Abstract:
INTRODUCTION:Procalcitonin (PCT) has been proposed as a marker of infection in critically ill patients; its level is related to the severity of infection. We evaluated the value of PCT as a marker of bacterial infection for emergency department patients. METHODS:This prospective observational study consecutively enrolled 120 adult atraumatic patients admitted through the emergency department of a 3000-bed tertiary university hospital in May 2001. Fifty-eight patients were infected and 49 patients were not infected. The white blood cell counts, the serum C-reactive protein (CRP) level (mg/l), and the PCT level (ng/ml) were compared between the infected and noninfected groups of patients. RESULTS:A white blood cell count >12,000/mm3 or <4000/mm3 was present in 36.2% of the infected patients and in 18.4% of the noninfected patients. The best cut-off serum levels for PCT and CRP, identified using the Youden's Index, were 0.6 ng/ml and 60 mg/l, respectively. Compared with CRP, PCT had a comparable sensitivity (69.5% versus 67.2%), a lower specificity (64.6% versus 93.9%), and a lower area under the receiver operating characteristic curve (0.689 versus 0.879). PCT levels, but not CRP levels, were significantly higher in bacteremic and septic shock patients. Multivariate logistic regression identified that a PCT level >/= 2.6 ng/ml was independently associated with the development of septic shock (odds ratio, 38.3; 95% confidence interval, 5.6-263.5; P < 0.001). CONCLUSIONS:PCT is not a better marker of bacterial infection than CRP for adult emergency department patients, but it is a useful marker of the severity of infection.
journal_name
Crit Carejournal_title
Critical care (London, England)authors
Chan YL,Tseng CP,Tsay PK,Chang SS,Chiu TF,Chen JCdoi
10.1186/cc2396keywords:
subject
Has Abstractpub_date
2004-02-01 00:00:00pages
R12-20issue
1eissn
1364-8535issn
1466-609Xpii
cc2396journal_volume
8pub_type
杂志文章相关文献
CRITICAL CARE文献大全abstract:INTRODUCTION:Sepsis is characterized by systemic microvascular dysfunction. Endothelial progenitor cells (EPCs) are critically involved in maintaining vascular homeostasis under both physiological and pathological conditions. The aim of the present study was to analyze the endothelial progenitor cell system in patients...
journal_title:Critical care (London, England)
pub_type: 杂志文章
doi:10.1186/cc10100
更新日期:2011-01-01 00:00:00
abstract::Progress in management of critically ill neurological patients has led to improved survival rates. However, severe residual neurological impairment, such as persistent coma, occurs in some survivors. This raises concerns about whether it is ethically appropriate to apply aggressive care routinely, which is also associ...
journal_title:Critical care (London, England)
pub_type: 杂志文章,评审
doi:10.1186/cc6107
更新日期:2007-01-01 00:00:00
abstract::BACKGROUND: That thrombocytopenia results in increased mortality or transfusion requirements has not been confirmed by previous studies. We performed a case-control study in which 36 patients who developed severe thrombocytopenia of less than 50x109 platelets/l were carefully matched for the severity of underlying dis...
journal_title:Critical care (London, England)
pub_type: 杂志文章
doi:10.1186/cc369
更新日期:1999-01-01 00:00:00
abstract:BACKGROUND:Diaphragm dysfunction develops frequently in ventilated intensive care unit (ICU) patients. Both disuse atrophy (ventilator over-assist) and high respiratory muscle effort (ventilator under-assist) seem to be involved. A strong rationale exists to monitor diaphragm effort and titrate support to maintain resp...
journal_title:Critical care (London, England)
pub_type: 杂志文章
doi:10.1186/s13054-018-2172-0
更新日期:2018-09-27 00:00:00
abstract::In sepsis, inflammation and thrombosis are both the cause and the result of interactions between circulating (for example, leukocytes and platelets), endothelial and smooth muscle cells. Microparticles are proinflammatory and procoagulant fragments originating from plasma membrane generated after cellular activation a...
journal_title:Critical care (London, England)
pub_type: 杂志文章,评审
doi:10.1186/cc9231
更新日期:2010-01-01 00:00:00
abstract::Severe sepsis can be a catastrophic condition that is often associated with poor outcomes. The early diagnosis and management of the condition are vital in order to improve the chances of survival. However, owing to the syndromal nature of its definition and the lack of a biomarker able to accurately confirm the condi...
journal_title:Critical care (London, England)
pub_type: 评论,杂志文章
doi:10.1186/cc11508
更新日期:2012-11-08 00:00:00
abstract:INTRODUCTION:The objective of the study was to describe the pharmacokinetics (PK) of fluconazole, anidulafungin, and caspofungin in critically ill patients and to compare with previously published data. We also sought to determine whether contemporary fluconazole doses achieved PK/pharmacodynamic (PD; PK/PD) targets in...
journal_title:Critical care (London, England)
pub_type: 杂志文章
doi:10.1186/s13054-015-0758-3
更新日期:2015-02-04 00:00:00
abstract::Great white sharks are responsible for about 10 cases of death annually worldwide, as compared with millions of deaths caused by sepsis. However, the basic principles of avoiding shark attacks and fighting sepsis seem to be similar: avoidance, attention, and speed, if necessary. The present review discusses the curren...
