Articles

Preliminary experience on the safety and tolerability of mechanical “insufflation-exsufflation” in subjects with artificial airway

Catheter suctioning of respiratory secretions in intubated subjects is limited to the proximal airway and associated with traumatic lesions to the mucosa and poor tolerance. “Mechanical insufflation-exsufflati...

Authors: Miguel Sánchez-García, Passio Santos, Gema Rodríguez-Trigo, Fernando Martínez-Sagasti, Tomás Fariña-González, Ángela del Pino-Ramírez, Carlos Cardenal-Sánchez, Beatriz Busto-González, Mónica Requesens-Solera, Mercedes Nieto-Cabrera, Francisco Romero-Romero and Antonio Núñez-Reiz

A high-flow nasal cannula system with relatively low flow effectively washes out CO₂ from the anatomical dead space in a sophisticated respiratory model made by a 3D printer

Although clinical studies of the high-flow nasal cannula (HFNC) and its effect on positive end-expiratory pressure (PEEP) have been done, the washout effect has not been well evaluated. Therefore, we made an e...

Authors: Yu Onodera, Ryo Akimoto, Hiroto Suzuki, Masayuki Okada, Masaki Nakane and Kaneyuki Kawamae

Extracorporeal membrane oxygenation line-associated complications: in vitro testing of cyanoacrylate tissue adhesive and securement devices to prevent infection and dislodgement

Extracorporeal membrane oxygenation (ECMO) delivers cardiac and/or respiratory support to critically ill patients who have failed conventional medical therapies. If the large-bore cannulas used to deliver ECMO...

Authors: Taressa Bull, Amanda Corley, Danielle J. Smyth, David J. McMillan, Kimble R. Dunster and John F. Fraser

Intra-cellular lactate concentration in T lymphocytes from septic shock patients — a pilot study

Sepsis-associated hyperlactatemia is a widely used biomarker, associated with initial severity and poor outcomes. This increased circulating lactate concentration has been proposed to result in part from a mis...

Authors: Thibaut Girardot, Thomas Rimmelé, Guillaume Monneret, Julien Textoris and Fabienne Venet

Alterations in mitochondrial respiration and reactive oxygen species in patients poisoned with carbon monoxide treated with hyperbaric oxygen

Carbon monoxide (CO) poisoning is the leading cause of poisoning mortality and morbidity in the USA. Carboxyhemoglobin (COHb) levels are not predictive of severity or prognosis. At this time, the measurement o...

Authors: David H. Jang, Utsha G. Khatri, Brenna P. Shortal, Matthew Kelly, Kevin Hardy, David S. Lambert and David M. Eckmann

PEEP titration: the effect of prone position and abdominal pressure in an ARDS model

Prone position and PEEP can both improve oxygenation and other parameters, but their interaction has not been fully described. Limited data directly compare selection of mechanically “optimal” or “best” PEEP i...

Authors: Joseph C. Keenan, Gustavo A. Cortes-Puentes, Lei Zhang, Alex B. Adams, David J. Dries and John J. Marini

Fully automated life support: an implementation and feasibility pilot study in healthy pigs

Automated systems are available in various application areas all over the world for the purpose of reducing workload and increasing safety. However, such support systems that would aid caregivers are still lac...

Authors: Wilfried Klingert, Jörg Peter, Christian Thiel, Karolin Thiel, Wolfgang Rosenstiel, Kathrin Klingert, Christian Grasshoff, Alfred Königsrainer and Martin Schenk

HLA-DR expression in neonates after cardiac surgery under cardiopulmonary bypass: a pilot study

Monocyte HLA-DR expression has been reported as a marker of immunosuppression and a predictor of sepsis development. However, to date, there is no report on monocyte HLA-DR monitoring exclusively in neonates (...

Authors: Alexis Chenouard, Cécile Braudeau, Nicolas Cottron, Pierre Bourgoin, Nina Salabert, Antoine Roquilly, Régis Josien, Nicolas Joram and Karim Asehnoune

Volume-replacement ratio for crystalloids and colloids during bleeding and resuscitation: an animal experiment

Fluid resuscitation remains a cornerstone in the management of acute bleeding. According to Starling's “Three-compartment model”, four-times more crystalloids have the same volume effect as colloids. However, ...

