Advances in shock research最新文献_第2页

Pharmacologic problems in shock research. 休克研究中的药理学问题。

Advances in shock research Pub Date : 1983-01-01

H R Adams

引用次数: 0

Advances in shock research Pub Date : 1983-01-01

J Askanazi, C Weissman, P A LaSala, P M Charlesworth

{"title":"Nutrients and ventilation.","authors":"J Askanazi, C Weissman, P A LaSala, P M Charlesworth","doi":"","DOIUrl":"","url":null,"abstract":"Nutritional support of the patient with respiratory failure may play a key role in recovery. Nutritional intake not only indirectly influences lung function by altering body composition and most defense mechanisms but interacts directly with respiratory function in a variety of ways. This review will focus on 2 such interactions; the effect of glucose on CO2 production and the effect of protein on ventilatory drive. Glucose administration results in increases in CO2 production via 2 mechanisms; 1) a thermogenic effect and 2) an increase in the respiratory quotient (RQ). In the hypermetabolic, acutely ill patient, both the thermogenic effect and the rise in the RQ contribute to the rise in CO2 production. In the malnourished patient, a rise in the RQ is the primary mechanism for the increase. In either case, the increased need for CO2 elimination results in an increase in ventilatory demand which may precipitate respiratory distress in a patient with previously compromised pulmonary function. Infusions of amino acids, either alone or as a part of a complete nutritional support regimen, results in an enhanced ventilatory response to CO2. This seems to be a result of the thermogenic effect of protein and an increase in the ratio of the plasma concentration of the large amino acids to tryptophan. We postulate that brain uptake of tryptophan which is a precursor to serotonin (a known respiratory inhibitor) is reduced by the presence of increased amounts of the large neutral amino acids that compete with tryptophan for transport across the blood brain barrier, thereby resulting in respiratory stimulation.","PeriodicalId":75453,"journal":{"name":"Advances in shock research","volume":"9 ","pages":"69-79"},"PeriodicalIF":0.0,"publicationDate":"1983-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"17469654","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Effectiveness of ethylketocyclazocine in hemorrhagic shock. 乙基酮环唑辛治疗失血性休克的疗效。

Advances in shock research Pub Date : 1983-01-01

M T Curtis, A M Lefer

引用次数: 0

Thromboxane synthetase inhibitors in septic shock. 血栓素合成酶抑制剂在感染性休克中的应用。

Advances in shock research Pub Date : 1983-01-01

B L Short, W M Gardiner, A N Mishik, P W Ramwell, D Walker, J R Fletcher

{"title":"Thromboxane synthetase inhibitors in septic shock.","authors":"B L Short, W M Gardiner, A N Mishik, P W Ramwell, D Walker, J R Fletcher","doi":"","DOIUrl":"","url":null,"abstract":"Thromboxane (TX) has been reported to cause mortality in endotoxin or septic shock. Cyclooxygenase inhibition improves survival in gram-negative or gram-positive shock. The exact level in the prostaglandin system of which the protection occurs is unknown. This study was designed to compare the effects of a cyclooxygenase inhibitor (indomethacin, IND) to a thromboxane synthetase inhibitor (IMI) on survival and on the production of Tx and prostacyclin (PGI2) in a clinically relevant rat gram-negative sepsis model. Three groups were studied: 1) control (N = 35) animals received E coli only; 2) IND (N = 35) treated animals received 3 mg/kg IP; 3) IMI (N = 35) treated animals received 30 mg/kg IP. All drugs were given 1 h after an IP injection of E coli (LD70) organisms. In this model only IND significantly improved survival. IND and IMI significantly blocked the production of Tx seen in septic shock. IND blocked PGI2 production whereas IMI increased the production. These results show that Tx may not be important in the irreversible stages of shock. Shunting prostaglandin production to PGI2 with thromboxane synthetase inhibitors needs to be considered when using this group of compounds. The mechanism of protection by IND remains unknown.","PeriodicalId":75453,"journal":{"name":"Advances in shock research","volume":"10 ","pages":"143-8"},"PeriodicalIF":0.0,"publicationDate":"1983-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"17738809","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Contractile function of heart muscle isolated from endotoxin-shocked guinea pigs and rats. 内毒素休克豚鼠和大鼠心肌的收缩功能。

