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Intensive Care Medicine Experimental

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https://www.readbyqxmd.com/read/29230608/combinatorial-therapy-with-two-pro-coagulants-and-one-osmotic-agent-reduces-the-extent-of-the-lesion-in-the-acute-phase-of-spinal-cord-injury-in-the-rat
#1
Mathieu Boutonnet, Elisabeth Laemmel, Eric Vicaut, Jacques Duranteau, Marc Soubeyrand
BACKGROUND: Spinal cord injury (SCI) is a complex disease that leads to a motor, sensitive, and vegetative impairment. So far, single therapies are ineffective for treating SCI in humans and a multifactorial therapeutic approach may be required. The aim of this work was to assess the effect of a triple therapy (TT) associating two pro-coagulant therapies (tranexamic acid and fibrinogen) with an anti-edema therapy (hypertonic saline solution), on the extent of the lesion 24 h post-injury...
December 11, 2017: Intensive Care Medicine Experimental
https://www.readbyqxmd.com/read/28779451/hemoadsorption-corrects-hyperresistinemia-and-restores-anti-bacterial-neutrophil-function
#2
Anthony Bonavia, Lauren Miller, John A Kellum, Kai Singbartl
BACKGROUND: Mounting evidence suggests that sepsis-induced morbidity and mortality are due to both immune activation and immunosuppression. Resistin is an inflammatory cytokine and uremic toxin. Septic hyperresistinemia (plasma resistin >20 ng/ml) has been associated with greater disease severity and worse outcomes, and it is further exacerbated by concomitant acute kidney injury (AKI). Septic hyperresistinemia disturbs actin polymerization in neutrophils leading to impaired neutrophil migration, a crucial first-line mechanism in host defense to bacterial infection...
December 2017: Intensive Care Medicine Experimental
https://www.readbyqxmd.com/read/28770541/optimal-esophageal-balloon-volume-for-accurate-estimation-of-pleural-pressure-at-end-expiration-and-end-inspiration-an-in-vitro-bench-experiment
#3
Yan-Lin Yang, Xuan He, Xiu-Mei Sun, Han Chen, Zhong-Hua Shi, Ming Xu, Guang-Qiang Chen, Jian-Xin Zhou
BACKGROUND: Esophageal pressure, used as a surrogate for pleural pressure, is commonly measured by air-filled balloon, and the accuracy of measurement depends on the proper balloon volume. It has been found that larger filling volume is required at higher surrounding pressure. In the present study, we determined the balloon pressure-volume relationship in a bench model simulating the pleural cavity during controlled ventilation. The aim was to confirm whether an optimal balloon volume range existed that could provide accurate measurement at both end-expiration and end-inspiration...
December 2017: Intensive Care Medicine Experimental
https://www.readbyqxmd.com/read/28766276/impact-of-membrane-lung-surface-area-and-blood-flow-on-extracorporeal-co2-removal-during-severe-respiratory-acidosis
#4
Christian Karagiannidis, Stephan Strassmann, Daniel Brodie, Philine Ritter, Anders Larsson, Ralf Borchardt, Wolfram Windisch
BACKGROUND: Veno-venous extracorporeal CO2 removal (vv-ECCO2R) is increasingly being used in the setting of acute respiratory failure. Blood flow rates through the device range from 200 ml/min to more than 1500 ml/min, and the membrane surface areas range from 0.35 to 1.3 m(2). The present study in an animal model with similar CO2 production as an adult patient was aimed at determining the optimal membrane lung surface area and technical requirements for successful vv-ECCO2R. METHODS: Four different membrane lungs, with varying lung surface areas of 0...
December 2017: Intensive Care Medicine Experimental
https://www.readbyqxmd.com/read/28702940/heart-rate-variability-in-critical-care-medicine-a-systematic-review
#5
Shamir N Karmali, Alberto Sciusco, Shaun M May, Gareth L Ackland
BACKGROUND: Heart rate variability (HRV) has been used to assess cardiac autonomic activity in critically ill patients, driven by translational and biomarker research agendas. Several clinical and technical factors can interfere with the measurement and/or interpretation of HRV. We systematically evaluated how HRV parameters are acquired/processed in critical care medicine. METHODS: PubMed, MEDLINE, EMBASE and the Cochrane Central Register of Controlled Trials (1996-2016) were searched for cohort or case-control clinical studies of adult (>18 years) critically ill patients using heart variability analysis...
December 2017: Intensive Care Medicine Experimental
https://www.readbyqxmd.com/read/28699088/sepsis-prediction-in-critically-ill-patients-by-platelet-activation-markers-on-icu-admission-a-prospective-pilot-study
#6
Nathalie Layios, Céline Delierneux, Alexandre Hego, Justine Huart, Christian Gosset, Christelle Lecut, Nathalie Maes, Pierre Geurts, Arnaud Joly, Patrizio Lancellotti, Adelin Albert, Pierre Damas, André Gothot, Cécile Oury
BACKGROUND: Platelets have been involved in both immune surveillance and host defense against severe infection. To date, whether platelet phenotype or other hemostasis components could be associated with predisposition to sepsis in critical illness remains unknown. The aim of this work was to identify platelet markers that could predict sepsis occurrence in critically ill injured patients. METHODS: This single-center, prospective, observational, 7-month study was based on a cohort of 99 non-infected adult patients admitted to ICUs for elective cardiac surgery, trauma, acute brain injury, and post-operative prolonged ventilation and followed up during ICU stay...
