Abstract:
OBJECTIVE:To examine the effects of hypertonic (7.5%) saline-6% dextran 70 (HSD) and isotonic (0.9%) saline-6% dextran 70 (ISD) on cardiovascular function and intestinal perfusion in experimental endotoxin shock. DESIGN:Experimental, randomized, unblinded, interventional study. SETTING:University experimental animal laboratory. SUBJECTS:Anesthetized and mechanically ventilated landrace pigs (n = 24). INTERVENTIONS:Induction of endotoxin (ET) shock by infusion of Escherichia coil lipopolysaccharide endotoxin (serotype 0111: B4) followed by no fluid treatment (control; C) or small-volume (4 mL/kg) treatment with HSD or ISD. MEASUREMENTS AND MAIN RESULTS:Mean arterial pressure, central venous pressure, pulmonary artery pressure, pulmonary artery occlusion pressure, cardiac output, portal vein blood flow, intestinal microcirculation, intramucosal (regional) P(CO2), intestinal-arterial gap of CO2, and intramucosal pH were monitored, and blood gases were analyzed. Infusion of ET resulted in hypokinetic shock, which in untreated animals led to cardiovascular deterioration and a survival rate of only 33% at 300 mins after start of ET infusion. ISD treatment transiently improved hemodynamic variables and mucosal blood flow but did not affect the survival rate vs. C. Significant beneficial, long-lasting effects of HSD infusion on hemodynamics, especially on mucosal blood flow and intramucosal pH, were demonstrable, resulting in a survival rate of 86%. The relative risk of death at 300 mins was 1.20 for ISD vs. C and 0.17 for HSD vs. C. CONCLUSION:Small-volume HSD resuscitation is much more effective than ISD resuscitation. Variables that were improved include cardiac output, portal blood flow, and intestinal mucosal blood flow in ET shock, all of which improve survival. Such beneficial effects of HSD on splanchnic perfusion may be of value in treating critically ill septic patients in the intensive care unit.
journal_name
Crit Care Medjournal_title
Critical care medicineauthors
Oi Y,Aneman A,Svensson M,Ewert S,Dahlqvist M,Haljamäe Hdoi
10.1097/00003246-200008000-00027subject
Has Abstractpub_date
2000-08-01 00:00:00pages
2843-50issue
8eissn
0090-3493issn
1530-0293journal_volume
28pub_type
杂志文章abstract:OBJECTIVE:To determine if exogenous interleukin (IL)-10 will decrease the morbidity or mortality of sepsis induced by cecal ligation and puncture. DESIGN:Prospective, randomized, controlled study. SETTING:University research laboratory. SUBJECTS:Adult, female, Balb¿c mice. INTERVENTIONS:Balb¿c mice were subjected t...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/00003246-199805000-00025
更新日期:1998-05-01 00:00:00
abstract::The resolution time of pneumothorax in neonates requiring tube thoracotomy is not known. We found that 28%, 50%, and 83% of 54 pneumothoraces in 40 neonates resolved within 24, 96, and 168 h of tube thoracotomy, respectively. Pneumothoraces that persisted beyond 168 h were in infants requiring ventilatory assistance. ...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/00003246-198505000-00010
更新日期:1985-05-01 00:00:00
abstract:OBJECTIVES:A 2400-mOsm/L hypertonic solution (isosal) with a lower sodium content, compared with conventional 7.5% hypertonic saline, was formulated using a mixture of sodium chloride, glucose, and mixed amino acids. This solution was developed to minimize hypernatremia during resuscitation. We assessed the effects of ...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/00003246-199607000-00027
更新日期:1996-07-01 00:00:00
abstract:OBJECTIVES:To measure pulmonary capillary pressure and pulmonary artery occlusion pressures both during control conditions and during acute lung injury and to evaluate the effects of inotropic therapy and volume loading on these measurements after lung injury. DESIGN:Prospective, randomized, controlled laboratory tria...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/00003246-200202000-00023
更新日期:2002-02-01 00:00:00
abstract:OBJECTIVE:To review current knowledge about the impact of prolonged mechanical ventilation on diaphragmatic function and biology. MEASUREMENTS:Systematic literature review. CONCLUSIONS:Prolonged mechanical ventilation can promote diaphragmatic atrophy and contractile dysfunction. As few as 18 hrs of mechanical ventil...
journal_title:Critical care medicine
pub_type: 杂志文章,评审
doi:10.1097/CCM.0b013e3181b6e760
更新日期:2009-10-01 00:00:00
abstract::The image of the physician as a therapist, as well as the general perception of the physician's role in society and in the life of patients and their families, has changed dramatically in past decades. In response, many conferences, editorials, and planning activities for medical and premedical curricula have been dev...
