Abstract:
OBJECTIVES:Trunk position at 45 degrees from the horizontal is associated with a decreased risk of gastroesophageal aspiration. The objectives of this study were to determine the accuracy of trunk flexion estimates compared to a reference standard measurement, and to determine agreement about trunk flexion among ICU clinicians. DESIGN:Prospective observational study. SETTING:Two university-affiliated medical-surgical ICUs. PATIENTS AND PARTICIPANTS:Thirty-three mechanically ventilated ICU patients, seven residents, two fellows, three intensivists, and twenty-eight bedside nurses. INTERVENTIONS:Prospectively, concurrently, and independently during rounds, one bedside nurse, one resident, one fellow, and one intensivist clinically estimated the trunk flexion of mechanically ventilated patients. To record the reference standard, a trained investigator measured trunk position in the vertical plane using a goniometer. MEASUREMENTS AND RESULTS:We made 438 clinical assessments on 33 patients aged 57.2+/-19.4 (SD) years with an APACHE II score of 27.3+/-9.4. Mean trunk flexion estimates were: nurses 24.3+/-12.3 degrees from the horizontal, residents 20.2+/-13.7, fellows 20.3+/-10.8, and intensivists 21.1+/-13.1 compared to the reference standard measurement 16.2+/-9.0 degrees. The accuracy of trunk flexion estimates was fair to moderate [intraclass correlation for reference standard versus nurses (ICC 0.42), residents (ICC 0.52), fellows (ICC 0.36), and intensivists (ICC 0.55)]. The agreement among different groups of clinicians was moderate. CONCLUSIONS:In mechanically ventilated patients, we found that clinical estimates of trunk position were moderately good, agreement amongst caregivers was moderately good, but that all clinicians tended to overestimate the angle of semirecumbency.
journal_name
Intensive Care Medjournal_title
Intensive care medicineauthors
McMullin JP,Cook DJ,Meade MO,Weaver BR,Letelier LM,Kahmamoui K,Higgins DA,Guyatt GHdoi
10.1007/s00134-002-1225-6keywords:
subject
Has Abstractpub_date
2002-03-01 00:00:00pages
304-9issue
3eissn
0342-4642issn
1432-1238journal_volume
28pub_type
杂志文章abstract:OBJECTIVE:a) to describe a non-barotraumatic ventilatory setting for independent lung ventilation (ILV); b) to determine the utility of single lung end-tidal CO(2) (EtCO(2)) monitoring to evaluate the ventilation to perfusion (V/Q) matching in each lung during ILV and for ILV weaning. DESIGN:prospective study. SETTIN...
journal_title:Intensive care medicine
pub_type: 临床试验,杂志文章
doi:10.1007/s00134-001-1149-6
更新日期:2001-12-01 00:00:00
abstract::Myxoedema coma is a medical emergency with high mortality. In this study, clinical response and plasma variations of thyroid hormones were analysed in 7 patients, 6 presenting with myxoedema coma and one with myxoedema ileus. These patients were treated with intravenous or oral l-thyroxine (l-T4). 1000 mu l-T4 iv were...
journal_title:Intensive care medicine
pub_type: 杂志文章
doi:10.1007/BF01708403
更新日期:1991-01-01 00:00:00
abstract::Values obtained for cardiac output (CO) were compared using thermodilution (TD) with those obtained using bioimpedance (Bi) as measured using the Bomed NCCOM3 (Revision 6) in 28 consecutive patients in the first 24 h after coronary artery bypass surgery (CABS). In 46 paired measurements made in the first 12 h after CA...
journal_title:Intensive care medicine
pub_type: 杂志文章
doi:10.1007/BF01720674
更新日期:1991-01-01 00:00:00
abstract:PURPOSE:To assess the ability of quantitative pupillometry [using the Neurological Pupil index (NPi)] to predict an unfavorable neurological outcome after cardiac arrest (CA). METHODS:We performed a prospective international multicenter study (10 centers) in adult comatose CA patients. Quantitative NPi and standard ma...
journal_title:Intensive care medicine
pub_type: 杂志文章,多中心研究
doi:10.1007/s00134-018-5448-6
更新日期:2018-12-01 00:00:00
abstract::Risk of critical illness is determined both by genetic and environmental influences, particularly those relating to infectious and cardiovascular diseases. Physiologically-based scoring systems cannot measure prior risk because they do not quantify physiological reserve independently of the acute illness. Genetic prof...
journal_title:Intensive care medicine
pub_type: 杂志文章,评审
doi:10.1007/s001340051120
更新日期:2000-01-01 00:00:00
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 int...
journal_title:Intensive care medicine
pub_type: 杂志文章
doi:10.1007/s001340050860
更新日期:1999-04-01 00:00:00
abstract:OBJECTIVE:Do-not-resuscitate orders (DNR orders) and advance directives (AD) have been developed and their use by patients is increasing. The objective of the study was to evaluate the compliance with patient's wishes and doctors' and nurses' agreement on decision-making in the treatment of elderly patients from a cros...
journal_title:Intensive care medicine
pub_type: 杂志文章
doi:10.1007/s001340000602
更新日期:2000-09-01 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:PURPOSE:Sepsis is a major health burden worldwide. Preclinical investigations in animals and retrospective studies in patients have suggested that inhibition of platelets may improve the outcome of sepsis. In this study we investigated whether chronic antiplatelet therapy impacts on the presentation and outcome of seps...
