Abstract:
OBJECTIVES:To establish priorities for research in critical care medicine in the UK using survey and nominal group (NG) techniques. DESIGN:The senior doctor and nurse from 325 intensive care units (ICUs) in the UK were invited to contribute up to ten research questions relevant to intensive care organisation, practice or outcomes. These were then ranked twice using a Likert scale by a panel (nominal group) consisting of ten doctors (two trainees) and two nurses from university teaching and district general (community) hospitals. The first ratings were performed privately, and the second after group discussion. Thirty questions, ten each with strong, moderate or weak support, were then returned for rating by the originating ICU staff and the results compared with those of the NG. RESULTS:One hundred eighty-five respondents (35.6 % university teaching, 62.1% district general, 2.3 % not stated) provided 811 questions of which 722 were research hypotheses. The most frequently identified topics were the evaluation of high dependency care, ICU characteristics, treatments for acute lung injury and acute renal failure, nurse:patient ratios, pulmonary artery catheterisation, aspects of medical and nursing practice, protocol evaluation, and interhospital transfers. These were condensed into 100 topics for consideration by the NG. Discussion and re-rating by the group resulted in strong support being offered for 37 topics, moderate support for 48, and weak support for 21. Following circulation of ten questions from each category, nine questions achieved strong support from both ICU staff and the NG. These were the effect on outcomes from critical illness of early intervention, high dependency care, nurse:patient ratios, interhospital transfers, early enteral feeding, optimisation of perioperative care, hospital type, regionalisation of paediatric intensive care and the use of pulmonary artery catheters. The absence of any questions relating to interventions targetting mediators of the immuno-inflammatory response could be a consequence of the failure of recent studies in sepsis to demonstrate benefits in outcome. CONCLUSIONS:The intensive care community in the UK appears to prioritise research into organisational aspects of clinical practice and practical aspects of organ-system support. Health services research and the biological sciences need to develop collaborative methods for evaluating interventions and outcomes.
journal_name
Intensive Care Medjournal_title
Intensive care medicineauthors
Goldfrad C,Vella K,Bion JF,Rowan KM,Black NAdoi
10.1007/s001340000628keywords:
subject
Has Abstractpub_date
2000-10-01 00:00:00pages
1480-8issue
10eissn
0342-4642issn
1432-1238journal_volume
26pub_type
杂志文章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:PURPOSE:To determine the global metabolomic profile as measured in circulating plasma from surviving and non-surviving patients with community-acquired pneumonia (CAP) and sepsis. METHODS:Random, outcome-stratified case-control sample from a prospective study of 1,895 patients hospitalized with CAP and sepsis. Cases (...
journal_title:Intensive care medicine
pub_type: 杂志文章,随机对照试验
doi:10.1007/s00134-013-2935-7
更新日期:2013-08-01 00:00:00
abstract:BACKGROUND:It remains uncertain why immunocompetent patients with bacterial community-acquired pneumonia (CAP) die, in spite of adequate antibiotics. METHODS:This is a secondary analysis of the CAPUCI database which was a prospective observational multicentre study. Two hundred and twelve immunocompetent patients admi...
journal_title:Intensive care medicine
pub_type: 杂志文章
doi:10.1007/s00134-008-1363-6
更新日期:2009-03-01 00:00:00
abstract:BACKGROUND:The systemic inflammatory response syndrome (SIRS) may be triggered by endotoxin. Humans have antibodies directed against the core of endotoxin (endotoxin core antibodies, EndoCAb) that appear to be protective following surgery and in sepsis. We hypothesised that children with elevated antibodies to endotoxi...
journal_title:Intensive care medicine
pub_type: 杂志文章
doi:10.1007/s00134-005-0019-z
更新日期:2006-02-01 00:00:00
abstract:: ...
journal_title:Intensive care medicine
pub_type: 杂志文章,评审
doi:10.1007/s00134-018-5107-y
更新日期:2018-11-01 00:00:00
abstract:OBJECTIVE:Interhospital transfers of critically ill pediatric patients in The Netherlands are accompanied by referring specialists or by specialist retrieval teams. We compared the interventions before and directly after transports and the complications and the equipment available during transports in the two groups. ...
