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Intensive Care Medicine Experimental

Julien Adjedj, Fabien Picard, Maarten Vanhaverbeke, Bernard De Bruyne, Alain Cariou, Ming Wu, Stefan Janssens, Olivier Varenne
BACKGROUND: Several indices exist to assess cerebral perfusion after cardiac arrest (CA). We aimed to investigate a new approach allowing absolute flow and microvascular resistance measurement based on selective arterial continuous thermodilution before and after CA resuscitation in a porcine model. METHODS: In anaesthetised pigs, intravascular absolute cerebral blood flow (CBF) and absolute coronary blood flow (ABF) with corresponding microvascular resistances were measured...
October 12, 2018: Intensive Care Medicine Experimental
Malik Benlabed, Anthony Martin Mena, Romain Gaudy, Maxime Perez, Stéphanie Genay, Jean-Daniel Hecq, Pascal Odou, Gilles Lebuffe, Bertrand Décaudin
BACKGROUND: In critically ill patients, drug incompatibilities frequently occur because of the number of drugs to be administered through a limited number of infusion lines. These are among the main causes of particulate contamination. However, little data is available to quantify particle exposure during simultaneous IV-drug infusion. The objective of this study was to evaluate the particulate matter potentially administered to critically ill patients. METHODS: The particulate matter (between 1 μm and 30 mm) of infused therapies used in ICUs for patients suffering from either septic shock or acute respiratory distress syndrome was measured in vitro over 6 h using a dynamic image analysis device, so that both overall particulate contamination and particle sizes could be determined...
October 11, 2018: Intensive Care Medicine Experimental
(no author information available yet)
No abstract text is available yet for this article.
October 2018: Intensive Care Medicine Experimental
David Vermette, Pamela Hu, Michael F Canarie, Melissa Funaro, Janis Glover, Richard W Pierce
BACKGROUND: Epithelial and endothelial barrier integrity, essential for homeostasis, is maintained by cellular boarder structures known as tight junctions (TJs). In critical illness, TJs may become disrupted, resulting in barrier dysfunction manifesting as capillary leak, pulmonary edema, gut bacterial translocation, and multiple organ failure. We aim to provide a clinically focused overview of TJ structure and function and systematically review and analyze all studies assessing markers of endothelial and epithelial TJ breakdown correlated with clinical outcomes in critically ill humans...
September 26, 2018: Intensive Care Medicine Experimental
Tomas Kovarnik, Miroslav Navratil, Jan Belohlavek, Mikulas Mlcek, Martin Chval, Zhi Chen, Stepan Jerabek, Otomar Kittnar, Ales Linhart
BACKGROUND: We studied a novel approach for the evaluation and management of volemia: minimally invasive monitoring of respiratory blood flow variations in the superior vena cava (SVC). We performed an experiment with 10 crossbred (Landrace × large white) female pigs (Sus scrofa domestica). METHODS: Hypovolemia was induced by bleeding from a femoral artery, in six stages. This was followed by blood return and then an infusion of 1000 ml saline, resulting in hypervolemia...
September 24, 2018: Intensive Care Medicine Experimental
Alexandra G May, R Garrett Jeffries, Brian J Frankowski, Greg W Burgreen, William J Federspiel
BACKGROUND: There is increasing evidence demonstrating the value of partial extracorporeal CO2 removal (ECCO2 R) for the treatment of hypercapnia in patients with acute exacerbations of chronic obstructive pulmonary disease and acute respiratory distress syndrome. Mechanical ventilation has traditionally been used to treat hypercapnia in these patients, however, it has been well-established that aggressive ventilator settings can lead to ventilator-induced lung injury. ECCO2 R removes CO2 independently of the lungs and has been used to permit lung protective ventilation to prevent ventilator-induced lung injury, prevent intubation, and aid in ventilator weaning...
September 24, 2018: Intensive Care Medicine Experimental
Alessandro Protti
Inhibition of the respiratory chain complex I plays a key role in the pathogenesis of metformin-induced lactic acidosis. In a work recently published in this journal, a novel cell-permeable succinate prodrug (NV118) increased in vitro mitochondrial oxygen consumption coupled with energy production and decreased lactate production in intact human platelets intoxicated with metformin. This result was interpreted in light of a "bypass" strategy. NV118 entered platelets and released succinate in their cytoplasm; succinate in turn donated electrons to complex II and thus reactivated the flow of electrons to the distal part of the respiratory chain independent of complex I...
September 24, 2018: Intensive Care Medicine Experimental
Jonas Tydén, N Larsson, S Lehtipalo, H Herwald, M Hultin, J Walldén, A F Behndig, J Johansson
BACKGROUND: Although mechanical ventilation is often lifesaving, it can also cause injury to the lungs. The lung injury is caused by not only high pressure and mechanical forces but also by inflammatory processes that are not fully understood. Heparin-binding protein (HBP), released by activated granulocytes, has been indicated as a possible mediator of increased vascular permeability in the lung injury associated with trauma and sepsis. We investigated if HBP levels were increased in the bronchoalveolar lavage fluid (BALF) or plasma in a pig model of ventilator-induced lung injury (VILI)...
