Microcirculation dysfunction in endotoxic shock rabbits is associated with impaired S-nitrosohemoglobin-mediated nitric oxide release from red blood cells: a preliminary study.

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.

Changes in end-tidal CO2 could predict fluid responsiveness in the passive leg raising test but not in the mini-fluid challenge test: A prospective and observational study.

Objective: The objective is to explore the value of end-tidal carbon dioxide (ETCO2) in replacing cardiac index for evaluating fluid responsiveness during the passive leg raising (PLR) test and mini-fluid challenge (mini-FC).

Methods: Patients experiencing septic shock and who were on mechanical ventilation in an intensive care unit were divided into responder and nonresponder groups according to whether their cardiac index increased by more than 10% after the FC. Before and after those tests, the changes in ETCO2, central venous pressure, heart rate, mean arterial pressure, pulse pressure, and cardiac output were recorded.

Integrated cardiopulmonary sonography: a useful tool for assessment of acute pulmonary edema in the intensive care unit.

Objectives: Bedside sonography has become a popular method of assessment of critically ill patients with shock and dyspnea. This study evaluated the usefulness of integrated cardiopulmonary sonography for assessment of acute pulmonary edema.

Methods: A total of 128 intensive care unit (ICU) patients with acute pulmonary edema were randomly divided into 2 groups: a sonography group, which received standard treatment as well as cardiopulmonary sonography, and a control group, which received standard treatment only.

[Value of peripheral perfusion index in the assessment of reactive hyperemia in septic patients].

Objective: To explore the changes of peripheral perfusion index (PI) during forearm vascular occlusion test (VOT) and examine its evaluative value of reactive hyperemia in septic patients.

Methods: Twenty-one patients with septic shock, 21 postoperative ones without infection and 18 health volunteers were prospectively recruited to undergo vascular occlusion test. An arrest of forearm blood flow was applied for 3 min with a sphygmomanometer inflated to a pressure approximately 30 mm Hg greater than systolic pressure around forearm.

[Variations of left ventricular-arterial coupling in septic shock].

Objective: To explore the variations of left ventricular-arterial coupling and elucidate its mechanisms in septic shock.

Methods: Septic shock rabbits were established by an intravenous injection of endotoxin. A total of 12 rabbits were divided randomly into sham operation group (S, n = 6) and endotoxin injection group (E, n = 6).

[Clinical role of evaluating vascular paralysis in septic shock patients].

Objective: To explore the effects of vascular paralysis upon prognosis and tissue perfusion in septic shock patients.

Methods: A total of 73 septic shock patients consecutively admitted into our department from January 2010 to July 2011 were retrospectively studied. Their hemodynamic data, arterial lactate concentration and APACHEII (acute physiology & chronic health evaluation II) score at the beginning of cardiac output monitoring (0h), as well as the outcome of Day 28 post-diagnosis were recorded.

Combining central venous-to-arterial partial pressure of carbon dioxide difference and central venous oxygen saturation to guide resuscitation in septic shock.

Purpose: Central venous oxygen saturation (Scvo2) is a useful therapeutic target when treating septic shock. We hypothesized that combining Scvo2 and central venous-to-arterial partial pressure of carbon dioxide difference (△Pco2) may provide additional information about survival.

Materials And Methods: We performed a retrospective analysis of 172 patients treated for septic shock.

[Predication of volume responsiveness by brachial artery velocity change during passive leg raising].

Objective: To evaluate whether or not brachial artery peak velocity (Vpeak-BA) induced by passive leg raising (PLR) may predict volume responsiveness.

Methods: We prospectively studied 29 patients enrolled into our intensive care unit (ICU) with spontaneous breathing during mechanical ventilation. Through echocardiography we compared the changes of brachial artery peak velocity induced by passive leg raising (ΔVBA-PLR) and the changes of left ventricle outflow tract velocity-time integral after volume expansion (ΔVTI-VE).

[The value of bedside lung ultrasound in emergency-plus protocol for the assessment of lung consolidation and atelectasis in critical patients].

Objective: To investigate the effect of the bedside lung ultrasound in emergency(BLUE)-plus lung ultrasound protocol on lung consolidation and atelectasis of critical patients.

Methods: All patients who need to receive mechanical ventilation for more than 48 hours in ICU from June 2010 to December 2011 in Peking Union Medical College Hospital were included in the study. BLUE-plus and BLUE lung ultrasound, bedside X-ray, lung CT examination were performed on all patients at the same time.

Control method exploration of nosocomial bloodstream infection and its effect evaluation.

Background: Currently, slightly more than 50% of bloodstream infections (BSIs) are hospital acquired. When these infections occur in patients in intensive care units, they are associated with a high mortality rate, additional hospital days and excess hospital costs. Because of multifactor of nosocomial BSIs, measurements of control nosocomial BSIs are wide variety and lead to some confusion in practice.