Authors: Ildikó László, Gábor Demeter, Nándor Öveges, Dániel Érces, József Kaszaki, Krisztián Tánczos and Zsolt Molnár

Combinatorial therapy with two pro-coagulants and one osmotic agent reduces the extent of the lesion in the acute phase of spinal cord injury in the rat

Spinal cord injury (SCI) is a complex disease that leads to a motor, sensitive, and vegetative impairment. So far, single therapies are ineffective for treating SCI in humans and a multifactorial therapeutic a...

Authors: Mathieu Boutonnet, Elisabeth Laemmel, Eric Vicaut, Jacques Duranteau and Marc Soubeyrand

Effect of Ringer’s acetate in different doses on plasma volume in rat models of hypovolemia

Even though crystalloids are the first choice for fluid resuscitation in hemodynamically unstable patients, their potency as plasma volume expanders in hypovolemia of different etiologies is largely unknown. T...

Authors: Svajunas Statkevicius, Attila Frigyesi and Peter Bentzer

Assessment of immune organ dysfunction in critical illness: utility of innate immune response markers

In critically ill patients, organ dysfunctions are routinely assessed, monitored, and treated. Mounting data show that substantial critical illness-induced changes in the immune system can be observed in most ...

Authors: Carmen Andrea Pfortmueller, Christian Meisel, Michaela Fux and Joerg C. Schefold

Anthrax immune globulin improves hemodynamics and survival during B. anthracis toxin-induced shock in canines receiving titrated fluid and vasopressor support

Although anthrax immune globulin (AIG) improved survival in antibiotic-treated Bacillus anthracis-challenged animal models, whether it adds to the benefit of conventional hemodynamic support for B. anthracis toxi...

Authors: Dante A. Suffredini, Xizhong Cui, Dharmvir Jaswal, Kenneth E. Remy, Yan Li, Junfeng Sun, Steven B. Solomon, Yvonne Fitz, Mahtab Moayeri, Stephen Leppla and Peter Q. Eichacker

An experimental model to measure the ability of headphones with active noise control to reduce patient’s exposure to noise in an intensive care unit

Defining the association between excessive noise in intensive care units, sleep disturbance and morbidity, including delirium, is confounded by the difficulty of implementing successful strategies to reduce pa...

Authors: Stuart Gallacher, Doyo Enki, Sian Stevens and Mark J. Bennett

Effects of regional perfusion block in healthy and injured lungs

Severe hypoperfusion can cause lung damage. We studied the effects of regional perfusion block in normal lungs and in the lungs that had been conditioned by lavage with 500 ml saline and high V ...

Authors: Barbara Cambiaghi, Francesco Vasques, Onnen Mörer, Christian Ritter, Tommaso Mauri, Nils Kunze-Szikszay, Karin Holke, Francesca Collino, Giorgia Maiolo, Francesca Rapetti, Elias Schulze-Kalthoff, Tommaso Tonetti, Günter Hahn, Michael Quintel and Luciano Gattinoni

Cardiopulmonary bypass in the newborn: effects of circulatory cell-free hemoglobin and hyperoxia evaluated in a novel rat pup model

Infants with congenital heart defects (CHD) are at risk for white matter brain injury. This novel rat pup model characterizes the systemic effects of intravasal cell-free hemoglobin and hyperoxia, hypothesizin...

Authors: Åsa Jungner, Suvi Vallius, Matteo Bruschettini, Olga Romantsik, Magnus Gram and David Ley

ESICM LIVES 2017

Authors:

Myeloperoxidase can differentiate between sepsis and non-infectious SIRS and predicts mortality in intensive care patients with SIRS

Systemic inflammatory response syndrome (SIRS) is a clinical syndrome following inflammation. Clinically, it is difficult to distinguish SIRS following an infection, i.e., sepsis, from non-infectious SIRS. Mye...

