Abstract:
INTRODUCTION:Our aims were to assess risk factors, clinical features, management and outcomes in critically ill patients in whom Aspergillus spp. were isolated from respiratory secretions, using a database from a study designed to assess fungal infections. METHODS:A multicentre prospective study was conducted over a 9-month period in 73 intensive care units (ICUs) and included patients with an ICU stay longer than 7 days. Tracheal aspirate and urine samples, and oropharyngeal and gastric swabs were collected and cultured each week. On admission to the ICU and at the initiation of antifungal therapy, the severity of illness was evaluated using the Acute Physiology and Chronic Health Evaluation II score. Retrospectively, isolation of Aspergillus spp. was considered to reflect colonization if the patient did not fulfil criteria for pneumonia, and infection if the patient met criteria for pulmonary infection and if the clinician in charge considered the isolation to be clinically valuable. Risk factors, antifungal use and duration of therapy were noted. RESULTS:Out of a total of 1756 patients, Aspergillus spp. were recovered in 36. Treatment with steroids (odds ratio = 4.5) and chronic obstructive pulmonary disease (odds ratio = 2.9) were significantly associated with Aspergillus spp. isolation in multivariate analysis. In 14 patients isolation of Aspergillus spp. was interpreted as colonization, in 20 it was interpreted as invasive aspergillosis, and two cases were not classified. The mortality rates were 50% in the colonization group and 80% in the invasive infection group. Autopsy was performed in five patients with clinically suspected infection and confirmed the diagnosis in all of these cases. CONCLUSION:In critically ill patients, treatment should be considered if features of pulmonary infection are present and Aspergillus spp. are isolated from respiratory secretions.
journal_name
Crit Carejournal_title
Critical care (London, England)authors
Garnacho-Montero J,Amaya-Villar R,Ortiz-Leyba C,León C,Alvarez-Lerma F,Nolla-Salas J,Iruretagoyena JR,Barcenilla Fdoi
10.1186/cc3488keywords:
subject
Has Abstractpub_date
2005-06-01 00:00:00pages
R191-9issue
3eissn
1364-8535issn
1466-609Xpii
cc3488journal_volume
9pub_type
杂志文章,多中心研究相关文献
CRITICAL CARE文献大全abstract:BACKGROUND:Post-cardiac arrest (CA) patients are at risk of secondary ischemic damage in the case of suboptimal brain oxygenation during an ICU stay. We hypothesized that elevated central venous pressures (CVP) would impair cerebral perfusion and oxygenation (venous cerebral congestion). The aim of the present study wa...
journal_title:Critical care (London, England)
pub_type: 杂志文章
doi:10.1186/s13054-016-1297-2
更新日期:2016-05-15 00:00:00
abstract::Many aspects of left ventricular function are explained by considering ventricular pressure-volume characteristics. Contractility is best measured by the slope, Emax, of the end-systolic pressure-volume relationship. Ventricular systole is usefully characterized by a time-varying elastance (ΔP/ΔV). An extended area, t...
journal_title:Critical care (London, England)
pub_type: 杂志文章,评审
doi:10.1186/s13054-016-1439-6
更新日期:2016-09-10 00:00:00
abstract:INTRODUCTION:Pulmonary embolism (PE) is one of the greatest diagnostic challenges in prehospital emergency setting. Most patients with suspected PE have a positive D-dimer and undergo diagnostic testing. Excluding PE with additional non-invasive tests would reduce the need for further imaging tests. We aimed to determi...
journal_title:Critical care (London, England)
pub_type: 杂志文章
doi:10.1186/cc8197
更新日期:2009-01-01 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:INTRODUCTION:The choice of invasive systemic haemodynamic monitoring in critically ill patients remains controversial as no multicentre comparative clinical data exist. Accordingly, we sought to study and compare the features and outcomes of patients who receive haemodynamic monitoring with either the pulmonary artery ...
journal_title:Critical care (London, England)
pub_type: 杂志文章
doi:10.1186/cc5126
更新日期:2006-01-01 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:New technology using partial carbon dioxide rebreathing has been developed to measure cardiac output. Because rebreathing increases respiratory effort, we investigated whether a newly developed system with 35 s rebreathing causes a lesser increase in respiratory effort under partial ventilatory support tha...
journal_title:Critical care (London, England)
pub_type: 杂志文章
doi:10.1186/cc3801
更新日期:2005-10-05 00:00:00
abstract:BACKGROUND:Critically ill patients in the intensive care unit (ICU) are at high risk for developing Clostridioides difficile infections (CDI). Risk factors predicting their mortality or standardized treatment recommendations have not been defined for this cohort. Our goal is to determine outcome and mortality associate...
