Abstract:
OBJECTIVE:To describe the syndrome of rhabdomyolysis during bacterial sepsis with regard to incidence, blood bacteriology and complications and to examine the association between hyperosmolal state and rhabdomyolysis, evaluating the relationship between plasma osmolality (Posm) and serum creatine phosphokinase (CPK) levels. DESIGN:Prospective study including all patients admitted to the intensive care unit (ICU) for sepsis with positive blood culture and rhabdomyolysis over a 3-year period. SETTING:Seven-bed medical/surgical ICU of a teaching hospital. PATIENTS:35 patients (group 1) with bacterial sepsis-induced rhabdomyolysis (15 males, 20 females; mean age 71+/-13 years) and 122 (group 2) bacteraemic septic patients without rhabdomyolysis (49 males, 73 females; mean age 68+/-15) were studied. Patients with rhabdomyolysis were divided into gram(+) and gram(-) subgroups according to the blood culture growth. RESULTS:From 491 patients recorded, 35 fulfilled the inclusion criteria for bacterial sepsis-induced rhabdomyolysis (7.1%). Gram-positive bacteria predominated in group 1 (69%), while gram-negative predominated (60%) in group 2. There was a correlation between CPK and Posm levels in the rhabdomyolysis Group (r = 0.52, R2 = 0.27, p = 0.003). There was a stronger correlation between these two variables (r = 0.67, R2 = 0.45, p = 0.001) in the gram(+).subgroup. Acute renal failure (68.5%) and electrolyte disorders such as hyperkalaemia (34%) and hypocalcaemia (48.5%) were the major complications in the rhabdomyolysis group. Sixteen (45.7%) patients in group 1 and 49 (40%) in group 2 died during their stay in the ICU from sepsis and multiple organ failure. Rhabdomyolysis was not considered a contributing factor to their death, as none of our patients died during or immediately after the syndrome. CONCLUSION:Bacterial sepsis-induced rhabdomyolysis results from certain types of microorganisms, mainly gram-positive and to a lesser extent gram-negative. Hyperosmolality is a predisposing mechanism for rhabdomyolysis during bacteraemic sepsis from any type of bacterial microorganism.
journal_name
Intensive Care Medjournal_title
Intensive care medicineauthors
Betrosian A,Thireos E,Kofinas G,Balla M,Papanikolaou M,Georgiadis Gdoi
10.1007/s001340050882keywords:
subject
Has Abstractpub_date
1999-05-01 00:00:00pages
469-74issue
5eissn
0342-4642issn
1432-1238journal_volume
25pub_type
杂志文章abstract::Arterial catheterization is the second most common invasive procedure performed in the intensive care unit. Despite the ubiquity of the procedure, complications including failure to place the catheter occur. While many clinicians are familiar with the use of ultrasound (US) guidance to decrease complication rates of c...
journal_title:Intensive care medicine
pub_type: 杂志文章,评审
doi:10.1007/s00134-009-1699-6
更新日期:2010-02-01 00:00:00
abstract:OBJECTIVE:On hospital admission, the morphology of the central pulmonary artery thromboemboli is an independent predictor of 30-day mortality in patients with massive pulmonary embolism (MPE). This may be due to the differential susceptibility of thromboemboli to thrombolysis. The aim of this study was to assess haemod...
journal_title:Intensive care medicine
pub_type: 杂志文章
doi:10.1007/s00134-004-2314-5
更新日期:2004-08-01 00:00:00
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:BACKGROUND:We determined the effects of two antibiotic policies (predominance of either beta-lactam antibiotics or fluroquinolones) on acquisition with third-generation cephalosporin-resistant Enterobacteriaceae (CRE) and fluoroquinolone-resistant CRE (FCRE) in two ICUs, with monitoring of other variables that may infl...
journal_title:Intensive care medicine
pub_type: 杂志文章,多中心研究,随机对照试验
doi:10.1007/s00134-009-1714-y
更新日期:2010-03-01 00:00:00
abstract:PURPOSE:To assess the effects of alveolar recruitment maneuvers (ARMs) on clinical outcomes in patients with acute respiratory distress syndrome (ARDS). METHODS:We conducted a search of the MEDLINE, EMBASE, LILACS, CINAHL, CENTRAL, Scopus, and Web of Science (from inception to July 2014) databases for all (i.e. no lan...
journal_title:Intensive care medicine
pub_type: 杂志文章,meta分析,评审
doi:10.1007/s00134-014-3413-6
更新日期:2014-09-01 00:00:00
abstract:PURPOSE:To describe changes in hemodynamic variables, sedation, and pain score after discontinuation of prolonged infusions of dexmedetomidine in a pediatric population of critically ill cardiac patients. METHODS:Retrospective case series of patients who received continuous infusions of dexmedetomidine for longer than...