journal_title:Intensive care medicine
pub_type: 杂志文章
doi:10.1007/s00134-003-2066-7
更新日期:2004-02-01 00:00:00
abstract::This article was originally published under a CC BY-NC 4.0 license, but has now been made available under a CC BY 4.0 license. The PDF and HTML versions of the paper have been modified accordingly. ...
journal_title:Intensive care medicine
pub_type: 杂志文章,已发布勘误
doi:10.1007/s00134-018-5254-1
更新日期:2018-05-01 00:00:00
abstract:PURPOSE:We assessed outcomes in brain-injured patients after implementation of a multi-faceted approach to reduce respiratory complications in intensive care units. METHODS:Prospective nationwide before-after trial. Consecutive adults with acute brain injury requiring mechanical ventilation for ≥24 h in 20 French inte...
journal_title:Intensive care medicine
pub_type: 杂志文章,多中心研究
doi:10.1007/s00134-017-4764-6
更新日期:2017-07-01 00:00:00
abstract::One hundred and eighteen 20-g radial artery catheters were prospectively evaluated in 109 cardiovascular surgical patients. 0.024% papaverine in saline was used as a continuous flushing solution. Using the Doppler method, obstruction of the radial artery with the catheter in situ was found in 11 (9.8%) patients. Decan...
journal_title:Intensive care medicine
pub_type: 杂志文章
doi:10.1007/BF00254675
更新日期:1986-01-01 00:00:00
abstract::The effects of 142 intravenous boluses of althesin (0.05 ml/kg) on cerebral perfusion pressure (CPP) were studied in twelve head injured comatose patients. The data were divided into those where the mean pre-bolus intracranial pressure (ICP) was above or below 20 mmHg and then subdivided into those where the minimum p...
journal_title:Intensive care medicine
pub_type: 杂志文章
doi:10.1007/BF00257469
更新日期:1988-01-01 00:00:00
abstract:PURPOSE:Evidence of variation in mortality after surgery may indicate preventable postoperative death. We sought to determine if regional differences in outcome were present in surgical patients admitted to critical care in the UK. METHODS:We extracted data on admission characteristics, case mix and outcome of all pat...
journal_title:Intensive care medicine
pub_type: 杂志文章
doi:10.1007/s00134-015-3980-1
更新日期:2015-10-01 00:00:00
abstract:OBJECTIVE:We compared two imipenem regimens for prevention of septic complications in patients with severe acute necrotizing pancreatitis (ANP). DESIGN AND SETTING:Prospective, randomized open clinical trial involving intensive care units of 14 Spanish Hospitals. PARTICIPANTS:92 patients with ANP. INTERVENTIONS:Imip...
journal_title:Intensive care medicine
pub_type: 临床试验,杂志文章,多中心研究,随机对照试验
doi:10.1007/s00134-003-1956-z
更新日期:2003-11-01 00:00:00
abstract::Results of the relationships between oxygen supply, demand, and uptake can be used to interpret cardiac output values, identify types of acute circulatory failure, guide attempts to improve cellular function, and thus prevent the development of multiple organ failure and death. Five steps in the interpretation of card...
journal_title:Intensive care medicine
pub_type: 杂志文章,评审
doi:10.1007/BF01785244
更新日期:1990-01-01 00:00:00
abstract::The World Health Organization defines overweight and obesity as the condition where excess or abnormal fat accumulation increases risks to health. The prevalence of obesity is increasing worldwide and is around 20% in ICU patients. Adipose tissue is highly metabolically active, and especially visceral adipose tissue h...
journal_title:Intensive care medicine
pub_type: 杂志文章,评审
doi:10.1007/s00134-019-05594-1
更新日期:2019-06-01 00:00:00
abstract:: ...
journal_title:Intensive care medicine
pub_type: 评论,社论
doi:10.1007/s00134-018-5498-9
更新日期:2019-01-01 00:00:00
abstract:OBJECTIVES:To examine whether urgent orotracheal intubation (OI) can induce bacteremia. To find predictive factors for post-intubation bacteremia. DESIGN:Prospective observational study. SETTING:Seventeen-bed medical intensive care unit in a university hospital. PATIENTS:Sixty-eight adult intensive care patients und...
journal_title:Intensive care medicine
pub_type: 杂志文章
doi:10.1007/s001340000841
更新日期:2001-02-01 00:00:00
abstract::Acute renal failure in critically ill patients is seldom an isolated problem but is more usually associated with multiple organ failure. When choosing an extracorporeal kidney replacement therapy, these other failing organs must be taken into account. Therefore the choice of an artificial kidney in patients requiring ...
