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Intensive Care Medicine Experimental

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https://www.readbyqxmd.com/read/29404815/intra-cellular-lactate-concentration-in-t-lymphocytes-from-septic-shock-patients-a-pilot-study
#1
Thibaut Girardot, Thomas Rimmelé, Guillaume Monneret, Julien Textoris, Fabienne Venet
BACKGROUND: Sepsis-associated hyperlactatemia is a widely used biomarker, associated with initial severity and poor outcomes. This increased circulating lactate concentration has been proposed to result in part from a mismatch between oxygen delivery and demand in organs. However, other mechanisms may participate. In particular, a metabolic reprogramming similar to the Warburg effect initially described in cancer cells could lead to increased lactate production by immune cells such as T lymphocytes after sepsis...
February 5, 2018: Intensive Care Medicine Experimental
https://www.readbyqxmd.com/read/29383459/alterations-in-mitochondrial-respiration-and-reactive-oxygen-species-in-patients-poisoned-with-carbon-monoxide-treated-with-hyperbaric-oxygen
#2
David H Jang, Utsha G Khatri, Brenna P Shortal, Matthew Kelly, Kevin Hardy, David S Lambert, David M Eckmann
BACKGROUND: Carbon monoxide (CO) poisoning is the leading cause of poisoning mortality and morbidity in the USA. Carboxyhemoglobin (COHb) levels are not predictive of severity or prognosis. At this time, the measurement of mitochondrial respiration may serve as a biomarker in CO poisoning. The primary objective of this study was to assess changes in mitochondrial function consisting of respiration and generation of reactive oxygen species (ROS) in peripheral blood mononuclear cells (PBMCs) obtained from patients with CO poisoning...
January 30, 2018: Intensive Care Medicine Experimental
https://www.readbyqxmd.com/read/29380160/peep-titration-the-effect-of-prone-position-and-abdominal-pressure-in-an-ards-model
#3
Joseph C Keenan, Gustavo A Cortes-Puentes, Lei Zhang, Alex B Adams, David J Dries, John J Marini
BACKGROUND: Prone position and PEEP can both improve oxygenation and other parameters, but their interaction has not been fully described. Limited data directly compare selection of mechanically "optimal" or "best" PEEP in both supine and prone positions, either with or without changes in chest wall compliance. To compare best PEEP in these varied conditions, we used an experimental ARDS model to compare the mechanical, gas exchange, and hemodynamic response to PEEP titration in supine and prone position with varied abdominal pressure...
January 30, 2018: Intensive Care Medicine Experimental
https://www.readbyqxmd.com/read/29340799/fully-automated-life-support-an-implementation-and-feasibility-pilot-study-in-healthy-pigs
#4
Wilfried Klingert, Jörg Peter, Christian Thiel, Karolin Thiel, Wolfgang Rosenstiel, Kathrin Klingert, Christian Grasshoff, Alfred Königsrainer, Martin Schenk
BACKGROUND: Automated systems are available in various application areas all over the world for the purpose of reducing workload and increasing safety. However, such support systems that would aid caregivers are still lacking in the medical sector. With respect to workload and safety, especially, the intensive care unit appears to be an important and challenging application field. Whereas many closed-loop subsystems for single applications already exist, no comprehensive system covering multiple therapeutic aspects and interactions is available yet...
January 16, 2018: Intensive Care Medicine Experimental
https://www.readbyqxmd.com/read/29327145/hla-dr-expression-in-neonates-after-cardiac-surgery-under-cardiopulmonary-bypass-a-pilot-study
#5
LETTER
Alexis Chenouard, Cécile Braudeau, Nicolas Cottron, Pierre Bourgoin, Nina Salabert, Antoine Roquilly, Régis Josien, Nicolas Joram, Karim Asehnoune
Monocyte HLA-DR expression has been reported as a marker of immunosuppression and a predictor of sepsis development. However, to date, there is no report on monocyte HLA-DR monitoring exclusively in neonates (< 28 days of life) who underwent cardiac surgery under cardiopulmonary bypass (CPB), which have a high risk of nosocomial infection. In this pilot study, we studied nine neonates with a diagnosis of congenital heart disease requiring surgery under CPB. There was a significant reduction in monocyte HLA-DR expression for the first two postoperative days, as compared to preoperatively (p = 0...
January 11, 2018: Intensive Care Medicine Experimental
https://www.readbyqxmd.com/read/29264668/volume-replacement-ratio-for-crystalloids-and-colloids-during-bleeding-and-resuscitation-an-animal-experiment
#6
Ildikó László, Gábor Demeter, Nándor Öveges, Dániel Érces, József Kaszaki, Krisztián Tánczos, Zsolt Molnár
BACKGROUND: Fluid resuscitation remains a cornerstone in the management of acute bleeding. According to Starling's "Three-compartment model", four-times more crystalloids have the same volume effect as colloids. However, this volume-replacement ratio remains a controversial issue as it may be affected by the degradation of the endothelial glycocalyx layer, a situation often found in the critically ill. Our aim was to compare colloid and crystalloid based fluid resuscitation during an experimental stroke volume index (SVI) guided hemorrhage and resuscitation animal model...
December 20, 2017: Intensive Care Medicine Experimental
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
#7
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
#8
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
#9
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
#10
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
#11
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
#12
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
#13
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
#14
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
#15
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
#16
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
#17
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
#18
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
#19
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
#20
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
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