Skip to main content
SpringerLink
Log in

Adult Respiratory Distress Syndrome and Sepsis

  • Chapter
Book cover Therapeutic Hypothermia

Part of the book series: Molecular and Cellular Biology of Critical Care Medicine ((MCCM,volume 4))

Abstract

Critical illness in adults is often followed by acute lung injury (ALI). The most severe form of ALI, termed Acute Respiratory Distress Syndrome (ARDS), has a mortality rate of about 50% in most series and higher than 90% when it is associated with severe sepsis and multiple system organ failure (1). Among the clinical conditions associated with the development of ARDS, sepsis is the most common and lethal. Despite recent advances in critical care medicine, the current therapeutic approach for ALI and ARDS is just supportive, not curative. Significant improvements in supportive treatment in the intensive care unit (e.g., more specific antibiotic treatment, improved mechanical ventilation, improved monitoring of circulation, better nursing care, etc.) are mainly responsible for improvements in survival in ARDS and sepsis. However, the incidence of sepsis is rising while a third of septic patients will succumb to this devastating syndrome (2). The septic insult results in a complex cascade of inflammatory mediators, such as cytokines, that is initiated by the organisms themselves or by their soluble products. Although cytokine production is not unique to systemic infection, measurement of circulating inflammatory mediators can confirm the presence of host inflammation, but may not distinguish crucial pathways involved in disease progression and outcome (3).

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Log in via an institution
Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 169.00
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 219.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info
Hardcover Book
USD 219.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

Preview

Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.

References

  1. Villar J, Petty TL, Slutsky AS. ARDS in its middle age: what have we learned? Appl Cardiopulm Pathophysiol 1998; 7:167–172.

    Google Scholar 

  2. Riedermann NC, Guo RF, Ward PA. The enigma of sepsis. J Clin Invest 2003; 112:460–467.

    Article  CAS  Google Scholar 

  3. Dinarello CA. Proinflammatory and anti-inflammatory cytokines as mediators in the pathogenesis of septic shock. Chest 1997; 112(Suppl):321S–329S.

    PubMed  CAS  Google Scholar 

  4. Eichacker PQ, Parent C, Kalil A, et al. Risk and the efficacy of anti-inflammatory agents: retrospective and confirmatory studies of sepsis. Am J Respir Crit Care Med 2002; 166:1197–1205.

    Article  PubMed  Google Scholar 

  5. Klastersky J, Kass EH. Is suppression of fever or hypothermia useful in experimental and clinical infectious diseases? J Infect Dis 1970; 121:81–86.

    PubMed  CAS  Google Scholar 

  6. Willford DC, Hill EP, Moores WY. Theoretical analysis of oxygen transport during hypothermia. J Clin Monit 1986; 2:30–43.

    Article  PubMed  CAS  Google Scholar 

  7. Christoforides C, Hedley-Whyte J. Effect of temperature and haemoglobin concentration on solubility of O2 in blood. J Appl Physiol 1969; 27:592–596.

    PubMed  CAS  Google Scholar 

  8. Hegnauer AH, D’Amato H. Oxygen consumption and cardiac output in the hypothermic dog. Am J Physiol 1954; 173:138–142.

    Google Scholar 

  9. Gilston A. Oxygen dynamics and induced hypothermia in sepsis. Resuscitation 1994; 28:65–70.

    Article  PubMed  CAS  Google Scholar 

  10. Bernard S. Induced hypothermia in intensive care medicine. Anaesth Intens Care 1996; 24:382–388.

    CAS  Google Scholar 

  11. Keller E, Imhof HG, Gasser S, et al. Endovascular cooling with heat exchange catheters: a new method to induce and maintain hypothermia. Intensive Care Med 2003; 29:939–943.

    PubMed  Google Scholar 

  12. Pernerstorfer T, Krafft P, Fitzgerald R, et al. Optimal values for oxygen transport during hypothermia in sepsis and ARDS. Acta Anaesthesiol Scand 1995; 107(Suppl):223–227.

    CAS  Google Scholar 

  13. Clemmer TP, Fisher CJ Jr, Bone RC, et al. Hypothermia in the sepsis syndrome and clinical outcome. The Methylprednisolone Severe Sepsis Study Group. Crit Care Med 1992; 20:1395–1401.