journal_title:Intensive care medicine
pub_type: 杂志文章
doi:10.1007/s00134-011-2441-8
更新日期:2012-02-01 00:00:00
abstract:OBJECTIVE:To test the hypothesis whether PMN-Elastase in bronchoalveolar lavage fluid (BALF) could reflect neutrophil activity in the lower respiratory tract. DESIGN:Prospectively, morphologic findings of acute and chronic inflammation in the transbronchial lung biopsy specimens were compared with the numbers of neutr...
journal_title:Intensive care medicine
pub_type: 杂志文章
doi:10.1007/BF01720908
更新日期:1994-05-01 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: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 d...
journal_title:Intensive care medicine
pub_type: 杂志文章
doi:10.1007/s001340050788
更新日期:1999-01-01 00:00:00
abstract:OBJECTIVE:To evaluate the use of antidotal therapy in patients with an elevated digitalis concentration following chronic or acute exposure. DESIGN AND SETTING:Retrospective review of patient records over 2 years in 20 city hospitals in France. PATIENTS:Overall 838 patients with an elevated serum digitalis concentrat...
journal_title:Intensive care medicine
pub_type: 杂志文章
doi:10.1007/s00134-008-1092-x
更新日期:2008-08-01 00:00:00
abstract:PURPOSE:Rapid shallow breathing may occur at any time during spontaneous breathing trials (SBT), questioning the utility of a single determination of the rapid shallow breathing index (RSBI). We hypothesize that change in RSBI during SBT may more accurately predict successful extubation than a single determination. ME...
journal_title:Intensive care medicine
pub_type: 杂志文章
doi:10.1007/s00134-009-1735-6
更新日期:2010-03-01 00:00:00
abstract:OBJECTIVE:We describe a patient with a prolonged and severe hypercapnia occurring during an episode of status asthmaticus induced by ophthalmic instillation of carteolol. SETTING:Prehospital Emergency Medical Service and Pulmonary Intensive Care Unit in a university hospital. PATIENT:A 35-year-old female developed an...
journal_title:Intensive care medicine
pub_type: 杂志文章
doi:10.1007/s001340050772
更新日期:1998-12-01 00:00:00
abstract::A veno-venous to-and-fro bypass method through a single blood access for extracorporeal lung assist with an artificial membrane lung is introduced. A premature newborn with severe respiratory distress was treated with this method. A 12 Fr. single lumen catheter with a spiral-embedded thin-wall, 0.25 mm in wall thickne...
journal_title:Intensive care medicine
pub_type: 杂志文章
doi:10.1007/BF00271065
更新日期:1989-01-01 00:00:00
abstract::Plasma colloid osmotic pressure (COP) has been calculated from both serum albumin concentration and plasma total protein concentration. These values have been compared to those measured directly using a membrane-transducer oncometer in a group of normal subjects, in a group of critically-ill patients with a variety of...
journal_title:Intensive care medicine
pub_type: 杂志文章
doi:10.1007/BF00254796
更新日期:1987-01-01 00:00:00
abstract:OBJECTIVES:A range of children receive extra-corporeal life support (ECLS) for respiratory failure, but there is little published data on this group. Our aims were: (1) to analyse predictors of outcome and (2) comment on inclusion and exclusion criteria. DESIGN:Retrospective review. SETTING:Tertiary ECLS centre. PAT...
journal_title:Intensive care medicine
pub_type: 杂志文章
doi:10.1007/s00134-008-1232-3
更新日期:2008-12-01 00:00:00
abstract::We evaluated the effect of a cimetidine continuous infusion (2 g in 24 h) on the intragastric pH of 16 critically ill patients (11 men, 5 women, mean age 45 years). During the 24 h pre-trial period and the subsequent 24 h cimetidine infusion, an intragastric combined electrode was placed in the fundus and the pH recor...
journal_title:Intensive care medicine
pub_type: 杂志文章
doi:10.1007/BF00262892
更新日期:1988-01-01 00:00:00
abstract:PURPOSE:Reporting neurodevelopmental outcome of 8-year-old children treated with neonatal extracorporeal membrane oxygenation (ECMO). METHODS:In a follow-up study in 135 8-year-old children who received neonatal ECMO between 1996 and 2001 we assessed intelligence (Revised Amsterdam Intelligence Test), concentration (B...
journal_title:Intensive care medicine
pub_type: 杂志文章,多中心研究
doi:10.1007/s00134-013-2973-1
更新日期:2013-09-01 00:00:00
abstract:OBJECTIVE:Fibroproliferation markers like procollagen I predict mortality in patients with acute lung injury (ALI) and acute respiratory distress syndrome (ARDS). We sought to determine whether bronchoalveolar lavage fluid (BALF) from patients with lung injury contained mediators that would activate procollagen I promo...
