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Shock Index

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6421. Effects of norepinephrine, epinephrine, and norepinephrine-dobutamine on systemic and gastric mucosal oxygenation in septic shock. (PubMed)

Effects of norepinephrine, epinephrine, and norepinephrine-dobutamine on systemic and gastric mucosal oxygenation in septic shock. To compare the effects of dopamine, norepinephrine, epinephrine, and the combination of norepinephrine and dobutamine on systemic and gastric mucosal oxygen metabolism in patients with septic shock.Sixteen patients with septic shock were enrolled in the present study. Each patient received dopamine firstly, then in a random succession epinephrine, norepinephrine (...) , or norepinephrine-dobutamine, a mean systemic arterial pressure adjusted to >9.31 kPa. After 120 min of each treatment, hemodynamic, oxygen metabolic, and gastric mucosal parameters were obtained.Epinephrine induced a significant increase in heart rate compared with other three groups (P <0.05), and a significant higher cardiac index compared with norepinephrine alone and norepinephrine-dobutamine (P <0.05). Oxygen extraction ratio values were lower with epinephrine infusion as compared with other three groups

2002 Acta pharmacologica Sinica Controlled trial quality: uncertain

6422. Enoximone in contrast to dobutamine improves hepatosplanchnic function in fluid-optimized septic shock patients. (PubMed)

Enoximone in contrast to dobutamine improves hepatosplanchnic function in fluid-optimized septic shock patients. To investigate the impact of dobutamine and enoximone on hepatosplanchnic perfusion and function in fluid-optimized septic patients.Prospective, randomized, double-blinded interventional study.Intensive care unit of a university hospital.Forty-eight septic shock patients were examined within 12 hrs after onset of septic shock. Patients were conventionally resuscitated, achieving (...) treated with dobutamine or enoximone. Within the first 10 hrs after baseline measurements, the dosage was increased until no further increase in the left ventricular stroke work index occurred. Then, positive inotropes were kept constant throughout the study.Measurements were performed at baseline and after 12 and 48 hrs after baseline measurements. Cardiac index, systemic oxygen delivery, systemic oxygen consumption, and liver blood flow increased significantly in both groups during treatment (p <.01

2001 Critical care medicine Controlled trial quality: uncertain

6423. Beneficial effects of short-term vasopressin infusion during severe septic shock. (PubMed)

Beneficial effects of short-term vasopressin infusion during severe septic shock. Septic shock is associated with vasopressin deficiency and a hypersensitivity to its exogenous administration. The goal of the current study was to determine whether short-term vasopressin infusion in patients experiencing severe septic shock has a vasopressor sparing effect while maintaining hemodynamic stability and adequate end-organ perfusion.Patients experiencing septic shock that required high-dose (...) at 4 h, whereas those randomized to vasopressin went from a median prestudy norepinephrine infusion of 25.0 microg/min to 5.3 microg/min at 4 h (P < 0.001). Mean arterial pressure and cardiac index were maintained in both groups. Urine output did not change in the norepinephrine group (median, 25 to 15 ml/h) but increased substantially in the vasopressin group (median, 32.5 to 65 ml/h; P < 0.05). Similarly, creatinine clearance did not change in the norepinephrine group but increased by 75

2002 Anesthesiology Controlled trial quality: uncertain

6424. Extracorporeal shock-wave therapy for tendonitis of the rotator cuff. A double-blind, randomised, controlled trial. (PubMed)

Extracorporeal shock-wave therapy for tendonitis of the rotator cuff. A double-blind, randomised, controlled trial. We have performed a double-blind placebo-controlled trial of moderate doses of extracorporeal shock-wave therapy (ESWT) for non-calcific tendonitis of the rotator cuff. Adults (74) with chronic tendonitis of the rotator cuff were randomised to receive either active (1500 pulses ESWT at 0.12 mJ/mm2) or sham treatment, monthly for three months. All were assessed before each (...) treatment, and at one and three months after the completion of treatment. The outcome was measured with regard to pain in the shoulder, including a visual analogue score for night pain, and a disability index. There were no significant differences between the two groups before treatment. The mean duration of symptoms in both groups was 23.3 months. Both showed significant and sustained improvements from two months onwards. There was no significant difference between them with respect to change

