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Intensive Care Medicine Experimental

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https://www.readbyqxmd.com/read/28523563/assessment-of-endothelial-cell-function-and-physiological-microcirculatory-reserve-by-video-microscopy-using-a-topical-acetylcholine-and-nitroglycerin-challenge
#1
Matthias Peter Hilty, Jacqueline Pichler, Bulent Ergin, Urs Hefti, Tobias Michael Merz, Can Ince, Marco Maggiorini
BACKGROUND: Assessment of the microcirculation is a promising target for the hemodynamic management of critically ill patients. However, just as the sole reliance on macrocirculatory parameters, single static parameters of the microcirculation may not represent a sufficient guide. Our hypothesis was that by serial topical application of acetylcholine (ACH) and nitroglycerin (NG), the sublingual microcirculation can be challenged to determine its endothelial cell-dependent and smooth muscle-dependent physiological reserve capacity...
December 2017: Intensive Care Medicine Experimental
https://www.readbyqxmd.com/read/28497420/the-role-of-high-airway-pressure-and-dynamic-strain-on-ventilator-induced-lung-injury-in-a-heterogeneous-acute-lung-injury-model
#2
Sumeet V Jain, Michaela Kollisch-Singule, Joshua Satalin, Quinn Searles, Luke Dombert, Osama Abdel-Razek, Natesh Yepuri, Antony Leonard, Angelika Gruessner, Penny Andrews, Fabeha Fazal, Qinghe Meng, Guirong Wang, Louis A Gatto, Nader M Habashi, Gary F Nieman
BACKGROUND: Acute respiratory distress syndrome causes a heterogeneous lung injury with normal and acutely injured lung tissue in the same lung. Improperly adjusted mechanical ventilation can exacerbate ARDS causing a secondary ventilator-induced lung injury (VILI). We hypothesized that a peak airway pressure of 40 cmH2O (static strain) alone would not cause additional injury in either the normal or acutely injured lung tissue unless combined with high tidal volume (dynamic strain). METHODS: Pigs were anesthetized, and heterogeneous acute lung injury (ALI) was created by Tween instillation via a bronchoscope to both diaphragmatic lung lobes...
December 2017: Intensive Care Medicine Experimental
https://www.readbyqxmd.com/read/28432665/systemic-and-microcirculatory-effects-of-blood-transfusion-in-experimental-hemorrhagic-shock
#3
Gonzalo Ferrara, Vanina S Kanoore Edul, Héctor S Canales, Enrique Martins, Carlos Canullán, Gastón Murias, Mario O Pozo, Juan F Caminos Eguillor, María G Buscetti, Can Ince, Arnaldo Dubin
BACKGROUND: The microvascular reperfusion injury after retransfusion has not been completely characterized. Specifically, the question of heterogeneity among different microvascular beds needs to be addressed. In addition, the identification of anaerobic metabolism is elusive. The venoarterial PCO2 to arteriovenous oxygen content difference ratio (Pv-aCO2/Ca-vO2) might be a surrogate for respiratory quotient, but this has not been validated. Therefore, our goal was to characterize sublingual and intestinal (mucosal and serosal) microvascular injury after blood resuscitation in hemorrhagic shock and its relation with O2 and CO2 metabolism...
December 2017: Intensive Care Medicine Experimental
https://www.readbyqxmd.com/read/28429311/improving-animal-welfare-using-continuous-nalbuphine-infusion-in-a-long-term-rat-model-of-sepsis
#4
Victor Jeger, Mattia Arrigo, Florian F Hildenbrand, Daniel Müller, Paulin Jirkof, Till Hauffe, Burkhardt Seifert, Margarete Arras, Donat R Spahn, Dominique Bettex, Alain Rudiger
BACKGROUND: Sepsis research relies on animal models to investigate the mechanisms of the dysregulated host response to infection. Animal welfare concerns request the use of potent analgesics for the Refinement of existing sepsis models, according to the 3Rs principle. Nevertheless, adequate analgesia is often missing, partly because the effects of analgesics in this particular condition are unknown. We evaluated the use of nalbuphine, an opioid with kappa agonistic and mu antagonistic effects, in rats with and without experimental sepsis...
