Effect of naloxone on immune responses after hemorrhagic shock.

Abstract:

OBJECTIVE:To determine whether naloxone administration after hemorrhagic shock has any beneficial or deleterious effect on immune responses. BACKGROUND DATA:Hemorrhagic shock is known to produce immunodepression in both humans and experimental animals. Although studies suggest that endogenous opioids play a role in immune regulation in adverse circulatory conditions, it remains controversial whether these opioids exert beneficial or detrimental effects on immunity after shock. Moreover, little information is available concerning the effects of opioid receptor blockade using naloxone on cell-mediated immunity and endocrine responses after shock. METHODS:Male C3H/HeN mice (25 g) were bled to and maintained at a mean arterial blood pressure of 35+/-5 mm Hg for 1 hr. The shed blood was then returned along with lactated Ringer's solution (two times the shed blood volume) to provide fluid resuscitation. The animals were randomized to receive either naloxone (1 mg/kg i.v.) or an equal volume of vehicle (saline) after the shed blood was returned, i.e., immediately before crystalloid resuscitation, and were killed at 2 hrs after resuscitation to obtain splenocytes, macrophages (peritoneal and splenic), and blood. MEASUREMENTS AND MAIN RESULTS:Bioassays revealed significantly decreased release of all studied interleukins (interleukins-1, -2, -3, and -6) by peritoneal and splenic macrophages as well as significantly decreased splenocyte proliferative capacity after shock in vehicle-treated mice. Naloxone administration after hemorrhage resulted in either similar or even more decreased levels of interleukin release compared with vehicle-treated hemorrhaged mice. Significantly increased plasma corticosterone concentrations were observed in vehicle-treated animals compared with control animals. Naloxone administration did not have any significant effects on corticosterone plasma concentrations after hemorrhage. CONCLUSIONS:These findings indicate the importance of the endogenous opioid system for the maintenance of immunity in adverse circulatory conditions, i.e., hemorrhage. Although additional studies involving different doses and/or times of naloxone administration may provide different results, the present findings raise the concern that naloxone administration in the traumatized host may have deleterious effects because it decreases peritoneal macrophage and splenic immune functions.

journal_name

Crit Care Med

journal_title

Critical care medicine

authors

Wichmann MW,Zellweger R,Ayala A,Chaudry IH

doi

10.1097/00003246-200001000-00030

subject

Has Abstract

pub_date

2000-01-01 00:00:00

pages

184-9

issue

1

eissn

0090-3493

issn

1530-0293

journal_volume

28

pub_type

杂志文章
  • Comparison of the renal effects of low to high doses of dopamine and dobutamine in critically ill patients: a single-blind randomized study.

    abstract:OBJECTIVE:The renal effects of dopamine in critically ill patients remain controversial. Low-dose dobutamine has been reported to improve renal function. We compared the effects of various doses of dopamine and dobutamine on renal function in critically ill patients. DESIGN:Prospective, single-blind, randomized study....

    journal_title:Critical care medicine

    pub_type: 临床试验,杂志文章,随机对照试验

    doi:10.1097/00003246-200004000-00002

    authors: Ichai C,Soubielle J,Carles M,Giunti C,Grimaud D

    更新日期:2000-04-01 00:00:00

  • The weaning continuum use of Acute Physiology and Chronic Health Evaluation III, Burns Wean Assessment Program, Therapeutic Intervention Scoring System, and Wean Index scores to establish stages of weaning.

    abstract:OBJECTIVE:To determine whether four stages of weaning (acute, prewean, wean, and outcome) could be identified by using clinical instruments designed to quantify severity of illness, patient stability, or weaning readiness. The instruments used were the Acute Physiology and Chronic Health Evaluation (APACHE III), the Th...

    journal_title:Critical care medicine

    pub_type: 杂志文章

    doi:10.1097/00003246-200007000-00013

    authors: Burns SM,Ryan B,Burns JE

    更新日期:2000-07-01 00:00:00

  • Surfactant protein-B polymorphisms and mortality in the acute respiratory distress syndrome.

    abstract:OBJECTIVE:To determine whether polymorphisms of the surfactant protein B gene may be associated with increased mortality in patients with the acute respiratory distress syndrome. DESIGN:A prospective cohort study. SETTING:Four adult intensive care units at a tertiary academic medical center. PATIENTS:Two hundred fou...

    journal_title:Critical care medicine

    pub_type: 杂志文章

    doi:10.1097/CCM.0b013e318183f608

    authors: Currier PF,Gong MN,Zhai R,Pothier LJ,Boyce PD,Xu L,Yu CL,Thompson BT,Christiani DC

