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Intensive Care Medicine Experimental

Sophie Dunberry-Poissant, Kim Gilbert, Caroline Bouchard, Frédérique Baril, Anne-Marie Cardinal, Sydnée L'Ecuyer, Mathieu Hylands, François Lamontagne, Guy Rousseau, Emmanuel Charbonney
BACKGROUND: Haemostasis and correction of hypovolemia are the pillars of early haemorrhage shock (HS) management. Vasopressors, which are not recommended as first-line therapy, are an alternative to aggressive fluid resuscitation, but data informing the risks and benefits of vasopressor therapy as fluid-sparing strategy is lacking. We aimed to study its impact on end organs, in the setting of a haemodynamic response to the initial volume resuscitation. METHODS: Following controlled HS (60 min) induced by blood withdrawal, under anaesthesia and ventilation, male Wistar rats (N = 10 per group) were randomly assigned to (1) sham, (2) HS with fluid resuscitation only [FR] and (3) HS with fluid resuscitation to restore haemodynamic (MAP: mean arterial pressure) then norepinephrine [FR+NE]...
November 12, 2018: Intensive Care Medicine Experimental
Judith Bellapart, Kylie Cuthbertson, Kimble Dunster, Sara Diab, David G Platts, Christopher Raffel, Levon Gabrielian, Adrian Barnett, Jennifer Paratz, Rob Boots, John F Fraser
BACKGROUND: Cerebral regional microcirculation is altered following severe head injury. In addition to tissue disruption, partial pressure of tissue oxygenation is impaired due to an increase in the oxygen tissue gradient. The heterogenic distribution of cerebral microcirculation is multifactorial, and acute anemia challenges further the delivery of oxygen to tissues. Currently, a restrictive transfusion threshold is globally applied; however, it is unclear how anemia modifies regional cerebral microcirculation; hence, it is unclear if by aiming to a global endpoint, specific anatomical regions undergo ischemia...
November 8, 2018: Intensive Care Medicine Experimental
Mohammad Fazel Bakhsheshi, Lynn Keenliside, Ting-Yim Lee
BACKGROUND: Selective brain cooling (SBC) methods could alleviate the complications associated with systemic hypothermia. The authors (MFB, LK, and T-YL) have developed a simple and an effective nasopharyngeal SBC method using a vortex tube. The primary focus of the study is to evaluate the effectiveness of this approach on rabbits and compare it with our previous published finding on piglets, which are mammals without and with a carotid rete, respectively. METHODS: Experiments were conducted on six rabbits...
November 1, 2018: Intensive Care Medicine Experimental
Andre Bredthauer, Karla Lehle, Angelika Scheuerle, Hubert Schelzig, Oscar McCook, Peter Radermacher, Csaba Szabo, Martin Wepler, Florian Simon
OBJECTIVE: In rodents, intravenous sulfide protected against spinal cord ischemia/reperfusion (I/R) injury during aortic balloon occlusion. We investigated the effect of intravenous sulfide on aortic occlusion-induced porcine spinal cord I/R injury. METHODS: Anesthetized and mechanically ventilated "familial hypercholesterolemia Bretoncelles Meishan" (FBM) pigs with high-fat-diet-induced hypercholesterolemia and atherosclerosis were randomized to receive either intravenous sodium sulfide 2 h (initial bolus, 0...
October 24, 2018: Intensive Care Medicine Experimental
Gianluigi Li Bassi, Raquel Guillamat Prats, Antonio Artigas, Eli Aguilera Xiol, Joan-Daniel Marti, Otavio T Ranzani, Montserrat Rigol, Laia Fernandez, Andrea Meli, Denise Battaglini, Nestor Luque, Miguel Ferrer, Ignacio Martin-Loeches, Pedro Póvoa, Davide Chiumello, Paolo Pelosi, Antoni Torres
BACKGROUND: We previously evaluated the efficacy of a ventilatory strategy to achieve expiratory flow bias and positive end-expiratory pressure (EFB + PEEP) or the Trendelenburg position (TP) for the prevention of ventilator-associated pneumonia (VAP). These preventive measures were aimed at improving mucus clearance and reducing pulmonary aspiration of bacteria-laden oropharyngeal secretions. This secondary analysis is aimed at evaluating the effects of aforementioned interventions on systemic inflammation and to substantiate the value of clinical parameters and cytokines in the diagnosis of VAP...
October 20, 2018: Intensive Care Medicine Experimental
Tamara Merz, Martin Wepler, Benedikt Nußbaum, Josef Vogt, Enrico Calzia, Rui Wang, Csaba Szabo, Peter Radermacher, Oscar McCook
BACKGROUND: Sepsis is associated with disturbed glucose metabolism and reduced mitochondrial activity and biogenesis, ultimately leading to multiple organ dysfunction, e.g., acute kidney injury (AKI). Cystathionine-γ-lyase (CSE), the major cardiovascular source of endogenous H2 S release, is implicated in the regulation of glucose metabolism and mitochondrial activity through a PGC1α-dependent mechanism, and critical for kidney function. Atherosclerosis is associated with mitochondrial dysfunction and reduced CSE expression...
October 20, 2018: Intensive Care Medicine Experimental
Tamara Merz, Britta Lukaschewski, Daniela Wigger, Aileen Rupprecht, Martin Wepler, Michael Gröger, Clair Hartmann, Matthew Whiteman, Csaba Szabo, Rui Wang, Christiane Waller, Peter Radermacher, Oscar McCook
BACKGROUND: Both the hydrogen sulfide/cystathionine-γ-lyase (H2 S/CSE) and oxytocin/oxytocin receptor (OT/OTR) systems have been reported to be cardioprotective. H2 S can stimulate OT release, thereby affecting blood volume and pressure regulation. Systemic hyper-inflammation after blunt chest trauma is enhanced in cigarette smoke (CS)-exposed CSE-/- mice compared to wildtype (WT). CS increases myometrial OTR expression, but to this point, no data are available on the effects CS exposure on the cardiac OT/OTR system...
October 19, 2018: Intensive Care Medicine Experimental
(no author information available yet)
No abstract text is available yet for this article.
October 19, 2018: 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
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