September 10, 2018: Intensive Care Medicine Experimental
Pierre Eyenga, Damien Roussel, Jerome Morel, Benjamin Rey, Caroline Romestaing, Virginie Gueguen-Chaignon, Shey-Shing Sheu, Jean Paul Viale
BACKGROUND: Tissue ATP depletion and oxidative stress have been associated with the severe outcomes of septic shock. One of the compensatory mechanisms to alleviate the sepsis-induced mitochondrial dysfunction could be the increase in oxidative phosphorylation efficiency (ATP/O). We propose to study liver mitochondrial function and oxidative stress and the regulatory mechanism of mitochondrial oxidative phosphorylation efficiency in an animal model of sepsis. METHODS: We induced sepsis in rats by cecal ligation and perforation (CLP)...
September 5, 2018: Intensive Care Medicine Experimental
Matthias van der Staay, Robert L Chatburn
Recent research results provide new incentives to recognize and prevent ventilator-induced lung injury (VILI) and create targeting schemes for new modes of mechanical ventilation. For example, minimization of breathing power, inspiratory power, and inspiratory pressure are the underlying goals of optimum targeting schemes used in the modes called adaptive support ventilation (ASV), adaptive ventilation mode 2 (AVM2), and MID-frequency ventilation (MFV). We describe the mathematical models underlying these targeting schemes and present theoretical analyses for minimizing tidal volume, tidal pressure (also known as driving pressure), or tidal power as functions of ventilatory frequency...
August 22, 2018: Intensive Care Medicine Experimental
Alain Rudiger, Victor Jeger, Mattia Arrigo, Christian A Schaer, Florian F Hildenbrand, Margarete Arras, Burkhardt Seifert, Mervyn Singer, Gabriele Schoedon, Donat R Spahn, Dominique Bettex
BACKGROUND: In sepsis, early outcome prediction would allow investigation of both adaptive mechanisms underlying survival and maladaptive mechanisms resulting in death. The aim of this study was to test whether early changes in heart rate monitored by telemetry could predict outcome in a long-term rat model of fecal peritonitis. METHODS: Male Wistar rats (n = 24) were instrumented with a central venous line for administration of fluids, antibiotics and analgesics...
August 20, 2018: Intensive Care Medicine Experimental
Jerome Aboab, Louis Mayaud, Veronique Sebille, Rodrigo de Oliveira, Merce Jourdain, Djillali Annane
Following publication of the original article [1], the author reported these required corrections to Fig. 5 and Fig. 6.
August 20, 2018: Intensive Care Medicine Experimental
Quoc Thang Hoang, Alexandre Nuzzo, Liliane Louedec, Sandrine Delbosc, Francesco Andreata, Jamila Khallou-Laschet, Maksud Assadi, Philippe Montravers, Dan Longrois, Olivier Corcos, Giuseppina Caligiuri, Antonino Nicoletti, Jean-Baptiste Michel, Alexy Tran-Dinh
BACKGROUND: CD31 is a key transmembrane neutrophil immunoregulatory receptor. Mesenteric ischemia/reperfusion-induced neutrophil activation leads to a massive cleavage and shedding of the most extracellular domains of CD31 into plasma, enhancing the deleterious effect of neutrophil activation. We have evaluated the preventive therapeutic potential of an engineered synthetic octapeptide (P8RI), which restores the inhibitory intracellular signaling of cleaved CD31, in an experimental model of acute mesenteric ischemia/reperfusion...
August 15, 2018: Intensive Care Medicine Experimental
Marcin F Osuchowski, Alfred Ayala, Soheyl Bahrami, Michael Bauer, Mihaly Boros, Jean-Marc Cavaillon, Irshad H Chaudry, Craig M Coopersmith, Clifford Deutschman, Susanne Drechsler, Philip Efron, Claes Frostell, Gerhard Fritsch, Waldemar Gozdzik, Judith Hellman, Markus Huber-Lang, Shigeaki Inoue, Sylvia Knapp, Andrey V Kozlov, Claude Libert, John C Marshall, Lyle L Moldawer, Peter Radermacher, Heinz Redl, Daniel G Remick, Mervyn Singer, Christoph Thiemermann, Ping Wang, W Joost Wiersinga, Xianzhong Xiao, Basilia Zingarelli
BACKGROUND: Pre-clinical animal studies precede the majority of clinical trials. While the clinical definitions of sepsis and recommended treatments are regularly updated, a systematic review of pre-clinical models of sepsis has not been done and clear modeling guidelines are lacking. OBJECTIVE: To address this deficit, a Wiggers-Bernard Conference on pre-clinical sepsis modeling was held in Vienna in May 2017. The goal of the conference was to identify limitations of pre-clinical sepsis models and to propose a set of guidelines, defined as the "Minimum Quality Threshold in Pre-Clinical Sepsis Studies" (MQTiPSS), to enhance translational value of these models...