    Article  PubMed  CAS  Google Scholar 

  14. Brun-Buisson C, Doyon F, Carlet J, et al. Incidence, risk factors, and outcome of severe sepsis and septic shock in adults. A multicenter prospective study in intensive care units. French ICU Group for Severe Sepsis. JAMA 1995; 274:968–974.

    Article  PubMed  CAS  Google Scholar 

  15. Pittet D, Thievent B, Wenzel RP, et al. Bedside prediction of mortality from bacteremic sepsis. A dynamic analysis of ICU patients. Am J Respir Crit Care Med 1996; 153:684–693.

    PubMed  CAS  Google Scholar 

  16. Block R, Jankowski JAZ, Lacoux P, Pennington CR. Does hypothermia protect against the development of hepatitis in paracetamol overdose? Anaesthesia 1992; 47:789–791.

    Article  PubMed  CAS  Google Scholar 

  17. Megarbane B, Axler O, Chary I, et al. Hypothermia with indoor occurrence is associated with a worse outcome. Intensive Care Med 2000; 26:1843–1849.

    Article  PubMed  CAS  Google Scholar 

  18. Wood SC. Interactions between hypoxia and hypothermia. Annu Rev Physiol 1991; 53:71–85.

    Article  PubMed  CAS  Google Scholar 

  19. Eiseman B, Wotkyns RS, Hirose H. Hypothermia and infection: three mechanisms of host protection in type III pneumococcal peritonitis. Ann Surg 1964; 160:994–1006.

    PubMed  CAS  Google Scholar 

  20. Bigelow WG, Lindsay WK, Harrison RC, et al. Oxygen transport and utilization in dogs at low body temperatures. Am J Physiol 1950; 160:125–137.

    PubMed  CAS  Google Scholar 

  21. Yoshioka T, Shires GT, Fantini GA. Hypothermia relieves oxidative stress in reperfused skeletal muscle following partial ischemia. J Surg Res 1992; 53:408–416.

    Article  PubMed  CAS  Google Scholar 

  22. Kuhn LA, Turner JK. Alterations in pulmonary and peripheral vascular resistance in immersion hypothermia. Circ Res 1959; 7:366–374.

    PubMed  CAS  Google Scholar 

  23. Gutierrez G, Warley AR, Dantzker DR. Oxygen delivery and utilization in hypothermic dogs. J Appl Physiol 1986; 60:751–757.

    PubMed  CAS  Google Scholar 

  24. Johnston WE, Vinten-Johansen J, Strickland RA, et al. Hypothermia with and without end-expiratory pressure in canine oleic acid pulmonary edema. Am Rev Respir Dis 1989; 140:110–117.

    PubMed  CAS  Google Scholar 

  25. Eaton JW, Skelton TD, Berger E. Survival at extreme altitude: protective effect of increased haemoglobin-oxygen affinity. Science 1974; 183:743–744.

    Article  PubMed  CAS  Google Scholar 

  26. Wetterberg T, Sjoberg T, Steen S. Effects of hypothermia in hypercapnia and hypercapnic hypoxemia. Acta Anaesthesiol Scand 1993; 37:296–302.

    PubMed  CAS  Google Scholar 

  27. Faenza S. Hypothermia: an adverse effect or a missing partner? Intensive Care Med 1997; 23:1015–1017.

    Article  PubMed  CAS  Google Scholar 

  28. Patel S, Pachter HL, Yee H, et al. Topical hepatic hypothermia attenuates pulmonary injury after hepatic ischemia and reperfusion. J Am Coll Surg 2000; 191:650–656.

    Article  PubMed  CAS  Google Scholar 

  29. The Hypothermia after Cardiac Arrest Study Group. Mild therapeutic hypothermia to improve the neurologic outcome after cardiac arrest. N Engl J Med 2002; 346:549–556.

    Article  Google Scholar 

  30. Bernard SA, Gray TW, Buist MD, et al. Treatment of comatose survivors of out-of-hospital cardiac arrest with induced hypothermia. N Engl J Med 2002; 346:557–563.

    Article  PubMed  Google Scholar 

  31. Henderson WR, Dhingra VK, Chittock DR, et al. Hypothermia in the management of traumatic brain injury. Intensive Care Med 2003; 29:1637–1644.

