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Shock Index

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6421. Salbutamol in cardiogenic shock complicating acute myocardial infarction. Full Text available with Trip Pro

Salbutamol in cardiogenic shock complicating acute myocardial infarction. Intravenous salbutamol (13 microgram/min) has been given to 31 patients with cardiogenic shock complicating acute myocardial infarction. Haemodynamic measurements were made in nine of these patients. Salbutamol increased cardiac index by 41 per cent from 1.25 +/- 0.06 l/min per m2 to 1.76 +/- 0.19 l/min per m2 and decreased systemic vascular resistance by 16 per cent from 26.2 +/- 1.9 units to 21.9 +/- 2.1 units. Heart (...) afterload reduction. Salbutamol may be useful in the treatment of cardiogenic shock and pump failure complicating acute myocardial infarction.

1980 British Heart Journal

6422. Modulation of postural tremors at the wrist by supramaximal electrical median nerve shocks in essential tremor, Parkinson's disease and normal subjects mimicking tremor. Full Text available with Trip Pro

Modulation of postural tremors at the wrist by supramaximal electrical median nerve shocks in essential tremor, Parkinson's disease and normal subjects mimicking tremor. The response of postural wrist tremors to supramaximal median nerve stimulation was examined in patients with hereditary essential tremor (n = 10) and Parkinson's disease (n = 9), and in normal subjects mimicking wrist tremor (n = 8). The average frequency of on-going tremor was the same in all three groups. Supramaximal (...) peripheral nerve shocks inhibited and then synchronised the rhythmic electromyographic (EMG) activity of all types of tremor. The duration of inhibition ranged from 90 to 210ms, varying inversely with the frequency of on-going tremor. There was no significant difference in mean duration of inhibition or in the timing of the first peak after stimulation on the average rectified EMG records between the three groups. The degree to which supramaximal peripheral nerve shocks could modulate the timing

1993 Journal of neurology, neurosurgery, and psychiatry

6423. A new canine model of endotoxin shock. Full Text available with Trip Pro

. coli) endotoxin intravenously, whilst those in the control group were subjected only to anaesthesia and instrumentation. E. coli endotoxin was given to dogs in the shock group as a bolus dose of 5 mg kg-1 followed by a continuous infusion at 2 mg kg-1 h-1. This produced immediate, severe, cardiovascular depression, with precipitous falls in mean arterial pressure (MAP), cardiac index (CI), stroke index (SI) and left ventricular (LV) dp/dt max. There were associated increases in systemic (...) A new canine model of endotoxin shock. A new canine model of endotoxin shock has been developed in which spontaneous recovery of cardiovascular function is largely prevented, the haemodynamic effects of anaesthesia are minimized and intravascular volume replacement is given. This model has been evaluated using two groups of five adult mongrel dogs anaesthetized with alpha-chloralose and breathing spontaneously. Animals in one group were anaesthetized, instrumented and given Escherichia coli (E

1984 British journal of pharmacology

6424. Effects of intravascular volume expansion on the cardiovascular response to naloxone in a canine model of severe endotoxin shock. Full Text available with Trip Pro

and sustained increases in the MAP and LV dp/dt max with an associated rise in the CI. TPRI rose initially in this series and then fell progressively. Further analysis of the improvements in the CI showed an increase in stroke index with a tendency for heart rate to fall. These findings suggest a myocardial action of naloxone in endotoxin shock, which is augmented by volume replacement. An initial, transient vasoconstrictor effect cannot, however, be excluded. Further work is required to determine (...) Effects of intravascular volume expansion on the cardiovascular response to naloxone in a canine model of severe endotoxin shock. The specific opiate receptor antagonist, naloxone, can produce haemodynamic improvement and increased survival in experimental shock. The efficacy of naloxone therapy in a canine model of endotoxin shock has been evaluated both with and without intravascular volume replacement. Animals were anaesthetized with alpha-chloralose and allowed to breathe spontaneously

1984 British journal of pharmacology

6425. Accumulation of Heat Shock Proteins in Field-Grown Cotton Full Text available with Trip Pro

Accumulation of Heat Shock Proteins in Field-Grown Cotton Cotton (Gossypium hirsutum L.) plants grown under field water deficits exhibited an 80 to 85% reduction in leaf area index, plant height, and dry matter accumulation compared with irrigated controls. Midday photosynthetic rates of dryland plants decreased 2-fold, and canopy temperatures increased to 40 degrees C at 80 days after planting compared with canopy temperatures of 30 degrees C for irrigated plants. Leaves from dryland plants (...) leaves. These data suggest that the proteins which accumulate in water-stressed cotton leaves at elevated temperatures (40 degrees C) are heat shock proteins and that these proteins can accumulate to substantial levels in field-stressed plants.