December 2017: Intensive Care Medicine Experimental
https://www.readbyqxmd.com/read/28677045/evaluation-of-an-advanced-organ-support-advos-system-in-a-two-hit-porcine-model-of-liver-failure-plus-endotoxemia
#7
Ahmed Al-Chalabi, Edouard Matevossian, Anne von Thaden, Catherine Schreiber, Peter Radermacher, Wolfgang Huber, Aritz Perez Ruiz de Garibay, Bernhard Kreymann
BACKGROUND: Novel extracorporeal procedures are constantly being developed and evaluated for use in patients with sepsis. Preclinical evaluation of such procedures usually requires testing in large animal models. In the present work, the safety and efficacy of a recently developed ADVanced Organ Support (ADVOS) system in a newly developed large animal two-hit model of liver failure combined with endotoxemia were tested. METHODS: After establishing the model in more than 50 animals, a randomized study was performed...
December 2017: Intensive Care Medicine Experimental
https://www.readbyqxmd.com/read/28616781/impact-of-hyperglycemia-on-cystathionine-%C3%AE-lyase-expression-during-resuscitated-murine-septic-shock
#8
Tamara Merz, Josef A Vogt, Ulrich Wachter, Enrico Calzia, Csaba Szabo, Rui Wang, Peter Radermacher, Oscar McCook
BACKGROUND: Cystathionine-γ-lyase (CSE) was shown to have a regulatory role in glucose metabolism. Circulatory shock can induce metabolic stress, thereby leading to hyperglycemia and mitochondrial dysfunction. In vitro data suggest an effect of high glucose on CSE expression. Therefore, the aim of this study was to investigate the effects of hyperglycemia on CSE expression in resuscitated murine septic shock. METHODS: Normo- (80-150 mg/dl) and hyperglycemic (>200 mg/dl) male C57/BL6J mice (n = 5-6 per group) underwent cecal ligation and puncture (CLP)-induced polymicrobial sepsis or sham procedure (n = 6 per group) and, 15 h afterwards, were anesthetized again, surgically instrumented and received intensive care treatment, including antibiotics, lung protective mechanical ventilation, circulatory support, and intravenous (i...
December 2017: Intensive Care Medicine Experimental
https://www.readbyqxmd.com/read/28600797/the-novel-nitric-oxide-donor-pdno-attenuates-ovine-ischemia-reperfusion-induced-renal-failure
#9
Kristofer F Nilsson, John Sandin, Lars E Gustafsson, Robert Frithiof
BACKGROUND: Renal ischemia-reperfusion injury is a common cause of acute kidney injury in intensive care and surgery. Recently, novel organic mononitrites of 1,2-propanediol (PDNO) were synthesized and shown to rapidly and controllably deploy nitric oxide in the circulation when administered intravenously. We hypothesized that intravenous infusion of PDNO during renal ischemia reperfusion would improve post-ischemic renal function and microcirculation. METHODS: Sixteen sheep were anesthetized, mechanically ventilated, and surgically instrumented...
December 2017: Intensive Care Medicine Experimental
https://www.readbyqxmd.com/read/28560615/effect-of-continuous-dialysis-on-blood-ph-in-acidemic-hypercapnic-animals-with-severe-acute-kidney-injury-a-randomized-experimental-study-comparing-high-vs-low-bicarbonate-affluent
#10
Thiago Gomes Romano, Luciano Cesar Pontes Azevedo, Pedro Vitale Mendes, Eduardo Leite Vieira Costa, Marcelo Park
BACKGROUND: Controlling blood pH during acute ventilatory failure and hypercapnia in individuals suffering from severe acute kidney injury (AKI) and undergoing continuous renal replacement therapy (CRRT) is of paramount importance in critical care settings. In this situation, the optimal concentration of sodium bicarbonate in the dialysate is still an unsolved question in critical care since high concentrations may worsen carbon dioxide levels and low concentrations may not be as effective in controlling pH...
December 2017: Intensive Care Medicine Experimental
https://www.readbyqxmd.com/read/28550659/hyperoxia-provokes-a-time-and-dose-dependent-inflammatory-response-in-mechanically-ventilated-mice-irrespective-of-tidal-volumes
#11
Hendrik J F Helmerhorst, Laura R A Schouten, Gerry T M Wagenaar, Nicole P Juffermans, Joris J T H Roelofs, Marcus J Schultz, Evert de Jonge, David J van Westerloo
BACKGROUND: Mechanical ventilation and hyperoxia have the potential to independently promote lung injury and inflammation. Our purpose was to study both time- and dose-dependent effects of supplemental oxygen in an experimental model of mechanically ventilated mice. METHODS: Healthy male C57Bl/6J mice, aged 9-10 weeks, were intraperitoneally anesthetized and randomly assigned to the mechanically ventilated group or the control group. In total, 100 mice were tracheotomized and mechanically ventilated for either 8 or 12 h after allocation to different settings for the applied fractions of inspired oxygen (FiO2, 30, 50, or 90%) and tidal volumes (7...
December 2017: Intensive Care Medicine Experimental
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
#12
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
#13
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
#14
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
#15
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
#16
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
#17
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
#18
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
#19
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
#20
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
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