1
40
3
-
Text
A resource consisting primarily of words for reading. Examples include books, letters, dissertations, poems, newspapers, articles, archives of mailing lists. Note that facsimiles or images of texts are still of the genre Text.
URL Address
<a href="http://doi.org/10.1097/00024382-199602000-00008" target="_blank" rel="noreferrer noopener">http://doi.org/10.1097/00024382-199602000-00008</a>
Rights
Article information provided for research and reference use only. All rights are retained by the journal listed under publisher and/or the creator(s).
Pages
130-134
Issue
2
Volume
5
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Dublin Core
The Dublin Core metadata element set is common to all Omeka records, including items, files, and collections. For more information see, http://dublincore.org/documents/dces/.
Title
A name given to the resource
Hypertonic Saline In Stabilized Hyperdynamic Sepsis
Publisher
An entity responsible for making the resource available
Shock
Date
A point or period of time associated with an event in the lifecycle of the resource
1996
1996-02
Subject
The topic of the resource
& Cardiology; cardiac-output; Cardiovascular System; delivery; dogs; fluid resuscitation; General & Internal Medicine; Hematology; hyperosmotic nacl; osmolality; oxygen consumption; respiratory-distress syndrome; septic shock; severe hemorrhagic-shock; Surgery
Creator
An entity primarily responsible for making the resource
Hannemann L; Reinhart K; Korell R; Spies C; Bredle D L
Description
An account of the resource
Hypertonic saline with or without colloidal solution has been successfully used for treating hemorrhagic shock in animal experiments and clinical studies. Due to its various effects at systemic, organ, and microcirculatory levels, the substance appears to be a promising candidate for improving tissue oxygenation in sepsis. We therefore investigated the hypothesis that infusion of hypertonic saline would further improve O-2 delivery, O-2 extraction, and O-2 uptake in hyperdynamic septic shock patients already stabilized by adequate volume and catecholamine infusion. Twenty-one patients received 2-4 mL/kg body weight of hypertonic saline in hydroxyethyl starch within 15 min. This hypertonic saline infusion caused a rapid significant increase in O-2 delivery by 14% but only a marginal increase in O-2 consumption (7% by cardiovascular Fick [p < .05], 4% by respiratory gases [n.s.]). Hypertonic saline increased the already elevated cardiac output by 24%. The pulmonary capillary wedge pressure increased from 14 +/- 3 to 23 +/- 3 mmHg and pulmonary shunt fraction increased 15%, but arterial PO2 did not fall. Except for the increase in pulmonary capillary wedge pressure, none of the cardiovascular changes lasted longer than 60 min. Plasma sodium levels increased from 138 +/- 25 to 163 +/- 38 mmol/L and normalized within 24 h. In these hyperdynamic septic patients, hypertonic saline infusion produced a transient increase in circulation, but no evidence of a substantial increase in O-2 consumption. Either there was no significant O-2 debt due to the already elevated O-2 delivery levels at baseline (700 mL/min/m(2)) or the global O-2 measurements we used were not able to detect discrete regional hypoxia.
Identifier
An unambiguous reference to the resource within a given context
<a href="http://doi.org/10.1097/00024382-199602000-00008" target="_blank" rel="noreferrer noopener">10.1097/00024382-199602000-00008</a>
Format
The file format, physical medium, or dimensions of the resource
Journal Article or Conference Abstract Publication
& Cardiology
1996
Bredle D L
cardiac-output
Cardiovascular System
Delivery
Dogs
fluid resuscitation
General & Internal Medicine
Hannemann L
Hematology
hyperosmotic nacl
Journal Article or Conference Abstract Publication
Korell R
osmolality
Oxygen Consumption
Reinhart K
respiratory-distress syndrome
Septic shock
severe hemorrhagic-shock
Shock
Spies C
Surgery
-
Text
A resource consisting primarily of words for reading. Examples include books, letters, dissertations, poems, newspapers, articles, archives of mailing lists. Note that facsimiles or images of texts are still of the genre Text.
URL Address
<a href="http://doi.org/10.1097/00003246-199512000-00004" target="_blank" rel="noreferrer noopener">http://doi.org/10.1097/00003246-199512000-00004</a>
Rights
Article information provided for research and reference use only. All rights are retained by the journal listed under publisher and/or the creator(s).
