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Intensive Care Medicine Experimental

Inéz Frerichs, Peter A Dargaville, Peter C Rimensberger
BACKGROUND: The provision of guidance in ventilator therapy by continuous monitoring of regional lung ventilation, aeration and respiratory system mechanics is the main clinical benefit of electrical impedance tomography (EIT). A new application was recently described in critically ill patients undergoing diagnostic bronchoalveolar lavage (BAL) with the intention of using EIT to identify the region where sampling was performed. Increased electrical bioimpedance was reported after fluid instillation...
February 15, 2019: Intensive Care Medicine Experimental
Makoto Sasaki, Yoshikazu Yamaguchi, Tetsuya Miyashita, Yuko Matsuda, Masahide Ohtsuka, Osamu Yamaguchi, Takahisa Goto
BACKGROUND: Endotracheal tubes used for neonates are not as resistant to breathing as originally anticipated; therefore, spontaneous breathing trials (SBTs) with continuous positive airway pressure (CPAP), without pressure support (PS), are recommended. However, PS extubation criteria have predetermined pressure values for each endotracheal tube diameter (PS 10 cmH2 O with 3.0- and 3.5-mm tubes or PS 8 cmH2 O with 4.0-mm tubes). This study aimed to assess the validity of these SBT criteria for neonates, using an artificial lung simulator, ASL 5000™ lung simulator, and a SERVO-i Universal™ ventilator (minute volume, 240-360 mL/kg/min; tidal volume, 30 mL; respiratory rate, 24-36/min; lung compliance, 0...
February 8, 2019: Intensive Care Medicine Experimental
Alessandro Terrani, Enrico Bassi, Caterina Valcarenghi, Emmanuel Charbonney, Paul Ouellet, Patrice Gosselin, Giacomo Bellani, Giuseppe Foti
BACKGROUND: Percutaneous dilatational tracheostomy (PDT) is the most frequently performed procedure in patients requiring prolonged mechanical ventilation. A crucial step in such procedures is needle insertion into the trachea. To simplify this procedure and increase its safety, we developed a new device, the translaryngeal Tracheostomy Needle Introducer (tTNI), for use with Fantoni's method. This cadaver study was designed to assess the performance of the tTNI on human anatomy. METHODS: We tested the tTNI in a cadaver laboratory; the operators included two experts trained in PDT and three without specific training in the procedure...
January 28, 2019: Intensive Care Medicine Experimental
Vanessa Zambelli, Anna Sigurtà, Laura Rizzi, Letizia Zucca, Paolo Delvecchio, Elena Bresciani, Antonio Torsello, Giacomo Bellani
BACKGROUND: Ventilator-induced diaphragmatic dysfunction (VIDD) is a common event during mechanical ventilation (MV) leading to rapid muscular atrophy and contractile dysfunction. Recent data show that renin-angiotensin system is involved in diaphragmatic skeletal muscle atrophy after MV. In particular, angiotensin-II can induce marked diaphragm muscle wasting, whereas angiotensin-(1-7) (Ang-(1-7)) could counteract this activity. This study was designed to evaluate the effects of the treatment with Ang-(1-7) in a rat model of VIDD with neuromuscular blocking agent infusion...
January 18, 2019: Intensive Care Medicine Experimental
Inés López-Alonso, Laura Amado-Rodriguez, Cecilia López-Martínez, Covadonga Huidobro, Guillermo M Albaiceta
No abstract text is available yet for this article.
January 11, 2019: Intensive Care Medicine Experimental
Marco Feri
No abstract text is available yet for this article.
January 9, 2019: Intensive Care Medicine Experimental
David A Berlin, Seth Manoach, Clara Oromendia, Paul M Heerdt
BACKGROUND: Positive pressure ventilation can decrease venous return and cardiac output. It is not known if expiratory ventilation assistance (EVA) through a small endotracheal tube can improve venous return and cardiac output. RESULTS: In a porcine model, switching from conventional positive pressure ventilation to (EVA) with - 8 cmH2 0 expiratory pressure increased the venous return and cardiac output. The stroke volume increased by 27% when the subjects were switched from conventional ventilation to EVA [53...
January 9, 2019: Intensive Care Medicine Experimental
Anna Herminghaus, Henrike Papenbrock, Rebecca Eberhardt, Christian Vollmer, Richard Truse, Jan Schulz, Inge Bauer, Adelheid Weidinger, Andrey V Kozlov, Johnny Stiban, Olaf Picker
BACKGROUND: Evidence suggests that early adaptive responses of hepatic mitochondria occur in experimentally induced sepsis. Little is known about both colonic mitochondrial function during abdominal infection and long-term changes in mitochondrial function under inflammatory conditions. We hypothesize that hepatic and colonic mitochondrial oxygen consumption changes time-dependently after sterile laparotomy and in the course of abdominal infection. The aim of the present study was to investigate the hepatic and colonic mitochondrial respiration after sterile laparotomy and abdominal infection over up to 96 h...
January 8, 2019: Intensive Care Medicine Experimental
Julie Mouillaux, Camille Allam, Thomas Rimmelé, Thomas Uberti, Benjamin Delwarde, Julien Textoris, Guillaume Monneret, Estelle Peronnet, Fabienne Venet
No abstract text is available yet for this article.
January 8, 2019: Intensive Care Medicine Experimental
Jane Fisher, Adam Linder, Peter Bentzer
BACKGROUND: Increased vascular permeability is a key feature in the pathophysiology of sepsis and the development of organ failure. Shedding of the endothelial glycocalyx is increasingly being recognized as an important pathophysiological mechanism but at present it is unclear if glypicans contribute to this response. We hypothesized that plasma levels of glypicans (GPC) are elevated in patients with sepsis. METHODS: Plasma GPC 1-6 levels were measured by ELISA in 10 patients with sepsis and 10 healthy controls as an initial screening...
January 7, 2019: Intensive Care Medicine Experimental
Bo Yao, Da-Wei Liu, Wen-Zhao Chai, Xiao-Ting Wang, Hong-Min Zhang
BACKGROUND: Microcirculation dysfunction with blood flow heterogeneity is an important characteristic in sepsis shock. We hypothesized that impaired ability of red blood cells to release nitric oxide resulted in microcirculation dysfunction in sepsis shock. METHODS: 4,4'-Diisothiocyanatostilbene-2,2'-disulfonic acid disodium salt hydrate (DIDS), an inhibitor of band3 protein, was used to inhibit S-nitrosohemoglobin-mediated nitric oxide release. Rabbits were randomly divided into four groups: control (n = 6), lipopolysaccharide (LPS) (n = 6), LPS + DIDS (n = 6), and control + DIDS group (n = 6)...
January 7, 2019: 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
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