2002 The Journal of Bone and Joint Surgery British Volume Controlled trial quality: predicted high

6425. Effects of epinephrine compared with the combination of dobutamine and norepinephrine on gastric perfusion in septic shock. (PubMed)

Effects of epinephrine compared with the combination of dobutamine and norepinephrine on gastric perfusion in septic shock. In septic shock, the alteration of the gut barrier contributes to the development of multiple organ failure. The aim of the study was to compare epinephrine with the combination of dobutamine and norepinephrine on gastric perfusion in patients with septic shock.In a prospective randomized study on 2 parallel groups, systemic and pulmonary hemodynamics (arterial and Swan (...) ). At randomization there was no significant difference between groups. At the time of evaluation, mean arterial pressure was 78 +/- 3 and 77 +/- 5 mm Hg in the epinephrine and dobutamine-norepinephrine groups, respectively. There was no significant difference between groups regardless of the systemic and pulmonary hemodynamic or blood gas variable considered. Nevertheless, compared with dobutamine-norepinephrine, epinephrine tended to induce greater values for cardiac index (5.0 +/- 1.6 versus 4.2 +/- 1.5 L/min

2002 Clinical pharmacology and therapeutics Controlled trial quality: uncertain

6426. Prospective randomized trial comparing shock wave lithotripsy and ureteroscopy for management of distal ureteral calculi. (PubMed)

and stone characteristics, treatment parameters, clinical outcomes, patient satisfaction and cost were assessed for each group.The 2 groups were comparable in regard to patient age, sex, body mass index, stone size, degree of hydronephrosis and time to treatment. Procedural and operating room times were statistically significantly shorter for the shock wave lithotripsy compared to the ureteroscopy group (34 and 72 versus 65 and 97 minutes, respectively). In addition, 94% of patients who underwent shock (...) Prospective randomized trial comparing shock wave lithotripsy and ureteroscopy for management of distal ureteral calculi. We compared the efficacy of shock wave lithotripsy and ureteroscopy for treatment of distal ureteral calculi.A total of 64 patients with solitary, radiopaque distal ureteral calculi 15 mm. or less in largest diameter were randomized to treatment with shock wave lithotripsy (32) using an HM3 lithotriptor (Dornier MedTech, Kennesaw, Georgia) or ureteroscopy (32). Patient

2001 The Journal of urology Controlled trial quality: uncertain

6427. Mechanical percussion, inversion and diuresis for residual lower pole fragments after shock wave lithotripsy: a prospective, single blind, randomized controlled trial. (PubMed)

Mechanical percussion, inversion and diuresis for residual lower pole fragments after shock wave lithotripsy: a prospective, single blind, randomized controlled trial. We compare the effectiveness of mechanical percussion and inversion with observation for eliminating lower caliceal fragments 3 months after shock wave lithotripsy.At 3 months after shock wave lithotripsy 69 patients with residual lower caliceal fragments 4 mm. or less were randomized to receive either mechanical percussion (...) to greater than 60 degrees after receiving 20 mg. furosemide.A total of 35 patients were randomized to receive immediate mechanical percussion and inversion therapy and 34 observation. Of the patients in the observation group 28 subsequently received mechanical percussion and inversion after completing the observation period. The groups were not different in gender, body mass index, side affected, stone location or renal anatomical features. The mechanical percussion and inversion group had

2001 The Journal of urology Controlled trial quality: uncertain

6428. High volume continuous venovenous haemofiltration (HV-CVVH) in an equine endotoxaemic shock model. (PubMed)

High volume continuous venovenous haemofiltration (HV-CVVH) in an equine endotoxaemic shock model. Equine acute abdominal disease is often associated with shock. Important aspects in the onset of this complication include hypovolaemia, the translocation of endotoxins from the gut and the subsequent activation of the cytokine network. The clinical efficacy of high volume continuous venovenous haemofiltration (HV-CVVH) and the clearance of cytokines were therefore investigated in an equine (...) differences were found between the treatment group and the control group. Only a slight increase in cardiac index and no marked decrease in mean arterial pressure were seen. A clear cytokine response was found in all ponies, though substantially different in magnitude between individuals. The clearance of cytokines from the blood increased in time, but did not lead to significant decrease in serum levels. In this study, HV-CVVH with a PMMA filter did not prove to have a significant beneficial effect

