-flow CPB (35 mL/kg/min). Animals were rewarmed to 37 degrees C (98.6 degrees F), removed from CPB, and ventilated for 90 min. Ten animals received conventional gas ventilation only (control), seven received initiation of LLV before CPB (prevention), and seven received initiation of LLV during the rewarming phase of CPB (treatment). After the animals were killed, the lungs were removed en bloc. The left lobe was dissected and formalin-fixed at 20 cm H2O overnight, followed by paraffin embedding. Sections were taken from the paraffin-embedded lungs. Neutrophil accumulation and lung injury were assessed by histochemical staining with leukocyte esterase and morphometrics, respectively. One hundred microscopic images were digitized from each tissue sample for lung morphometrics, and neutrophil counts were obtained from every fifth image. MEASUREMENTS AND MAIN RESULTS:Lung tissue sections showed a significantly lower number of neutrophils per alveolar area in the prevention and treatment groups than in the control group (control 681 +/- 65, prevention 380 +/- 49, treatment 412 +/- 101 neutrophils per alveolar area [cells/mm2]; p <.05 for both prevention and treatment compared with control). There were no differences in lung injury as assessed with morphometrics or hemodynamic measurements between any of the three groups. CONCLUSIONS:The data suggest that LLV reduces the CPB-induced neutrophil sequestration in the pulmonary parenchyma independent of its effects on the circulatory physiology or evidence of early lung injury.
journal_name
Crit Care Medjournal_title
Critical care medicineauthors
Williams EA,Welty SE,Geske RS,Hubble CL,Craig DM,Quick G,Meliones JN,Cheifetz IMdoi
10.1097/00003246-200104000-00021subject
Has Abstractpub_date
2001-04-01 00:00:00pages
789-95issue
4eissn
0090-3493issn
1530-0293journal_volume
29pub_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::Cardiac arrest has a poor prognosis, regardless of age group. Children who fail to respond to two standard doses of epinephrine (0.01 mg/kg) rarely survive to hospital discharge, and most die without the return of spontaneous circulation (ROSC). We treated seven consecutive children in cardiac arrest with high dose ep...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/00003246-198912000-00004
更新日期:1989-12-01 00:00:00
abstract:OBJECTIVE:To determine the utility of thoracic computed tomography (TCT) in the initial assessment of critically ill patients with chest injuries. DESIGN:Prospective observational study of cohorts. SETTING:Trauma intensive care unit (ICU) of a Spanish Level III hospital (US equivalent Level I). PATIENTS:Three hundre...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/00003246-200005000-00018
更新日期:2000-05-01 00:00:00
abstract::During the control period in this study, small premature infants, 1500 g in birth weight, had insensible water loss (IWL) of 2.28 g/kg/hr (equivlaent to 54 ml/kg/day), which is considerably higher than in full term infants. Under phototherapy, there was a significant increase in IWL (3.14 g/kg/hr) associated with incr...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/00003246-197511000-00006
更新日期:1975-11-01 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:There is substantial variation in use of life sustaining technologies in patients near the end of life but little is known about variation in physicians' initial ICU admission and intubation decision making processes. Our objective is to describe variation in hospital-based physicians' communication behavior...
journal_title:Critical care medicine
pub_type: 杂志文章,多中心研究
doi:10.1097/CCM.0b013e318287f0dd
更新日期:2013-06-01 00:00:00
abstract:OBJECTIVE:To address issues of antibiotic dosing during sustained low-efficiency dialysis by using available pharmacokinetic data, intermittent and continuous renal replacement therapy dialysis guidelines, and our experience with sustained low-efficiency dialysis. DATA RESOURCES:Published clinical trials, case reports...
journal_title:Critical care medicine
pub_type: 杂志文章,评审
doi:10.1097/CCM.0b013e318206c3b2
更新日期:2011-03-01 00:00:00
abstract:OBJECTIVE:The antimetabolite drug, 5-fluorouracil, inhibits microbial growth. Coating of central venous catheters with 5-fluorouracil may reduce the risk of catheter infection. Our objective was to compare the safety and efficacy of central venous catheters externally coated with 5-fluorouracil with those coated with c...
