Biomedical subjects

N Smail

Publications and source records attributed to N Smail.

22 records · Page 2Linked to original sources

PubMed1997

Effects of norepinephrine on regional blood flow and oxygen extraction capabilities during endotoxic shock.

We explored the effects of norepinephrine on blood flow distribution and oxygen extraction capabilities during hyperdynamic endotoxic shock. Twelve anesthetized and mechanically ventilated dogs received 2 mg/kg of Escherichia coli endotoxin followed by a general saline infusion and were then randomly divided into two groups: six received norepinephrine (1 microg/kg/min), and six served as control subjects. The norepinephrine group maintained higher mean arterial pressure, cardiac index, left ventricular stroke work index, and hepatic arterial blood flow without altering blood flow to portal, mesenteric, and renal beds. When cardiac tamponade was induced to study tissue oxygen extraction capabilities, the norepinephrine group had a lower critical oxygen delivery in whole body (11.5 +/- 5.2 versus 14.3 +/- 1.4 ml/kg/min, p < 0.05) and in liver (25.0 +/- 11.3 versus 38.0 +/- 9.0 ml/min, p = NS) and a higher critical oxygen extraction ratio in whole body (53.8 +/- 17.7 versus 32.0 +/- 6.1%, p < 0.05), and in liver (57.0 +/- 11.9 versus 35.2 +/- 4.3%, p < 0.05). We conclude that during endotoxic shock in dogs, norepinephrine hardly influences blood flow distribution and could even increase hepatic artery blood flow, and it can also improve whole body and liver oxygen extraction capabilities.

Animals↗

PubMed1996

Transgastric, pulsed Doppler echocardiographic determination of cardiac output.

OBJECTIVE: The aim of this study was to evaluate the accuracy of cardiac output measurement with transesophageal echocardiography (TEE) using a transgastric, pulsed Doppler method in acutely ill patients. DESIGN: Cardiac output was simultaneously measured by thermodilution (TD) and a transgastric, pulsed Doppler method. SETTING: The study was carried out in a surgical intensive care unit as part of the management protocol of the patients. PATIENTS: Thirty consecutive acutely ill patients with a Swan-Ganz catheter, mechanically ventilated, sedated and with a stable hemodynamic condition were included. MEASUREMENTS: Pulsed Doppler TEE was performed using a transgastric approach in order to obtain a long axis view of the left ventricle. Cardiac output was calculated from the left ventricular outflow tract diameter, the velocity time integral of the blood flow profile and heart rate. RESULTS: One patient was excluded because of the presence of aortic regurgitation and another, because of the impossibility of obtaining a transgastric view. Twenty-eight simultaneous measurements were performed in 28 patients. A clinically acceptable correlation and agreement were found between the two methods (Doppler cardiac output = 0.889 thermodilution cardiac output +0.74 l/min, r = 0.975, p <0.0001). CONCLUSION: Transgastric pulsed Doppler measurement across the left ventricular outflow tract with TEE is a very feasible and clinically acceptable method for cardiac output measurement in acutely ill patients.

Adult↗

PubMed1996

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PubMed1995

Role of systemic inflammatory response syndrome and infection in the occurrence of early multiple organ dysfunction syndrome following severe trauma.

OBJECTIVE: To evaluate the role of infection and systemic inflammatory response syndrome (SIRS) on the occurrence of early posttraumatic MODS. DESIGN: Retrospective study. SETTING: University Teaching Hospital ICU. PATIENTS: 163 consecutive patients hospitalized for more than 48 hours following severe trauma. MEASUREMENTS AND MAIN RESULTS: The patients were classified into two groups in respect to the existence of MODS at day 2. There was 27 patients in the MODS group and 136 patients in the no MODS group. The two groups were similar with respect to age, sex ratio and Simplified Acute Physiology Score. The MODS group had a higher mortality (52 versus 7%), Injury Severity Score (45 +/- 14 versus 31 +/- 13), hypovolemic shock rate (74 versus 30%), massive volume replacement rate (59 versus 6%) and SIRS rate (81 versus 54%) than the no MODS group (P < 0.05). The rate of infection was similarly low in the MODS and no MODS group (4 versus 6% respectively). CONCLUSION: Early MODS is often associated with hypotension and massive volume administration but very rarely with infection, despite the high rate of SIRS.

Adult↗