共查询到20条相似文献,搜索用时 15 毫秒
1.
Purpose
To quantify the effects of minor variations in the definition and measurement of systemic inflammatory response syndrome (SIRS) criteria and organ failure on the observed incidences of sepsis, severe sepsis and septic shock. 相似文献2.
Carolina Ruiz Glenn Hernandez Cristian Godoy Patricio Downey Max Andresen Alejandro Bruhn 《Critical care (London, England)》2010,14(5):R170
Introduction
Previous studies have suggested that high volume hemofiltration (HVHF) may contribute to revert hypotension in severe hyperdynamic septic shock patients. However, arterial pressure stabilization occurs due to an increase in systemic vascular resistance, which could eventually compromise microcirculatory blood flow and perfusion. The goal of this study was to determine if HVHF deteriorates sublingual microcirculation in severe hyperdynamic septic shock patients. 相似文献3.
Morelli A Donati A Ertmer C Rehberg S Orecchioni A Di Russo A Pelaia P Pietropaoli P Westphal M 《Intensive care medicine》2011,37(6):963-969
Purpose
Terlipressin bolus infusion may contribute to overshooting increases in systemic vascular resistance with concomitant reductions in systemic blood flow and oxygen delivery. Whether these effects negatively impact on microcirculatory perfusion is still not known. The objective of the present study was, therefore, to elucidate the effects of a single terlipressin bolus dose of 0.5 mg on microcirculatory perfusion in patients with catecholamine-dependent septic shock. 相似文献4.
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5.
Background
Adult studies evaluating corticosteroids have found varied efficacy. One study showing mortality benefit utilized fludrocortisone (FLU) and hydrocortisone (HC) (Effect of treatment with low doses of hydrocortisone and fludrocortisone on mortality in patients with septic shock. JAMA 288:862–871, 2002). Use of FLU in children has not been described. We developed a protocol using HC for systemic inflammatory response syndrome (SIRS) and shock with optional addition of FLU. 相似文献6.
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7.
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8.
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9.
Martin W Dünser Esko Ruokonen Ville Pettilä Hanno Ulmer Christian Torgersen Christian A Schmittinger Stephan Jakob Jukka Takala 《Critical care (London, England)》2009,13(6):R181-7
Introduction
It is unclear to which level mean arterial blood pressure (MAP) should be increased during septic shock in order to improve outcome. In this study we investigated the association between MAP values of 70 mmHg or higher, vasopressor load, 28-day mortality and disease-related events in septic shock. 相似文献10.
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11.
Johan Mårtensson Max Bell Anders Oldner Shengyuan Xu Per Venge Claes-Roland Martling 《Intensive care medicine》2010,36(8):1333-1340
Purpose
To study the impact of inflammation/sepsis on the concentrations of neutrophil gelatinase-associated lipocalin (NGAL) in plasma and urine in adult intensive care unit (ICU) patients and to estimate the predictive properties of NGAL in plasma and urine for early detection of acute kidney injury (AKI) in patients with septic shock.Methods
Sixty-five patients admitted to the general ICU at the Karolinska University Hospital Solna, Sweden, with normal plasma creatinine were assessed for eligibility. Twenty-seven patients with systemic inflammatory response syndrome (SIRS), severe sepsis, or septic shock without AKI and 18 patients with septic shock and concomitant AKI were included in the final analysis. Plasma and urine were analyzed twice daily for plasma NGAL (pNGAL), C-reactive protein (CRP), procalcitonin, myeloperoxidase, plasma cystatin C, plasma creatinine, urine NGAL (uNGAL), urine cystatin C, and urine α1-microglobulin.Results
Of the 45 patients, 40 had elevated peak levels of pNGAL. Peak levels of pNGAL were not significantly different between septic shock patients with and without AKI. Peak levels of uNGAL were below the upper reference limit in all but four patients without AKI. uNGAL was a good predictor (area under ROC 0.86) whereas pNGAL was a poor predictor (area under ROC 0.67) for AKI within the next 12 h in patients with septic shock.Conclusions
pNGAL is raised in patients with SIRS, severe sepsis, and septic shock and should be used with caution as a marker of AKI in ICU patients with septic shock. uNGAL is more useful in predicting AKI as the levels are not elevated in septic patients without AKI. 相似文献12.
Andrea Morelli Christian Ertmer Sebastian Rehberg Matthias Lange Alessandra Orecchioni Amalia Laderchi Alessandra Bachetoni Mariadomenica D'Alessandro Hugo Van Aken Paolo Pietropaoli Martin Westphal 《Critical care (London, England)》2008,12(6):R143
Introduction
Previous findings suggest that a delayed administration of phenylephrine replacing norepinephrine in septic shock patients causes a more pronounced hepatosplanchnic vasoconstriction as compared with norepinephrine. Nevertheless, a direct comparison between the two study drugs has not yet been performed. The aim of the present study was, therefore, to investigate the effects of a first-line therapy with either phenylephrine or norepinephrine on systemic and regional hemodynamics in patients with septic shock.Methods
We performed a prospective, randomized, controlled trial in a multidisciplinary intensive care unit in a university hospital. We enrolled septic shock patients (n = 32) with a mean arterial pressure below 65 mmHg despite adequate volume resuscitation. Patients were randomly allocated to treatment with either norepinephrine or phenylephrine infusion (n = 16 each) titrated to achieve a mean arterial pressure between 65 and 75 mmHg. Data from right heart catheterization, a thermodye dilution catheter, gastric tonometry, acid-base homeostasis, as well as creatinine clearance and cardiac troponin were obtained at baseline and after 12 hours. Differences within and between groups were analyzed using a two-way analysis of variance for repeated measurements with group and time as factors. Time-independent variables were compared with one-way analysis of variance.Results
No differences were found in any of the investigated parameters.Conclusions
The present study suggests there are no differences in terms of cardiopulmonary performance, global oxygen transport, and regional hemodynamics when phenylephrine was administered instead of norepinephrine in the initial hemodynamic support of septic shock.Trial registration
ClinicalTrial.gov NCT00639015 相似文献13.
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14.
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15.
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16.
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17.
Jean-François Georger Olfa Hamzaoui Anis Chaari Julien Maizel Christian Richard Jean-Louis Teboul 《Intensive care medicine》2010,36(11):1882-1889
Purpose
To examine the consequences of administration of norepinephrine on muscle tissue oxygenation in severely hypotensive septic shock patients. 相似文献18.
Torgersen C Luckner G Schröder DC Schmittinger CA Rex C Ulmer H Dünser MW 《Intensive care medicine》2011,37(9):1432-1437
Purpose
To evaluate the association between concomitant arginine-vasopressin (AVP)/hydrocortisone therapy and mortality in severe septic shock patients. 相似文献19.
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