Advances in shock research Pub Date : 1983-01-01

J L Parker

{"title":"Contractile function of heart muscle isolated from endotoxin-shocked guinea pigs and rats.","authors":"J L Parker","doi":"","DOIUrl":"","url":null,"abstract":"Cardiac effects of endotoxin shock were compared in left atrial preparations isolated from guinea pigs and rats injected with 4 or 8 mg/kg E coli endotoxin. Heart muscles isolated from both species during endotoxin shock exhibited significant contractile depression which could be reversed by increasing extracellular Ca++ concentrations. Force-frequency relationships were shifted downward by endotoxin shock in both species. However, significant interspecies differences were observed in inotropic responsiveness of heart muscles isolated from shocked rats and guinea pigs. Atria from shocked guinea pigs demonstrated markedly prolonged rates of recovery from the negative inotropic effects of gentamicin (4.0 mM) and a low Ca++ medium (0.5 mM). In contrast, rates of recovery from these interventions were not altered by endotoxin shock in heart muscle from rats. Furthermore, contractile recovery from 15-min hypoxia was characterized by a significant \"overshoot\" phenomenon in heart muscles from shocked guinea pigs but not from shocked rats. These data suggest that although endotoxin shock produces cardiac depression in both the rat and the guinea pig, contractile responses to selected inotropic interventions are different and may reflect different cellular sites or mechanisms whereby shock produces cardiac depression in these two species.","PeriodicalId":75453,"journal":{"name":"Advances in shock research","volume":"9 ","pages":"133-45"},"PeriodicalIF":0.0,"publicationDate":"1983-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"17931682","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Cerebral, coronary, and renal blood flows during hemorrhagic hypotension in anesthetized miniature swine. 麻醉微型猪出血性低血压期间的脑、冠状动脉和肾血流。

Advances in shock research Pub Date : 1983-01-01

M H Laughlin

{"title":"Cerebral, coronary, and renal blood flows during hemorrhagic hypotension in anesthetized miniature swine.","authors":"M H Laughlin","doi":"","DOIUrl":"","url":null,"abstract":"The purpose of these studies was to measure cerebral, coronary, and renal blood flow in miniature swine during hemorrhagic hypotension. Blood flows (BF) were measured in 16 anesthetized, female, miniature swine (35-50 kg) with the radiolabeled microsphere technique using 15-microns spheres. The animals were exposed to a standard, stepwise hemorrhagic shock protocol which set mean aortic pressure at 65, 50, 35, and 20 mm Hg for 10-15 min at each stage. Heart rate and aortic and central venous pressures were measured throughout these studies. Arterial pCO2, pO2 pH, and Hct were measured at the time of BF measurements. BFs were measured under baseline conditions and during three of the four stages of hypotension in each animal. BF was measured in the following tissues: brain (13 samples), heart (120 samples), kidney (left and right), spleen, liver, muscle, and skin. Coronary BF was consistently decreased during hypotension. Endo/Epi flow ratios were also decreased; however, they remained greater than or equal to 1.0. Renal BF and BF to most other tissues showed graded decreases with hypotension. Cerebral BF did not change significantly at any level of hypotension. The maintenance of cerebral BF in swine at such low arterial pressures (22 mm Hg) may be related to the decrease in central venous pressure (-8 mm Hg), which results in a delta P of 30 mm Hg, and/or to the swine's carotid rete mirabile.","PeriodicalId":75453,"journal":{"name":"Advances in shock research","volume":"9 ","pages":"189-201"},"PeriodicalIF":0.0,"publicationDate":"1983-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"17931686","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Fifth Annual Conference on Shock, June 1982. Keynote address: Shock research and therapy in the 1980s. 第五届冲击年会，1982年6月。主题演讲:20世纪80年代的休克研究和治疗。

Advances in shock research Pub Date : 1983-01-01

A E Baue

引用次数: 0

The pathophysiology of septic shock: responses to different doses of live Escherichia coli injection in rats. 脓毒性休克的病理生理:对大鼠不同剂量活大肠杆菌注射的反应。

Advances in shock research Pub Date : 1983-01-01

J Tanaka, T Sato, R T Jones, B F Trump, R A Cowley

{"title":"The pathophysiology of septic shock: responses to different doses of live Escherichia coli injection in rats.","authors":"J Tanaka, T Sato, R T Jones, B F Trump, R A Cowley","doi":"","DOIUrl":"","url":null,"abstract":"Responses to different doses of Escherichia coli (E coli; 0-18) injection were studied from the pathological standpoint. Various amounts of live E coli were intravenously injected through the tail vein (group A: 2.7-3.3 X 10(9); B: 1.7-2.0 X 10(9); C: 1.2-1.5 X 10(9); D: 0.3-0.5 X 10(9) organisms/100 g of body weight). All rats from group A died within 6 h; 14 out of 15 rats from group D survived. Hypothermia was commonly seen in the lethal groups (groups A, B, and C) prior to death, and hyperthermia was observed only in groups C and D. Leukopenia was seen in all groups and remained in the lethal groups, whereas in group D, leukocytosis following leukopenia was observed at 12 and 24 h. Light microscopic studies were performed in the lethal groups, showing the following differences among the three lethal groups; a dose-related depletion of white pulp of the spleen, cortical hemorrhage of the adrenal glands (only in groups A and B), foci of bacterial colonies in the heart and small intestine with aggregated leucocytes (only in group C); focal liver necrosis was found in group C, but not in group A. Tubular necrosis and cast formation were also predominant in the kidneys of group C animals. The above findings indicate that the milder, lethal group shows more severe morphological changes in all organs except the spleen and adrenal glands, and suggest that sudden death from bacteremia may involve a depleted host defense.","PeriodicalId":75453,"journal":{"name":"Advances in shock research","volume":"9 ","pages":"101-14"},"PeriodicalIF":0.0,"publicationDate":"1983-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"17410044","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Crystalloid versus colloid for fluid resuscitation of hypovolemic patients. 晶体与胶体在低血容量患者液体复苏中的作用。

