Abstract:
OBJECTIVES:To assess the relations between anemia, serum erythropoietin (EPO), iron status, and inflammatory mediators in multiply traumatized patients. DESIGN:Prospective observational study. SETTING:Intensive care unit. PATIENTS:Twenty-three patients suffering from severe trauma (injury severity score > or =30). INTERVENTIONS:None. MEASUREMENTS AND MAIN RESULTS:Blood samples were collected within 12 hrs after the accident (day 1) and in the morning on days 2, 4, 6, and 9 to determine blood cell status, serum EPO, tumor necrosis factor-alpha (TNF-alpha), soluble tumor necrosis factor-receptor I (sTNF-rI), interleukin-1 receptor antagonist (IL1-ra), interleukin-6 (IL-6), neopterin, and iron status, respectively. Hemoglobin concentration was low at admission (mean, 10.0 g/dL; range, 6.8-12.9 g/dL) and did not increase during the observation time. Serum EPO concentration was 49.8 U/L (mean value) on day 1 and did not show significant increases thereafter. No correlation was found between EPO and hemoglobin concentrations. TNF-alpha remained within the normal range. sTNF-rI was high at admission and increased further. IL1-ra was above the normal range. IL-6 was very high at admission and did not decrease thereafter. The initial neopterin concentration was normal, but increased until day 9. Serum iron was significantly decreased on day 2 posttrauma and remained low during the study. Serum ferritin increased steadily from day 2, reaching its maximum on day 9. In contrast, concentrations of transferrin were low from admission onward. CONCLUSIONS:Multiply traumatized patients exhibit an inadequate EPO response to low hemoglobin concentrations. Thus, anemia in severe trauma is the result of a complex network of bleeding, blunted EPO response to low hemoglobin concentrations, inflammatory mediators, and a hypoferremic state.
journal_name
Crit Care Medjournal_title
Critical care medicineauthors
Hobisch-Hagen P,Wiedermann F,Mayr A,Fries D,Jelkmann W,Fuchs D,Hasibeder W,Mutz N,Klingler A,Schobersberger Wdoi
10.1097/00003246-200104000-00009subject
Has Abstractpub_date
2001-04-01 00:00:00pages
743-7issue
4eissn
0090-3493issn
1530-0293journal_volume
29pub_type
杂志文章abstract:OBJECTIVE:Transarterial chemoembolization is a widely used therapy for the treatment of hepatocellular carcinoma. A rare adverse event is acute respiratory distress syndrome from pulmonary embolization of Lipiodol, an iodinated oil commonly used during the procedure. The objective of this report is to describe an atypi...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/CCM.0000000000000307
更新日期:2014-06-01 00:00:00
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 c...
journal_title:Critical care medicine
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1097/00003246-200112000-00011
更新日期:2001-12-01 00:00:00
abstract:OBJECTIVES:To examine perceptions of nurses and physicians in regard to ethical decision-making climate in the ICU and to test the hypothesis that the worse the ethical decision-making climate, the greater the discordance between nurses' and physicians' rating of ethical decision-making climate with physicians hypothes...
journal_title:Critical care medicine
pub_type: 杂志文章,多中心研究
doi:10.1097/CCM.0000000000004017
更新日期:2019-12-01 00:00:00
abstract:OBJECTIVE:The aim of this study was to investigate whether hyperglycemia enhances the systemic inflammatory response and oxidative stress induced by endotoxin. DESIGN:Laboratory investigation. SETTING:University medical school. SUBJECTS:Forty-one male Sprague-Dawley rats. INTERVENTIONS:A hyperglycemic condition was...