journal_title:Intensive care medicine
pub_type: 杂志文章,评审
doi:10.1007/BF00261492
更新日期:1989-01-01 00:00:00
abstract:OBJECTIVE:To validate a simple method avoiding discard volumes in pediatric patients with indwelling arterial and venous lines. DESIGN:Zero-discarding was achieved by passive extracorporeal arteriovenous backflow via standard single pressure transducer equipment. We tested backflow distances (10, 20 and 30 cm beyond t...
journal_title:Intensive care medicine
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1007/s001340100951
更新日期:2001-06-01 00:00:00
abstract::The increase of the inflationary lung volume created by a respiratory maneuver is critical for preventing postoperative alveolar collapse. We measured this volume as achieved with IPPB or incentive spirometry (IS) in 20 postoperative surgical patients. Using IPPB, with gas flow and peak airway pressures carefully adju...
journal_title:Intensive care medicine
pub_type: 杂志文章
doi:10.1007/BF01641120
更新日期:1977-12-01 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::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 the involvement of intestinal angiotensin II type 2 receptors in the outcome of acute severe hypovolemia as well as systemic and regional mesenteric hemodynamics and intestinal mucosal functions in anesthetized pigs. DESIGN AND SETTING:Prospective, interventional animal study in a university r...
journal_title:Intensive care medicine
pub_type: 杂志文章
doi:10.1007/s00134-005-2686-1
更新日期:2005-08-01 00:00:00
abstract::A 29-year-old woman was admitted to the Rouen University Hospital for attempted suicide by ingestion of a carbamate insecticide (Temik G, containing 10% aldicarb). Cardio-respiratory arrest occurred at the second hour and acute necrotic hemorrhagic pancreatitis on the second day. Further evolution was uneventful, and ...
journal_title:Intensive care medicine
pub_type: 杂志文章
doi:10.1007/BF02425057
更新日期:1994-01-01 00:00:00
abstract:OBJECTIVE:Invasive candidiasis (IC) outcomes in intensive care units (ICUs) could be improved by the early administration of antifungals. The Candida Score (CS) prediction rule has been proposed for the selection of patients who could develop IC. Procalcitonin (PCT) levels allow prompt identification of sepsis, but the...
journal_title:Intensive care medicine
pub_type: 杂志文章
doi:10.1007/s00134-009-1623-0
更新日期:2009-12-01 00:00:00
abstract:OBJECTIVE:This study was undertaken to determine the delay of extubation attributable to ventilator-associated pneumonia (VAP) in comparison to other complications and complexity of surgery after repair of congenital heart lesions in neonates and children. METHODS:Cohort study in a pediatric intensive care unit of a t...
journal_title:Intensive care medicine
pub_type: 杂志文章
doi:10.1007/s001340051285
更新日期:2000-07-01 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 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 evaluate trends in mortality and related factors among trauma patients who developed acute respiratory distress syndrome (ARDS). STUDY:Observational study based on data prospectively gathered in computerized trauma registry. SETTING:Trauma intensive care unit (ICU) of 48 beds in level I trauma center. P...
journal_title:Intensive care medicine
pub_type: 杂志文章
doi:10.1007/s001340100955
更新日期:2001-07-01 00:00:00
abstract:PURPOSE:To compare the concentration conformity of infusion solutions manually prepared on intensive care units (ICU) with solutions from pharmacy-based, automated production. METHODS:A prospective observational study conducted in a university hospital in Germany. Drug concentrations of 100 standardised infusion solut...
journal_title:Intensive care medicine
pub_type: 杂志文章
doi:10.1007/s00134-011-2230-4
更新日期:2011-08-01 00:00:00
abstract:OBJECTIVE:We undertook this study to evaluate the influence of the inspiration:expiration (I:E) ratio on intracranial pressure and cerebral perfusion in patients with acute stroke. DESIGN:Ventilated patients with acute stroke were examined under a protocol involving variations of I:E ratio from 1:2 to 1:1 to 1:2 under...
journal_title:Intensive care medicine
pub_type: 杂志文章
doi:10.1007/s00134-002-1351-1
更新日期:2002-08-01 00:00:00