Pages
1962-1970
Issue
12
Volume
23
Search for Full-text
Locate full-text within NEOMED Library's e-journal collections
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Dublin Core
The Dublin Core metadata element set is common to all Omeka records, including items, files, and collections. For more information see, http://dublincore.org/documents/dces/.
Title
A name given to the resource
Comparison Of Dopamine To Dobutamine And Norepinephrine For Oxygen Delivery And Uptake In Septic Shock
Publisher
An entity responsible for making the resource available
Critical Care Medicine
Date
A point or period of time associated with an event in the lifecycle of the resource
1995
1995-12
Subject
The topic of the resource
agents; cardiac-output; catecholamines; consumption; dobutamine; dopamine; General & Internal Medicine; hemodynamics; infusion; inotropic; intra-pulmonary shunt; lactic-acidosis; norepinephrine; oxygen consumption; septic shock; severe sepsis; skeletal-muscle; therapy; transport
Creator
An entity primarily responsible for making the resource
Hannemann L; Reinhart K; Grenzer O; Meierhellmann A; Bredle D L
Description
An account of the resource
Objectives: To test whether dopamine infusion improves oxygen delivery (D over dot O-2) and oxygen uptake (V over dot O-2) in hyperdynamic septic shock patients stabilized by adequate volume and dobutamine alone, or by the combination of dobutamine and norepinephrine. Design: Prospective clinical trial of two patient groups. Group 1 (n = 15) was stabilized with dobutamine, and group 2 (n = 10) was stabilized with dobutamine and norepinephrine. Setting: Intensive care unit in a university hospital. Patients: Twenty-five postoperative, hyperdynamic septic shock patients. Interventions: The stabilizing catecholamine infusion was replaced in a stepwise manner by dopamine to achieve a similar mean arterial pressure (dopamine doses: group 1, mean 22 +/- 15 mu g/kg/min [range 6 to 52]; and group 2, mean 57 +/- 41 mu g/kg/min [range 15 to 130]). Measurements and Main Results: A complete hemodynamic profile was performed with oxygen transport-related variables at baseline, after replacement by dopamine and after resetting to the original catecholamine infusion. The change to dopamine resulted in increases in cardiac index (group 1: 20% [p < .01]; group 2: 33% [p < .01]), and D over dot O-2 (group 1: 19% [p < .01]; group 2: 27% [p < .01]). However, V over dot O-2, whether directly measured from the respiratory gases or calculated by the cardiovascular Fick principle, did not change in both groups with dopamine, while the oxygen extraction ratio decreased significantly in both groups with dopamine. Heart rate, pulmonary artery occlusion pressure, and pulmonary shunt fraction all increased with dopamine, Pao(2) decreased, but oxygen saturation remained stable in both groups with dopamine. Conclusions: Short-term dopamine infusion in hyperdynamic septic shock patients, de. spite producing higher global D over dot O-2, was not superior to dobutamine or the combination of dobutamine and norepinephrine infusion.
Identifier
An unambiguous reference to the resource within a given context
<a href="http://doi.org/10.1097/00003246-199512000-00004" target="_blank" rel="noreferrer noopener">10.1097/00003246-199512000-00004</a>
Format
The file format, physical medium, or dimensions of the resource
Journal Article or Conference Abstract Publication
1995
agents
Bredle D L
cardiac-output
catecholamines
consumption
Critical care medicine
dobutamine
Dopamine
General & Internal Medicine
Grenzer O
Hannemann L
Hemodynamics
infusion
inotropic
intra-pulmonary shunt
Journal Article or Conference Abstract Publication
lactic-acidosis
Meierhellmann A
Norepinephrine
Oxygen Consumption
Reinhart K
Septic shock
severe sepsis
skeletal-muscle
therapy
transport
-
Text
A resource consisting primarily of words for reading. Examples include books, letters, dissertations, poems, newspapers, articles, archives of mailing lists. Note that facsimiles or images of texts are still of the genre Text.
URL Address
n/a
Rights
Article information provided for research and reference use only. All rights are retained by the journal listed under publisher and/or the creator(s).
