Abstract:
INTRODUCTION:We compared the effects of mechanical ventilation with a lower tidal volume (V(T)) strategy versus those of greater V(T) in patients with or without acute lung injury (ALI)/acute respiratory distress syndrome (ARDS) on the use of opioids and sedatives. METHODS:This is a secondary analysis of a previously conducted before/after intervention study, which consisting of feedback and education on lung protective mechanical ventilation using lower V(T). We evaluated the effects of this intervention on medication prescriptions from days 0 to 28 after admission to our multidisciplinary intensive care unit. RESULTS:Medication prescriptions in 23 patients before and 38 patients after intervention were studied. Of these patients, 10 (44%) and 15 (40%) suffered from ALI/ARDS. The V(T) of ALI/ARDS patients declined from 9.7 ml/kg predicted body weight (PBW) before to 7.8 ml/kg PBW after the intervention (P = 0.007). For patients who did not have ALI/ARDS there was a trend toward a decline from 10.2 ml/kg PBW to 8.6 ml/kg PBW (P = 0.073). Arterial carbon dioxide tension was significantly greater after the intervention in ALI/ARDS patients. Neither the proportion of patients receiving opioids or sedatives, or prescriptions at individual time points differed between pre-intervention and post-intervention. Also, there were no statistically significant differences in doses of sedatives and opioids. Findings were no different between non-ALI/ARDS patients and ALI/ARDS patients. CONCLUSION:Concerns regarding sedation requirements with use of lower V(T) are unfounded and should not preclude its use in patients with ALI/ARDS.
journal_name
Crit Carejournal_title
Critical care (London, England)authors
Wolthuis EK,Veelo DP,Choi G,Determann RM,Korevaar JC,Spronk PE,Kuiper MA,Schultz MJdoi
10.1186/cc5969subject
Has Abstractpub_date
2007-01-01 00:00:00pages
R77issue
4eissn
1364-8535issn
1466-609Xpii
cc5969journal_volume
11pub_type
杂志文章相关文献
CRITICAL CARE文献大全abstract::With imprecise definitions, inexact measurement tools, and flawed study execution, our clinical science often lags behind bedside experience and simply documents what appear to be the apparent faults or validity of ongoing practices. These impressions are later confirmed, modified, or overturned by the results of the ...
journal_title:Critical care (London, England)
pub_type: 杂志文章,评审
doi:10.1186/s13054-017-1904-x
更新日期:2017-12-28 00:00:00
abstract:INTRODUCTION:Serum concentrations of adhesion molecules may be connected to the pathogenesis of secondary brain injury after spontaneous intracerebral hemorrhage (ICH). This study posits the hypothesis that levels of adhesion molecules substantially increase after ICH and are decreased thereafter, and that they can pre...
journal_title:Critical care (London, England)
pub_type: 杂志文章
doi:10.1186/cc10568
更新日期:2011-01-01 00:00:00
abstract:INTRODUCTION:The use of human recombinant activated protein C (rhAPC) for the treatment of severe sepsis remains controversial despite multiple reported trials. The efficacy of rhAPC remains a matter of dispute. We hypothesized that patients with septic shock who were treated with rhAPC had an improved in-hospital mort...
journal_title:Critical care (London, England)
pub_type: 杂志文章
doi:10.1186/cc10089
更新日期:2011-01-01 00:00:00
abstract:INTRODUCTION:To systematically review studies evaluating the performance of Sequential Organ Failure Assessment (SOFA)-based models for predicting mortality in patients in the intensive care unit (ICU). METHODS:Medline, EMBASE and other databases were searched for English-language articles with the major objective of ...
journal_title:Critical care (London, England)
pub_type: 杂志文章,评审
doi:10.1186/cc7160
更新日期:2008-01-01 00:00:00
abstract::In a group of postoperative patients, Taniguchi and coworkers compared the effect of a computerized system for weaning against 'manual care'. The computerized system involved automatic adjustments to the level of pressure support to achieve a target respiratory rate. Manual care involved adjustments to the level of pr...