    更新日期:2008-09-01 00:00:00

  • Accuracy of brain multimodal monitoring to detect cerebral hypoperfusion after traumatic brain injury*.

    abstract:OBJECTIVE:To examine the accuracy of brain multimodal monitoring-consisting of intracranial pressure, brain tissue PO2, and cerebral microdialysis--in detecting cerebral hypoperfusion in patients with severe traumatic brain injury. DESIGN:Prospective single-center study. PATIENTS:Patients with severe traumatic brain ...

    journal_title:Critical care medicine

    pub_type: 杂志文章

    doi:10.1097/CCM.0000000000000720

    authors: Bouzat P,Marques-Vidal P,Zerlauth JB,Sala N,Suys T,Schoettker P,Bloch J,Daniel RT,Levivier M,Meuli R,Oddo M

    更新日期:2015-02-01 00:00:00

  • Increased resistance of hygroscopic condenser humidifiers when using a closed circuit suction system.

    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:

    authors: Martinez FJ,Pietchel S,Wise C,Walek J,Beamis JF

    更新日期:1994-10-01 00:00:00

  • Validation of a compact system for measuring gas exchange.

    abstract::Measuring gas exchange in critically ill patients can provide valuable information on their nutritional status and energy expenditure. Several semiautomated machines are available for measuring oxygen consumption (VO2) and carbon dioxide production (VCO2). This study evaluated, under controlled laboratory conditions, ...

    journal_title:Critical care medicine

    pub_type: 杂志文章

    doi:10.1097/00003246-198609000-00010

    authors: Eccles RC,Swinamer DL,Jones RL,King EG

    更新日期:1986-09-01 00:00:00

  • Laboratory evaluation and use of the Engström metabolic computer in the clinical setting.

    abstract::Laboratory evaluation and use of the Engström metabolic computer (EMC) in a clinical setting are described. The accuracy of the EMC was tested using an inert gas dilution technique. Mean errors in oxygen consumption (VO2) and CO2 production compared with predicted values were less than 2% of predicted, and generally l...

    journal_title:Critical care medicine

    pub_type: 杂志文章

    doi:10.1097/00003246-199008000-00016

    authors: Regan CJ,Snowdon SL,Campbell IT

    更新日期:1990-08-01 00:00:00

  • Hemoglobin solutions--not just red blood cell substitutes.

    abstract:OBJECTIVE:To review current knowledge about cell-free hemoglobin solutions. DATA SOURCES:All studies involving cell-free hemoglobin were retrieved from a computerized MEDLINE search from 1980 to 1998. We also reviewed the reference lists of all available review articles and primary studies to identify references not f...

    journal_title:Critical care medicine

    pub_type: 杂志文章,评审

    doi:10.1097/00003246-200008000-00058

    authors: Creteur J,Sibbald W,Vincent JL

    更新日期:2000-08-01 00:00:00

  • Intensive Care Society's Acute Physiology and Chronic Health Evaluation (APACHE II) study in Britain and Ireland: a prospective, multicenter, cohort study comparing two methods for predicting outcome for adult intensive care patients.

    abstract:OBJECTIVE:To compare the ability of two methods--Acute Physiology and Chronic Health Evaluation (APACHE II) and Mortality Prediction Model (MPM)--to predict hospital outcome for a large group of intensive care patients from Britain and Ireland. DESIGN:Prospective, multicenter, cohort study. SETTING:Twenty-six general...

    journal_title:Critical care medicine

    pub_type: 杂志文章,多中心研究

    doi:10.1097/00003246-199409000-00007

    authors: Rowan KM,Kerr JH,Major E,McPherson K,Short A,Vessey MP

    更新日期:1994-09-01 00:00:00

  • Bedside respiratory analysis by pocket computer.

    abstract::A computer program is presented which analyzes acid-base and respiratory variables. This program's advantages include limited data input, hand-held portability, error identification, and succinct analysis statements. It is a useful adjunct to daily care of the critically ill. ...

    journal_title:Critical care medicine

    pub_type: 杂志文章

    doi:10.1097/00003246-198601000-00015

    authors: Lynn LA,Sunderrajan EV

    更新日期:1986-01-01 00:00:00

  • Qualitative comparison of carbon dioxide-induced change in cerebral near-infrared spectroscopy versus jugular venous oxygen saturation in adults with acute brain disease.

    abstract:OBJECTIVE:To compare carbon dioxide-induced changes in cerebral oxy- and deoxyhemoglobin, measured by near-infrared spectroscopy, with those changes in jugular venous oxygen saturation in adult patients with acute brain disease. DESIGN:A prospective study. SETTING:The medical and surgical intensive care unit of a uni...