December 2017: Intensive Care Medicine Experimental
https://www.readbyqxmd.com/read/28409476/the-effects-of-hyperoxia-on-microvascular-endothelial-cell-proliferation-and-production-of-vaso-active-substances
#5
Ilias Attaye, Yvo M Smulders, Monique C de Waard, Heleen M Oudemans-van Straaten, Bob Smit, Michiel H Van Wijhe, Rene J Musters, Pieter Koolwijk, Angelique M E Spoelstra-de Man
BACKGROUND: Hyperoxia, an arterial oxygen pressure of more than 100 mmHg or 13% O2, frequently occurs in hospitalized patients due to administration of supplemental oxygen. Increasing evidence suggests that hyperoxia induces vasoconstriction in the systemic (micro)circulation, potentially affecting organ perfusion. This study addresses effects of hyperoxia on viability, proliferative capacity, and on pathways affecting vascular tone in cultured human microvascular endothelial cells (hMVEC)...
December 2017: Intensive Care Medicine Experimental
https://www.readbyqxmd.com/read/28405943/myocardial-oxidative-stress-correlates-with-left-ventricular-dysfunction-on-strain-echocardiography-in-a-rodent-model-of-sepsis
#6
Bereketeab Haileselassie, Erik Su, Iraklis Pozios, Diego F Niño, Hongyun Liu, Dai-Yin Lu, Ioannis Ventoulis, William B Fulton, Chhinder P Sodhi, David Hackam, Brian O'Rourke, Theodore Abraham
BACKGROUND: Recognition of cardiomyopathy in sepsis can be challenging due to the limitations of conventional measures such as ejection fraction (EF) and fractional shortening (FS) in the context of variable preload and afterload conditions. This study correlates myocardial function using strain echocardiography (SE) with cardiomyocyte oxidative stress in a murine model of sepsis. METHODS: C57BL/6J mice were randomized into control (n = 10), sham (n = 25), and a cecal ligation and puncture (CLP) (n = 33) model of sepsis...
December 2017: Intensive Care Medicine Experimental
https://www.readbyqxmd.com/read/28390055/extracorporeal-co2-removal-by-hemodialysis-in-vitro-model-and-feasibility
#7
Alexandra G May, Ayan Sen, Matthew E Cove, John A Kellum, William J Federspiel
BACKGROUND: Critically ill patients with acute respiratory distress syndrome and acute exacerbations of chronic obstructive pulmonary disease often develop hypercapnia and require mechanical ventilation. Extracorporeal carbon dioxide removal can manage hypercarbia by removing carbon dioxide directly from the bloodstream. Respiratory hemodialysis uses traditional hemodialysis to remove CO2 from the blood, mainly as bicarbonate. In this study, Stewart's approach to acid-base chemistry was used to create a dialysate that would maintain blood pH while removing CO2 as well as determine the blood and dialysate flow rates necessary to remove clinically relevant CO2 volumes...
December 2017: Intensive Care Medicine Experimental
https://www.readbyqxmd.com/read/28378187/ultra-low-dose-sequential-computed-tomography-for-quantitative-lung-aeration-assessment-a-translational-study
#8
Lorenzo Ball, Anja Braune, Francesco Corradi, Claudia Brusasco, Alessandro Garlaschi, Thomas Kiss, Thomas Bluth, Francesca Simonassi, Alice Bergamaschi, Jörg Kotzerke, Marcus J Schultz, Marcelo Gama de Abreu, Paolo Pelosi
BACKGROUND: Quantitative lung computed tomography (CT) provides fundamental information about lung aeration in critically ill patients. We tested a scanning protocol combining reduced number of CT slices and tube current, comparing quantitative analysis and radiation exposure to conventional CT. METHODS: In pigs, CT scans were performed during breath hold in a model of lung injury with three different protocols: standard spiral with 180 mAs tube current-time product (Spiral180), sequential with 20-mm distance between slices and either 180 mAs (Sequential180) or 50 mAs (Sequential50)...