journal_title:Critical care medicine
pub_type: 传,历史文章,杂志文章
doi:10.1097/00003246-198810000-00012
更新日期:1988-10-01 00:00:00
abstract:OBJECTIVE:To study the course of gastric regional PCO2 (PrCO2) in patients with cardiogenic shock requiring intra-aortic balloon (IAB) counterpulsation and the prognostic value of PrCO2 in this patient population. DESIGN:A prospective, observational clinical study. SETTING:Medical intensive care unit in a university ...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/00003246-200010000-00013
更新日期:2000-10-01 00:00:00
abstract:OBJECTIVE:To determine the feasibility of utilizing a scintigraphic technique to differentiate patients with adult respiratory distress syndrome due to sepsis syndrome from control volunteers and patients with congestive heart failure. Gamma scintigraphy was compared with chest roentgenograms to predict mortality rate ...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/00003246-199201000-00012
更新日期:1992-01-01 00:00:00
abstract:OBJECTIVE:We aim to describe current clinical practice, the past decade of experience and factors related to improved outcomes for pediatric patients receiving high-frequency oscillatory ventilation. We have also modeled predictive factors that could help stratify mortality risk and guide future high-frequency oscillat...
journal_title:Critical care medicine
pub_type: 杂志文章,多中心研究
doi:10.1097/CCM.0000000000001278
更新日期:2015-12-01 00:00:00
abstract:OBJECTIVE:To estimate the prevalence of, the risk factors associated with, and the outcome of tracheostomy in a heterogeneous population of mechanically ventilated patients. DESIGN:Prospective, observational cohort study. SETTING:A total of 361 intensive care units from 12 countries. PATIENTS:A cohort of 5,081 patie...
journal_title:Critical care medicine
pub_type: 评论,杂志文章,多中心研究
doi:10.1097/01.ccm.0000150026.85210.13
更新日期:2005-02-01 00:00:00
abstract:BACKGROUND:The randomized two-way factorial Dressing Study (1,636 patients, 28,931 catheter days) showed that a chlorhexidine-impregnated sponge decreased the incidence of major catheter-related infections from 1.4‰ to 0.6‰ catheter days, and that scheduled dressing changes every 7 days was not inferior to scheduled ch...
journal_title:Critical care medicine
pub_type: 杂志文章,随机对照试验
doi:10.1097/CCM.0b013e31822f0604
更新日期:2012-01-01 00:00:00
abstract:OBJECTIVE:Keratinocyte growth factor (KGF) is expressed primarily by fibroblasts, is important for alveolar epithelial proliferation/function, and protects against lung injury in multiple animal models. We wished to determine whether acute lung injury/acute respiratory distress syndrome (ALI/ARDS) alveolar fluid induce...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/CCM.0b013e31819fc81a
更新日期:2009-05-01 00:00:00
abstract:OBJECTIVES:To assess the feasibility, biochemical efficacy, and safety of liberal versus conventional glucose control in ICU patients with diabetes. DESIGN:Prospective, open-label, sequential period study. SETTING:A 22-bed mixed ICU of a tertiary hospital in Australia. PATIENTS:We compared 350 consecutive patients w...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/CCM.0000000000003087
更新日期:2018-06-01 00:00:00
abstract:OBJECTIVES:To explore the relationship between timing of continuous renal replacement therapy commencement and clinical outcomes in critically ill patients with acute kidney injury. The primary outcomes were all-cause mortality at 28 and 90 days. DESIGN:Nested observational cohort study using data from the Randomized ...