    journal_title:Critical care medicine

    pub_type: 杂志文章

    doi:10.1097/00003246-199510000-00019

    authors: Tateishi A,Maekawa T,Soejima Y,Sadamitsu D,Yamamoto M,Matsushita M,Nakashima K

    更新日期:1995-10-01 00:00:00

  • Community-, Healthcare-, and Hospital-Acquired Severe Sepsis Hospitalizations in the University HealthSystem Consortium.

    abstract:OBJECTIVES:Severe sepsis poses a major burden on the U.S. healthcare system. Previous epidemiologic studies have not differentiated community-acquired severe sepsis from healthcare-associated severe sepsis or hospital-acquired severe sepsis hospitalizations. We sought to compare and contrast community-acquired severe s...

    journal_title:Critical care medicine

    pub_type: 杂志文章

    doi:10.1097/CCM.0000000000001164

    authors: Page DB,Donnelly JP,Wang HE

    更新日期:2015-09-01 00:00:00

  • Cycling empirical antimicrobial agents to prevent emergence of antimicrobial-resistant Gram-negative bacteria among intensive care unit patients.

    abstract:OBJECTIVE:To determine the impact of the rotation of antimicrobial agents on the rates of infection, intestinal colonization, and acquisition with antimicrobial-resistant Gram-negative bacteria. DESIGN:Pre- and postintervention design. SETTING:A 19-bed, medical intensive care unit. PATIENTS:Individuals admitted to t...

    journal_title:Critical care medicine

    pub_type: 杂志文章

    doi:10.1097/01.ccm.0000147685.79487.28

    authors: Warren DK,Hill HA,Merz LR,Kollef MH,Hayden MK,Fraser VJ,Fridkin SK

    更新日期:2004-12-01 00:00:00

  • Improving ICU-Based Palliative Care Delivery: A Multicenter, Multidisciplinary Survey of Critical Care Clinician Attitudes and Beliefs.

    abstract:OBJECTIVE:Addressing the quality gap in ICU-based palliative care is limited by uncertainty about acceptable models of collaborative specialist and generalist care. Therefore, we characterized the attitudes of physicians and nurses about palliative care delivery in an ICU environment. DESIGN:Mixed-methods study. SETT...

    journal_title:Critical care medicine

    pub_type: 杂志文章,多中心研究

    doi:10.1097/CCM.0000000000002099

    authors: Wysham NG,Hua M,Hough CL,Gundel S,Docherty SL,Jones DM,Reagan O,Goucher H,Mcfarlin J,Cox CE

    更新日期:2017-04-01 00:00:00

  • Survival in patients with severe adult respiratory distress syndrome treated with high-level positive end-expiratory pressure.

    abstract:OBJECTIVE:To assess the mortality rate and complications in a population of surgical patients with severe adult respiratory distress syndrome (ARDS) treated with positive end-expiratory pressure (PEEP) of > 15 cm H2O in an attempt to reduce intrapulmonary shunt to approximately 0.20 and reduce FIO2 to < 0.50. DESIGN:R...

    journal_title:Critical care medicine

    pub_type: 杂志文章

    doi:10.1097/00003246-199509000-00008

    authors: DiRusso SM,Nelson LD,Safcsak K,Miller RS

    更新日期:1995-09-01 00:00:00

  • Inhibition by methylprednisolone of leukocyte-induced pulmonary damage.

    abstract:BACKGROUND AND METHODS:The purpose of this study was twofold: the development of a chronic model of leukocyte-mediated pulmonary injury and the evaluation of the protective effects of methylprednisolone. Rabbits were inoculated ip with zymosan. Blood gases and circulating leukocytes were evaluated. Survivors were kille...

    journal_title:Critical care medicine

    pub_type: 杂志文章

    doi:10.1097/00003246-199102000-00023

    authors: Chiara O,Giomarelli PP,Borrelli E,Casini A,Segala M,Grossi A

    更新日期:1991-02-01 00:00:00

  • Continuous lateral rotation therapy to prevent ventilator-associated pneumonia.

    abstract:OBJECTIVE:To investigate the impact of prophylactic continuous lateral rotation therapy on the prevalence of ventilator-associated pneumonia, duration of mechanical ventilation, length of stay, and mortality in critically ill medical patients. DESIGN:Prospective, randomized, clinical study. SETTING:Three medical inte...

    journal_title:Critical care medicine

    pub_type: 杂志文章,随机对照试验

    doi:10.1097/CCM.0b013e3181bc8218

    authors: Staudinger T,Bojic A,Holzinger U,Meyer B,Rohwer M,Mallner F,Schellongowski P,Robak O,Laczika K,Frass M,Locker GJ

