Abstract:
OBJECTIVE:(1) To describe the pattern of intracranial pressure (ICP) and cerebral perfusion pressure (CPP) in a group of severe head-injured patients, (2) to quantify complications of ICP monitoring, and (3) to describe a management protocol and its results. DESIGN:Prospective observational study. SETTING:General intensive care unit in a teaching hospital. PATIENTS:138 comatose patients, selected according to the following criteria: age > 16 years, coma [Glasgow Coma Scale (GCS) < or = 8] with at least one pupil reactive after resuscitation, digital recording of intracranial and arterial pressure, and jugular saturation measurements. MEASUREMENTS AND RESULTS:Median GCS was 5, and 62 patients had significant extracranial injuries; 71 had intracranial hematomas, which were urgently evacuated. Mean ICP was 20.5 mmHg (SD 8.34), mean CPP was 71.86 mmHg (SD 11.22); cerebral extraction of oxygen averaged 29 %. Medical therapy was used to control ICP in 130 cases; 93 patients required hyperventilation. Vasopressors were infused in 16 cases; in 14 cases a barbiturate infusion was started. In 6 patients all pharmacological treatments failed and surgical decompression was done. The only complication of ICP monitoring was meningitis in 3 patients. Outcome at 6 months was a good recovery and moderate disability for 82 patients (59.4%), severe disability and vegetative status for 37 (26.8%), and 19 patients died (13.7%). The severity of intracranial hypertension was related to poorer results at 6 months. CONCLUSIONS:Intracranial hypertension is very frequent in severe head injury but can be reasonably well controlled by combined surgical and medical therapy.
journal_name
Intensive Care Medjournal_title
Intensive care medicineauthors
Stocchetti N,Rossi S,Buzzi F,Mattioli C,Paparella A,Colombo Adoi
10.1007/s001340050860keywords:
subject
Has Abstractpub_date
1999-04-01 00:00:00pages
371-6issue
4eissn
0342-4642issn
1432-1238journal_volume
25pub_type
杂志文章abstract:OBJECTIVE:To derive recommendations for the dosing of commonly used medications in the morbidly obese patient in the ICU. DATA SOURCES:Articles were obtained through computerized searches involving MEDLINE. The bibliographies of retrieved publications and textbooks were reviewed for additional references. STUDY SELEC...
journal_title:Intensive care medicine
pub_type: 杂志文章,评审
doi:10.1007/s00134-003-2059-6
更新日期:2004-01-01 00:00:00
abstract:PURPOSE:To determine incidence, risk factors and outcome of tracheal ischemic lesions related to intubation. METHODS:Planned post hoc analysis using patients from a previous randomized controlled study. Fiberoptic tracheoscopy was performed during the 24 h following extubation. In patients with >2 ischemic lesions, ul...
journal_title:Intensive care medicine
pub_type: 杂志文章
doi:10.1007/s00134-012-2750-6
更新日期:2013-04-01 00:00:00
abstract::Nosocomial pneumonia continues to represent a significant cause of morbidity and mortality in hospitalized patients. Bacteria are responsible for greater than 90% of the pneumonias, the most common isolates being aerobic Gram-negative bacilli and S. aureus. Cornerstones of treatment are intravenous antibiotics and sup...
journal_title:Intensive care medicine
pub_type: 杂志文章,评审
doi:10.1007/BF01752974
更新日期:1992-01-01 00:00:00
abstract::The article "Accumulation of hydroxyethyl starch in human and animal tissues: a systematic review", written by Christian J. Wiedermann and Michael Joannidis, was originally published Online First without Open Access. ...
journal_title:Intensive care medicine
pub_type: 已发布勘误
doi:10.1007/s00134-020-06269-y
更新日期:2020-10-14 00:00:00
abstract:OBJECTIVE:A case-control comparison of Doppler guidance on the success rate of central venous cannulation in patients with normal or reduced intracranial compliance. DESIGN:A single operator performed central venous access procedures with continuous wave Doppler guidance. It was used on patients on a ventilator. The p...
journal_title:Intensive care medicine
pub_type: 临床试验,杂志文章
doi:10.1007/s00134-003-1862-4
更新日期:2003-09-01 00:00:00
abstract:OBJECTIVE:To investigate the hemodynamic and metabolic effects of the peroxisome proliferator-activated receptor (PPAR)-gamma ligand and nuclear-factor (NF)-kappa B inhibitor 15-deoxy-Delta12,14-prostaglandin-J2 (15d-PGJ2) during long-term, hyperdynamic porcine endotoxemia. DESIGN:Prospective, randomized, controlled e...
journal_title:Intensive care medicine
pub_type: 杂志文章
doi:10.1007/s00134-006-0107-8
更新日期:2006-05-01 00:00:00
abstract:BACKGROUND:After resuscitation, asphyxiated neonates often develop poor cardiac function with hypotension, pulmonary hypertension and multiorgan ischemia. In a swine model of neonatal hypoxia-reoxygenation, effects of epinephrine, dobutamine and milrinone on systemic, pulmonary and regional hemodynamics and oxygen tran...