December 2017: Intensive Care Medicine Experimental
https://www.readbyqxmd.com/read/28342161/granulocyte-and-monocyte-adsorptive-apheresis-ameliorates-sepsis-in-rats
#9
Shuai Ma, Qingqing Xu, Bo Deng, Yin Zheng, Hongyan Tian, Li Wang, Feng Ding
BACKGROUND: Overwhelming activation of granulocytes and monocytes is central to inflammatory responses during sepsis. Granulocyte and monocyte adsorptive apheresis (GMA) is an extracorporeal leukocyte apheresis device filled with cellulose acetate beads and selectively adsorbs granulocytes and monocytes from the peripheral blood. METHODS: In this study, septic rats received the GMA treatment for 2 h at 18 h after cecal ligation and puncture. RESULTS: GMA selectively adsorbed activated neutrophils and monocytes from the peripheral blood, reduced serum inflammatory cytokine expression, and seemed to improve organ injuries and animal survival...
December 2017: Intensive Care Medicine Experimental
https://www.readbyqxmd.com/read/28321823/cardiovascular-disease-and-resuscitated-septic-shock-lead-to-the-downregulation-of-the-h2s-producing-enzyme-cystathionine-%C3%AE-lyase-in-the-porcine-coronary-artery
#10
Tamara Merz, Tatjana Stenzel, Benedikt Nußbaum, Martin Wepler, Csaba Szabo, Rui Wang, Peter Radermacher, Oscar McCook
BACKGROUND: Downregulation of the hydrogen sulfide (H2S)-producing enzymes cystathionine-γ-lyase (CSE), cystathionine-β-synthase (CBS), and/or 3-mercaptopyruvate sulfurtransferase (3-MST) is associated with chronic cardiovascular pathologies. Nevertheless, equivocal data are available on both the expression and function of these enzymes in coronary arteries (CA). We recently reported that atherosclerotic pigs subjected to sepsis developed impaired cardiac function, which coincided with decreased myocardial CSE expression and increased nitrotyrosine formation...
December 2017: Intensive Care Medicine Experimental
https://www.readbyqxmd.com/read/28303483/proliferation-and-differentiation-of-adipose-tissue-in-prolonged-lean-and-obese-critically-ill-patients
#11
Chloë Goossens, Sarah Vander Perre, Greet Van den Berghe, Lies Langouche
BACKGROUND: In prolonged non-obese critically ill patients, preservation of adipose tissue is prioritized over that of the skeletal muscle and coincides with increased adipogenesis. However, we recently demonstrated that in obese critically ill mice, this priority was switched. In the obese, the use of abundantly available adipose tissue-derived energy substrates was preferred and counteracted muscle wasting. These observations suggest that different processes are ongoing in adipose tissue of lean vs...
December 2017: Intensive Care Medicine Experimental
https://www.readbyqxmd.com/read/28303482/extracellular-superoxide-dismutase-is-necessary-to-maintain-renal-blood-flow-during-sepsis-development
#12
Larissa Constantino, Letícia Selinger Galant, Francieli Vuolo, Karla Lorena Guarido, Luiza Wilges Kist, Giovanna Medeiros Tavares de Oliveira, Matheus Augusto de Bittencourt Pasquali, Cláudio Teodoro de Souza, José Eduardo da Silva-Santos, Maurício Reis Bogo, José Cláudio Fonseca Moreira, Cristiane Ritter, Felipe Dal-Pizzol
BACKGROUND: Extracellular superoxide dismutase (ECSOD) protects nitric oxide (NO) bioavailability by decreasing superoxide levels and preventing peroxynitrite generation, which is important in maintaining renal blood flow and in preventing acute kidney injury. However, the profile of ECSOD expression after sepsis is not fully understood. Therefore, we intended to evaluate the content and gene expression of superoxide dismutase (SOD) isoforms in the renal artery and their relation to renal blood flow...