    Article  PubMed  Google Scholar 

  32. Haeger VHM. Hypothermia in therapy of hyperpyrexia and poor general condition. Nord Med 1957; 57:246–249.

    PubMed  CAS  Google Scholar 

  33. Blair E, Buxton RW, Cowley RA, Mansberger AR Jr. The use of hypothermia in septic shock. JAMA 1961; 178:916–919.

    PubMed  CAS  Google Scholar 

  34. Cockett ATK, Goodwin WE. Hypothermia as a therapeutic adjunct in management of bacteremic shock after urological surgery. J Urol 1961; 85:358–364.

    PubMed  CAS  Google Scholar 

  35. Gilston A. A hypothermic regime for acute respiratory failure. Intensive Care Med 1983; 9:37–39.

    Article  PubMed  CAS  Google Scholar 

  36. Hurst JM, DeHaven CB, Branson R, Solomkin JS. Combined use of high-frequency jet ventilation and induced hypothermia in the treatment of refractory respiratory failure. Crit Care Med 1985; 13:771–772.

    Article  PubMed  CAS  Google Scholar 

  37. Browning D, Goodrum DT. Treatment of acute severe asthma assisted by hypothermia. Anaesthesia 1992; 47:223–225.

    Article  PubMed  CAS  Google Scholar 

  38. Wetterberg T, Steen S. Combined use of hypothermia and buffering in the treatment of critical respiratory failure. Acta Anaesthesiol Scand 1992; 36:490–492.

    Article  PubMed  CAS  Google Scholar 

  39. Villar J, Slutsky AS. Effects of induced hypothermia in patients with septic adult respiratory distress syndrome. Resuscitation 1993; 26:183–192.

    Article  PubMed  CAS  Google Scholar 

  40. Gilston A. Oxygen balance in acute respiratory failure. Appl Cardiopulm Pathophysiol 1987; 2:211–214.

    Google Scholar 

  41. Finch CA, Lenfant C. Oxygen transport in man. N Engl J Med 1972; 286:407–415.

    Article  PubMed  CAS  Google Scholar 

  42. Dantzker DR, Foresman B, Gutierrez G. Oxygen supply and utilization relationship. A reevaluation. Am Rev Respir Dis 1991; 143:675–679.

    PubMed  CAS  Google Scholar 

  43. Kimura A, Sakurada S, Ohkuni H, et al. Moderate hypothermia delays pro-inflammatory cytokine production of human peripheral blood mononuclear cells. Crit Care Med 2002; 30:1499–1502.

    Article  PubMed  CAS  Google Scholar 

  44. Gerlach H, Esposito C, Stern DM. Modulation of endothelial hemostatic properties: an active role in the host response. Annu Rev Med 1990; 41:15–24.

    Article  PubMed  CAS  Google Scholar 

  45. Lim CM, Kim MS, Ahn JJ, et al. Hypothermia protects against endotoxin-induced acute lung injury in rats. Intensive Care Med 2003; 29:453–459.

    PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Hospital Universitario NS de Candelaria, Santa Cruz de Tenerife, Canary Islands, Spain

    Jesús Villar MD, PhD & Elena Espinosa MD, PhD

Authors
  1. Jesús Villar MD, PhD
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Elena Espinosa MD, PhD
    View author publications

    You can also search for this author in PubMed Google Scholar

Editor information

Editors and Affiliations

  1. Department of Critical Care, University of Pittsburgh, Pittsburgh, PA, 15213, USA

    Samuel A. Tisherman MD

  2. Emergency Medicine, Medical University of Vienna, 1090, Vienna, Austria

    Fritz Sterz MD

Rights and permissions

Reprints and permissions

Copyright information

© 2005 Springer Science+Business Media, Inc.

About this chapter

Cite this chapter

Villar, J., Espinosa, E. (2005). Adult Respiratory Distress Syndrome and Sepsis. In: Tisherman, S.A., Sterz, F. (eds) Therapeutic Hypothermia. Molecular and Cellular Biology of Critical Care Medicine, vol 4. Springer, Boston, MA. https://doi.org/10.1007/0-387-25403-X_11

Download citation

  • DOI: https://doi.org/10.1007/0-387-25403-X_11

  • Publisher Name: Springer, Boston, MA

  • Print ISBN: 978-0-387-25402-9

  • Online ISBN: 978-0-387-25403-6

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics

Search

Navigation