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.0b013e3181f265ba
更新日期:2010-11-01 00:00:00
abstract::The hemodynamic effects of digitalis were examined in ten patients with acute cardiac failure. Administration of 10 micrograms/kg of digoxin iv resulted in significant increases in cardiac index, stroke volume index, and left ventricular stroke work index within one hour in five patients with acute myocardial infarcti...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/00003246-198711000-00002
更新日期:1987-11-01 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:The physicochemical approach, described by Stewart to investigate the acid-base balance, includes the strong ion gap (SIG), a quantitative measure of "unmeasured" anions, which strongly correlates to the corrected anion gap. The chemical nature of these anions is for the most part unknown. We hypothesized tha...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/CCM.0B013E31816443CB
更新日期:2008-03-01 00:00:00
abstract:OBJECTIVE:To determine the occurrence rate of complications and mortality in patients with severe asthma requiring endotracheal intubation and mechanical ventilation. DESIGN:Retrospective review of medical records from September 1982 to July 1988. SETTING:Urban, teaching hospital serving primarily indigent patients. ...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/00003246-199311000-00023
更新日期:1993-11-01 00:00:00
abstract::A safe, simple, reliable technique for sampling uncontaminated peripheral bronchial secretions in patients with endotracheal tubes has been developed. It is easily performed and requires no special training or equipment. This report summarizes the techniques's usefulness in providing diagnostic samples of peripheral a...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/00003246-197703000-00003
更新日期:1977-03-01 00:00:00
abstract:OBJECTIVES:To determine plasma aluminum concentrations and 24-hr urine aluminum excretion rate in long-term mechanically ventilated patients treated with 6 g of sucralfate daily for stress ulcer prophylaxis. DESIGN:Prospective study in long-term mechanically ventilated critically ill patients. SETTING:A surgical inte...
journal_title:Critical care medicine
pub_type: 临床试验,杂志文章
doi:
更新日期:1994-11-01 00:00:00
abstract:OBJECTIVE:To study the effect of early and continuous venovenous hemofiltration (CVVH) on the plasma concentrations of several humoral mediators of inflammation and subsequent organ dysfunction in septic patients. DESIGN:Randomized, controlled trial. SETTING:Intensive care unit of a tertiary hospital. PATIENTS:Twent...
journal_title:Critical care medicine
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1097/00003246-200201000-00016
更新日期:2002-01-01 00:00:00
abstract:OBJECTIVES:Despite having dysregulated iron metabolism, critically ill patients may receive exogenous iron for the treatment of anemia. Iron is associated with increased tissue apoptosis and may facilitate bacterial growth. We hypothesized that exogenous iron administration given after the onset of sepsis would lead to...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/01.ccm.0000124878.02614.4c
更新日期:2004-05-01 00:00:00
abstract:OBJECTIVE:To determine the abnormalities present in endotracheal tubes removed from mechanically ventilated patients for "massive airleak." "Massive airleak" was defined as a leak that the attending physician felt was indicative of endotracheal tube defect such that extubation (and reintubation, if needed) would be ind...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:
更新日期:1993-04-01 00:00:00
abstract::The focus on improving education in critical care medicine must begin early in medical school training and further be promoted during residency if there is to be an increase in intensivists in the hospital workforce. This is "critical" to healthcare reform movements that are endorsing full-time critical care coverage ...
