Abstract:
OBJECTIVE:Intracerebral hemorrhage (ICH) is associated with a high mortality. The present study sought to determine the incidence of spontaneous ICH in an intensive care unit (ICU) and associated factors. DESIGN:A 6 year retrospective study. SETTING:A general ICU in a university hospital. PATIENTS:All ICU patients developing ICH were included in the study. All trauma and neurosurgical patients were excluded, as well as patients who were admitted to the ICU because of ICH. MEASUREMENTS AND RESULTS:During the study period 3032 patients were hospitalized in the ICU, and 834 were excluded. The remaining 2198 patients comprised the study population. Computed tomography of the head was performed in a total of 227 patients, and the 9 patients found to have new onset ICH comprise the group of interest. None of these patients were hypertensive. Seven of the patients had either a primary hematologic malignancy or bone marrow transplantation. Eight had thrombocytopenia of <100x10(9)/l (median 10x10(9)/l, range 3-150x10(9)/l), and in 6 it preceded ICH by 5 days or more. Only in one patient were both PTT and PT prolonged. All were mechanically ventilated with high peak inspiratory pressure (PIP) (median 37 cm H2O, range 20-43 cm H2O). Arterial carbon dioxide tension (PaCO2) was considerably elevated (median 65 mm Hg, range 41-87 mm Hg). All of the patients had impaired renal and hepatic function (urea: median 14 mmol/l, range 9.9-52 mmol/l; bilirubin: median 94 micromol/l, range 20-360 micromol/l), and five had septicemia. Eight of the patients bled to other sites before they developed ICH. All patients died shortly after the diagnosis of ICH. CONCLUSIONS:Spontaneous nonhypertensive ICH is a rare, fatal event in the ICU. Associated factors include thrombocytopenia, the need for mechanical ventilation, elevated PIP and PaCO2, sepsis, and impaired hepatic and renal function.
journal_name
Intensive Care Medjournal_title
Intensive care medicineauthors
Oppenheim-Eden A,Glantz L,Eidelman LA,Sprung CLdoi
10.1007/s001340050788keywords:
subject
Has Abstractpub_date
1999-01-01 00:00:00pages
63-7issue
1eissn
0342-4642issn
1432-1238journal_volume
25pub_type
杂志文章abstract:OBJECTIVE:The aim of this study was to identify risk factors and to describe epidemiological patterns for early-(EOB) and late-onset bacteremias (LOB) after trauma. DESIGN:A prospective study conducted on 141 consecutive trauma patients. SETTING:A general intensive care unit (ICU) of a university hospital. PATIENTS:...
journal_title:Intensive care medicine
pub_type: 杂志文章
doi:10.1007/BF01709514
更新日期:1996-08-01 00:00:00
abstract::The purpose of this study was noninvasive assessment of respiratory compliance and resistance in mechanically ventilated patients with acute respiratory failure (ARF). To this end, flow, change in lung volume, and airway pressure were measured at the proximal tip of the endotracheal tubes in twenty nine critically ill...
journal_title:Intensive care medicine
pub_type: 杂志文章
doi:10.1007/BF00263528
更新日期:1988-01-01 00:00:00
abstract::As part of a nationwide evaluation of intensive care, we examined patient- and hospital-related factors which could influence the patterns of utilization of arterial cannulae and central venous and pulmonary artery catheters. We also studied the possible impact of these interventions on the short-term outcome among 14...
journal_title:Intensive care medicine
pub_type: 杂志文章
doi:10.1007/BF01713935
更新日期:1991-01-01 00:00:00
abstract::We studied the effect of thiopental loading during resuscitation of 53 patients following cardiopulmonary arrest and compared the outcome with that found in 54 patients treated conventionally in the 30 previous months. Thiopental therapy (10 mg/kg i.v.) was begun within 30 min of the arrest once hemodynamic stability ...