    更新日期:2010-02-01 00:00:00

  • Prophylaxis of upper gastrointestinal bleeding in intensive care units: a meta-analysis.

    abstract::A meta-analysis was performed of 15 randomized studies on the prophylaxis with cimetidine and/or ant-acids of upper GI bleeding acquired in the ICU. There were eight comparisons of a group receiving cimetidine with a control group, nine comparisons of a group receiving antacids with a control group, and ten comparison...

    journal_title:Critical care medicine

    pub_type: 临床试验,杂志文章

    doi:10.1097/00003246-198909000-00003

    authors: Lacroix J,Infante-Rivard C,Jenicek M,Gauthier M

    更新日期:1989-09-01 00:00:00

  • Sympathetic Vasoconstrictor Responsiveness of the Leg Vasculature During Experimental Endotoxemia and Hypoxia in Humans.

    abstract:OBJECTIVE:Sympathetic vasoconstriction regulates peripheral circulation and controls blood pressure, but sepsis is associated with hypotension. We evaluated whether apparent loss of sympathetic vasoconstrictor responsiveness relates to distended smooth muscles or to endotoxemia and/or hypoxia. DESIGN:Prospective descr...

    journal_title:Critical care medicine

    pub_type: 杂志文章

    doi:10.1097/CCM.0000000000001486

    authors: Brassard P,Zaar M,Thaning P,Secher NH,Rosenmeier JB

    更新日期:2016-04-01 00:00:00

  • A prospective, multicenter derivation of a biomarker panel to assess risk of organ dysfunction, shock, and death in emergency department patients with suspected sepsis.

    abstract:OBJECTIVE:To define a biomarker panel to predict organ dysfunction, shock, and in-hospital mortality in emergency department (ED) patients with suspected sepsis. DESIGN:Prospective observational study. SETTING:EDs of ten academic medical centers. PATIENTS:There were 971 patients enrolled. INCLUSION CRITERIA:1) ED p...

    journal_title:Critical care medicine

    pub_type: 杂志文章,多中心研究

    doi:10.1097/CCM.0b013e318192fd9d

    authors: Shapiro NI,Trzeciak S,Hollander JE,Birkhahn R,Otero R,Osborn TM,Moretti E,Nguyen HB,Gunnerson KJ,Milzman D,Gaieski DF,Goyal M,Cairns CB,Ngo L,Rivers EP

    更新日期:2009-01-01 00:00:00

  • Disagreement Between Clinicians and Score in Decision-Making Capacity of Critically Ill Patients.

    abstract:OBJECTIVES:To compare the assessment of decision-making capacity of ICU patients by attending clinicians (physicians, nurses, and residents) with a capacity score measured by the Mini-Mental Status Examination, completed by Aid to Capacity Evaluation if necessary. The primary outcome was agreement between physicians' a...

    journal_title:Critical care medicine

    pub_type: 杂志文章,多中心研究

    doi:10.1097/CCM.0000000000003550

    authors: Bertrand PM,Pereira B,Adda M,Timsit JF,Wolff M,Hilbert G,Gruson D,Garrouste-Orgeas M,Argaud L,Constantin JM,Chabanne R,Quenot JP,Bohe J,Guerin C,Papazian L,Jonquet O,Klouche K,Delahaye A,Riu B,Zieleskiewicz L,Darm

    更新日期:2019-03-01 00:00:00

  • Critical care medicine use and cost among Medicare beneficiaries 1995-2000: major discrepancies between two United States federal Medicare databases.

    abstract:OBJECTIVE:A comparison of federal Medicare databases to identify critical care medicine (CCM) use, cost discrepancies, and their possible causes. DESIGN:A 6-yr (1995-2000) retrospective analysis of Medicare hospital and CCM use and cost, comparing the Hospital Cost Report Information System (HCRIS) with Medicare Provi...

    journal_title:Critical care medicine

    pub_type: 杂志文章

    doi:10.1097/01.CCM.0000257255.57899.5D

    authors: Halpern NA,Pastores SM,Thaler HT,Greenstein RJ

    更新日期:2007-03-01 00:00:00

  • Randomized Feasibility Trial of a Low Tidal Volume-Airway Pressure Release Ventilation Protocol Compared With Traditional Airway Pressure Release Ventilation and Volume Control Ventilation Protocols.

    abstract:OBJECTIVES:Low tidal volume (= tidal volume ≤ 6 mL/kg, predicted body weight) ventilation using volume control benefits patients with acute respiratory distress syndrome. Airway pressure release ventilation is an alternative to low tidal volume-volume control ventilation, but the release breaths generated are variable ...