journal_title:Critical care (London, England)
pub_type: 杂志文章
doi:10.1186/s13054-019-2648-6
更新日期:2019-12-09 00:00:00
abstract::This review presents key publications from the research field of sepsis published in Critical Care and other relevant journals during 2013. The results of these experimental studies and clinical trials are discussed in the context of current scientific and clinical background. The discussion highlights and summarises ...
journal_title:Critical care (London, England)
pub_type: 杂志文章,评审
doi:10.1186/s13054-014-0578-x
更新日期:2014-10-15 00:00:00
abstract:INTRODUCTION:Lung protective ventilation requires low tidal volume and suitable positive end-expiratory pressure (PEEP). To date, few methods have been accepted for clinical use to set the appropriate PEEP. The aim of this study was to test the feasibility of PEEP titration guided by ventilation homogeneity using the g...
journal_title:Critical care (London, England)
pub_type: 杂志文章
doi:10.1186/cc8860
更新日期:2010-01-01 00:00:00
abstract:BACKGROUND:Renal perfusion status remains poorly studied at the bedside during septic shock. We sought to measure cortical renal perfusion in patients with septic shock during their first 3 days of care using renal contrast enhanced ultrasound (CEUS). METHODS:We prospectively included 20 ICU patients with septic shock...
journal_title:Critical care (London, England)
pub_type: 杂志文章
doi:10.1186/s13054-018-2067-0
更新日期:2018-06-15 00:00:00
abstract::The majority of intensive care practitioners, until comparatively recently, was content to discharge surviving patients to the care of referring primary specialty colleagues who would undertake subsequent inpatient and outpatient care. With the exception of mortality statistics from clinical studies, the practitioners...
journal_title:Critical care (London, England)
pub_type: 杂志文章,评审
doi:10.1186/cc1532
更新日期:2002-10-01 00:00:00
abstract:INTRODUCTION:Fluid resuscitation is crucial in managing hemodynamically unstable patients. The last decade witnessed the use of pulse pressure variation (PPV) to predict fluid responsiveness. However, as far as we know, no systematic review and meta-analysis has been carried out to evaluate the value of PPV in predicti...
journal_title:Critical care (London, England)
pub_type: 杂志文章,meta分析,评审
doi:10.1186/s13054-014-0650-6
更新日期:2014-11-27 00:00:00
abstract:INTRODUCTION:Transthoracic echocardiography (TTE) is a useful tool for minimally invasive hemodynamic monitoring in the ICU. Dynamic indices (such as the inferior vena cava distensibility index (dIVC)) can be used to predict fluid responsiveness in mechanically ventilated patients. Although quantitative use of the dIVC...
journal_title:Critical care (London, England)
pub_type: 杂志文章
doi:10.1186/cc13693
更新日期:2014-01-14 00:00:00
abstract:INTRODUCTION:The present study assessed the opinion of general practitioners (GPs) concerning their relationships with intensivists. METHODS:An anonymous questionnaire was mailed to 7,239 GPs. GPs were asked about their professional activities, postgraduate intensive care unit (ICU) training, the rate of patient admit...
journal_title:Critical care (London, England)
pub_type: 杂志文章
doi:10.1186/cc9061
更新日期:2010-01-01 00:00:00
abstract:BACKGROUND:Neurocritical illness is a growing healthcare problem with profound socioeconomic effects. We assessed differences in healthcare costs and long-term outcome for different forms of neurocritical illnesses treated in the intensive care unit (ICU). METHODS:We used the prospective Finnish Intensive Care Consort...
journal_title:Critical care (London, England)
pub_type: 杂志文章,多中心研究
doi:10.1186/s13054-018-2151-5
更新日期:2018-09-20 00:00:00
abstract:BACKGROUND:Kidney congestion is a common pathophysiologic pathway of acute kidney injury (AKI) in sepsis and heart failure. There is no noninvasive tool to measure kidney intracapsular pressure (KIP) directly. METHODS:We evaluated the correlation of KIP with kidney elasticity measured by ultrasound surface wave elasto...
journal_title:Critical care (London, England)
pub_type: 杂志文章
doi:10.1186/s13054-017-1847-2
更新日期:2017-10-19 00:00:00
abstract::The early recognition and management of sepsis remain the greatest challenges in the field of critical care medicine. Endothelial injury is one of the hallmarks of sepsis, leading to capillary leak, microcirculatory dysfunction, organ failure, and eventual death in many critically ill patients. The angiogenic growth f...
journal_title:Critical care (London, England)
pub_type: 评论,杂志文章,评审
doi:10.1186/cc7685
更新日期:2009-01-01 00:00:00
abstract:INTRODUCTION:The goal of the current study was to investigate the effect of aging on the development of endothelial dysfunction in a murine model of sepsis, and to compare it with the effect of genetic deficiency of the endothelial isoform of nitric oxide synthase (eNOS). METHODS:Cecal ligation and puncture (CLP) was ...