journal_title:Critical care (London, England)
pub_type: 评论,杂志文章
doi:10.1186/cc7746
更新日期:2009-01-01 00:00:00
abstract::Emergency departments (EDs) face several challenges in maintaining consistent quality care in the face of steadily increasing public demand. Improvements in the survival rate of critically ill patients in the ED are directly related to the advancement of early recognition and treatment. Frequent episodes of overcrowdi...
journal_title:Critical care (London, England)
pub_type: 杂志文章
doi:10.1186/s13054-014-0692-9
更新日期:2014-12-08 00:00:00
abstract::Sepsis is characterized by a dysregulated immune response to infection leading to life-threatening organ dysfunction. Sepsis-induced liver injury is recognized as a powerful independent predictor of mortality in the intensive care unit. During systemic infections, the liver regulates immune defenses via bacterial clea...
journal_title:Critical care (London, England)
pub_type: 杂志文章,评审
doi:10.1186/s13054-020-03327-1
更新日期:2020-10-19 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:INTRODUCTION:In critically ill patients, delirium is a serious and frequent disorder that is associated with a prolonged intensive care and hospital stay and an increased morbidity and mortality. Without the use of a delirium screening instrument, delirium is often missed by ICU nurses and physicians. The effects of im...
journal_title:Critical care (London, England)
pub_type: 杂志文章
doi:10.1186/cc7991
更新日期:2009-01-01 00:00:00
abstract:BACKGROUND:Hemophagocytic lymphohistiocytosis (HLH) is a rare though often fatal hyperinflammatory syndrome mimicking sepsis in the critically ill. Diagnosis relies on the HLH-2004 criteria and HScore, both of which have been developed in pediatric or adult non-critically ill patients, respectively. Therefore, we aimed...
journal_title:Critical care (London, England)
pub_type: 杂志文章
doi:10.1186/s13054-020-02941-3
更新日期:2020-05-24 00:00:00
abstract:: ...
journal_title:Critical care (London, England)
pub_type: 评论,社论
doi:10.1186/s13054-019-2325-9
更新日期:2019-02-13 00:00:00
abstract::Two international multicentre randomised controlled trials of drotrecogin alfa (activated) (DrotAA), the Recombinant Human Activated Protein C Worldwide Evaluation of Severe Sepsis (PROWESS) and Administration of Drotrecogin Alfa (Activated) in Early Stage Severe Sepsis (ADDRESS) trials, have produced inconsistent res...
journal_title:Critical care (London, England)
pub_type: 杂志文章,评审
doi:10.1186/cc4947
更新日期:2006-01-01 00:00:00
abstract::The Surviving Sepsis Campaign guidelines for the management of severe sepsis and septic shock recommend that the initial hemodynamic resuscitation be done according to the protocol used by Rivers and colleagues in their well-known early goal-directed therapy (EGDT) study. However, it may well be that their patients we...
journal_title:Critical care (London, England)
pub_type: 杂志文章,评审
doi:10.1186/cc6979
更新日期:2008-01-01 00:00:00
abstract::Tight glycemic control has engendered large numbers of investigations, with conflicting results. The world has largely embraced intensive insulin as a practice, but applies this therapy with great variability in the manner of glucose control and measurement. The present commentary reviews what we actually know with ce...
journal_title:Critical care (London, England)
pub_type: 评论,杂志文章,评审
doi:10.1186/cc9236
更新日期:2010-01-01 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::Vasoplegic syndrome is a common occurrence following cardiothoracic surgery and is characterized as a high-output shock state with poor systemic vascular resistance. The pathophysiology is complex and includes dysregulation of vasodilatory and vasoconstrictive properties of smooth vascular muscle cells. Specific bypas...
journal_title:Critical care (London, England)
pub_type: 杂志文章,评审
doi:10.1186/s13054-020-2743-8
更新日期:2020-02-04 00:00:00
abstract:INTRODUCTION:The objective of this study was to identify and characterize the most highly cited clinical research articles published on sepsis. METHODS:A comprehensive list of citation classics in sepsis was generated by searching the database of Web of Science-Expanded (1970 to present) using keywords 'sepsis' or 'se...
journal_title:Critical care (London, England)
pub_type: 杂志文章
doi:10.1186/cc11401
更新日期:2012-06-26 00:00:00
abstract:BACKGROUND:Middle East respiratory syndrome coronavirus infection is associated with high mortality rates but limited clinical data have been reported. We describe the clinical features and outcomes of patients admitted to an intensive care unit (ICU) with Middle East respiratory syndrome coronavirus (MERS-CoV) infecti...