2002 Equine veterinary journal Controlled trial quality: uncertain

6429. Efficacy Study of LV Assist Device to Treat Patients With Cardiogenic Shock (ISAR-SHOCK)

Efficacy Study of LV Assist Device to Treat Patients With Cardiogenic Shock (ISAR-SHOCK) Efficacy Study of LV Assist Device to Treat Patients With Cardiogenic Shock (ISAR-SHOCK) - Full Text View - ClinicalTrials.gov Hide glossary Glossary Study record managers: refer to the if submitting registration or results information. Search for terms x × Study Record Detail Saved Studies Save this study Warning You have reached the maximum number of saved studies (100). Please remove one or more studies (...) before adding more. Efficacy Study of LV Assist Device to Treat Patients With Cardiogenic Shock (ISAR-SHOCK) The safety and scientific validity of this study is the responsibility of the study sponsor and investigators. Listing a study does not mean it has been evaluated by the U.S. Federal Government. Read our for details. ClinicalTrials.gov Identifier: NCT00417378 Recruitment Status : Completed First Posted : January 1, 2007 Last Update Posted : November 28, 2007 Sponsor: Deutsches Herzzentrum

2006 Clinical Trials

6430. Muscle perfusion and oxygen consumption by near-infrared spectroscopy in septic-shock and non-septic-shock patients. (PubMed)

venous occlusion were measured by NIRS in the brachioradialis muscle. We calculated Qtis by the rate of HbO(2) and HbH increase in the first 30 s of venous occlusion divided by haemoglobin blood concentration. VO(2)tis was calculated by subtraction of the arterial HbH from the initial increase of HbH after venous occlusion extrapolated to 1 min. Tissue oxygenation index [TOI = HbO(2)/(HbO(2)+HbH)] was also measured before venous occlusion. Two measurements in patients with septic shock, and one (...) Muscle perfusion and oxygen consumption by near-infrared spectroscopy in septic-shock and non-septic-shock patients. To measure muscle blood flow (Qtis) and oxygen consumption (VO(2)tis) in septic and non-septic critically ill patients by near-infrared spectroscopy (NIRS).Surgical intensive care unit of a university hospital.Four patients with septic shock, eight post-surgical critically ill patients and ten healthy volunteers.Oxyhaemoglobin (HbO(2)) and deoxyhaemoglobin (HbH) variations after

2003 Intensive Care Medicine

6431. Cardiogenic shock caused by right ventricular infarction: a report from the SHOCK registry. (PubMed)

shock due to predominant RV (n = 49) or left ventricular (LV) failure (n = 884) in the SHould we emergently revascularize Occluded coronaries for Cardiogenic shocK? (SHOCK) trial registry.Patients with predominant RV shock were younger, with a lower prevalence of previous MI (25.5 vs. 40.1%, p = 0.047), anterior MI, and multivessel disease (34.8 vs. 77.8%, p < 0.001) and a shorter median time between the index MI and the diagnosis of shock (2.9 vs. 6.2 h, p = 0.003) in comparison to patients with LV (...) Cardiogenic shock caused by right ventricular infarction: a report from the SHOCK registry. The purpose of this study was to determine the characteristics and outcomes of patients with acute myocardial infarction (MI) complicated by cardiogenic shock due to predominant right ventricular (RV) infarction.Although RV infarction has been shown to have favorable long-term outcomes, the influence of RV infarction on mortality in cardiogenic shock is unknown.We evaluated 933 patients in cardiogenic

2003 Journal of the American College of Cardiology

6432. Effects of sustained post-traumatic shock and initial fluid resuscitation on extravascular lung water content and pulmonary vascular pressures in a porcine model of shock. (PubMed)