December 2017: Intensive Care Medicine Experimental
https://www.readbyqxmd.com/read/28290154/the-role-of-calpains-in-ventilator-induced-diaphragm-atrophy
#13
Xiaoping Zhu, Hieronymus W H van Hees, Leo Heunks, Feifei Wang, Lei Shao, Jiaru Huang, Lei Shi, Shaolin Ma
BACKGROUND: Controlled mechanical ventilation (CMV) is associated with diaphragm dysfunction. Dysfunction results from muscle atrophy and injury of diaphragm muscle fibers. Enhanced proteolysis and reduced protein synthesis play an important role in the development of atrophy. The current study is to evaluate the effects of the calpains inhibitor calpeptin on the development of diaphragm atrophy and activation of key enzymes of the ubiquitin-proteasome pathway in rats under CMV. METHODS: Three groups of rats were studied: control animals (CON, n = 8), rats subjected to 24 h of MV (CMV, n = 8), and rats subjected to 24 h of MV after administration of the calpain inhibitor calpeptin (CMVC, n = 8)...
December 2017: Intensive Care Medicine Experimental
https://www.readbyqxmd.com/read/28265979/intraperitoneal-adoptive-transfer-of-mesenchymal-stem-cells-enhances-recovery-from-acid-aspiration-acute-lung-injury-in-mice
#14
Tommaso Mauri, Vanessa Zambelli, Claudia Cappuzzello, Giacomo Bellani, Erica Dander, Marina Sironi, Vittoria Castiglioni, Andrea Doni, Alberto Mantovani, Andrea Biondi, Cecilia Garlanda, Giovanna D'amico, Antonio Pesenti
BACKGROUND: Mesenchymal stem cells (MSCs) might act as fine-tuners of inflammation during acute lung injury. We assessed the effects of adoptive transfer of MSCs in acid aspiration acute lung injury and explored the role of long pentraxin PTX3. METHODS: We conducted a prospective experimental interventional study on wild-type (WT) and PTX3-deficient (PTX3(-/-)) mice. Acute lung injury was induced in WT and PTX3(-/-) mice by instillation of hydrochloric acid into the right bronchus...
December 2017: Intensive Care Medicine Experimental
https://www.readbyqxmd.com/read/28251580/experimental-assessment-of-oxygen-homeostasis-during-acute-hemodilution-the-integrated-role-of-hemoglobin-concentration-and-blood-pressure
#15
Tiffanie Kei, Nikhil Mistry, Albert K Y Tsui, Elaine Liu, Stephen Rogers, Allan Doctor, David F Wilson, Jean-Francois Desjardins, Kim Connelly, C David Mazer, Gregory M T Hare
BACKGROUND: Low hemoglobin concentration (Hb) and low mean arterial blood pressure (MAP) impact outcomes in critically ill patients. We utilized an experimental model of "normotensive" vs. "hypotensive" acute hemodilutional anemia to test whether optimal tissue perfusion is dependent on both Hb and MAP during acute blood loss and fluid resuscitation, and to assess the value of direct measurements of the partial pressure of oxygen in tissue (PtO2). METHODS: Twenty-nine anesthetized rats underwent 40% isovolemic hemodilution (1:1) (or sham-hemodilution control, n = 4) with either hydroxyethyl starch (HES) (n = 14, normotensive anemia) or saline (n = 11, hypotensive anemia) to reach a target Hb value near 70 g/L...
December 2017: Intensive Care Medicine Experimental
https://www.readbyqxmd.com/read/28243924/the-respiratory-pressure-abdominal-volume-curve-in-a-porcine-model
#16
Adrian Regli, Bart Leon De Keulenaer, Bhajan Singh, Lisen Emma Hockings, Bill Noffsinger, Peter Vernon van Heerden
BACKGROUND: Increasing intra-abdominal volume (IAV) can lead to intra-abdominal hypertension (IAH) or abdominal compartment syndrome. Both are associated with raised morbidity and mortality. IAH can increase airway pressures and impair ventilation. The relationship between increasing IAV and airway pressures is not known. We therefore assessed the effect of increasing IAV on airway and intra-abdominal pressures (IAP). METHODS: Seven pigs (41.4 +/-8.5 kg) received standardized anesthesia and mechanical ventilation...
