共查询到20条相似文献,搜索用时 15 毫秒
1.
Thooft A Favory R Salgado DR Taccone FS Donadello K De Backer D Creteur J Vincent JL 《Critical care (London, England)》2011,15(5):R222
Introduction
Septic shock is characterized by altered tissue perfusion associated with persistent arterial hypotension. Vasopressor therapy is generally required to restore organ perfusion but the optimal mean arterial pressure (MAP) that should be targeted is uncertain. The aim of this study was to assess the effects of increasing MAP using norepinephrine (NE) on hemodynamic and metabolic variables and on microvascular reactivity in patients with septic shock. 相似文献2.
Mesquida J Espinal C Gruartmoner G Masip J Sabatier C Baigorri F Pinsky MR Artigas A 《Intensive care medicine》2012,38(4):592-597
Purpose
To analyze the prognostic value of tissue oxygen saturation (StO2) in septic shock patients with restored mean arterial pressure (MAP). 相似文献3.
Badin J Boulain T Ehrmann S Skarzynski M Bretagnol A Buret J Benzekri-Lefevre D Mercier E Runge I Garot D Mathonnet A Dequin PF Perrotin D 《Critical care (London, England)》2011,15(3):R135-12
Introduction
Because of disturbed renal autoregulation, patients experiencing hypotension-induced renal insult might need higher levels of mean arterial pressure (MAP) than the 65 mmHg recommended level in order to avoid the progression of acute kidney insufficiency (AKI).Methods
In 217 patients with sustained hypotension, enrolled and followed prospectively, we compared the evolution of the mean arterial pressure (MAP) during the first 24 hours between patients who will show AKI 72 hours after inclusion (AKIh72) and patients who will not. AKIh72 was defined as the need of renal replacement therapy or "Injury" or "Failure" classes of the 5-stage RIFLE classification (Risk, Injury, Failure, Loss of kidney function, End-stage renal disease) for acute kidney insufficiency using the creatinine and urine output criteria. This comparison was performed in four different subgroups of patients according to the presence or not of AKI at the sixth hour after inclusion (AKIh6 as defined as a serum creatinine level above 1.5 times baseline value within the first six hours) and the presence or not of septic shock at inclusion.The ability of MAP averaged over H6 to H24 to predict AKIh72 was assessed by the area under the receiver operating characteristic curve (AUC) and compared between groups.Results
The MAP averaged over H6 to H24 or over H12 to H24 was significantly lower in patients who showed AKIh72 than in those who did not, only in septic shock patients with AKIh6, whereas no link was found between MAP and AKIh72 in the three others subgroups of patients. In patients with septic shock plus AKIh6, MAP averaged over H6 to H24 or over H12 to H24 had an AUC of 0.83 (0.72 to 0.92) or 0.84 (0.72 to 0.92), respectively, to predict AKIh72 . In these patients, the best level of MAP to prevent AKIh72 was between 72 and 82 mmHg.Conclusions
MAP about 72 to 82 mmHg could be necessary to avoid acute kidney insufficiency in patients with septic shock and initial renal function impairment. 相似文献4.
Pierrakos C Velissaris D Scolletta S Heenen S De Backer D Vincent JL 《Intensive care medicine》2012,38(3):422-428
Purpose
Response to fluid challenge is often defined as an increase in cardiac index (CI) of more than 10–15%. However, in clinical practice CI values are often not available. We evaluated whether changes in mean arterial pressure (MAP) correlate with changes in CI after fluid challenge in patients with septic shock. 相似文献5.
Introduction
Refractory septic shock has dismal prognosis despite aggressive therapy. The purpose of the present study is to report the effects of terlipressin (TP) as a rescue treatment in children with catecholamine refractory hypotensive septic shock. 相似文献6.
John L Moran Petra L Graham Sue Rockliff Andrew D Bersten 《Critical care (London, England)》2010,14(4):R134
Introduction
Current low (stress) dose corticosteroid regimens may have therapeutic advantage in severe sepsis and septic shock despite conflicting results from two landmark randomised controlled trials (RCT). We systematically reviewed the efficacy of corticosteroid therapy in severe sepsis and septic shock. 相似文献7.
Park HY Suh GY Song JU Yoo H Jo IJ Shin TG Lim SY Woo S Jeon K 《Critical care (London, England)》2012,16(1):R3
Introduction
The use of low-dose steroid therapy in the management of septic shock has been extensively studied. However, the association between the timing of low-dose steroid therapy and the outcome has not been evaluated. Therefore, we evaluated whether early initiation of low-dose steroid therapy is associated with mortality in patients with septic shock. 相似文献8.
Jorge Monserrat Raul de Pablo Eduardo Reyes David Díaz Hugo Barcenilla Manuel R Zapata Antonio De la Hera Alfredo Prieto Melchor Álvarez-Mon 《Critical care (London, England)》2009,13(1):R26-8
Introduction
Given the pivotal role of T lymphocytes in the immune system, patients with septic shock may show T cell abnormalities. We have characterised the T cell compartment in septic shock and assess its clinical implications. 相似文献9.
Massimo Girardis Laura Rinaldi Lara Donno Marco Marietta Mauro Codeluppi Patrizia Marchegiano Claudia Venturelli the 'Sopravvivere alla Sepsi 'group of the Modena-University Hospital 《Critical care (London, England)》2009,13(5):R143
Introduction
The application in clinical practice of evidence-based guidelines for the management of patients with severe sepsis/septic shock is still poor in the emergency department, while little data are available for patients admitted to the intensive care unit (ICU). The aim of this study was to evaluate the effect of an in-hospital sepsis program on the adherence to evidence-based guidelines and outcome of patients with severe sepsis/septic shock admitted to the ICU. 相似文献10.
