Abstract:
OBJECTIVE:To evaluate the pathophysiology involved in hypocalcemia in septic shock and to investigate the value of calcium administration. DESIGN:Prospective, randomized placebo-controlled trial with parallel groups. SETTING:Animal research laboratory at the University Hospital of Uppsala. SUBJECTS:Twenty-four pigs aged 12-14 wks receiving general anesthesia. INTERVENTIONS:Twenty pigs received endotoxin infusion (10 microg/kg/hr) for 6 hrs. Ten of these pigs also received a calcium infusion (20 mmol total) in parallel. Four control pigs received only saline. MEASUREMENTS AND MAIN RESULTS:At the end of the study, blood ionized calcium (Ca2+) had declined from 1.32+/-0.04 mmol/L (mean +/- SD) to 1.09+/-0.06 mmol/L in pigs receiving endotoxin (p < .05 vs. controls) compared with 1.38+/-0.04 mmol/L to 1.25+/-0.07 mmol/L in controls and 1.39+/-0.03 mmol/L to 1.24+/-0.07 mmol/L in endotoxemic pigs receiving calcium. In both endotoxemic groups, total calcium levels in ascites were increased by 56% (p < .005 vs. controls), and an accumulation of calcium in the liver was mainly seen in the endotoxemic group receiving calcium (p < .008 vs. controls). Total Ca2+ levels in adiposal tissue and skeletal muscle were similar in all groups. Calcium administration did not significantly alter systemic hemodynamics or survival in this model of septic shock (four survivors in the endotoxemic group and five in the calcium administration group). CONCLUSIONS:Endotoxemia in the pig rapidly induced hypocalcemia. Calcium accumulation was found in ascites and in the liver, but not in other examined tissues. Calcium administration, restoring the Ca2+ concentration, did not improve hemodynamics or survival in this model of hypodynamic sepsis. Porcine endotoxemic shock, which replicates human septic shock, seems to be suitable for evaluating calcium turnover.
journal_name
Crit Care Medjournal_title
Critical care medicineauthors
Carlstedt F,Eriksson M,Kiiski R,Larsson A,Lind Ldoi
10.1097/00003246-200008000-00037subject
Has Abstractpub_date
2000-08-01 00:00:00pages
2909-14issue
8eissn
0090-3493issn
1530-0293journal_volume
28pub_type
杂志文章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::Given the multiple biological, metabolic, and pharmacologic effects of supplemental arginine, much effort has been devoted to defining its role in numerous clinical conditions. Herein, we review the multiple pathways of arginine metabolism with its various enzyme systems; the effect of arginine on nutrition, healing, ...
journal_title:Critical care medicine
pub_type: 杂志文章,评审
doi:10.1097/01.CCM.0000279188.97421.FE
更新日期:2007-09-01 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:OBJECTIVE:To describe the experience of pediatric intensive care hospitalization from the perspective of a parents of children with severe, antecedent disability. DESIGN:Qualitative analysis of data obtained through semistructured interviews. SETTING:Pediatric intensive care unit (PICU) in a children's hospital. SUB...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/CCM.0b013e3181a00578
更新日期:2009-06-01 00:00:00
abstract:OBJECTIVE:To determine if selective decontamination of the digestive tract (SDD) influences the proinflammatory immune response of the gut after hemorrhage. DESIGN:Random assignment to either unmanipulated control after 7 days of SDD or conventional rat chow, or hemorrhagic shock group after the same time of conventio...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/00003246-200206000-00030
更新日期:2002-06-01 00:00:00
abstract:OBJECTIVE:To evaluate the effects of monoclonal antibody to tumor necrosis factor (TNF)-alpha on the hemodynamic alterations and survival rate in rats subjected to intestinal ischemia/reperfusion. DESIGN:Prospective, randomized study. SETTING:Animal laboratory of an institute for research in traumatology. SUBJECTS:M...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/00003246-199609000-00020
更新日期:1996-09-01 00:00:00
abstract:OBJECTIVE:To test the hypothesis that therapeutic hypercapnia enhances the proinflammatory responses to endotoxemia in the lung and spleen of rats. DESIGN:Prospective randomized study. SETTINGS:Hospital research institute. SUBJECTS:Forty-eight adult male rats. INTERVENTIONS:Rats were randomly assigned for a 24-hr p...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/CCM.0b013e31820ee1f2
更新日期:2011-06-01 00:00:00
abstract:OBJECTIVE:This study evaluates the ability of perflubron to inhibit pulmonary neutrophil accumulation during partial liquid ventilation (PLV) in the setting of acute lung injury. DESIGN:Randomized, controlled, nonblinded study. SETTING:Research laboratory at a university. SUBJECTS:Male, Sprague-Dawley rats (n = 120,...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/00003246-199810000-00028