journal_title:Critical care (London, England)
pub_type: 杂志文章
doi:10.1186/s13054-016-1303-8
更新日期:2016-05-07 00:00:00
abstract::The rate of oxygen consumption by certain tissues is impaired when mice or rats are injected with lipopolysaccharide. A similar change in the rate of oxygen consumption is observed when Caco-2 human enterocyte-like cells are incubated in vitro with cytomix, a cocktail of cytokines containing tumor necrosis factor, IL-...
journal_title:Critical care (London, England)
pub_type: 杂志文章,评审
doi:10.1186/cc1824
更新日期:2002-12-01 00:00:00
abstract::Great variability exists in data collection and coding of variables in studies on traumatic brain injury (TBI). This confounds comparison of results and analysis of data across studies. The difficulties in performing a meta-analysis of individual patient data were recently illustrated in the IMPACT project (Internatio...
journal_title:Critical care (London, England)
pub_type: 杂志文章
doi:10.1186/cc8163
更新日期:2009-01-01 00:00:00
abstract:BACKGROUND:Critical illness following head injury is associated with a hypermetabolic state but there are insufficient epidemiological data describing acute nutrition delivery to this group of patients. Furthermore, there is little information describing relationships between nutrition and clinical outcomes in this pop...
journal_title:Critical care (London, England)
pub_type: 杂志文章
doi:10.1186/s13054-015-1177-1
更新日期:2016-01-07 00:00:00
abstract::This article is one of ten reviews selected from the Annual Update in Intensive Care and Emergency medicine 2017. Other selected articles can be found online at http://ccforum.com/series/annualupdate2017 . Further information about the Annual Update in Intensive Care and Emergency Medicine is available from http://www...
journal_title:Critical care (London, England)
pub_type: 杂志文章,评审
doi:10.1186/s13054-017-1642-0
更新日期:2017-03-21 00:00:00
abstract:INTRODUCTION:Intravenous (IV) voriconazole is not recommended in patients with creatinine clearance <50 ml/min to avoid potentially toxic accumulation of sulfobutylether-β-cyclodextrin (SBECD). The purpose of this study was to evaluate the pharmacokinetics of SBECD, voriconazole, and voriconazole N-oxide in critically ...
journal_title:Critical care (London, England)
pub_type: 杂志文章
doi:10.1186/s13054-015-0753-8
更新日期:2015-02-03 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::Severe critical illness is often complicated by intensive care unit-acquired weakness (ICU-AW), which is associated with increased ICU and post-ICU mortality, delayed weaning from mechanical ventilation and long-term functional disability. Several mechanisms have been implicated in the pathophysiology of ICU-AW, but m...
journal_title:Critical care (London, England)
pub_type: 杂志文章
doi:10.1186/s13054-016-1308-3
更新日期:2016-05-19 00:00:00
abstract::Barriers to the use of selective digestive decontamination include concerns about emergence of resistant organisms, over-estimation of current performance in preventing ventilator-associated pneumonia (VAP), alternative methods of preventing VAP, and misunderstanding of mechanisms of action. A definitive cluster-rando...
journal_title:Critical care (London, England)
pub_type: 杂志文章
doi:10.1186/cc13165
更新日期:2013-12-19 00:00:00
abstract:INTRODUCTION:Management of daily activities in ICUs is challenging. ICU shift leaders, charge nurses and intensivists have to make several immediate ad hoc decisions to enable the fluent flow of ICU activities. Even though the management of ICU activities is quite well delineated by international consensus guidelines, ...
journal_title:Critical care (London, England)
pub_type: 杂志文章
doi:10.1186/cc10341
更新日期:2011-08-08 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: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:INTRODUCTION:The gut is often considered as the motor of critical illness through bacterial translocation, which amplifies the inflammatory response and alters the immune status. However, systemic bacterial translocation was rarely proven and endotoxin measurement only reflects translocation of Gram-negative-derived pr...
journal_title:Critical care (London, England)
pub_type: 杂志文章
doi:10.1186/cc7980
更新日期:2009-01-01 00:00:00