Sadaka F O'Brien J Migneron M Stortz J Vanston A Taylor RW 《Critical care (London, England)》2011,15(2):R89-7
Introduction
The use of human recombinant activated protein C (rhAPC) for the treatment of severe sepsis remains controversial despite multiple reported trials. The efficacy of rhAPC remains a matter of dispute. We hypothesized that patients with septic shock who were treated with rhAPC had an improved in-hospital mortality compared to patients with septic shock with similar acuity who did not receive rhAPC. 相似文献11.
Philippe Seguin Bruno Laviolle Patrick Guinet Isabelle Morel Yannick Mallédant Eric Bellissant 《Critical care (London, England)》2005,10(1):R32
Introduction
Microcirculatory blood flow, and notably gut perfusion, is important in the development of multiple organ failure in septic shock. We compared the effects of dopexamine and norepinephrine (noradrenaline) with those of epinephrine (adrenaline) on gastric mucosal blood flow (GMBF) in patients with septic shock. The effects of these drugs on oxidative stress were also assessed. 相似文献12.
Fernando Palizas Arnaldo Dubin Tomas Regueira Alejandro Bruhn Elias Knobel Silvio Lazzeri Natalio Baredes Glenn Hernández 《Critical care (London, England)》2009,13(2):R44
Introduction
Resuscitation goals for septic shock remain controversial. Despite the normalization of systemic hemodynamic variables, tissue hypoperfusion can still persist. Indeed, lactate or oxygen venous saturation may be difficult to interpret. Our hypothesis was that a gastric intramucosal pH-guided resuscitation protocol might improve the outcome of septic shock compared with a standard approach aimed at normalizing systemic parameters such as cardiac index (CI). 相似文献13.
Karlsson S Heikkinen M Pettilä V Alila S Väisänen S Pulkki K Kolho E Ruokonen E;Finnsepsis Study Group 《Critical care (London, England)》2010,14(6):R205
Introduction
This prospective study investigated the predictive value of procalcitonin (PCT) for survival in 242 adult patients with severe sepsis and septic shock treated in intensive care. 相似文献14.
Donnino MW Cocchi MN Salciccioli JD Kim D Naini AB Buettner C Akuthota P 《Critical care (London, England)》2011,15(4):R189-8
Introduction
Mitochondrial dysfunction is associated with increased mortality in septic shock. Coenzyme Q10 (CoQ10) is a key cofactor in the mitochondrial respiratory chain, but whether CoQ10 is depleted in septic shock remains unknown. Moreover, statin therapy may decrease CoQ10 levels, but whether this occurs acutely remains unknown. We measured CoQ10 levels in septic shock patients enrolled in a randomized trial of simvastatin versus placebo. 相似文献15.
David J Sturgess Thomas H Marwick Chris Joyce Carly Jenkins Mark Jones Paul Masci David Stewart Bala Venkatesh 《Critical care (London, England)》2010,14(2):R44
Introduction
Diastolic dysfunction as demonstrated by tissue Doppler imaging (TDI), particularly E/e' (peak early diastolic transmitral/peak early diastolic mitral annular velocity) is common in critical illness. In septic shock, the prognostic value of TDI is undefined. This study sought to evaluate and compare the prognostic significance of TDI and cardiac biomarkers (B-type natriuretic peptide (BNP); N-terminal proBNP (NTproBNP); troponin T (TnT)) in septic shock. The contribution of fluid management and diastolic dysfunction to elevation of BNP was also evaluated. 相似文献16.
Rainer Meierhenrich Elisa Steinhilber Christian Eggermann Manfred Weiss Sami Voglic Daniela Bögelein Albrecht Gauss Michael Georgieff Wolfgang Stahl 《Critical care (London, England)》2010,14(3):R108
Introduction
Since data regarding new-onset atrial fibrillation (AF) in septic shock patients are scarce, the purpose of the present study was to evaluate the incidence and prognostic impact of new-onset AF in this patient group. 相似文献17.
Imad Abboud Nicolas Lerolle Saik Urien Jean-Marc Tadié Françoise Leviel Jean-Yves Fagon Christophe Faisy 《Critical care (London, England)》2009,13(4):R120-8
Introduction
In septic patients, an unpredictable response to epinephrine may be due to pharmacodynamic factors or to non-linear pharmacokinetics. The purpose of this study was to investigate the pharmacokinetics of epinephrine and its determinants in patients with septic shock. 相似文献18.
Caroline Guignant Nicolas Voirin Fabienne Venet Françoise Poitevin Christophe Malcus Julien Bohé Alain Lepape Guillaume Monneret 《Intensive care medicine》2009,35(11):1859-1867
Purpose
Improvements in survival after septic shock will most likely rely on our capacity to manage individualized therapies based on the measurement of rapidly accessible biomarkers. As the early phase of septic shock is dominated by severe alterations of the cardiovascular system, the predictive value for mortality of pro-vasopressin (pro-AVP) and pro-adrenomedullin (pro-ADM), two vasoactive pro-hormones, was assessed. 相似文献19.
20.
van Hees HW Schellekens WJ Linkels M Leenders F Zoll J Donders R Dekhuijzen PN van der Hoeven JG Heunks LM 《Critical care (London, England)》2011,15(5):R233