1985 Plant physiology

6426. Comparative Genomic Hybridization Analysis of Sperm DNA Apoptosis After Exposure to Heat Shock Full Text available with Trip Pro

Comparative Genomic Hybridization Analysis of Sperm DNA Apoptosis After Exposure to Heat Shock A DNA disc chip assay based on comparative genomic hybridization (CGH) was developed to measure sperm DNA integrity. The objective was to correlate DNA integrity of heat-treated sperm with the sperm capacitation index (CI) determined from the sperm penetration assay.Basic semen and kinematic parameters were measured (N = 6). Sperm were washed in two-layer colloid suspensions and split portions (...) capacitating sperm unaffected by heat shock treatment. The remaining parameters were not related to sperm DNA stability.Fragile DNA were found in a population of sperm associated with poor capacitation characteristics and apoptosis was observed after heat treatment. The results suggested that sperm dysfunction might be due to apoptotic sperm DNA resulting from an elevated temperature in the surroundings. The data suggested that the second population of high capacitating sperm induced chaperones

2002 Journal of assisted reproduction and genetics

6427. Effects of epidural anesthesia on cardiovascular response and survival in experimental hemorrhagic shock in dogs. (Abstract)

Effects of epidural anesthesia on cardiovascular response and survival in experimental hemorrhagic shock in dogs. The purpose of the present study was to assess the effects of epidural anesthesia on cardiovascular responses and survival in experimental hemorrhagic shock in dogs. Thirty mongrel dogs were randomly assigned to one of three groups on the basis of anesthetic technique: the upper-level group (n = 10), receiving general anesthesia plus upper-level (mainly thoracic region) epidural (...) anesthesia; the lower-level group (n = 10), receiving general anesthesia plus lower-level (mainly lumbar region) epidural anesthesia; and the control group (n = 10), receiving general anesthesia alone. After withdrawal of blood, the changes in mean arterial pressure (40 mmHg) and cardiac index were similar in all groups. In the upper-level group, a lower heart rate and systemic vascular resistance than the control group were maintained throughout in the presence of severe hypotension. A significant

1990 Anesthesiology

6428. The benefits of 7.5% NaCl/6% dextran 70 (HSD) for prehospital resuscitation of hemorrhagic shock: improved oxygen transport. (Abstract)

an iv HSD (4 ml/kg) infusion over 5 min, and then transport. The animals receiving HSD had improved (P less than 0.05) cardiac work and oxygen consumption during transport (MAP = 59 +/- 3 vs 38 +/- 4 mmHg; cardiac index (CI) = 3.2 +/- 0.2 vs 1.3 +/- 0.1 L min-1 M-2; O2CI = 115 +/- 7 vs 104 +/- 7 ml min-1 M-2), paralleled by reduced serum lactate (5.3 +/- 0.8 vs 7.0 +/- 2.3 mmol/L) and decreased metabolic acidosis. The benefits of HSD in attenuating shock-induced oxygen debt were corroborated (...) The benefits of 7.5% NaCl/6% dextran 70 (HSD) for prehospital resuscitation of hemorrhagic shock: improved oxygen transport. The purpose of this study was to compare the benefit of small volume hypertonic saline/dextran (HSD) versus the risk of obligatory time to administer it on-scene in a model of acute hemorrhagic shock. Dogs were bled to a mean arterial pressure (MAP) of 20 mmHg and then randomized to either: a) direct transport to the emergency department (ED) or b) 10 min delay to insert

1989 Brazilian journal of medical and biological research = Revista brasileira de pesquisas médicas e biológicas / Sociedade Brasileira de Biofísica ... [et al.]