    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.0000000000003437

    authors: Hirshberg EL,Lanspa MJ,Peterson J,Carpenter L,Wilson EL,Brown SM,Dean NC,Orme J,Grissom CK

    更新日期:2018-12-01 00:00:00

  • Somatosensory and brainstem auditory evoked potentials in cardiac arrest patients treated with hypothermia.

    abstract:OBJECTIVE:To evaluate the prognostic value of short-latency median nerve somatosensory evoked potentials and brainstem auditory evoked potentials in outcome prediction for comatose cardiac arrest patients treated with hypothermia. DESIGN:Prospective, randomized, controlled trial of mild hypothermia after out-of-hospit...

    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.0000171536.63641.d9

    authors: Tiainen M,Kovala TT,Takkunen OS,Roine RO

    更新日期:2005-08-01 00:00:00

  • Multiple organ dysfunction syndrome: exploring the paradigm of complex nonlinear systems.

    abstract:OBJECTIVES:The objectives of this article are to introduce and explore a novel paradigm based on complex nonlinear systems, and to evaluate its application to critical care research regarding the systemic host response and multiple organ dysfunction syndrome (MODS). DATA SOURCES:Published original work, review article...

    journal_title:Critical care medicine

    pub_type: 杂志文章,评审

    doi:10.1097/00003246-200007000-00003

    authors: Seely AJ,Christou NV

    更新日期:2000-07-01 00:00:00

  • Infusion of methylene blue in human septic shock: a pilot, randomized, controlled study.

    abstract:OBJECTIVE:To evaluate the effects of continuous infusion of methylene blue (MB), an inhibitor of the nitric oxide pathway, on hemodynamics and organ functions in human septic shock. DESIGN:Prospective, randomized, controlled, open-label, pilot study. SETTING:Multidisciplinary intensive care unit of a university hospi...

    journal_title:Critical care medicine

    pub_type: 临床试验,杂志文章,随机对照试验

    doi:10.1097/00003246-200110000-00002

    authors: Kirov MY,Evgenov OV,Evgenov NV,Egorina EM,Sovershaev MA,Sveinbjørnsson B,Nedashkovsky EV,Bjertnaes LJ

    更新日期:2001-10-01 00:00:00

  • Cardioprotection, attenuated systemic inflammation, and survival benefit of beta1-adrenoceptor blockade in severe sepsis in rats.

    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

    authors: Ackland GL,Yao ST,Rudiger A,Dyson A,Stidwill R,Poputnikov D,Singer M,Gourine AV

    更新日期:2010-02-01 00:00:00

  • Discriminant power and information content of Ranson's prognostic signs in acute pancreatitis: a meta-analytic study.

    abstract:OBJECTIVE:To determine a meta-analytical definition of the discriminant power of Ranson's signs in the prediction of acute pancreatitis severity and outcome, and of their information content, also compared with clinical judgment. DATA SOURCES:Two hundred eleven studies since 1974, reporting any predictive system for a...

    journal_title:Critical care medicine

    pub_type: 杂志文章,meta分析

    doi:10.1097/00003246-199910000-00035

    authors: De Bernardinis M,Violi V,Roncoroni L,Boselli AS,Giunta A,Peracchia A

    更新日期:1999-10-01 00:00:00

  • Adverse effects of high-dose epinephrine on cerebral blood flow during experimental cardiopulmonary resuscitation.

    abstract:OBJECTIVE:To study the effects of high-dose epinephrine, compared with standard-dose epinephrine, on the dynamics of superficial cortical cerebral blood flow as well as global cerebral oxygenation during experimental cardiopulmonary resuscitation. We hypothesized that high-dose epinephrine might be unable to improve ce...

    journal_title:Critical care medicine

    pub_type: 杂志文章

    doi:10.1097/00003246-200005000-00028

    authors: Gedeborg R,Silander HC,Ronne-Engström E,Rubertsson S,Wiklund L

    更新日期:2000-05-01 00:00:00

  • Propofol does not induce pulmonary dysfunction in stressed endotoxic pigs receiving Intralipid.

    abstract:OBJECTIVE:To assess the effect of diisopropyl phenol (propofol), with and without Intralipid, on the cardiopulmonary system and on thromboxane production in endotoxic pigs. DESIGN:Prospective, randomized animal study. SETTING:Animal research laboratory at a major teaching hospital. SUBJECTS:Twenty-four pigs, divided...

    journal_title:Critical care medicine

    pub_type: 杂志文章

    doi:10.1097/01.CCM.0000070445.76287.6E

    authors: Ziser A,Strickland RA,Murray MJ

    更新日期:2003-07-01 00:00:00