更新日期:1998-10-01 00:00:00
abstract:OBJECTIVE:To evaluate the role of continuous lateral rotational therapy on the development of ventilator-associated pneumonia in patients requiring long-term mechanical ventilation. DESIGN:Prospective control study. SETTING:Chronic ventilator unit in tertiary care hospital. METHODS:Thirty-seven patients requiring lo...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/00003246-200209000-00006
更新日期:2002-09-01 00:00:00
abstract:OBJECTIVES:Explosive traumatic injury to an extremity may lead to both local and distant organ injury. Regional traumatic tissue hypothermia has been reported to offer systemic protection; here we investigated the protective effects of regional limb hypothermia on local tissue trauma and the lungs. Furthermore, the opt...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/CCM.0b013e3182a84daa
更新日期:2014-01-01 00:00:00
abstract:OBJECTIVES:The aim of this study was to analyze the effect of the International Nosocomial Infection Control Consortium's multidimensional approach on the reduction of ventilator-associated pneumonia in patients hospitalized in intensive care units. DESIGN:A prospective active surveillance before-after study. The stud...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/CCM.0b013e3182657916
更新日期:2012-12-01 00:00:00
abstract:OBJECTIVES:To examine a hygroscopic condenser after clinical use and to describe the interaction of a hygroscopic condenser and a closed circuit suction system used simultaneously. DESIGN:Prospective evaluation of hygroscopic condensers used clinically, and laboratory investigation of a hygroscopic condenser used with...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:
更新日期:1994-10-01 00:00:00
abstract:OBJECTIVE:Life-threatening conditions cause severe changes in the organization and conformation of macromolecules, creating urgent requirements for protein repair to ensure survival. As molecular chaperones, heat shock proteins (HSP) that have specialized functions in protein folding are now well established to restore...
journal_title:Critical care medicine
pub_type: 杂志文章,评审
doi:
更新日期:2002-01-01 00:00:00
abstract::This report describes an unusual hemolytic transfusion reaction. A group O donor was inadvertently transfused with 100 ml of group A red cells during the course of plasmapheresis. Granulocytopenia, thrombocytopenia, hypofibrinogenemia and low levels of factors V, VIII, and IX developed immediately after the infusion. ...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/00003246-197501000-00003
更新日期:1975-01-01 00:00:00
abstract:OBJECTIVE:To determine whether peptic activity in bronchoalveolar fluid, due to the presence of the gastric proteolytic enzyme pepsin, could serve as a biochemical marker for pulmonary aspiration of gastric contents. DESIGN:Prospective, experimental trial. SETTING:A university animal research laboratory. SUBJECTS:Th...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/00003246-199611000-00019
更新日期:1996-11-01 00:00:00
abstract:OBJECTIVES:To evaluate the preload dependence of femoral maximal change in pressure over time (dP/dtmax) during volume expansion in preload dependent and independent critically ill patients. DESIGN:Retrospective database analysis. SETTING:Two adult polyvalent ICUs. PATIENTS:Twenty-five critically ill patients with a...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/CCM.0000000000004515
更新日期:2020-10-01 00:00:00
abstract:OBJECTIVES:Despite the common occurrence of brain injury in patients undergoing extracorporeal membrane oxygenation, it is unclear which cannulation method carries a higher risk of brain injury. We compared the prevalence of brain injury between patients undergoing venoarterial and venovenous extracorporeal membrane ox...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/CCM.0000000000004618
更新日期:2020-12-01 00:00:00
abstract:OBJECTIVE:To determine whether the energy expenditure of mechanically ventilated multiple trauma patients correlates with the severity of injury and illness indices before important systemic infection has complicated the clinical course, and to compare the energy expenditure with the energy expenditure expected from th...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/00003246-199912000-00013