) were randomly allocated to three groups: control (C, n=9), shock resuscitated with either NaCl 0.9% (S, n=10), or 4% gelatine (G, n=10). Shock was maintained for 1 h followed by fluid resuscitation with either normal saline or 4% gelatine solution. Cardiac output (CO), mean arterial pressure (MAP), mixed venous saturation (Sv(O(2))), blood lactate concentration, mean pulmonary artery pressure (MPAP), MPAP/MAP, pulmonary vascular resistance (PVR), extravascular lung water index (EVLWi), Pa(O(2))/FI (...) Effects of sustained post-traumatic shock and initial fluid resuscitation on extravascular lung water content and pulmonary vascular pressures in a porcine model of shock. The temporal evolution of lung injury following post-traumatic shock is poorly understood. In the present study we have tested the hypothesis that manifestations of pulmonary vascular dysfunction may be demonstrable within the first hour after the onset of shock.Twenty-nine anaesthetized pigs (mean weight 27.4 kg; (SD) 3.2

2003 British Journal of Anaesthesia

6433. Shock wave lithotripsy at 60 or 120 shocks per minute: a randomized, double-blind trial. (PubMed)

radiopaque stones in the renal collecting system were randomized to SWL at 60 or 120 shocks per minute. They were followed at 2 weeks and 3 months. The primary outcome was the success rate, defined as stone-free status or asymptomatic fragments less than 5 mm 3 months after treatment.A total of 220 patients were randomized, including 111 to 60 shocks per minute and 109 to 120 shocks per minute. The 2 groups were comparable in regard to age, sex, body mass index, stent status and initial stone area (...) Shock wave lithotripsy at 60 or 120 shocks per minute: a randomized, double-blind trial. The rate of shock wave administration is a factor in the per shock efficiency of shock wave lithotripsy (SWL). Experimental evidence suggests that decreasing shock wave frequency from 120 shocks per minute results in improved stone fragmentation. To our knowledge this study is the first to examine the effect of decreased shock wave frequency in patients with renal stones.Patients with previously untreated

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2005 The Journal of urology Controlled trial quality: predicted high

6434. Hemodynamic parameters are prognostically important in cardiogenic shock but similar following early revascularization or initial medical stabilization: a report from the SHOCK Trial. (PubMed)

Hemodynamic parameters are prognostically important in cardiogenic shock but similar following early revascularization or initial medical stabilization: a report from the SHOCK Trial. In cardiogenic shock (CS), conclusive data on serial hemodynamic measurements for treatment guidance and prognosis are lacking.The SHOCK (Should We Emergently Revascularize Occluded Coronaries for Cardiogenic Shock?) Trial tested early revascularization (ERV) vs initial medical stabilization (IMS) in CS (...) (median time, 10.6 h) than in the ERV group (median time, 12.5 h; p = 0.043). At baseline, stroke volume index (SVI) was an independent predictor of 30-day mortality after adjustment for age (odds ratio, 0.69 per 5 mL/m2 increase; 95% confidence interval, 0.55 to 0.87; p = 0.002). At follow-up, both stroke work index (SWI) [odds ratio, 0.54 per 5 g/m/m2 increase; 95% confidence interval, 0.39 to 0.76; p < 0.001] and SVI (odds ratio, 0.59 per 5 mL/m2 increase; 95% confidence interval, 0.45 to 0.77; p

2007 Chest Controlled trial quality: uncertain

6435. Shock Trial: Should We Emergently Revascularize Occluded Coronaries for Cardiogenic Shock.

Shock Trial: Should We Emergently Revascularize Occluded Coronaries for Cardiogenic Shock. Shock Trial: Should We Emergently Revascularize Occluded Coronaries for Cardiogenic Shock. - Full Text View - ClinicalTrials.gov Hide glossary Glossary Study record managers: refer to the if submitting registration or results information. Search for terms x × Study Record Detail Saved Studies Save this study Warning You have reached the maximum number of saved studies (100). Please remove one or more (...) studies before adding more. Shock Trial: Should We Emergently Revascularize Occluded Coronaries for Cardiogenic Shock. The safety and scientific validity of this study is the responsibility of the study sponsor and investigators. Listing a study does not mean it has been evaluated by the U.S. Federal Government. Read our for details. ClinicalTrials.gov Identifier: NCT00000552 Recruitment Status : Completed First Posted : October 28, 1999 Last Update Posted : March 4, 2014 Sponsor: New England Research

1999 Clinical Trials

6436. The ability of traditional vital signs and shock index to identify ruptured ectopic pregnancy. (PubMed)

The ability of traditional vital signs and shock index to identify ruptured ectopic pregnancy. This study evaluated the correlation between vital signs and hemoperitoneum and the association between abnormal vital signs and tubal rupture.With the use of a retrospective case-control design, the initial heart rate, systolic blood pressure, and heart rate/systolic blood pressure were correlated with respect to degree of hemoperitoneum; predictive values were calculated.Fifty-two patients were