Advances in shock research Pub Date : 1983-01-01

R F Tranbaugh, F R Lewis

{"title":"Crystalloid versus colloid for fluid resuscitation of hypovolemic patients.","authors":"R F Tranbaugh, F R Lewis","doi":"","DOIUrl":"","url":null,"abstract":"The choice of the initial asanguinous fluid--either crystalloid or colloid--used for the resuscitation of the hypovolemic patient remains controversial. Colloid supporters argue for the careful preservation of the plasma colloid osmotic pressure (PCOP) to protect the lung from pulmonary edema. A careful analysis of the Starling microvascular forces operative at the pulmonary capillary makes such an effect unlikely. In fact, the lung is relatively immune to hemodilution and any decrease in PCOP is roughly one fourth as important as increases in hydrostatic pressure in causing increased fluid exchange. A critical review of the experimental and clinical studies comparing crystalloid versus colloid resuscitation essentially shows no physiologic difference in the two solutions. Using the thermal-green dye technique of extra-vascular lung water (EVLW) measurement in twenty crystalloid resuscitated trauma (n = 10) and burn (n = 10) patients, we have specifically evaluated the pulmonary effects of profound depression of PCOP and a negative PCOP - PAWP gradient (a shorthand form of the Starling equation argued to predict the presence of pulmonary edema if + 4 mm Hg or less). Average resuscitative fluid volumes during the first two hospital days were: 31.8 litres of crystalloid and no colloid for each burn patient; and 18.5 liters of crystalloid, 21 units of blood and 1 liter of colloid (as fresh frozen plasma) for each trauma patient. EVLW remained in the normal range of 7.0 +/- 1.0 ml/kg during the first five hospital days for all patients despite profound decrease in PCOP (less than 15 mm Hg) and a low or negative PCOP - PAWP gradient. Crystalloid resuscitation clearly is not harmful to the lung and it is equally as effective as colloid resuscitation. Crystalloid is markedly less expensive than colloid and, given the greater cost of colloid without evident benefit, one wonders how their further use can be justified.","PeriodicalId":75453,"journal":{"name":"Advances in shock research","volume":"9 ","pages":"203-16"},"PeriodicalIF":0.0,"publicationDate":"1983-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"17410047","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Indomethacin suppresses the early cardiodepressant factor released by endotoxin in the rat: possible involvement of a prostacyclin-related material. 吲哚美辛抑制大鼠内毒素释放的早期心脏抑制因子:可能与前列环素相关物质有关。

Advances in shock research Pub Date : 1983-01-01

A Carli, M C Auclair, C Vernimmen

{"title":"Indomethacin suppresses the early cardiodepressant factor released by endotoxin in the rat: possible involvement of a prostacyclin-related material.","authors":"A Carli, M C Auclair, C Vernimmen","doi":"","DOIUrl":"","url":null,"abstract":"Unlabelled: The aim of this study was to determine if a prostaglandin-related material--in particular prostacyclinlike substance--could explain our previous findings showing that a sublethal dose of endotoxin caused the early release of a serum lipid-soluble factor able to decrease various activities of cultured rat heart cells (CRHC) through an intracellular calcium dysregulation. Sera were sampled from rats 4 h after administration of 2 mg/kg E coli endotoxin (E) and their cardiodepressant effect on CRHC determined by an electrooptical technique. E-treated rat serum (ETRS) cardiodepressant effect was compared to that of 0.1 ng/ml prostacyclin (PGI2) and of 0.029 ng/ml nifedipine, a calcium antagonist. The reversal effect of caffeine, a substance known for its positive inotropic effect by increasing intracellular calcium availability at the sarcoplasmic reticulum site, has been tested against the depressant effect of ETRS, PGI2, and nifedipine.Results: 1) Compared to control, serum from endotoxin-treated rats with or without imidazole pretreatment depressed contractility of CRHC in a similar fashion, whereas pretreatment with indomethacin had a much less marked effect; 2) PGI2, nifedipine, and ETRS depressed CRHC contractility in much the same way; 3) caffeine reversed the depressant effect of PGI2 and ETRS, but was much less effective against nifedipine effect. These results suggest that the cardiodepressant effect of ETRS is mediated by a prostaglandinlike substance, other than thromboxane, acting through reduced intracellular calcium availability. PGI2 or PGI2-related material is consistent with such a depressant effect and such a mechanism.","PeriodicalId":75453,"journal":{"name":"Advances in shock research","volume":"10 ","pages":"161-71"},"PeriodicalIF":0.0,"publicationDate":"1983-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"17410180","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0