December 2017: Intensive Care Medicine Experimental
https://www.readbyqxmd.com/read/28224564/increased-glucocorticoid-receptor-expression-in-sepsis-is-related-to-heat-shock-proteins-cytokines-and-cortisol-and-is-associated-with-increased-mortality
#17
Konstantinos Vardas, Stavroula Ilia, Amalia Sertedaki, Evangelia Charmandari, Efrossini Briassouli, Dimitris Goukos, Kleovoulos Apostolou, Katerina Psarra, Efthimia Botoula, Stylianos Tsagarakis, Eleni Magira, Christina Routsi, Constantine A Stratakis, Serafim Nanas, George Briassoulis
BACKGROUND: The purposes of this study are to examine if the human glucocorticoid receptor (hGR) isoform-α mRNA and hGR protein expressions are deficient in the acute phase of sepsis (S) compared to systemic inflammatory response syndrome (SIRS) and healthy subjects (H) and to evaluate if the hGRα and hGR alterations are associated with cortisol changes and if they are related to (1) extracellular and intracellular heat shock proteins (HSP) 72 and 90α; (2) ACTH, prolactin, and interleukins (ILs); and (3) outcome...
December 2017: Intensive Care Medicine Experimental
https://www.readbyqxmd.com/read/28168516/-in-a-dark-place-we-find-ourselves-light-intensity-in-critical-care-units
#18
LETTER
Hannah J Durrington, Richard Clark, Ruari Greer, Franck P Martial, John Blaikley, Paul Dark, Robert J Lucas, David W Ray
Intensive care units provide specialised care for critically ill patients around the clock. However, intensive care unit patients have disrupted circadian rhythms. Furthermore, disrupted circadian rhythms are associated with worse outcome. As light is the most powerful 're-setter' of circadian rhythm, we measured light intensity on intensive care unit. Light intensity was low compared to daylight during the 'day'; frequent bright light interruptions occurred over 'night'. These findings are predicted to disrupt circadian rhythms and impair entrainment to external time...
December 2017: Intensive Care Medicine Experimental
https://www.readbyqxmd.com/read/28150228/personalizing-mechanical-ventilation-according-to-physiologic-parameters-to-stabilize-alveoli-and-minimize-ventilator-induced-lung-injury-vili
#19
REVIEW
Gary F Nieman, Joshua Satalin, Penny Andrews, Hani Aiash, Nader M Habashi, Louis A Gatto
It has been shown that mechanical ventilation in patients with, or at high-risk for, the development of acute respiratory distress syndrome (ARDS) can be a double-edged sword. If the mechanical breath is improperly set, it can amplify the lung injury associated with ARDS, causing a secondary ventilator-induced lung injury (VILI). Conversely, the mechanical breath can be adjusted to minimize VILI, which can reduce ARDS mortality. The current standard of care ventilation strategy to minimize VILI attempts to reduce alveolar over-distension and recruitment-derecruitment (R/D) by lowering tidal volume (Vt) to 6 cc/kg combined with adjusting positive-end expiratory pressure (PEEP) based on a sliding scale directed by changes in oxygenation...
December 2017: Intensive Care Medicine Experimental
https://www.readbyqxmd.com/read/28124196/baseline-thrombospondin-1-concentrations-are-not-associated-with-mortality-in-septic-patients-a-single-center-cohort-study-on-the-intensive-care-unit
#20
Ruben J van der Wekken, Hans Kemperman, Mark Roest, Dylan W de Lange
BACKGROUND: The initial phase of sepsis is characterized by hyperinflammation. Levels of thrombospondin-1 (TSP-1) rise rapidly during acute inflammation. The purpose of this clinical study was to study the association between plasma TSP-1 levels and mortality in patients with sepsis on the intensive care unit. METHODS: Critically ill adult patients with sepsis, severe sepsis, or septic shock were included. They were further divided into tertiles based on their baseline plasma TSP-1 concentrations...
December 2017: Intensive Care Medicine Experimental
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