journal_title:Intensive care medicine
pub_type: 临床试验,杂志文章
doi:10.1007/BF00265112
更新日期:1987-01-01 00:00:00
abstract::A 17-year-old patient with Shone's disease had to be readmitted to the hospital 3 months after implantation of an artificial aortic valve because of extreme mitral insufficiency with consecutive pulmonary edema and hepatic dysfunction. He had been orally anticoagulated and presented with a high international normalize...
journal_title:Intensive care medicine
pub_type: 杂志文章
doi:10.1007/s001340051023
更新日期:1999-10-01 00:00:00
abstract:OBJECTIVE:To clarify the effects of hypercapnia (increased PaCO2) on gastric mucosal oxygenation during anaesthesia in dogs. DESIGN:Prospective, controlled animal study. SETTING:Experimental research laboratory of an university hospital. SUBJECTS:Six chronically instrumented dogs. INTERVENTIONS:Dogs were anaestheti...
journal_title:Intensive care medicine
pub_type: 杂志文章
doi:10.1007/s00134-008-1183-8
更新日期:2008-10-01 00:00:00
abstract:OBJECTIVE:The purpose of the study was do describe the architecture of accretions occurring on the tips of central venous catheters (CVC). DESIGN:A conservative procedure was used followed by two different techniques of electron microscopy. SETTING AND PATIENTS:the study included 19 catheters which have been used on ...
journal_title:Intensive care medicine
pub_type: 杂志文章
doi:10.1007/BF01708582
更新日期:1992-01-01 00:00:00
abstract:OBJECTIVE:The pressure-volume (P/V) curve has been proposed as a tool to adjust the ventilatory settings in cases of acute respiratory distress syndrome (ARDS). The aim of this study was to test the influence of P/V tracing methodology on the presence and value of the upper inflection point (UIP). METHODS:In 13 medica...
journal_title:Intensive care medicine
pub_type: 杂志文章
doi:10.1007/s00134-002-1293-7
更新日期:2002-07-01 00:00:00
abstract::A 29-year-old woman suffered a cardiac arrest, due to profound hyperkalaemia, caused by the use of a potassium-containing salt substitute. She was resuscitated, but post-hypoxic brain damage occurred. Some of the sparse literature is reviewed. ...
journal_title:Intensive care medicine
pub_type: 杂志文章,评审
doi:10.1007/BF00255641
更新日期:1988-01-01 00:00:00
abstract::A total of 6178 persons with out-of-hospital (70%) and in hospital (30%) cardiac arrests from the first of January 1982 until the end of 1989 were reviewed retrospectively with respect to 4 variables, contributing to a score for specific prediction of poor prognosis (cut-off point: greater than 3 points). These includ...
journal_title:Intensive care medicine
pub_type: 杂志文章
doi:10.1007/BF01706419
更新日期:1992-01-01 00:00:00
abstract:PURPOSE:To provide evidence-based guidelines for early enteral nutrition (EEN) during critical illness. METHODS:We aimed to compare EEN vs. early parenteral nutrition (PN) and vs. delayed EN. We defined "early" EN as EN started within 48 h independent of type or amount. We listed, a priori, conditions in which EN is o...
journal_title:Intensive care medicine
pub_type: 杂志文章,meta分析,实务指引,评审
doi:10.1007/s00134-016-4665-0
更新日期:2017-03-01 00:00:00
abstract:BACKGROUND:Invasive candidiasis and candidemia are frequently encountered in the nosocomial setting particularly in the intensive care unit (ICU). OBJECTIVE AND METHODS:To review the current management of invasive candidiasis and candidemia in non-neutropenic adult ICU patients based on a review of the literature and ...
journal_title:Intensive care medicine
pub_type: 杂志文章,评审
doi:10.1007/s00134-008-1339-6
更新日期:2009-02-01 00:00:00
abstract:OBJECTIVE:To implement delirium monitoring, test reliability, and monitor compliance of performing the Confusion Assessment Method for the Intensive Care Unit (CAM-ICU) in trauma patients. DESIGN AND SETTING:Prospective, observational study in a level 1 trauma unit of a tertiary care, university-based medical center. ...