[Left ventricular-arterial coupling in the resuscitation of refractory septic shock].

Objective: To explore the role of left ventricular-arterial coupling in the resuscitation of refractory septic shock.

Methods: A total of 58 patients with refractory septic shock admitted from January 2010 to July 2011 were retrospectively studied. Hemodynamic data, arterial lactate concentration and APACHEII (acute physiology & chronic health evaluation II) score at the beginning of and 24 hours after cardiac output monitoring, as well as the outcome of Day 28 post-diagnosis were recorded.

[Combination of central venous-to-arterial PCO2 difference with central venous oxygen saturation to guide the shock resuscitation].

Objective: Central venous oxygen saturation (ScvO2) is a useful therapeutic target in septic shock and high-risk postoperative patients. We tested the hypothesis that central venous-to-arterial carbon dioxide difference (ΔPCO(2)) combine with ScvO2 to guide shock resuscitation is better than ScvO2 only.

Methods: A retrospective study was conducted for 93 septic shock and high-risk postoperative patients.

[Correlation of transcutaneous oxygen challenge test and central venous oxygen saturation in septic shock patients].

Objective: To investigate the correlation of transcutaneous oxygen challenge test (OCT) [the degree of PtcO2 response to increased fractional inspired oxygen concentration (FiO2) of 1.0 is identified as transcutaneous OCT] and central venous oxygen saturation (ScvO2) in septic shock patients after resuscitation.

Methods: A total of 49 septic shock patients were prospectively studied.

[Impact of extended focus assessed transthoracic echocardiography protocol in septic shock patients].

Objective: To investigate the impact of extended focus assessed transthoracic echocardiography (eFATE) in septic shock patients.

Methods: A total of 83 septic shock patients were recruited. And they were divided into the eFATE and routine groups.

The transcutaneous oxygen challenge test: a noninvasive method for detecting low cardiac output in septic patients.

The transcutaneous partial pressure of oxygen (PtcO₂) index has been used to detect low-flow state in circulatory failure, but the value of the transcutaneous oxygen challenge test (OCT) to estimate low cardiac output has not been thoroughly evaluated. The prospective observational study examined 62 septic patients requiring PiCCO-Plus for cardiac output monitoring. Simultaneous basal blood gases from the arterial, central venous catheters were obtained.

[Effects of central venous pressure on acute kidney injury in septic shock].

Objective: To investigate the effects of central venous pressure on acute kidney injury (AKI) in septic shock.

Methods: A total of 86 septic shock patients with PiCCO (pulse indicator continuous cardiac output) monitoring admitted at our department from January 2009 to January 2011 were retrospectively studied. They were divided into 2 groups based on central venous pressure (CVP) at 24 hs after PiCCO monitoring.

[Correlation between pressure and volume parameters of septic shock patients with cardiac depression].

Objective: To investigate the characteristics and influence of cardiac depression on patients with septic shock.

Methods: Seventy seven septic shock patients treated from January 2005 to June 2009 were retrospectively studied, they were divided into two groups based on cardiac index (CI) after early resuscitation, high CI group: CI >/= 3 L/(min.m(2)), low CI group: CI < 3 L/(min.

[The clinical significance of Aspergillus isolation from airway samples in critically ill patients].

Objective: To analyze the risk factors and clinical significance of Aspergillus isolation from airway samples of critically ill patients.

Methods: The study was conducted in an ICU between January 2007 and December 2007. The data of patients receiving mechanical ventilation with suspected invasive pulmonary fungal infection were analyzed.

[Stress gastrointestinal bleeding in critically ill patients and its effect on the prognosis].

Objective: To investigate stress gastrointestinal bleeding in critically ill patients and its effect on the prognosis.

Methods: Clinical data of 1148 critically ill patients consecutively admitted to Intensive Care Unit of East Campuses of Peking Union Medical College Hospital during 2008 were analyzed retrospectively. The main contents of investigation included morbility and mortality of stress gastrointestinal bleeding in critically ill patients and its relationship with multiple organ dysfunction.

Acute renal failure during sepsis: potential role of cell cycle regulation.

Objectives: This study aimed to evaluate cell cycle regulation in acute kidney injury after intraperitoneal sepsis in rats.

Methods: Polymicrobial sepsis was induced by cecal ligation and puncture (CLP) in rats. At 0, 6, 12, 24, 48, and 72 h after CLP, serum creatinine was evaluated.

[The role of central venous pressure to evaluate volume responsiveness in septic shock patients].

Objective: To investigate the clinical role of central venous pressure (CVP) to evaluate fluid responsiveness in septic shock patients.

Methods: 66 septic shock patients were studied, every patient was administered a volume challenge, before and after it, CVP, intrathoracic blood volume index (ITBVI), global end-diastolic volume index (GEDVI), cardiac index (CI), stroke volume index (SVI) were measured by PiCCO method. All the obtained values were analyzed by statistics method.