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.0000000000000343
更新日期:2014-08-01 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::One hundred patients were ventilated with high-frequency jet ventilation (HFJV) during the initial 24-h postoperative period in the surgical and neurosurgical ICUs. Eighty-three were successfully weaned, 2 could not be ventilated adequately with HFJV, and 15 with criteria of acute respiratory failure received HFJV for...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/00003246-198409000-00022
更新日期:1984-09-01 00:00:00
abstract:OBJECTIVE:To test the effects of three hemoglobin solutions on liver function and hepatic morphology after resuscitation from severe hemorrhagic shock. DESIGN:Prospective study. SETTING:Laboratory. SUBJECTS:Thirty-three beagle dogs. INTERVENTION:Hemorrhagic shock was induced in anesthetized dogs by removal of blood...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/00003246-199604000-00019
更新日期:1996-04-01 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:Levosimendan is a novel inodilator that improves cardiac contractility by sensitizing troponin C to calcium. This drug has proved to be effective in treating advanced congestive heart failure but has not been evaluated in septic settings. The purpose of the present study was to study the effects of this drug ...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/00003246-200111000-00022
更新日期:2001-11-01 00:00:00
abstract:OBJECTIVES:To investigate the frequency, types, and implications of complications during intensive care in patients after status epilepticus has been successfully terminated. DESIGN:Retrospective study. SETTING:ICUs at a Swiss tertiary academic medical care center. PATIENTS:Data were collected from the digital patie...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/CCM.0000000000004642
更新日期:2020-12-01 00:00:00
abstract:OBJECTIVE:Increasing evidence, including publication of the Transfusion Requirements in Critical Care trial in 1999, supports a lower hemoglobin threshold for RBC transfusion in ICU patients. However, little is known regarding the influence of this evidence on clinical practice over time in a large population-based coh...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/CCM.0b013e31828e9a49
更新日期:2013-10-01 00:00:00
abstract:OBJECTIVE:Our knowledge of the molecular mechanisms of sepsis has attained exponential growth. Yet, the pillars of its care remain antibiotics, fluid resuscitation, and physiologic support of failing organ systems. The inability to bring biologic breakthroughs to the bedside is not for lack of effort. Over 60 clinical ...
journal_title:Critical care medicine
pub_type: 杂志文章,评审
doi:10.1097/CCM.0000000000003271
更新日期:2018-09-01 00:00:00
abstract:OBJECTIVE:Circulating serum levels of procalcitonin rise significantly during bacterial infection. Because calcitonin is known to be a monocyte chemoattractant, we investigated whether procalcitonin, a prohormone of calcitonin, also affects leukocyte migration. DESIGN:Prospective, controlled in vitro study. SETTING:U...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/00003246-200205000-00025
更新日期:2002-05-01 00:00:00
abstract:OBJECTIVE:The aim of this study is to test the hypothesis that recruitment maneuvers (RMs) might act differently in models of pulmonary (p) and extrapulmonary (exp) acute lung injury (ALI) with similar transpulmonary pressure changes. DESIGN:Prospective, randomized, controlled experimental study. SETTING:University r...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/CCM.0b013e3181760e5d
更新日期:2008-06-01 00:00:00
abstract:OBJECTIVE:To describe the current status and the clinical data related to the effects of tight glucose control by intensive insulin therapy in critically ill patients. DESIGN:Review article. SETTING:University hospital. PATIENTS:Medical and surgical critically ill patients in whom a correlation between blood glucose...
journal_title:Critical care medicine
pub_type: 杂志文章,评审
doi:10.1097/01.CCM.0000278046.24345.C7
更新日期:2007-09-01 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:OBJECTIVE:Acute aneurysmal subarachnoid hemorrhage (SAH) is a complex multifaceted disorder that plays out over days to weeks. Many patients with SAH are seriously ill and require a prolonged intensive care unit stay. Cardiopulmonary complications are common. The management of patients with SAH focuses on the anticipat...
journal_title:Critical care medicine
pub_type: 杂志文章,评审
doi:10.1097/CCM.0b013e318195865a
更新日期:2009-02-01 00:00:00
abstract::Prolonged therapeutic paralysis with pancuronium is commonly used in ICUs to facilitate mechanical ventilation of patients with respiratory failure. Sedation is usually given concomitantly to reduce patient discomfort, but assessment of its adequacy is made difficult by the paralysis. We recently cared for a former IC...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/00003246-198401000-00018
更新日期:1984-01-01 00:00:00
abstract:CONTEXT:Reducing aspiration of gastric contents by placing mechanically ventilated patients in a semirecumbent position has been associated with lower incidences of ventilator-associated pneumonia (VAP). The feasibility and efficacy of this intervention in a larger patient population, however, are unknown. OBJECTIVE:A...
journal_title:Critical care medicine
pub_type: 杂志文章,多中心研究,随机对照试验
doi:10.1097/01.ccm.0000198529.76602.5e
更新日期:2006-02-01 00:00:00
abstract::The disciplines of critical care and palliative care may initially seem to be polar opposites, yet they share fundamental features. Both focus on the sickest patients in the healthcare system. Each discipline's primary goal-extending life for critical care and comfort and quality of life for palliative care-represents...
journal_title:Critical care medicine
pub_type: 杂志文章,评审
doi:10.1097/01.CCM.0000237347.94229.23
更新日期:2006-11-01 00:00:00