journal_title:Critical care (London, England)
pub_type: 杂志文章,评审
doi:10.1186/cc14729
更新日期:2015-01-01 00:00:00
abstract:INTRODUCTION:Succinylcholine and rocuronium are widely used to facilitate rapid sequence induction (RSI) intubation in intensive care. Concerns relate to the side effects of succinylcholine and to slower onset and inferior intubation conditions associated with rocuronium. So far, succinylcholine and rocuronium have not...
journal_title:Critical care (London, England)
pub_type: 杂志文章,随机对照试验
doi:10.1186/cc10367
更新日期:2011-08-16 00:00:00
abstract:INTRODUCTION:A major pathophysiologic mechanism in sepsis is impaired host immunity which results in failure to eradicate invading pathogens and increased susceptibility to secondary infections. Although many immunosuppressive mechanisms exist, increased expression of the inhibitory receptor programmed cell death 1 (PD...
journal_title:Critical care (London, England)
pub_type: 杂志文章
doi:10.1186/cc13176
更新日期:2014-01-04 00:00:00
abstract::The European Clinical Trials Directive requires an informed consent from the patient or a proxy in drug trials. Although informed consent is a valuable tool to protect patients' rights in clinical trials, this requirement largely impedes research in critical care settings, and if pursued in this context, it does not p...
journal_title:Critical care (London, England)
pub_type: 评论,杂志文章
doi:10.1186/cc10113
更新日期:2011-01-01 00:00:00
abstract:BACKGROUND:Endothelial hyperpermeability following cardiopulmonary bypass (CPB) contributes to microcirculatory perfusion disturbances and postoperative complications after cardiac surgery. We investigated the postoperative course of renal and pulmonary endothelial barrier function and the association with microcircula...
journal_title:Critical care (London, England)
pub_type: 杂志文章
doi:10.1186/s13054-019-2418-5
更新日期:2019-04-11 00:00:00
abstract:BACKGROUND:Inhaled nitric oxide (iNO) is a rescue therapy for severe hypoxemia in patients with acute respiratory distress syndrome (ARDS). Pooled data from clinical trials have signaled a renal safety warning for iNO therapy, but the significance of these findings in daily clinical practice is unclear. We used primary...
journal_title:Critical care (London, England)
pub_type: 杂志文章
doi:10.1186/s13054-016-1566-0
更新日期:2016-11-30 00:00:00
abstract:INTRODUCTION:Patients with acute-on-chronic liver failure show an aggravated hyperdynamic circulation. We evaluated, in a controlled manner, potential changes in systemic haemodynamics induced by the molecular adsorbent recirculating system (MARS) and the Prometheus system liver detoxification devices in a group of pat...
journal_title:Critical care (London, England)
pub_type: 杂志文章,随机对照试验
doi:10.1186/cc4985
更新日期:2006-01-01 00:00:00
abstract:INTRODUCTION:Recent data have suggested that patient admission during intensive care unit (ICU) morning bedside rounds is associated with less favorable outcome. We undertook the present study to explore the association between morning round-time ICU admissions and hospital mortality in a large Canadian health region. ...
journal_title:Critical care (London, England)
pub_type: 杂志文章,多中心研究
doi:10.1186/cc11329
更新日期:2012-05-03 00:00:00
abstract::Percutaneous dilatation tracheostomy in the intensive care setting presents an increasingly important concept for establishing a large-bore tracheal airway with minimal surgical intervention. Over the last years, different technical solutions have been studied to assess their respective risks and benefits to determine...
journal_title:Critical care (London, England)
pub_type: 评论,杂志文章
doi:10.1186/cc2968
更新日期:2004-10-01 00:00:00
abstract:INTRODUCTION:Our aim was to evaluate the role of B-type natriuretic peptide (BNP) percentage variations at 24 hours and at discharge compared to its value at admission in order to demonstrate its predictive value for outcomes in patients with acute decompensated heart failure (ADHF). METHODS:This was a multicenter Ita...
journal_title:Critical care (London, England)
pub_type: 杂志文章,多中心研究
doi:10.1186/cc9067
更新日期:2010-01-01 00:00:00
abstract:BACKGROUND:Atrial fibrillation occurs frequently in patients following cardiac surgery and can be a cause of increased morbidity and mortality. The use of dexmedetomidine to prevent atrial fibrillation is unclear. The present study was designed to evaluate the effect of dexmedetomidine sedation on the incidence of atri...
journal_title:Critical care (London, England)
pub_type: 杂志文章
doi:10.1186/s13054-016-1480-5
更新日期:2016-09-21 00:00:00
abstract:BACKGROUND:Accurate prediction of delirium in the intensive care unit (ICU) may facilitate efficient use of early preventive strategies and stratification of ICU patients by delirium risk in clinical research, but the optimal delirium prediction model to use is unclear. We compared the predictive performance and user c...