Authors: Irene T. Schrijver, Hans Kemperman, Mark Roest, Jozef Kesecioglu and Dylan W. de Lange

Fluid loading and norepinephrine infusion mask the left ventricular preload decrease induced by pleural effusion

Pleural effusion (PLE) may lead to low blood pressure and reduced cardiac output. Low blood pressure and reduced cardiac output are often treated with fluid loading and vasopressors. This study aimed to determ...

Authors: Kristian Borup Wemmelund, Viktor Kromann Ringgård, Simon Tilma Vistisen, Janus Adler Hyldebrandt, Erik Sloth and Peter Juhl-Olsen

Sepsis 2017 Paris

Authors:

An extracorporeal carbon dioxide removal (ECCO₂R) device operating at hemodialysis blood flow rates

Extracorporeal carbon dioxide removal (ECCO₂R) systems have gained clinical appeal as supplemental therapy in the treatment of acute and chronic respiratory injuries with low tidal volume or non-invasive ventilat...

Authors: R. Garrett Jeffries, Laura Lund, Brian Frankowski and William J. Federspiel

Protective ventilation reduces Pseudomonas aeruginosa growth in lung tissue in a porcine pneumonia model

Mechanical ventilation with positive end expiratory pressure and low tidal volume, i.e. protective ventilation, is recommended in patients with acute respiratory distress syndrome. However, the effect of prote...

Authors: Jesper Sperber, Axel Nyberg, Miklos Lipcsey, Åsa Melhus, Anders Larsson, Jan Sjölin and Markus Castegren

Automated bedside flow cytometer for mHLA-DR expression measurement: a comparison study with reference protocol

In various ICU conditions, measurement of diminished expression of human leukocyte antigen-DR on circulating monocytes (mHLA-DR) by flow cytometry appears to be a reliable marker of acquired immunosuppression....

Authors: Mehdi Zouiouich, Morgane Gossez, Fabienne Venet, Thomas Rimmelé and Guillaume Monneret

Whole blood microRNA markers are associated with acute respiratory distress syndrome

MicroRNAs (miRNAs) can play important roles in inflammation and infection, which are common manifestations of acute respiratory distress syndrome (ARDS). We assessed if whole blood miRNAs were potential diagno...

Authors: Zhaozhong Zhu, Liming Liang, Ruyang Zhang, Yongyue Wei, Li Su, Paula Tejera, Yichen Guo, Zhaoxi Wang, Quan Lu, Andrea A. Baccarelli, Xi Zhu, Ednan K. Bajwa, B. Taylor Thompson, Guo-Ping Shi and David C. Christiani

Hemoadsorption corrects hyperresistinemia and restores anti-bacterial neutrophil function

Mounting evidence suggests that sepsis-induced morbidity and mortality are due to both immune activation and immunosuppression. Resistin is an inflammatory cytokine and uremic toxin. Septic hyperresistinemia (...

Authors: Anthony Bonavia, Lauren Miller, John A. Kellum and Kai Singbartl

Optimal esophageal balloon volume for accurate estimation of pleural pressure at end-expiration and end-inspiration: an in vitro bench experiment

Esophageal pressure, used as a surrogate for pleural pressure, is commonly measured by air-filled balloon, and the accuracy of measurement depends on the proper balloon volume. It has been found that larger fi...

Authors: Yan-Lin Yang, Xuan He, Xiu-Mei Sun, Han Chen, Zhong-Hua Shi, Ming Xu, Guang-Qiang Chen and Jian-Xin Zhou

Impact of membrane lung surface area and blood flow on extracorporeal CO₂ removal during severe respiratory acidosis

Veno-venous extracorporeal CO₂ removal (vv-ECCO₂R) is increasingly being used in the setting of acute respiratory failure. Blood flow rates through the device range from 200 ml/min to more than 1500 ml/min, and t...

Authors: Christian Karagiannidis, Stephan Strassmann, Daniel Brodie, Philine Ritter, Anders Larsson, Ralf Borchardt and Wolfram Windisch

Heart rate variability in critical care medicine: a systematic review

Heart rate variability (HRV) has been used to assess cardiac autonomic activity in critically ill patients, driven by translational and biomarker research agendas. Several clinical and technical factors can in...