journal_title:Critical care medicine
pub_type: 杂志文章,评审
doi:10.1097/01.CCM.0000252917.25301.18
更新日期:2007-02-01 00:00:00
abstract::The effects of PEEP and subsequent augmentation of cardiac output by sodium nitroprusside (SNP) were examined in a canine model of asymmetric oleic acid injury to the right lung. PEEP (9.2 +/- 0.5 cm H2O) was added to six animals to decrease venous admixture (Qsp/Qt) from 50.6 +/- 4.4% to 16.0 +/- 1.3% (p less than .0...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/00003246-198903000-00008
更新日期:1989-03-01 00:00:00
abstract:OBJECTIVES:To compare the frequency and preventability of adverse drug events and potential adverse drug events in intensive care units (ICUs) and non-ICUs. To evaluate systems factors involving the individual caregivers, care unit teams, and patients involved in each adverse drug event by comparing ICUs with non-ICUs ...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/00003246-199708000-00014
更新日期:1997-08-01 00:00:00
abstract::A patient with neurogenic pulmonary edema was successfully treated with the alpha-blocking agent, chlorpromazine. A pathophysiologic basis for this drug's efficacy is discussed. ...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/00003246-198503000-00016
更新日期:1985-03-01 00:00:00
abstract:OBJECTIVE:To explore the feedback regulation of glucocorticoids on corticotropin secretion in patients with septic and nonseptic circulatory shock. DESIGN:Prospective study. SETTING:An intensive care unit of a general hospital. PATIENTS:Two groups of patients with septic shock (n = 11) or nonseptic shock (n = 7). A ...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/00003246-199303000-00018
更新日期:1993-03-01 00:00:00
abstract:OBJECTIVE:To compare the outcomes and the short- and long-term complications of percutaneous translaryngeal tracheostomy (TLT) and surgical tracheostomy (ST). DESIGN:Prospective, randomized clinical trial with 1-yr double-blind follow-up. SETTING:A general intensive care unit of a university hospital. PATIENTS:A tot...
journal_title:Critical care medicine
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1097/01.ccm.0000163401.77581.86
更新日期:2005-05-01 00:00:00
abstract:OBJECTIVE:The demand for intensive care beds far exceeds their availability in many European countries. Consequently, many critically ill patients occupy hospital beds outside intensive care units, throughout the hospital. The outcome of patients who fit intensive care unit admission criteria but are hospitalized in re...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/01.ccm.0000133021.22188.35
更新日期:2004-08-01 00:00:00
abstract:OBJECTIVE:Treatment of preterm infants with respiratory distress syndrome (RDS) with exogenous surfactant has greatly improved clinical outcome. Some infants require multiple doses, and it has not been studied whether these large amounts of exogenous surfactant disturb endogenous surfactant metabolism in humans. We stu...
journal_title:Critical care medicine
pub_type: 临床试验,杂志文章
doi:10.1097/00003246-200010000-00001
更新日期:2000-10-01 00:00:00
abstract:OBJECTIVE:Because anemia of inflammation is common in ICU patients and hepcidin is the key regulator of iron homeostasis, we examined time-dependent changes in hepcidin, erythropoietin, iron, and inflammatory markers in surgical ICU patients with anemia. DESIGN:Prospective single-center clinical noninterventional stud...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/CCM.0000000000003089
更新日期:2018-06-01 00:00:00
abstract:OBJECTIVE:To explore the hypothesis that beta-1 adrenoreceptor blockade may be protective through the attenuation of sympathetic hyperactivity and catecholaminergic inflammatory effects on cardiac and hepatic function. DESIGN:Prospective, randomized, controlled study. SETTING:Animal laboratory in a university medical...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/CCM.0b013e3181c03dfa
更新日期:2010-02-01 00:00:00
abstract:OBJECTIVE:To directly compare the cerebrovascular effects of norepinephrine and dopamine in patients with acute traumatic brain injury. DESIGN:Prospective randomized crossover trial. SETTING:Neurosciences critical care unit of a university hospital. PATIENTS:Ten acutely head-injured patients requiring vasoactive dru...
journal_title:Critical care medicine
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1097/01.ccm.0000120054.32845.a6
更新日期:2004-04-01 00:00:00
abstract:OBJECTIVE:We previously reported improved oxygenation, but no change, in rates of extracorporeal membrane oxygenation (ECMO) use or death among infants with persistent pulmonary hypertension of the newborn who received inhaled nitric oxide (NO) with conventional ventilation, irrespective of lung disease. The goal of ou...
journal_title:Critical care medicine
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1097/00003246-200011000-00031
更新日期:2000-11-01 00:00:00
abstract:BACKGROUND:Acute lung injury (ALI) and its more severe form, acute respiratory distress syndrome (ARDS), are devastating disorders of overwhelming pulmonary inflammation and hypoxemia, resulting in high morbidity and mortality. AIM:To provide the clinician with a summary of the literature on the epidemiology, diagnosi...
journal_title:Critical care medicine
pub_type: 杂志文章,评审
doi:10.1097/CCM.0b013e3181aee5dd
更新日期:2009-08-01 00:00:00