journal_title:Intensive care medicine
pub_type: 杂志文章
doi:10.1007/s00134-010-1820-x
更新日期:2010-06-01 00:00:00
abstract:OBJECTIVE:To evaluate the extent to which respiratory changes in inferior vena cava (IVC) diameter can be used to predict fluid responsiveness. DESIGN:Prospective clinical study. SETTING:Hospital intensive care unit. PATIENTS:Twenty-three patients with acute circulatory failure related to sepsis and mechanically ven...
journal_title:Intensive care medicine
pub_type: 临床试验,杂志文章
doi:10.1007/s00134-004-2259-8
更新日期:2004-09-01 00:00:00
abstract::The use of induced hypertension in head injury patients is controversial. We present the case of a 19-year-old man admitted with severe head trauma after a road accident and describe the beneficial effects that increasing arterial blood pressure had on the cerebral perfusion pressure, cerebral blood flow and jugular b...
journal_title:Intensive care medicine
pub_type: 杂志文章,评审
doi:10.1007/s001340050997
更新日期:1999-09-01 00:00:00
abstract::Although colitis is often seen in critically all patients who have received multiple broad-spectrum antibiotics, there are no reports describing severe sepsis as a result of Clostridium difficile infection. We describe three cases of severe sepsis with local intestinal Clostridium difficile infection as the only ident...
journal_title:Intensive care medicine
pub_type: 杂志文章
doi:10.1007/BF02044130
更新日期:1996-09-01 00:00:00
abstract:OBJECTIVE:To assess the safety and efficacy of sustained inflations (SI) as lung recruitment maneuvers (RMs) in ventilated pediatric intensive care unit (PICU) patients. DESIGN:Observational, prospective data collection. SETTING:Tertiary-care PICU. PATIENTS AND PARTICIPANTS:Thirty-two consecutive ventilated pediatri...
journal_title:Intensive care medicine
pub_type: 杂志文章
doi:10.1007/s00134-007-0764-2
更新日期:2007-10-01 00:00:00
abstract:PURPOSE:Chronic pulmonary hypertension (PH) therapy is poorly investigated in intensive care. Our aim was to evaluate haemodynamic and neuroendocrine effects of the dual endothelin-1 (ET-1) blocker tezosentan in monocrotaline (MCT)-induced PH. METHODS:Male Wistar rats (180-200 g, n = 194) randomly received 60 mg kg(-1...
journal_title:Intensive care medicine
pub_type: 杂志文章
doi:10.1007/s00134-012-2484-5
更新日期:2012-06-01 00:00:00
abstract::Status epilepticus is one of the most frequent neurological emergencies in the intensive care unit. Standard treatment includes intravenous barbiturates, benzodiazepines and phenytoin. However, drug coma is sometimes necessary to control refractory status epilepticus. We report such a case, successfully treated by int...
journal_title:Intensive care medicine
pub_type: 杂志文章
doi:10.1007/BF01707672
更新日期:1994-01-01 00:00:00
abstract:: ...
journal_title:Intensive care medicine
pub_type: 评论,社论
doi:10.1007/s00134-018-5399-y
更新日期:2018-11-01 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:OBJECTIVE:To evaluate the perceived health and cognitive status in survivors of chronic obstructive pulmonary disease (COPD) exacerbations requiring mechanical ventilation. DESIGN AND SETTING:Prospective controlled cohort study in a respiratory intermediate intensive care unit. PATIENTS:Sixty-three COPD patients at t...
journal_title:Intensive care medicine
pub_type: 临床试验,杂志文章
doi:10.1007/s00134-001-1165-6
更新日期:2002-02-01 00:00:00
abstract:PURPOSE:Type 1 angiotensin II (AT1) receptor antagonists have anti-inflammatory effects in vitro and in patients. The purpose of this study was to investigate whether losartan (LOS), an AT1 receptor antagonist, reduces lung damage by inhibiting the induction of high mobility group box 1 (HMGB1) protein and cytokines by...
journal_title:Intensive care medicine
pub_type: 杂志文章
doi:10.1007/s00134-009-1545-x
更新日期:2009-08-01 00:00:00
abstract:OBJECTIVE:To determine the cell content and purity of Ficoll-separated peripheral blood mononuclear cells and granulocyte isolates in sepsis patients compared to healthy controls. DESIGN AND SETTING:Prospective study in the adult and pediatric intensive care departments of the Erasmus University Medical Center in the ...