Authors: Shamir N. Karmali, Alberto Sciusco, Shaun M. May and Gareth L. Ackland

Sepsis prediction in critically ill patients by platelet activation markers on ICU admission: a prospective pilot study

Platelets have been involved in both immune surveillance and host defense against severe infection. To date, whether platelet phenotype or other hemostasis components could be associated with predisposition to...

Authors: Nathalie Layios, Céline Delierneux, Alexandre Hego, Justine Huart, Christian Gosset, Christelle Lecut, Nathalie Maes, Pierre Geurts, Arnaud Joly, Patrizio Lancellotti, Adelin Albert, Pierre Damas, André Gothot and Cécile Oury

Evaluation of an ADVanced Organ Support (ADVOS) system in a two-hit porcine model of liver failure plus endotoxemia

Novel extracorporeal procedures are constantly being developed and evaluated for use in patients with sepsis. Preclinical evaluation of such procedures usually requires testing in large animal models. In the p...

Authors: Ahmed Al-Chalabi, Edouard Matevossian, Anne von Thaden, Catherine Schreiber, Peter Radermacher, Wolfgang Huber, Aritz Perez Ruiz de Garibay and Bernhard Kreymann

Impact of hyperglycemia on cystathionine-γ-lyase expression during resuscitated murine septic shock

Cystathionine-γ-lyase (CSE) was shown to have a regulatory role in glucose metabolism. Circulatory shock can induce metabolic stress, thereby leading to hyperglycemia and mitochondrial dysfunction. In vitro da...

Authors: Tamara Merz, Josef A. Vogt, Ulrich Wachter, Enrico Calzia, Csaba Szabo, Rui Wang, Peter Radermacher and Oscar McCook

The novel nitric oxide donor PDNO attenuates ovine ischemia-reperfusion induced renal failure

Renal ischemia-reperfusion injury is a common cause of acute kidney injury in intensive care and surgery. Recently, novel organic mononitrites of 1,2-propanediol (PDNO) were synthesized and shown to rapidly an...

Authors: Kristofer F. Nilsson, John Sandin, Lars E. Gustafsson and Robert Frithiof

Effect of continuous dialysis on blood pH in acidemic hypercapnic animals with severe acute kidney injury: a randomized experimental study comparing high vs. low bicarbonate affluent

Controlling blood pH during acute ventilatory failure and hypercapnia in individuals suffering from severe acute kidney injury (AKI) and undergoing continuous renal replacement therapy (CRRT) is of paramount i...

Authors: Thiago Gomes Romano, Luciano Cesar Pontes Azevedo, Pedro Vitale Mendes, Eduardo Leite Vieira Costa and Marcelo Park

Hyperoxia provokes a time- and dose-dependent inflammatory response in mechanically ventilated mice, irrespective of tidal volumes

Mechanical ventilation and hyperoxia have the potential to independently promote lung injury and inflammation. Our purpose was to study both time- and dose-dependent effects of supplemental oxygen in an experi...

Authors: Hendrik J. F. Helmerhorst, Laura R. A. Schouten, Gerry T. M. Wagenaar, Nicole P. Juffermans, Joris J. T. H. Roelofs, Marcus J. Schultz, Evert de Jonge and David J. van Westerloo

Assessment of endothelial cell function and physiological microcirculatory reserve by video microscopy using a topical acetylcholine and nitroglycerin challenge

Assessment of the microcirculation is a promising target for the hemodynamic management of critically ill patients. However, just as the sole reliance on macrocirculatory parameters, single static parameters o...

Authors: Matthias Peter Hilty, Jacqueline Pichler, Bulent Ergin, Urs Hefti, Tobias Michael Merz, Can Ince and Marco Maggiorini

The role of high airway pressure and dynamic strain on ventilator-induced lung injury in a heterogeneous acute lung injury model

Acute respiratory distress syndrome causes a heterogeneous lung injury with normal and acutely injured lung tissue in the same lung. Improperly adjusted mechanical ventilation can exacerbate ARDS causing a sec...