journal_title:Intensive care medicine
pub_type: 杂志文章,随机对照试验
doi:10.1007/s00134-008-1031-x
更新日期:2008-07-01 00:00:00
abstract::We investigated the levels of auto-PEEP and dynamic hyperinflation during high frequency jet ventilation (HFJV) and controlled mechanical ventilation (CMV) in six patients with chronic obstructive pulmonary disease within the first 36 h of acute exacerbation. The comparative evaluation was performed at similar conditi...
journal_title:Intensive care medicine
pub_type: 杂志文章
doi:10.1007/BF02575298
更新日期:1990-01-01 00:00:00
abstract::Placement of a Swan-Ganz catheter can cause many complications. This case report presents a new complication of Swan-Ganz catheter insertion--placement of the Swan-Ganz catheter tip in the coronary sinus. ...
journal_title:Intensive care medicine
pub_type: 杂志文章
doi:10.1007/BF00254707
更新日期:1987-01-01 00:00:00
abstract:PURPOSE:Gastrointestinal motility can be impaired by serious illness or medications, compromising enteral feeding in critical care patients. We compared small bowel transit time and morphology in neurosurgical critical care (ICU) patients with those in healthy subjects. METHODS:We evaluated small intestinal transit ti...
journal_title:Intensive care medicine
pub_type: 杂志文章
doi:10.1007/s00134-009-1415-6
更新日期:2009-06-01 00:00:00
abstract:OBJECTIVE:There is considerable heterogeneity among randomized trials comparing high-frequency ventilation (HFV) with conventional mechanical ventilation (CMV) in premature neonates with respiratory distress syndrome. We investigated what factors explained differences in outcome among these trials. DESIGN:Meta-regress...
journal_title:Intensive care medicine
pub_type: 杂志文章,meta分析
doi:10.1007/s00134-007-0545-y
更新日期:2007-04-01 00:00:00
abstract::Malaria remains today one of the major health problems in the tropics with increased morbidity and mortality. The most serious complications are caused by Plasmodium falciparum, which, in contrast to the benign malarias, may progress to a life-threatening multi-system disease. Our case concerns a young woman in the 14...
journal_title:Intensive care medicine
pub_type: 杂志文章
doi:10.1007/s001340050939
更新日期:1999-07-01 00:00:00
abstract:OBJECTIVE:Oxygen consumption (VO2) obtained from respiratory gases by indirect calorimetry (VO2,IC) with a metabolic monitor integrated in a ventilator were to be compared to VO2 obtained by the Fick principle (VO2,Fick) in septic patients following an increase in oxygen delivery (DO2) induced by positive inotropic sup...
journal_title:Intensive care medicine
pub_type: 临床试验,杂志文章
doi:10.1007/s001340000635
更新日期:2000-12-01 00:00:00
abstract::We report a case of hyperinflation induced isorythmic atrio-ventricular dissociation with circulatory failure in a patient with chronic obstructive pulmonary disease. The arrythmia was successfully treated by applying "pressure support ventilation" (PSV: 20 cmH2O) which, by decreasing the respiratory rate and increasi...
journal_title:Intensive care medicine
pub_type: 杂志文章
doi:10.1007/BF00263868
更新日期:1989-01-01 00:00:00
abstract:OBJECTIVE:To define the mechanisms of the stable and prolonged post-operative plasma volume expansion observed with Hydroxyethyl Starches (HES) and to determine whether a partial intravascular hydrolysis of large molecules contribute to reinforce the colloid-osmotic effect. DESIGN:Prospective, pharmacologic study usin...
journal_title:Intensive care medicine
pub_type: 临床试验,杂志文章
doi:10.1007/BF01700163
更新日期:1995-07-01 00:00:00
abstract:OBJECTIVE:The role of haemofiltration as an adjunctive treatment of sepsis remains a contentious issue. To address the role of dose and to explore the biological effects of haemofiltration we compared the effects of standard and high-volume haemofiltration (HVHF) in a peritonitis-induced model of porcine septic shock. ...