journal_title:Intensive care medicine
pub_type: 杂志文章
doi:10.1007/s00134-007-0989-0
更新日期:2008-05-01 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:OBJECTIVE:To measure water balance and changes in distribution, and the effect of giving supplementary albumin, early after a burn injury. DESIGN:Consecutive patients (matched groups) and healthy controls. SETTING:National burn unit in a Swedish university hospital. PATIENTS AND SUBJECTS:Eighteen patients with 18%-9...
journal_title:Intensive care medicine
pub_type: 杂志文章
doi:10.1007/s001340100935
更新日期:2001-05-01 00:00:00
abstract:RATIONALE:Delirium incidence in intensive care unit (ICU) patients is high and associated with poor outcome. Identification of high-risk patients may facilitate its prevention. PURPOSE:To develop and validate a model based on data available at ICU admission to predict delirium development during a patient's complete I...
journal_title:Intensive care medicine
pub_type: 杂志文章,多中心研究
doi:10.1007/s00134-015-3777-2
更新日期:2015-06-01 00:00:00
abstract::Male gender predisposes to severe sepsis and septic shock. This effect has been ascribed to higher levels of testosterone. The ESPNIC ARDS database was searched, to determine if there was evidence of a similar male preponderance in severe sepsis in prepubertal patients in spite of low levels of male sex hormones at th...
journal_title:Intensive care medicine
pub_type: 杂志文章
doi:10.1007/s00134-003-1948-z
更新日期:2003-10-01 00:00:00
abstract:OBJECTIVE:To determine the value of procalcitonin (PCT) in the early diagnosis (and differentiation) of patients with SIRS, sepsis, severe sepsis, and septic shock in comparison to C-reactive protein (CRP), white blood cell and thrombocyte count, and APACHE-II score (AP-II). DESIGN:Prospective cohort study including a...
journal_title:Intensive care medicine
pub_type: 杂志文章
doi:10.1007/BF02900728
更新日期:2000-03-01 00:00:00
abstract:OBJECTIVE:The most recent approach to estimate nursing resources consumption has led to the generation of the Nine Equivalents of Nursing Manpower use Score (NEMS). The objective of this prospective study was to establish a completely automatically generated calculation of the NEMS using a patient data management syste...
journal_title:Intensive care medicine
pub_type: 杂志文章
doi:10.1007/s00134-004-2239-z
更新日期:2004-07-01 00:00:00
abstract:PURPOSE:To assess the generalisability of published clinical risk predictive models for invasive candidiasis in ICU patients. METHODS:The performance characteristics of published clinical risk factor-only and Candida colonisation-only predictive models for invasive candidiasis were assessed in a multicentre cohort of ...
journal_title:Intensive care medicine
pub_type: 杂志文章,多中心研究
doi:10.1007/s00134-009-1619-9
更新日期:2009-12-01 00:00:00
abstract::Nine patients hospitalized for tetanus were studied under the same protocol which included two haemodynamic studies with a preload trial (PLT). The first being made during therapy (diazepam barbiturate association), on the sixth day of hospitalisation, and the second one after recovery. The comparison of the results s...
journal_title:Intensive care medicine
pub_type: 杂志文章
doi:10.1007/BF01700252
更新日期:1978-07-01 00:00:00
abstract:PURPOSE:Extracorporeal life support (ECLS) is used for patients with refractory heart failure with or without respiratory failure. This temporary support is provided by blood pumps which are connected to large vessels. Bleeding episodes are a typical complication in patients with ECLS. Recently, several studies illustr...
journal_title:Intensive care medicine
pub_type: 杂志文章
doi:10.1007/s00134-011-2370-6
更新日期:2012-01-01 00:00:00
abstract:OBJECTIVE:To assess the effects of the association of positive end-expiratory pressure (PEEP) with different inflation volumes (V(T)'s) on passive lung deflation and alveolar recruitment in ARDS patients. DESIGN:Clinical study using PEEP with two different V(T)'s and analyzing whether passive lung deflation and alveol...
journal_title:Intensive care medicine
pub_type: 杂志文章
doi:10.1007/s001340051275
更新日期:2000-07-01 00:00:00
abstract:OBJECTIVE:To identify and reduce medication-prescribing errors by introducing systematic physician education and post-cardiac surgery admission prescription forms. DESIGN:Errors were defined as: incomplete prescriptions; potential adverse drug events (ADEs), i.e. either intercepted or non-intercepted incorrect prescri...
journal_title:Intensive care medicine
pub_type: 杂志文章
doi:10.1007/s00134-008-1054-3
更新日期:2008-06-01 00:00:00
abstract:OBJECTIVE:To determine the magnitude and time course of adrenergic effects on metabolism in volunteers and possible implications for the use of sympathomimetics in the critically ill. DESIGN:Descriptive laboratory investigation. SUBJECTS:7 volunteers. INTERVENTION:Primed continuous infusions of stable isotope tracer...
journal_title:Intensive care medicine
pub_type: 杂志文章
doi:10.1007/BF01707665
更新日期:1994-01-01 00:00:00