journal_title:Critical care (London, England)
pub_type: 临床试验,杂志文章,多中心研究
doi:10.1186/s13054-018-2037-6
更新日期:2018-05-05 00:00:00
abstract::In the previous issue of Critical Care, Meybohm and colleagues provide evidence to support hypothermia as a kind of therapeutic option for patients suffering cardiac arrest. Although anesthetics had been used to induce hypothermia, sevoflurane post-conditioning fails to confer additional anti-inflammatory effects afte...
journal_title:Critical care (London, England)
pub_type: 评论,杂志文章
doi:10.1186/cc8923
更新日期:2010-01-01 00:00:00
abstract:BACKGROUND:Inflammation plays an important role in the initiation and progression of acute kidney injury (AKI). However, evidence regarding the prognostic effect of the platelet-to-lymphocyte ratio (PLR), a novel systemic inflammation marker, among patients with AKI is scarce. In this study, we investigated the value o...
journal_title:Critical care (London, England)
pub_type: 杂志文章
doi:10.1186/s13054-017-1821-z
更新日期:2017-09-08 00:00:00
abstract:BACKGROUND:Clinical team composition for prehospital paediatric intubation may affect success and complication rates. We performed a systematic review and meta-analysis to determine the success and complication rates by type of clinical team. METHODS:We searched MEDLINE, EMBASE, and CINAHL for interventional and obser...
journal_title:Critical care (London, England)
pub_type: 杂志文章,meta分析
doi:10.1186/s13054-020-02865-y
更新日期:2020-04-15 00:00:00
abstract:INTRODUCTION:The interdependence between endotoxemia, gram negative (GN) bacteremia and mortality has been extensively studied. Underlying patient risk and GN bacteremia types are possible confounders of the relationship. METHODS:Published studies with ≥ 10 patients in either ICU or non-ICU settings, endotoxemia detec...
journal_title:Critical care (London, England)
pub_type: 杂志文章,评审
doi:10.1186/cc11462
更新日期:2012-08-07 00:00:00
abstract::Bacterial pathogens possess an array of specific mechanisms that confer virulence and the capacity to avoid host defence mechanisms. Mechanisms of virulence are often mediated by the subversion of normal aspects of host biology. In this way the pathogen modifies host function so as to promote the pathogen's survival o...
journal_title:Critical care (London, England)
pub_type: 杂志文章,评审
doi:10.1186/cc7091
更新日期:2008-01-01 00:00:00
abstract:INTRODUCTION:Due to resource limitations, few critical care interventions have been rigorously evaluated with adequately powered randomized clinical trials (RCTs). There is a need to improve the efficiency of RCTs in critical care so that more definitive high quality RCTs can be completed with the available resources. ...
journal_title:Critical care (London, England)
pub_type: 杂志文章,随机对照试验
doi:10.1186/cc10110
更新日期:2011-01-01 00:00:00
abstract:INTRODUCTION:Glutamine supplementation has beneficial effects on morbidity and mortality in critically ill patients, possibly in part through an attenuation of the proinflammatory cytokine response and a stimulation of heat shock protein (HSP)70. We infused either alanine-glutamine or saline during endotoxin challenge ...
journal_title:Critical care (London, England)
pub_type: 杂志文章,随机对照试验
doi:10.1186/cc7696
更新日期:2009-01-01 00:00:00
abstract::Central venous oxygen saturation (ScvO2) >70% or mixed venous oxygen saturation (SvO2) >65% is recommended for both septic and non-septic patients. Although it is the task of experts to suggest clear and simple guidelines, there is a risk of reducing critical care to these simple recommendations. This article reviews ...
journal_title:Critical care (London, England)
pub_type: 杂志文章,评审
doi:10.1186/s13054-014-0579-9
更新日期:2014-11-10 00:00:00
abstract::Developments in recent years have placed powerful new tools of diagnosis, therapy, and communication at the disposal of medicine in general, and of critical care in particular. The art of healing requires not only technical proficiency, but also personal connection, multidisciplinary teamwork, and commitment to the ve...
journal_title:Critical care (London, England)
pub_type: 杂志文章
doi:10.1186/cc14721
更新日期:2015-01-01 00:00:00
abstract:INTRODUCTION:Mechanical ventilation (MV) with high tidal volumes may induce or aggravate lung injury in critical ill patients. We compared the effects of a protective versus a conventional ventilatory strategy, on systemic and lung production of tumor necrosis factor-alpha (TNF-alpha) and interleukin-8 (IL-8) in patien...
journal_title:Critical care (London, England)
pub_type: 杂志文章,随机对照试验
doi:10.1186/cc8919
更新日期:2010-01-01 00:00:00
abstract:INTRODUCTION:Lymphocyte apoptosis has been suggested to play a central role in sepsis pathophysiology, and studies in animal models demonstrated that blocking this pathway improves outcome. However, no routine biomarkers of apoptosis are so far available in patients. Thus, the aim of our study was to assess the differe...
journal_title:Critical care (London, England)
pub_type: 杂志文章
doi:10.1186/cc9181
更新日期:2010-01-01 00:00:00