Authors: Sumeet V. Jain, Michaela Kollisch-Singule, Joshua Satalin, Quinn Searles, Luke Dombert, Osama Abdel-Razek, Natesh Yepuri, Antony Leonard, Angelika Gruessner, Penny Andrews, Fabeha Fazal, Qinghe Meng, Guirong Wang, Louis A. Gatto, Nader M. Habashi and Gary F. Nieman

Systemic and microcirculatory effects of blood transfusion in experimental hemorrhagic shock

The microvascular reperfusion injury after retransfusion has not been completely characterized. Specifically, the question of heterogeneity among different microvascular beds needs to be addressed. In addition...

Authors: Gonzalo Ferrara, Vanina S. Kanoore Edul, Héctor S. Canales, Enrique Martins, Carlos Canullán, Gastón Murias, Mario O. Pozo, Juan F. Caminos Eguillor, María G. Buscetti, Can Ince and Arnaldo Dubin

Improving animal welfare using continuous nalbuphine infusion in a long-term rat model of sepsis

Sepsis research relies on animal models to investigate the mechanisms of the dysregulated host response to infection. Animal welfare concerns request the use of potent analgesics for the Refinement of existing se...

Authors: Victor Jeger, Mattia Arrigo, Florian F. Hildenbrand, Daniel Müller, Paulin Jirkof, Till Hauffe, Burkhardt Seifert, Margarete Arras, Donat R. Spahn, Dominique Bettex and Alain Rudiger

The effects of hyperoxia on microvascular endothelial cell proliferation and production of vaso-active substances

Hyperoxia, an arterial oxygen pressure of more than 100 mmHg or 13% O₂, frequently occurs in hospitalized patients due to administration of supplemental oxygen. Increasing evidence suggests that hyperoxia induces...

Authors: Ilias Attaye, Yvo M. Smulders, Monique C. de Waard, Heleen M. Oudemans-van Straaten, Bob Smit, Michiel H. Van Wijhe, Rene J. Musters, Pieter Koolwijk and Angelique M. E. Spoelstra–de Man

Myocardial oxidative stress correlates with left ventricular dysfunction on strain echocardiography in a rodent model of sepsis

Recognition of cardiomyopathy in sepsis can be challenging due to the limitations of conventional measures such as ejection fraction (EF) and fractional shortening (FS) in the context of variable preload and a...

Authors: Bereketeab Haileselassie, Erik Su, Iraklis Pozios, Diego F. Niño, Hongyun Liu, Dai-Yin Lu, Ioannis Ventoulis, William B. Fulton, Chhinder P. Sodhi, David Hackam, Brian O’Rourke and Theodore Abraham

Extracorporeal CO₂ removal by hemodialysis: in vitro model and feasibility

Critically ill patients with acute respiratory distress syndrome and acute exacerbations of chronic obstructive pulmonary disease often develop hypercapnia and require mechanical ventilation. Extracorporeal ca...

Authors: Alexandra G. May, Ayan Sen, Matthew E. Cove, John A. Kellum and William J. Federspiel

Ultra-low-dose sequential computed tomography for quantitative lung aeration assessment—a translational study

Quantitative lung computed tomography (CT) provides fundamental information about lung aeration in critically ill patients. We tested a scanning protocol combining reduced number of CT slices and tube current,...

Authors: Lorenzo Ball, Anja Braune, Francesco Corradi, Claudia Brusasco, Alessandro Garlaschi, Thomas Kiss, Thomas Bluth, Francesca Simonassi, Alice Bergamaschi, Jörg Kotzerke, Marcus J. Schultz, Marcelo Gama de Abreu and Paolo Pelosi

Granulocyte and monocyte adsorptive apheresis ameliorates sepsis in rats

Overwhelming activation of granulocytes and monocytes is central to inflammatory responses during sepsis. Granulocyte and monocyte adsorptive apheresis (GMA) is an extracorporeal leukocyte apheresis device fil...