Pages
773-779
Issue
3
Volume
151
Search for Full-text
Locate full-text within NEOMED Library's e-journal collections
<p>Users with a NEOMED Library login can search for full-text journal articles at the following url: <a href="https://libraryguides.neomed.edu/home">https://libraryguides.neomed.edu/home</a></p>
Dublin Core
The Dublin Core metadata element set is common to all Omeka records, including items, files, and collections. For more information see, http://dublincore.org/documents/dces/.
Title
A name given to the resource
N-ACETYLCYSTEINE PRESERVES OXYGEN-CONSUMPTION AND GASTRIC-MUCOSAL PH DURING HYPEROXIC VENTILATION
Publisher
An entity responsible for making the resource available
American Journal of Respiratory and Critical Care Medicine
Date
A point or period of time associated with an event in the lifecycle of the resource
1995
1995-03
Subject
The topic of the resource
cardiac-output; critically-ill patients; endotoxin; gas-exchange; General & Internal Medicine; l-arginine; nitric-oxide synthesis; relaxing factor; Respiratory System; septic patients; skeletal-muscle; superoxide
Creator
An entity primarily responsible for making the resource
Reinhart K; Spies C D; Meierhellmann A; Bredle D L; Hannemann L; Specht M; Schaffartzik W
Description
An account of the resource
Hyperoxic ventilation, used to prevent hypoxemia during potential periods of hypoventilation, has been reported to paradoxically decrease whole body oxygen consumption (Vo(2)). Reduction in nutritive blood flow due to oxygen radical production is one possible mechanism. We investigated whether pretreatment with the sulfhydryl group donor and O-2 radical scavenger N-acetylcysteine (NAG) would preserve whole body Vo(2) and prevent deterioration of oxygenation in gastric mucosal tissue during hyperoxia. Thirty-eight patients, requiring hemodynamic monitoring (radial and pulmonary artery catheters) due to sepsis syndrome, were included in this randomized experiment. All patients exhibited stable clinical conditions (hemodynamics, body temperature, hemoglobin, Flo(2) < 0.5). A gastric tonometer was placed to measure the gastric intramucosal pH (pH(i)), which indirectly assesses nutritive blood flow to the mucosa. Cardiac output was determined by thermodilution and Vo(2) by cardiovascular Fick. After baseline measurements, patients randomly received either 150 mg . kg(-1) NAC (n = 19) or placebo (n = 19) in 250 ml 5% dextrose intravenously over a period of 15 min. Measurements were repeated 30 min after starting NAC or placebo infusion, 30 min after starting hyperoxia (Flo(2) = 1.0), and 60 min after resetting the original Flo(2). There were no significant differences between groups in any of the measurements before treatment and after the return to baseline Flo(2) at the end of the study. NAG, but not placebo infusion, caused a slight but significant increase in cardiac output and decrease in systemic vascular resistance. Significant differences between groups during hyperoxia were: Vo(2) (NAG: 114 +/- 9 mi min(-1) m(-2) versus placebo: 81 +/- 31 ml . min(-1) m(-2); p = 0.008) and oxygen extraction ratio (NAG: 21 +/- 6% versus placebo: 14 +/- 5%; p = 0.003). The mean decrease of Vo(2) was 11% in the NAC group versus 34% in the placebo group. The mean decrease of the oxygen extraction ratio was 12% in the NAC group versus 34% in the placebo group. NAC prevented a decrease in pH(i) in hyperoxia (NAG: 7.28 +/- 0.10 versus placebo: 7.14 +/- 0.18; p = 0.012). NAC helped preserve whole body oxygen uptake, oxygen extraction ratio, and pH(i) during brief hyperoxia in these septic patients. This suggests that pretreatment with NAC can attenuate impaired tissue oxygenation during hyperoxia.
Identifier
An unambiguous reference to the resource within a given context
n/a
Format
The file format, physical medium, or dimensions of the resource
Journal Article
1995
American journal of respiratory and critical care medicine
Bredle D L
cardiac-output
critically-ill patients
endotoxin
gas-exchange
General & Internal Medicine
Hannemann L
Journal Article
l-arginine
Meierhellmann A
nitric-oxide synthesis
Reinhart K
relaxing factor
Respiratory System
Schaffartzik W
septic patients
skeletal-muscle
Specht M
Spies C D
superoxide