6429. Effect of human hemoglobin on systemic and regional hemodynamics in a porcine model of endotoxemic shock. (Abstract)

Effect of human hemoglobin on systemic and regional hemodynamics in a porcine model of endotoxemic shock. Excessive release of nitric oxide has been implicated as being an important factor contributing to systemic arterial hypotension in septic shock. Hemoglobin is an effective nitric oxide scavenger. The purpose of this study was to test the hypothesis that treatment with cross-linked human hemoglobin can ameliorate systemic arterial hypotension and improve organ perfusion in a porcine model (...) ) solution.After infusion of endotoxin, mean arterial pressure decreased significantly (p < .05) but baseline cardiac index was maintained in both groups. In hemoglobin-treated pigs (group 1), mean arterial pressure was higher than in controls (group 2) from t = 60 to 120 mins (p < .05). There were no significant differences between the two groups in systemic vascular resistance index, renal blood flow, mesenteric blood flow, systemic oxygen delivery, or systemic oxygen extraction. Ileal mucosal blood flow

1996 Critical care medicine

6430. Therapy of shock based on pathophysiology, monitoring, and outcome prediction. (Abstract)

Therapy of shock based on pathophysiology, monitoring, and outcome prediction. High-risk patients who survived general (noncardiac) surgery were observed to have cardiac index (CI) values averaging 4.5 L/min.m2, oxygen delivery (DO2) greater than 600 ml/min.m2, and oxygen consumption (VO2) 170 ml/min.m2 during the first 2 or three days postoperatively. Patients who subsequently died maintained relatively normal CI, DO2, and VO2 values in this period. Values of other variables in survivors (...) and nonsurvivors were not appreciably different. An index based on these observations correctly predicted outcome in 94% in a subsequent prospective study. Two hypotheses: a) that increased flow and oxygen transport represent compensatory physiologic responses to an earlier tissue oxygen debt, and b) that these survivors' values were appropriate therapeutic goals, were tested in prospective randomized clinical trials. The protocol group attained those therapeutic goals. This resulted in significantly reduced

1990 Critical care medicine

6431. Plasma exchange does not improve survival in a canine model of human septic shock. (Abstract)

Plasma exchange does not improve survival in a canine model of human septic shock. Whether plasma exchange would improve survival in antibiotic-treated canines with septic shock was investigated. Escherichia coli O86H8 (1.4 X 10(10)) was surgically implanted as an intraperitoneal clot in 18 two-year-old (10-12 kg) purpose-bred beagles. Beginning 4 hours after surgery, all animals received cefoxitin and gentamicin for 5 days. Three treatment groups were defined: 1) a no apheresis, or control (...) . Serial radionuclide left ventricular ejection fractions and femoral and pulmonary arterial catheter hemodynamics were measured simultaneously in awake animals. All six animals in the plasma exchange group died. In both the sham and control groups, only one of six animals survived. Survival times were ordered (median in hours) (control [372 h] > sham apheresis [48 h] > plasma exchange [24 h] [p < 0.038]). Decreases in mean cardiac index and mean arterial pressure (from before apheresis to after) at 5

1993 Transfusion

6432. Comparison of dopamine to dobutamine and norepinephrine for oxygen delivery and uptake in septic shock. (Abstract)

Comparison of dopamine to dobutamine and norepinephrine for oxygen delivery and uptake in septic shock. To test whether dopamine infusion improves oxygen delivery (Do2) and oxygen uptake (VO2) in hyperdynamic septic shock patients stabilized by adequate volume and dobutamine alone, or by the combination of dobutamine and norepinephrine.Prospective clinical trial of two patient groups. Group 1 (n = 15) was stabilized with dobutamine, and group 2 (n = 10) was stabilized with dobutamine (...) and norepinephrine.Intensive care unit in a university hospital.Twenty-five postoperative, hyperdynamic septic shock patients.The stabilizing catecholamine infusion was replaced in a stepwise manner by dopamine to achieve a similar mean arterial pressure (dopamine doses: group 1, mean 22 +/- 15 micrograms/kg/min [range 6 to 52]; and group 2, mean 57 +/- 41 micrograms/kg/min [range 15 to 130]).A complete hemodynamic profile was performed with oxygen transport-related variables at baseline, after replacement by dopamine