更新日期:1999-12-01 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 investigate the optimal rewarming rate following therapeutic hypothermia in a rate model of cardiopulmonary resuscitation. Both clinical and laboratory studies have demonstrated that mild therapeutic hypothermia following cardiopulmonary resuscitation improves myocardial and neurologic outcomes of cardiac ...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/CCM.0b013e3182a63fff
更新日期:2014-02-01 00:00:00
abstract:OBJECTIVE:The objective of this study was to determine the clinical features associated with candidemia caused by non-albicans Candida spp. and with potentially fluconazole-resistant Candida spp. (C. glabrata and C. krusei) among candidemic intensive care unit patients. DESIGN:The authors conducted a nationwide prospe...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/CCM.0b013e3181760f42
更新日期:2008-07-01 00:00:00
abstract:OBJECTIVE:To assess the coping strategies used by family decision makers of adult critical care patients during and after the critical care experience and the relationship of coping strategies to posttraumatic stress symptoms experienced 60 days after hospitalization. DESIGN:A single-group descriptive longitudinal cor...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/CCM.0000000000000934
更新日期:2015-06-01 00:00:00
abstract::Gastric mucosal damage produced by topical application of necrotizing agents is diminished by topical or systemic pretreatment with a variety of E and F prostaglandins. The rat restraint model of gastric mucosal injury is more analogous to clinical stress ulceration than are models using intragastric application of to...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/00003246-198901000-00011
更新日期:1989-01-01 00:00:00
abstract:OBJECTIVES:Interventions that reduce the generation or the effects of reactive oxygen species exert controversial effects in animal models of lung injury, and these could be secondary to the pro-oxidant effects of antioxidants generally by their interaction with iron. We here describe the effects of N-acetylcysteine, d...
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:OBJECTIVES:To determine the incidence and characteristics of children with brain death in the pediatric intensive care unit (ICU), and to assess the incidence of the clinical triad (Turner's triad) of central diabetes insipidus, low glucose demand, and low CO2 production. DESIGN:Retrospective review of medical records...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/00003246-199408000-00014
更新日期:1994-08-01 00:00:00
abstract:OBJECTIVES:Lung-protective ventilation for acute respiratory distress syndrome aims for providing sufficient oxygenation and carbon dioxide clearance, while limiting the harmful effects of mechanical ventilation. "Flow-controlled ventilation", providing a constant expiratory flow, has been suggested as a new lung-prote...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/CCM.0000000000004209
更新日期:2020-03-01 00:00:00
abstract:OBJECTIVE:Families and other surrogate decisionmakers for chronically critically ill patients often lack information about patient prognosis or options for care. This study describes an approach to develop and validate a printed information brochure about chronic critical illness aimed at improving comprehension of the...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/CCM.0b013e31822d7901
更新日期:2012-01-01 00:00:00
abstract:OBJECTIVE:To evaluate the hypothesis that splanchnic ischemia and mucosal hypoxia are responsible for lipopolysaccharide-induced intramucosal acidosis in pigs. DESIGN:Prospective, randomized, unblinded study. SETTING:Surgical research laboratory at a large, university-affiliated medical center. SUBJECTS:Anesthetized...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/00003246-199507000-00011
更新日期:1995-07-01 00:00:00
abstract::Trauma is the leading cause of both morbidity and mortality in the pediatric population, and traumatic injury causes > 50% of all childhood deaths. Significant mortality rates have been reported for children with traumatic brain injury. Although children have better survival rates as compared with adults with traumati...
journal_title:Critical care medicine
pub_type: 杂志文章,评审
doi:10.1097/00003246-200211001-00003
更新日期:2002-11-01 00:00:00
abstract:OBJECTIVE:To determine whether continuous gas flow in the breathing circuit or an airleak around the tracheal tube cuff will introduce errors into the measurement of oxygen consumption (VO2) with indirect calorimetry. DESIGN:Nonrandomized, controlled trial. SETTING:Experimental laboratory. SUBJECTS:Ten healthy, anes...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/00003246-199209000-00023
更新日期:1992-09-01 00:00:00