2003 American Journal of Obstetrics and Gynecology

6437. Do all nonsurvivors of cardiogenic shock die with a low cardiac index? (PubMed)

Do all nonsurvivors of cardiogenic shock die with a low cardiac index? To characterize the hemodynamic course of cardiogenic shock and to relate the cause of death to ongoing cardiac failure or multiple organ dysfunction.Retrospective study.A 31-bed department of intensive care in a university hospital.All patients admitted for cardiogenic shock from January 1999 to December 2000.None.Charts were reviewed for demographic, clinical, hemodynamic, oxygen transport, inflammation, and organ (...) dysfunction data. Of 62 patients with cardiogenic shock, 40 (65%) did not survive. Eight patients (20%) died from fatal arrhythmia, 14 patients (35%) died with low cardiac index (CI) [ie, < 2.2 L/min/m(2)], and 18 patients (45%) died with normalized CI (ie, > 2.2 L/min/m(2)) and a higher CI/oxygen extraction ratio. Of these 18 patients, 9 had evidence of infection. The patients with normalized CI were younger and stayed longer in the ICU than patients with low CI.A substantial number of patients

2003 Chest

6438. Shock index in diagnosing early acute hypovolemia. (PubMed)

Shock index in diagnosing early acute hypovolemia. The aim of this study was to determine the hemodynamic response and calculated shock index (SI=heart rate [HR]/systolic blood pressure [SBP]) in early acute blood loss.This was a prospective observational study that enrolled healthy blood donors. Patients were excluded if not eligible for blood donation. Baseline vital signs were obtained, 450 mL of blood was removed over 20 minutes, and vital signs were repeated immediately postdonation while

2005 American Journal of Emergency Medicine

6439. Hemodynamically Unstable Pulmonary Embolism in the RIETE Registry: Systolic Blood Pressure or Shock Index? (PubMed)

Hemodynamically Unstable Pulmonary Embolism in the RIETE Registry: Systolic Blood Pressure or Shock Index? Patients with acute pulmonary embolism (PE) presenting with haemodynamic instability have the worst prognosis. However, what is understood by haemodynamic instability has not been clearly defined. The Registro Informatizado de la Enfermedad Tromboembólica (RIETE) is an ongoing registry of consecutive patients with symptomatic, objectively confirmed, acute deep vein thrombosis or PE (...) . The present authors compared the predictive value of a systolic blood pressure (SBP) value of <100 mmHg and <90 mmHg and the shock index (cardiac frequency divided by SBP) on 30-day mortality in consecutive patients with PE. As of May 2006, 6,599 patients with PE were enrolled in the study. Of these, 417 (6.3%) died within 30 days: 153 of the initial PE, 29 of recurrent PE and 235 due to other causes. Of the 417 individuals who died, 127 (30%) had a positive shock index, 60 (14%) had SBP <100 mmHg and 33

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2007 European Respiratory Journal

6440. Renal arterial resistance in septic shock: effects of increasing mean arterial pressure with norepinephrine on the renal resistive index assessed with Doppler ultrasonography. (PubMed)

Renal arterial resistance in septic shock: effects of increasing mean arterial pressure with norepinephrine on the renal resistive index assessed with Doppler ultrasonography. To determine the effects of increasing mean arterial pressure (MAP) on renal resistances assessed by Doppler ultrasonography in septic shock.Prospective, single-center, nonrandomized, open-label trial in the surgical intensive care unit in a university teaching hospital.11 patients with septic shock who required fluid (...) resuscitation and norepinephrine to increase and maintain MAP at or above 65 mmHg.Norepinephrine was titrated in 11 patients in septic shock during three consecutive not randomized periods of 2 h to achieve a MAP at successively 65, 75, and 85 mmHg.At the end of each period hemodynamic parameters and renal function variables (urinary output, creatinine, clearance) were measured, and Doppler ultrasonography was performed on interlobar arteries to assess the renal resistive index. When increasing MAP from 65

2007 Intensive Care Medicine

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