1995 Critical care medicine

6433. Dobutamine improves the adequacy of gastric mucosal perfusion in epinephrine-treated septic shock. (Abstract)

PCO2 gap group was defined by a PCO2 gap > 8 torr (> 1.1 kPa) (n = 13), and the normal PCO2 gap group by a PCO2 gap < or = 8 torr (< or = 1.1 kPa)(n = 7).Dobutamine at 5 micrograms/kg/min had no significant effects on mean arterial pressure, heart rate, cardiac index, systemic vascular resistance, oxygen delivery, and oxygen consumption in epinephrine-treated septic shock. No patients developed arrhythmia or electrocardiographic signs of myocardial ischemia. During dobutamine infusion, arterial (...) Dobutamine improves the adequacy of gastric mucosal perfusion in epinephrine-treated septic shock. To assess the effects of dobutamine at a rate of 5 micrograms/kg/min on hemodynamics and gastric intramucosal acidosis in patients with hyperdynamic septic shock treated with epinephrine.A prospective, interventional, clinical trial.An adult, 16-bed medical/surgical intensive care unit of a university hospital.Twenty septic shock patients with a mean arterial pressure of > 75 mm Hg and a cardiac

1997 Critical care medicine

6434. Differential serum protein changes following supplemental albumin resuscitation for hypovolemic shock. (Abstract)

Differential serum protein changes following supplemental albumin resuscitation for hypovolemic shock. The effects of supplemental albumin infusion on serum protein homeostasis were studied in 94 seriously injured patients who received an average of 14.4 transfusion, 9.2 L electrolyte solution, and 829 ml fresh frozen plasma before and during operation. Based on randomization, 46 patients received an average of 31 gm albumin during operation followed by 150 gm/day for 5 days; 48 patients (...) received no albumin. Supplemental albumin caused a significant (p = less than 0.05) increase in total serum protein and albumin concentrations. In contrast, supplemental albumin caused a significant decrease in alpha 1 globulin, alpha 2 globulin, beta globulin, gamma globulin, and fibrinogen levels. The prothrombin time used as index of prothrombin concentration was significantly prolonged in albumin patients. These changes, not previously documented, need further evaluation to determine clinical

1980 Journal of Trauma Controlled trial quality: uncertain

6435. Combined hemodynamic effects of dopamine and dobutamine in cardiogenic shock. (Abstract)

Combined hemodynamic effects of dopamine and dobutamine in cardiogenic shock. In eight mechanically ventilated patients in cardiogenic shock, we assessed the hemodynamic effects of an infusion of dopamine and dobutamine and evaluated its role in preventing the deleterious effects of administering each amine alone. Each patient received three infusions in a randomly assigned order: dopamine, 15 micrograms/kg/min; dobutamine, 15 micrograms/kg/min; and a combination of dopamine, 7.5 micrograms/kg (...) /min, and dobutamine, 7.5 micrograms/kg/min. Stroke volume index increased similarly with the three infusions, but dopamine alone increased oxygen consumption (p less than 0.05 vs dobutamine alone and dopamine-dobutamine combined). The dopamine-dobutamine combination increased mean arterial pressure (p less than 0.05 vs dobutamine), maintained pulmonary capillary wedge pressure within normal limits (p less than vs dopamine), and prevented the worsening of hypoxemia induced by dopamine (p less than

1983 Circulation Controlled trial quality: uncertain

6436. Naloxone and methylprednisolone sodium succinate enhance sympathomedullary discharge in patients with septic shock. (Abstract)

Naloxone and methylprednisolone sodium succinate enhance sympathomedullary discharge in patients with septic shock. Naloxone and methylprednisolone sodium succinate (MPSS) may act in synergy to improve hemodynamics in patients with septic shock by enhancement of sympathomedullary discharge. This randomized double-blind study describes the effect of various dosing regimens of naloxone and MPSS upon hemodynamics and plasma catecholamines in patients with septic shock (n = 57). Consecutive bolus (...) in combination with MPSS, plasma levels of epinephrine and norepinephrine were increased approximately five-to tenfold. In patients treated with bolus plus continuous infusion of naloxone given with or without MPSS, only plasma epinephrine levels were increased. Systolic blood pressure and left ventricular stroke work index were improved within 15 minutes in groups which received naloxone and corticosteroids regardless of dose. In those groups, there were no changes in heart rate or filling pressure