journal_title:Intensive care medicine
pub_type: 杂志文章
doi:10.1007/s00134-008-1318-y
更新日期:2009-02-01 00:00:00
abstract:PURPOSE:Ventricular-arterial (V-A) decoupling decreases myocardial efficiency and is exacerbated by tachycardia that increases static arterial elastance (Ea). We thus investigated the effects of heart rate (HR) reduction on Ea in septic shock patients using the beta-blocker esmolol. We hypothesized that esmolol improve...
journal_title:Intensive care medicine
pub_type: 杂志文章
doi:10.1007/s00134-016-4351-2
更新日期:2016-10-01 00:00:00
abstract:BACKGROUND:Current medical knowledge lacks specific information regarding creatine kinase (CK) elevation in influenza A pH1N1 (2009) infection. OBJECTIVES:Primary endpoints were correlation between CK at intensive care unit (ICU) admission and ICU mortality. Secondary endpoints were ICU length of stay (LOS), mechanica...
journal_title:Intensive care medicine
pub_type: 杂志文章
doi:10.1007/s00134-012-2565-5
更新日期:2012-07-01 00:00:00
abstract:OBJECTIVES:To determine the effects of an intravenous bolus dose of a vasopressin analogue, terlipressin (1 mg), on systemic haemodynamic parameters and gastric mucosal perfusion (GMP) in patients with catecholamine-treated septic shock using a gastric tonometry and laser-Doppler flowmetry technique. DESIGN:Prospectiv...
journal_title:Intensive care medicine
pub_type: 临床试验,杂志文章
doi:10.1007/s00134-003-2094-3
更新日期:2004-04-01 00:00:00
abstract:OBJECTIVE:To assess procalcitonin (PCT) and C-reactive protein (CRP) plasma concentrations and clearance in nonseptic end-stage renal failure patients undergoing their first three hemodialysis sessions. DESIGN AND SETTING:Prospective observational consecutive clinical study at a university hospital. PATIENTS:The stud...
journal_title:Intensive care medicine
pub_type: 杂志文章
doi:10.1007/s00134-003-1664-8
更新日期:2003-04-01 00:00:00
abstract::Production of beta-lactamases is the most important means of bacterial resistance to beta-lactam antibiotics. The traditional, plasmid-mediated beta-lactamases were initially confined to Enterobacteriaceae but have now spread to other genera and species including Pseudomonas aeruginosa, Haemophilus influenzae, and Nei...
journal_title:Intensive care medicine
pub_type: 杂志文章,评审
doi:10.1007/BF01745244
更新日期:1994-07-01 00:00:00
abstract:OBJECTIVE:To investigate the accuracy of lung ultrasonography (LUS) in the quantification of lung water in critically ill patients by using quantitative computed tomography (CT) as the gold standard for the determination of lung weight. METHODS:Twenty consecutive patients admitted to an intensive care unit who underwe...
journal_title:Intensive care medicine
pub_type: 杂志文章
doi:10.1007/s00134-012-2694-x
更新日期:2013-01-01 00:00:00
abstract:PURPOSE:Hypoxia-ischemia (HI), as a major cause of fetal brain damage, has long-lasting neurological implications. Therefore, therapeutic interventions that attenuate the neuropathological outcome of HI while also improving the neurofunctional outcome are of paramount clinical importance. The aim of this study was to i...
journal_title:Intensive care medicine
pub_type: 杂志文章
doi:10.1007/s00134-010-1913-6
更新日期:2010-09-01 00:00:00
abstract:OBJECTIVE:Pressure measurements at the level of the right atrium are commonly used in clinical anesthesia and the intensive care unit (ICU). There is growing interest in the use of peripheral venous sites for estimating central venous pressure (CVP). This study compared bias, precision, and covariance in simultaneous m...
journal_title:Intensive care medicine
pub_type: 临床试验,杂志文章
doi:10.1007/s00134-003-2052-0
更新日期:2004-04-01 00:00:00