August 14, 2018: Intensive Care Medicine Experimental
Christopher John Joyce, Kiran Shekar, David Andrew Cook
BACKGROUND: Venovenous extracorporeal membrane oxygenation (vv-ECMO) is an effective treatment for severe respiratory failure. The interaction between the cardiorespiratory system and the oxygenator can be explored with mathematical models. Understanding the physiology will help the clinician optimise therapy. As others have examined O2 exchange, the main focus of this study was on CO2 exchange. METHODS: A model of the cardiorespiratory system during vv-ECMO was developed, incorporating O2 , CO2 and N2 exchange in both the lung and the oxygenator...
August 9, 2018: Intensive Care Medicine Experimental
Caroline Laroye, Jérémie Lemarié, Amir Boufenzer, Pierre Labroca, Lisiane Cunat, Corentine Alauzet, Frédérique Groubatch, Clémence Cailac, Lucie Jolly, Danièle Bensoussan, Loïc Reppel, Sébastien Gibot
BACKGROUND: Septic shock is the leading cause of death in intensive care units. The pathophysiological complexity of this syndrome contributes to an absence of specific treatment. Several preclinical studies in murine models of septic shock have shown improvements to organ injury and survival after administration of mesenchymal stem cells (MSCs). To better mimic a clinical approach in humans, we investigated the impact of randomized controlled double-blind administration of clinical-grade umbilical cord-derived MSCs to a relevant pig model of septic shock...
August 8, 2018: Intensive Care Medicine Experimental
Lauge Vammen, Søren Rahbek, Niels Secher, Jonas Agerlund Povlsen, Niels Jessen, Bo Løfgren, Asger Granfeldt
BACKGROUND: Cardiac arrest carries a poor prognosis. The typical cardiac arrest patient is comorbid, and studies have shown that diabetes mellitus is an independent risk factor for increased mortality after cardiac arrest. Despite this, animal studies lack to investigate cardiac arrest in the setting of diabetes mellitus. We hypothesize that type 2 diabetes mellitus in a rat model of cardiac arrest is associated with increased organ dysfunction when compared with non-diabetic rats. METHODS: Zucker diabetic fatty (ZDF) rats (n = 13), non-diabetic Zucker lean control (ZLC) rats (n = 15), and non-diabetic Sprague Dawley (SprD) rats (n = 8), underwent asphyxia-induced cardiac arrest...
August 7, 2018: Intensive Care Medicine Experimental
Sarah Piel, Johannes K Ehinger, Imen Chamkha, Eleonor Åsander Frostner, Fredrik Sjövall, Eskil Elmér, Magnus J Hansson
BACKGROUND: Metformin is the most common pharmacological treatment for type 2 diabetes. It is considered safe but has been associated with the development of lactic acidosis under circumstances where plasma concentrations exceed therapeutic levels. Metformin-induced lactic acidosis has been linked to the drug's toxic effect on mitochondrial function. Current treatment strategies aim to remove the drug and correct for the acidosis. With a mortality of 20%, complementary treatment strategies are needed...
August 1, 2018: Intensive Care Medicine Experimental
María C Arango-Granados, Virginia Zarama Córdoba, Andrés M Castro Llanos, Luis A Bustamante Cristancho
BACKGROUND: Methods to guide fluid therapy in spontaneously breathing patients are scarce. No studies have reported the accuracy of end-tidal CO2 (ET-CO2 ) to predict volume responsiveness in these patients. We sought to evaluate the ET-CO2 gradient (ΔET-CO2 ) after a passive leg rise (PLR) maneuver to predict volume responsiveness in spontaneously breathing healthy adults. METHODS: We conducted a prospective study in healthy adult human volunteers. A PLR maneuver was performed and cardiac output (CO) was measured by transthoracic echocardiography...
July 30, 2018: Intensive Care Medicine Experimental
Ellen Broberg, Martiné Wlosinska, Lars Algotsson, Anna-Carin Olin, Darcy Wagner, Leif Pierre, Sandra Lindstedt
BACKGROUND: Different mechanical ventilation settings are known to affect lung preservation for lung transplantation. Measurement of particle flow in exhaled air may allow online assessment of the impact of ventilation before changes in the tissue can be observed. We hypothesized that by analyzing the particle flow, we could understand the impact of different ventilation parameters. METHODS: Particle flow was monitored in vivo, post mortem, and in ex vivo lung perfusion (EVLP) in six porcines with the Pexa (particles in exhaled air) instrument...
July 27, 2018: Intensive Care Medicine Experimental
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