1984 Life sciences Controlled trial quality: uncertain

6437. Comparison of haemodynamic responses to dobutamine and salbutamol in cardiogenic shock after acute myocardial infarction. Full Text available with Trip Pro

effects when used in cardiogenic shock after acute myocardial infarction. Both drugs increase cardiac index but heart rate also rises, and the increase in stroke index is relatively small. Mean arterial pressure is altered little by either agent, but dobutamine (in contrast with dopamine) tends to reduce pulmonary artery end-diastolic pressure, which may be beneficial. (...) Comparison of haemodynamic responses to dobutamine and salbutamol in cardiogenic shock after acute myocardial infarction. Nine patients with critically reduced cardiac output after acute myocardial infarction underwent a single cross-over comparison of dobutamine and salbutamol to compare the haemodynamic effects of these drugs, which have, respectively, predominantly beta 1-adrenergic and beta 2-adrenergic agonist activity. The responses were used to select the more appropriate treatment

1982 British medical journal (Clinical research ed.) Controlled trial quality: uncertain

6438. Effectiveness of dextran 70 versus Ringer's acetate in traumatic shock and adult respiratory distress syndrome. (Abstract)

of dextran 70 showed a significantly higher increase in cardiac index than those challenged with 2 L of Ringer's acetate. It is concluded that in the severely traumatized patient, a fluid program based on dextran 70 is superior to Ringer's acetate alone. Furthermore, patients should continue on a fluid program containing dextran 70 to counteract unrecognized hypovolemia. Our results support the assumption that early aggressive shock treatment with dextran 70, followed by continued dextran administration (...) Effectiveness of dextran 70 versus Ringer's acetate in traumatic shock and adult respiratory distress syndrome. During a 3-yr period, 31 adult victims of severe traumatic shock were enrolled in a prospective randomized investigation of the relative effectiveness of dextran 70 vs. Ringer's acetate to treat shock and protect against trauma-induced adult respiratory distress syndrome (ARDS). Fourteen patients were given dextran 70 and Ringer's acetate to compensate for interstitial fluid loss

1986 Critical care medicine Controlled trial quality: uncertain

6439. Measurement of tissue perfusion by oxygen transport patterns in experimental shock and in high-risk surgical patients. (Abstract)

Measurement of tissue perfusion by oxygen transport patterns in experimental shock and in high-risk surgical patients. Survivors of high-risk general (noncardiac) surgery were observed to have cardiac index (CI) values averaging 4.5 l/min.m2, oxygen delivery (DO2) of greater than 600 ml/min.m2, and oxygen consumption (VO2) of 170 ml/min.m2. In contrast, these values were relatively normal in patients who subsequently died. A very early predictive index based on these observations was found

1990 Intensive Care Medicine Controlled trial quality: uncertain

6440. Influence of N-acetylcysteine on indirect indicators of tissue oxygenation in septic shock patients: results from a prospective, randomized, double-blind study. (Abstract)

Influence of N-acetylcysteine on indirect indicators of tissue oxygenation in septic shock patients: results from a prospective, randomized, double-blind study. Deactivation of endothelium-derived relaxing factor due to an increased oxygen radical load during sepsis may contribute to an impairment in microcirculatory blood flow. We investigated whether treatment with the sulfhydryl donor and oxygen radical scavenger, N-acetylcysteine, would improve whole-body oxygen consumption (VO2), gastric (...) intramucosal pH, and veno-arterial CO2 gradient (veno-arterial PCO2) during septic shock.Prospective, randomized, double-blind study conducted over 2 yrs.Septic shock patients admitted to the intensive care unit.Fifty-eight patients requiring hemodynamic monitoring (radial and pulmonary artery catheters) due to septic shock, were included in this study. All patients were examined within 72 hrs after the onset of sepsis. They were optimally resuscitated by conventional means with volume and inotropic agents

1994 Critical care medicine Controlled trial quality: predicted high

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