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Abstract:
BACKGROUND:Hemorrhage is a leading cause of death on the battlefield. Current methods for predicting hemodynamic deterioration during hemorrhage are of limited accuracy and practicality. During a study of the effects of remote ischemic preconditioning in pigs that underwent hemorrhage, we noticed arrhythmias among all pigs that died before the end of the experiment but not among surviving pigs. The present study was designed to identify and characterize the early maladaptive hemodynamic responses (tachycardia in the presence of hypotension without a corresponding increase in cardiac index or mean arterial blood pressure) and their predictive power for early mortality in this experimental model. METHODS:Controlled hemorrhagic shock was induced in 16 pigs. Hemodynamic parameters were monitored continuously for 7 h following bleeding. Changes in cardiovascular and laboratory parameters were analyzed and compared between those that had arrhythmia and those that did not. RESULTS:All animals had similar changes in parameters until the end of the bleeding phase. Six animals developed arrhythmias and died early, while 10 had no arrhythmias and survived longer than 6 h or until euthanasia. Unlike survivors, those that died did not compensate for cardiac output (CO), diastolic blood pressure (DBP), and stroke volume (SV). Oxygen delivery (DO2) and mixed venous saturation (SvO2) remained low in animals that had arrhythmia, while achieving certain measures of recuperation in animals that did not. Serum lactate increased earlier and continued to rise in all animals that developed arrhythmias. No significant differences in hemoglobin concentrations were observed between groups. CONCLUSIONS:Despite similar initial changes in variables, we found that low CO, DBP, SV, DO2, SvO2, and high lactate are predictive of death in this animal model. The results of this experimental study suggest that maladaptive responses across a range of cardiovascular parameters that begin early after hemorrhage may be predictive of impending death, particularly in situations where early resuscitative treatment may be delayed.
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最新影响因子:3.533 | 期刊ISSN:1073-2322 | CiteScore:2.75 |
出版周期:Monthly | 是否OA:YES | 出版年份:1994 |
自引率:9.40% | 研究方向:医学-外科 |
出版地区:UNITED STATES |
SCI期刊coverage:Science Citation Index Expanded(科学引文索引扩展)
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Shock includes studies of novel therapeutic approaches, such as immunomodulation, gene therapy, nutrition, and others. There is no single journal, which encompasses the etiology, cellular and molecular mechanisms, and therapeutic approaches to the treatment of shock in a comprehensive and coherent manner, while still maintaining a clear focus on the pathobiology of shock. The journal is poised to meet the present and future needs of investigators involved in sophisticated basic and clinical studies of shock, trauma, sepsis, endotoxemia, ischemia/reperfusion, inflammation, and other related pathophysiologic states.
休克包括研究新的治疗方法,如免疫调节、基因治疗、营养和其他。目前还没有一本包含病因、细胞和分子机制以及以综合和连贯的方式治疗休克的治疗方法的杂志,但仍保持对休克病理学的明确关注。该杂志将满足研究人员目前和未来的需求,他们参与了对休克、创伤、败血症、内毒素血症、缺血/再灌注、炎症和其他相关病理生理状态的复杂基础和临床研究。
大类(学科) | 小类(学科) | 学科排名 |
医学 |
SURGERY (外科) 3区 CRITICAL CARE MEDICINE (危重病医学) 3区 HEMATOLOGY (血液学) 3区 PERIPHERAL VASCULAR DISEASE (外周血管病) 2区 |
15/33 27/71 26/65 42/200 |
年度总发文量 | 年度论文发表量 | 年度综述发表量 |
188 | 157 | 31 |
引文计数(2018)
文献(2015-2017)
1678次引用
610篇文献
序号 | 类别 | 排名 | 百分位 |
1 |
大类(学科):Medicine
小类(学科):Emergency Medicine
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#4/77
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2 |
大类(学科):Medicine
小类(学科):Critical Care and Intensive Care Medicine
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#17/84
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接受率: 中等(50%命中)
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研究方向:动脉瘤 麻醉
审稿时间: 2个月内 接受率: 比较困难(25%命中)
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影响因子:2.655
ISSN:1520-9512
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影响因子:3.427
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影响因子:2.973
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研究方向:医学-呼吸系统
影响因子:3.289
ISSN:2055-1010
研究方向:PRIMARY HEALTH CARE-RESPIRATORY SYSTEM
影响因子:10.262
ISSN:0012-3692
研究方向:医学-呼吸系统
影响因子:2.339
ISSN:0020-1324
研究方向:医学-呼吸系统
影响因子:102.642
ISSN:2213-2600
研究方向:RESPIRATORY SYSTEM-RESPIRATORY SYSTEM
发表一篇学和医学成像类SCI论文
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