1,721,528 research outputs found
Lactate change after cardiopulmonary resuscitation: Everything is in the baseline value!
No full textSCOPUS: le.jinfo:eu-repo/semantics/publishe
Microcirculation alterations in patients with severe sepsis
No full textThe microcirculation is the place where oxygen exchanges take place at the organ level. The microcirculation has been neglected for a long time by clinicians due to technical difficulties to access it at bedside, but recent technological advances have allowed the identification of microcirculatory alterations in patients with sepsis. Microcirculatory alterations are frequently observed in sepsis even when systemic hemodynamics are within targets. These alterations are characterized by the heterogeneity of perfusion with nonperfused vessels in close vicinity of well perfused ones. These findings contribute to the alterations in oxygen extraction in sepsis and explain why signs of tissue hypoperfusion can be observed even in presence of normal or high venous oxygen saturation (ie, microcirculatory shunt). These alterations are associated with organ dysfunction and mortality. Different mechanisms can be involved in their development and this has major implications for the potential therapies that can be applied. This review focuses on the implications and mechanisms associated with these microcirculatory alterations and on potential therapeutic strategies.SCOPUS: ar.jinfo:eu-repo/semantics/publishe
Link between coagulation abnormalities and microcirculatory dysfunction in critically ill patients
No full textSCOPUS: re.jinfo:eu-repo/semantics/publishe
Evaluation of Tissue Oxygenation
No full textThe main goal of hemodynamic resuscitation is to preserve and/or restore tissue oxygenation. However, tissue oxygenation in itself is seldom measured in clinical practice due to technical limitations. Indirect measurements such as venous oxygen saturation and lactate levels are more often measured, but these may fail to detect impairment in tissue perfusion. Recent advances in technologies have allowed to detect that microcirculatory alterations are frequently observed in critically ill patients, especially in sepsis. These alterations are characterized by a decrease in capillary density and impaired perfusion in some but not all capillaries, which induce perfusion and oxygenation heterogeneities. This is of particular relevance for monitoring as the device should be able to detect tissue perfusion heterogeneity or its consequences. In this chapter we will describe these alterations and discuss the different techniques that can be used to explore tissue perfusion/oxygenation at bedside
Monitoring the microcirculation.
No full textOne of the main goals of hemodynamic support is to preserve tissue perfusion. However issue perfusion is related more to microvascular perfusion than aortic blood flow. Monitoring the microcirculation has long been difficult. Recent technologic advances have made feasible monitoring of the microcirculation at bedside of critically ill patients. In this review, we will discuss the relevance of the various tools available to monitor the microcirculation. Videomicroscopic devices such as sidestream darkfield imaging are the most appropriate techniques to evaluate the microcirculation, taking into account the heterogeneous aspect of diseased microcirculation, as in sepsis. The microcirculation can also be indirectly assessed by measuring tissue PCO2. Transcutaneous PCO2 measurement at ear lobe is particularly promising. Finally, near infrared spectroscopy can also provide interesting information, especially using vascular occlusion tests which reactivity of the microcirculation to a transient hypoxic insult. These different devices have provided important data helping us to better understand the pathophysiology of sepsis and multiple organ failure.Journal ArticleReviewinfo:eu-repo/semantics/publishe
Pathophysiology of microcirculatory dysfunction and the pathogenesis of septic shock
No full textMultiple experimental and human trials have shown that microcirculatory alterations are frequent in sepsis. In this review, we discuss the various mechanisms that are potentially involved in their development and the implications of these alterations. Endothelial dysfunction, impaired inter-cell communication, altered glycocalyx, adhesion and rolling of white blood cells and platelets, and altered red blood cell deformability are the main mechanisms involved in the development of these alterations. Microcirculatory alterations increase the diffusion distance for oxygen and, due to the heterogeneity of microcirculatory perfusion in sepsis, may promote development of areas of tissue hypoxia in close vicinity to welloxygenated zones. The severity of microvascular alterations is associated with organ dysfunction and mortality. At this stage, therapies to specifically target the microcirculation are still being investigated. © 2014 Landes Bioscience.SCOPUS: re.jinfo:eu-repo/semantics/publishe
Going Beyond Counting First Authors in Author Co-citation Analysis
Full text linkThe present study examines one of the fundamental aspects of author co-citation analysis (ACA) - the way co-citation
counts are defined. Co-citation counting provides the data on which all subsequent statistical analyses and mappings
are based, and we compare ACA results based on two different types of co-citation counting - the traditional type that
only counts the first one among a cited work's authors on the one hand and a non-traditional type that takes into
account the first 5 authors of a cited work on the other hand. Results indicate that the picture produced through this non-traditional author co-citation counting contains more coherent author groups and is therefore considerably clearer. However, this picture represents fewer specialties in the research field being studied than that produced through the traditional first-author co-citation counting when the same number of top-ranked authors is selected and analyzed. Reasons for these effects are discussed
Variations on the Author
Full text link“Variations on the Author” discusses two of Eduardo Coutinho’s recent films (Um Dia na Vida, from 2010, and Últimas Conversas, posthumously released in 2015) and their contribution to the general question of documentary authorship. The director’s filmography is characterized by a consistent yet self-effacing form of authorial self-inscription: Coutinho often features as an interviewer that rather than express opinions propels discourses; an interviewer that is good at listening. This mode of self-inscription characterizes him as an author who is not expressive but who is nonetheless markedly present on the screen. In Um Dia na Vida, however, Coutinho is completely absent form the image, while Últimas Conversas, on the contrary, includes a confessional prologue that moves the director from the margins to the center of his films. This article examines the ways in which these works stand out in the filmography of a director who offers new insights into the notion of cinematic authorship
Appropriate Similarity Measures for Author Cocitation Analysis
Full text linkWe provide a number of new insights into the methodological discussion about author cocitation analysis. We first argue that the use of the Pearson correlation for measuring the similarity between authors’ cocitation profiles is not very satisfactory. We then discuss what kind of similarity measures may be used as an alternative to the Pearson correlation. We consider three similarity measures in particular. One is the well-known cosine. The other two similarity measures have not been used before in the bibliometric literature. Finally, we show by means of an example that our findings have a high practical relevance.information science;Pearson correlation;cosine;similarity measure;author cocitation analysis
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