journal_title:Critical care (London, England)
pub_type: 杂志文章
doi:10.1186/s13054-014-0511-3
更新日期:2014-09-16 00:00:00
abstract:INTRODUCTION:Our aim in this study was to assess whether the new Glasgow Coma Scale, Age, and Systolic Blood Pressure (GAP) scoring system, which is a modification of the Mechanism, Glasgow Coma Scale, Age, and Arterial Pressure (MGAP) scoring system, better predicts in-hospital mortality and can be applied more easily...
journal_title:Critical care (London, England)
pub_type: 杂志文章,多中心研究
doi:10.1186/cc10348
更新日期:2011-08-10 00:00:00
abstract::The recent bus crash in Switzerland involving many children provides several lessons for the pre-hospital care community. The use of multiple helicopters that are capable of flying at night and that carry advanced medical pre-hospital teams undoubtedly saved lives following the tragedy. We describe the medical respons...
journal_title:Critical care (London, England)
pub_type: 杂志文章
doi:10.1186/cc11370
更新日期:2012-07-11 00:00:00
abstract::Mechanically ventilated, intubated patients are at increased risk for tracheal colonization with bacterial pathogens that may progress to heavy bacterial colonization, ventilator-associated tracheobronchitis (VAT), and/or ventilator-associated pneumonia (VAP). Previous studies report that 10 to 30 % of patients with V...
journal_title:Critical care (London, England)
pub_type: 杂志文章
doi:10.1186/s13054-016-1472-5
更新日期:2016-09-29 00:00:00
abstract::Acute respiratory distress syndrome (ARDS) has a substantial mortality rate and annually affects more than 140,000 people in the USA alone. Standard management includes lung protective ventilation but this impairs carbon dioxide clearance and may lead to right heart dysfunction or increased intracranial pressure. Extr...
journal_title:Critical care (London, England)
pub_type: 杂志文章,评审
doi:10.1186/cc11356
更新日期:2012-09-21 00:00:00
abstract::Cardiogenic shock is a lethal condition. Physicians are searching for hemodynamic markers which could help risk-stratification of patients in this picture. Torgersen and coworkers present an hourly time integral of the cardiac power index and cardiac index drops to predict outcomes in the setting of cardiogenic shock....
journal_title:Critical care (London, England)
pub_type: 评论,杂志文章
doi:10.1186/cc8176
更新日期:2009-01-01 00:00:00
abstract:INTRODUCTION:Inflammation and coagulation are closely linked, and both can be triggered by endotoxin. Thrombelastometry and impedance aggregometry are of diagnostic and predictive value in critically ill patients. In this observational study we investigated the correlation of endotoxin activity with thrombelasometric a...
journal_title:Critical care (London, England)
pub_type: 杂志文章
doi:10.1186/cc12892
更新日期:2013-09-11 00:00:00
abstract::Extracorporeal membrane oxygenation (ECMO) is a technique for providing life support, in case the natural lungs are failing and are not able to maintain a sufficient oxygenation of the body's organ systems. ECMO technique was an adaptation of conventional cardiopulmonary bypass techniques and introduced into treatment...
journal_title:Critical care (London, England)
pub_type: 杂志文章,评审
doi:10.1186/cc689
更新日期:2000-01-01 00:00:00
abstract::In this article we review recent advances made in the pathophysiology, diagnosis, and treatment of inhalation injury. Historically, the diagnosis of inhalation injury has relied on nonspecific clinical exam findings and bronchoscopic evidence. The development of a grading system and the use of modalities such as chest...
journal_title:Critical care (London, England)
pub_type: 杂志文章,评审
doi:10.1186/s13054-015-1077-4
更新日期:2015-10-28 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::In an effort to reduce the complications related to invasive ventilation, the use of noninvasive ventilation (NIV) has increased over the last years in patients with acute respiratory failure. However, failure rates for NIV remain high in specific patient categories. Several studies have identified factors that contri...
journal_title:Critical care (London, England)
pub_type: 杂志文章,评审
doi:10.1186/cc13141
更新日期:2013-12-05 00:00:00
abstract:INTRODUCTION:Continuous renal replacement therapy (CRRT) has been widely used in critically ill acute kidney injury (AKI) patients. Moreover, some centers operate a specialized CRRT team (SCT) composed of physicians and nurses, but few studies have yet determined the superiority of SCT control. METHODS:A total of 334 ...
journal_title:Critical care (London, England)
pub_type: 杂志文章
doi:10.1186/s13054-014-0454-8
更新日期:2014-08-13 00:00:00