journal_title:Intensive care medicine
pub_type: 杂志文章
doi:10.1007/s00134-004-2503-2
更新日期:2005-01-01 00:00:00
abstract:OBJECTIVE:Erythrocytes influence the magnitude of hypoxia-induced pulmonary artery pressure increase. It is, however, unknown to what extent haemoconcentration and haemodilution affect this response and whether intrapulmonary blood volume (and thus vessel dimensions) alters the magnitude of pressure increase. Furthermo...
journal_title:Intensive care medicine
pub_type: 杂志文章
doi:10.1007/s001340051327
更新日期:2000-08-01 00:00:00
abstract:PURPOSE:Mechanical ventilation with lower tidal volumes (≤6 ml/kg of predicted body weight, PBW) could benefit patients without acute respiratory distress syndrome (ARDS). However, tidal volume reduction could be associated with increased patient discomfort and sedation needs, and consequent longer duration of ventilat...
journal_title:Intensive care medicine
pub_type: 杂志文章,meta分析,评审
doi:10.1007/s00134-014-3318-4
更新日期:2014-07-01 00:00:00
abstract:OBJECTIVE:Impairment of haemostasis has been described with slowly degradable medium molecular weight hydroxyethyl starch (MMW-HES), whereas rapidly degradable MMW-HES is generally considered to have no important effects on blood coagulation. This study was undertaken to investigate the effects of a rapidly degradable ...
journal_title:Intensive care medicine
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1007/s001340101107
更新日期:2001-11-01 00:00:00
abstract:PURPOSE:To systematically review clinical and preclinical data on hydroxyethyl starch (HES) tissue storage. METHODS:MEDLINE (PubMed) was searched and abstracts were screened using defined criteria to identify articles containing original data on HES tissue accumulation. RESULTS:Forty-eight studies were included: 37 h...
journal_title:Intensive care medicine
pub_type: 杂志文章,评审
doi:10.1007/s00134-013-3156-9
更新日期:2014-02-01 00:00:00
abstract:OBJECTIVE:To determine the relationship between ionized calcium concentrations and blood lactate levels during cardiac arrest and cardiopulmonary resuscitation (CPR). DESIGN:A prospective cohort study. SETTING:Emergency department (ED) and general intensive care unit in a city hospital (tertiary care center). PATIEN...
journal_title:Intensive care medicine
pub_type: 杂志文章
doi:10.1007/s001340050493
更新日期:1997-12-01 00:00:00
abstract:OBJECTIVE:To define the different types of costs incurred in the care of critically ill patients and to describe some of the most commonly used methods for measuring and allocating these costs. DESIGN:Literature review. Definitions for opportunity, direct and indirect, fixed, variable, marginal, and total costs are de...
journal_title:Intensive care medicine
pub_type: 杂志文章,评审
doi:10.1007/s00134-002-1279-5
更新日期:2002-06-01 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: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:OBJECTIVE:Evaluation of the distribution and antibiotic susceptibility of the aerobic gram-negative bacilli (AGNB) isolated from patients in intensive care units (ICU study). DESIGN AND SETTING:Microbiological study carried out in 1991 in 39 teaching hospitals. A standardized method was used to determine the minimum i...
journal_title:Intensive care medicine
pub_type: 杂志文章
doi:10.1007/BF01699228
更新日期:1996-10-01 00:00:00
abstract::Two patients with severe hepatic and renal failure underwent emergency hepatic retransplantation (2nd and 6th day after transplantation). Continuous arteriovenous haemodialysis was begun before surgery and successfully performed, without any incident, during the retransplantation with a biospal (SCU/CAVH AN 69 S) devi...
journal_title:Intensive care medicine
pub_type: 杂志文章
doi:10.1007/BF01706360
更新日期:1990-01-01 00:00:00
abstract:OBJECTIVE:To investigate whether ultrasound determination of the inferior vena cava diameter (IVCD) and its collapsibility index (IVCCI) could be used to optimize the fluid removal rate while avoiding hypotension during slow continuous ultrafiltration (SCUF). METHODS:Twenty-four consecutive patients [13 men and 11 wom...
journal_title:Intensive care medicine
pub_type: 杂志文章
doi:10.1007/s00134-009-1745-4
更新日期:2010-04-01 00:00:00
abstract:PURPOSE:Information on predisposing risk factors influencing long-term survival after extracorporeal membrane oxygenation (ECMO) support remains scarce. In critically ill patients chronic obstructive pulmonary disease (COPD) is an independent risk factor for mortality and morbidity. We assessed the influence of COPD on...
journal_title:Intensive care medicine
pub_type: 杂志文章
doi:10.1007/s00134-013-2931-y
更新日期:2013-08-01 00:00:00