Authors: Shuai Ma, Qingqing Xu, Bo Deng, Yin Zheng, Hongyan Tian, Li Wang and Feng Ding

Cardiovascular disease and resuscitated septic shock lead to the downregulation of the H₂S-producing enzyme cystathionine-γ-lyase in the porcine coronary artery

Downregulation of the hydrogen sulfide (H₂S)-producing enzymes cystathionine-γ-lyase (CSE), cystathionine-β-synthase (CBS), and/or 3-mercaptopyruvate sulfurtransferase (3-MST) is associated with chronic cardiovas...

Authors: Tamara Merz, Tatjana Stenzel, Benedikt Nußbaum, Martin Wepler, Csaba Szabo, Rui Wang, Peter Radermacher and Oscar McCook

Proliferation and differentiation of adipose tissue in prolonged lean and obese critically ill patients

In prolonged non-obese critically ill patients, preservation of adipose tissue is prioritized over that of the skeletal muscle and coincides with increased adipogenesis. However, we recently demonstrated that ...

Authors: Chloë Goossens, Sarah Vander Perre, Greet Van den Berghe and Lies Langouche

Extracellular superoxide dismutase is necessary to maintain renal blood flow during sepsis development

Extracellular superoxide dismutase (ECSOD) protects nitric oxide (NO) bioavailability by decreasing superoxide levels and preventing peroxynitrite generation, which is important in maintaining renal blood flow...

Authors: Larissa Constantino, Letícia Selinger Galant, Francieli Vuolo, Karla Lorena Guarido, Luiza Wilges Kist, Giovanna Medeiros Tavares de Oliveira, Matheus Augusto de Bittencourt Pasquali, Cláudio Teodoro de Souza, José Eduardo da Silva-Santos, Maurício Reis Bogo, José Cláudio Fonseca Moreira, Cristiane Ritter and Felipe Dal-Pizzol

The role of calpains in ventilator-induced diaphragm atrophy

Controlled mechanical ventilation (CMV) is associated with diaphragm dysfunction. Dysfunction results from muscle atrophy and injury of diaphragm muscle fibers. Enhanced proteolysis and reduced protein synthes...

Authors: Xiaoping Zhu, Hieronymus W. H. van Hees, Leo Heunks, Feifei Wang, Lei Shao, Jiaru Huang, Lei Shi and Shaolin Ma

Intraperitoneal adoptive transfer of mesenchymal stem cells enhances recovery from acid aspiration acute lung injury in mice

Mesenchymal stem cells (MSCs) might act as fine-tuners of inflammation during acute lung injury. We assessed the effects of adoptive transfer of MSCs in acid aspiration acute lung injury and explored the role ...

Authors: Tommaso Mauri, Vanessa Zambelli, Claudia Cappuzzello, Giacomo Bellani, Erica Dander, Marina Sironi, Vittoria Castiglioni, Andrea Doni, Alberto Mantovani, Andrea Biondi, Cecilia Garlanda, Giovanna D’amico and Antonio Pesenti

Experimental assessment of oxygen homeostasis during acute hemodilution: the integrated role of hemoglobin concentration and blood pressure

Low hemoglobin concentration (Hb) and low mean arterial blood pressure (MAP) impact outcomes in critically ill patients. We utilized an experimental model of “normotensive” vs. “hypotensive” acute hemodilution...

Authors: Tiffanie Kei, Nikhil Mistry, Albert K. Y. Tsui, Elaine Liu, Stephen Rogers, Allan Doctor, David F. Wilson, Jean-Francois Desjardins, Kim Connelly, C. David Mazer and Gregory M. T. Hare

The respiratory pressure—abdominal volume curve in a porcine model

Increasing intra-abdominal volume (IAV) can lead to intra-abdominal hypertension (IAH) or abdominal compartment syndrome. Both are associated with raised morbidity and mortality. IAH can increase airway pressu...

Authors: Adrian Regli, Bart Leon De Keulenaer, Bhajan Singh, Lisen Emma Hockings, Bill Noffsinger and Peter Vernon van Heerden