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pub_type: 杂志文章
doi:10.1097/01.ccm.0000163225.88827.63
更新日期:2005-05-01 00:00:00
abstract:OBJECTIVE:To examine the pulmonary and cardiac function of children who survived an episode of acute hypoxemic respiratory failure. DESIGN:Descriptive cohort analysis. SETTING:Pediatric clinical research center of a university hospital. PATIENTS:Utilizing the criteria of PaO2 < 75 torr (< 10 kPa) with an FIO2 of > 0...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/00003246-199601000-00024
更新日期:1996-01-01 00:00:00
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pub_type: 杂志文章,meta分析,评审
doi:10.1097/CCM.0000000000000224
更新日期:2014-06-01 00:00:00
abstract::Twenty-four pediatric patients undergoing corrective posterior spinal fusion surgery for idiopathic scoliosis were studied to determine the frequency with which the syndrome of inappropriate antidiuretic hormone secretion (SIADH) developed. We measured arterial blood gases, serum and urine electrolytes and osmolalitie...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/00003246-198307000-00009
更新日期:1983-07-01 00:00:00
abstract:OBJECTIVES:Our primary goal was to evaluate the impact on in-hospital mortality rate of adequate empirical antibiotic therapy, after controlling for confounding variables, in a cohort of patients admitted to the intensive care unit (ICU) with sepsis. The impact of adequate empirical antibiotic therapy on early (<3 days...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/01.CCM.0000098031.24329.10
更新日期:2003-12-01 00:00:00
abstract::Clinically, asystole or a bradyarrhythmia may follow countershock of ventricular fibrillation (VF) in up to 40% of attempts. This study evaluated the effects of artificial cardiac pacing, calcium chloride (CaCl2), and epinephrine in postcountershock asystole/bradycardia. Micromanometer catheters were positioned in the...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/00003246-198509000-00001
更新日期:1985-09-01 00:00:00
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doi:10.1097/00003246-199703000-00002
更新日期:1997-03-01 00:00:00
abstract:OBJECTIVE:To investigate if prone position delays the progression of experimental ventilator-induced lung injury, possibly due to a more homogeneous distribution of strain within lung parenchyma. DESIGN:Prospective, randomized, controlled trial. SETTING:Animal laboratory of a university hospital. SUBJECTS:Thirty-fiv...
journal_title:Critical care medicine
pub_type: 评论,杂志文章
doi:10.1097/01.ccm.0000150660.45376.7c
更新日期:2005-02-01 00:00:00
abstract:OBJECTIVES:To study the relation between nitrite, nitrate, nitrotyrosine, and nitrosothiols as NO indices in human septic shock. DESIGN:A prospective clinical study. SETTING:Intensive care units in a university hospital and a central county hospital. PATIENTS:Sixteen patients admitted for septic shock. Nine healthy ...
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pub_type: 杂志文章
doi:10.1097/00003246-200008000-00017
更新日期:2000-08-01 00:00:00
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doi:10.1097/01.CCM.0000253407.89594.15
更新日期:2007-02-01 00:00:00
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doi:10.1097/CCM.0000000000001864
更新日期:2016-11-01 00:00:00
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doi:10.1097/CCM.0000000000004667
更新日期:2020-12-01 00:00:00
abstract::Biological systems are innately complex, display nonlinear behavior, and respond to both disease and its treatment in similar complex ways. Complex systems display self-organization and predictive behavior along a range of possible states, often referred to as chaotic behavior, and can be both characterized and quanti...
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pub_type: 杂志文章
doi:10.1097/CCM.0b013e3181f24484
更新日期:2010-10-01 00:00:00
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doi:10.1097/00003246-200208000-00005
更新日期:2002-08-01 00:00:00
abstract:OBJECTIVE:To compare measurement of cardiac output by the CO2 rebreathing method vs. the thermodilution cardiac output technique in the setting of acute respiratory failure in patients with chronic obstructive pulmonary disease. DESIGN:Prospective, comparative study of two methods in a consecutive sample. SETTING:Int...
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pub_type: 杂志文章
doi:10.1097/00003246-199401000-00017
更新日期:1994-01-01 00:00:00
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pub_type: 杂志文章
doi:10.1097/00003246-199011000-00020
更新日期:1990-11-01 00:00:00
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doi:10.1097/00003246-200006000-00071
更新日期:2000-06-01 00:00:00
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pub_type: 临床试验,杂志文章,随机对照试验
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更新日期:1989-04-01 00:00:00
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pub_type: 杂志文章
doi:10.1097/01.ccm.0000128573.28173.2e
更新日期:2004-06-01 00:00:00
abstract:OBJECTIVE:Critically ill patients often develop large gastric residual volumes during nasogastric feeding as a result of poor gastroduodenal motility. Nasojejunal feeding may decrease the severity of this complication. The aim of this study was to determine whether nasojejunal feeding improved tolerance of enteral nutr...
journal_title:Critical care medicine
pub_type: 临床试验,杂志文章,随机对照试验
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更新日期:2002-03-01 00:00:00
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doi:10.1097/00003246-200204000-00015
更新日期:2002-04-01 00:00:00
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journal_title:Critical care medicine
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更新日期:1996-10-01 00:00:00
abstract:OBJECTIVE:Phenylephrine is often used for management of cerebral perfusion pressure after traumatic brain injury, but can have undesirable actions. Few studies have evaluated alternatives. The hypothesis was that arginine vasopressin was as effective as phenylephrine for maintaining tissue oxygenation during cerebral p...
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doi:10.1097/CCM.0b013e3181847af3
更新日期:2008-09-01 00:00:00
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pub_type: 杂志文章
doi:
更新日期:1992-10-01 00:00:00
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更新日期:2010-01-01 00:00:00
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更新日期:2020-12-01 00:00:00
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更新日期:2017-08-01 00:00:00