journal_title:Intensive care medicine
pub_type: 杂志文章
doi:10.1007/s00134-015-4171-9
更新日期:2016-03-01 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:OBJECTIVE:While using a transcutaneous system for assessment of liver function by indocyanine green plasma disappearance rate (ICG-PDR) in critically ill patients, we compared the agreement between ICG-PDR obtained by the recommended standard ICG dosage (0.5 mg/kg) and a reduced dosage (0.25 mg/kg). DESIGN:Clinical st...
journal_title:Intensive care medicine
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1007/s00134-003-2091-6
更新日期:2004-03-01 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: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::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:PURPOSE:Previous observational studies have inconsistently associated early hyperoxia with worse outcomes after cardiac arrest, and have methodological limitations. We tested this association using a high-resolution database controlling for multiple disease-specific markers of severity of illness and care processes. M...
journal_title:Intensive care medicine
pub_type: 杂志文章
doi:10.1007/s00134-014-3555-6
更新日期:2015-01-01 00:00:00
abstract::We describe a case of the dialysis disequilibrium syndrome (DDS) that was marked by the rapid onset of cerebral edema and the subsequent development of acute respiratory failure. The patient was treated successfully with a combination of mechanical hyperventilation and mannitol. The clinical presentation, pathogenesis...
journal_title:Intensive care medicine
pub_type: 杂志文章
doi:10.1007/s001340051214
更新日期:2000-05-01 00:00:00
abstract:PURPOSE:Acute heart failure (AHF) causes high burden of mortality, morbidity, and repeated hospitalizations worldwide. This guidance paper describes the tailored treatment approaches of different clinical scenarios of AHF and CS, focusing on the needs of professionals working in intensive care settings. RESULTS:Tissue...
journal_title:Intensive care medicine
pub_type: 杂志文章,评审
doi:10.1007/s00134-015-4041-5
更新日期:2016-02-01 00:00:00
abstract::A 63-year-old man underwent distal oesophagectomy and proximal gastrectomy. Postoperatively, controlled ventilation was necessary for 53 days because of anastomotic leakage. Multiple sedative regimens proved to be inadequate. By contrast, a fentanyl-midazolam combination with continuous supplementation of clonidine 0....
journal_title:Intensive care medicine
pub_type: 杂志文章
doi:10.1007/BF01705163
更新日期:1990-01-01 00:00:00
abstract:PURPOSE:Protective mechanical ventilation based on multiple ventilator parameters such as tidal volume, plateau pressure, and driving pressure has been widely used in acute respiratory distress syndrome (ARDS). More recently, mechanical power (MP) was found to be associated with mortality. The study aimed to investigat...
journal_title:Intensive care medicine
pub_type: 杂志文章
doi:10.1007/s00134-019-05627-9
更新日期:2019-06-01 00:00:00
abstract::Marked respiratory insufficiency was established in 20 of 91 patients with acute pancreatitis. 16 of them died, 12 from uncontrollable hypoxaemia. At postmortem the most prominent finding was microatelectasis, the occurrence of which correlated highly with the serum amylase activity. ...
journal_title:Intensive care medicine
pub_type: 杂志文章
doi:10.1007/BF01683069
更新日期:1977-08-01 00:00:00
abstract:OBJECTIVE:The aim of the present study was (1) to determine the prevalence of intensive care unit (ICU) admissions due to an adverse drug reaction (ADR), and (2) to compare affected patients with patients admitted to the ICU for the treatment of deliberate self-poisoning using medical drugs. DESIGN:Prospective observa...
journal_title:Intensive care medicine
pub_type: 杂志文章
doi:10.1007/s00134-008-1250-1
更新日期:2009-02-01 00:00:00
abstract:OBJECTIVES:Inhalation of nitric oxide (NO) selectively dilates pulmonary vessels in well-ventilated regions. Prostaglandin F2 alpha (PGF2 alpha) is a vasoconstrictor and is reported to enhance hypoxic pulmonary vasoconstriction. The objective of this study was to examine whether the combination of intravenous PGF2 alph...
journal_title:Intensive care medicine
pub_type: 杂志文章
doi:10.1007/BF01709742
更新日期:1996-07-01 00:00:00
abstract:OBJECTIVES:Controversies concerning the pivotal trial and negative results from other Drotrecogin alfa activated (DAA) trials have raised questions about its efficacy in severe sepsis patients. Based on all available evidence, our study aimed to respond to: (1) What is the current probability that DAA is not better tha...
journal_title:Intensive care medicine
pub_type: 杂志文章
doi:10.1007/s00134-008-1159-8
更新日期:2008-10-01 00:00:00
abstract:OBJECTIVE:To evaluate clinical and microbiologic characteristics, modalities of treatment and outcome of patients with cervical necrotizing fasciitis admitted to our institution. DESIGN:Retrospective clinical investigation. PATIENTS AND METHODS:We reviewed the charts of 20 consecutive patients hospitalized in our Int...
journal_title:Intensive care medicine
pub_type: 杂志文章
doi:10.1007/s001340050959
更新日期:1999-08-01 00:00:00
abstract:OBJECTIVE:To evaluate the incidence and the circumstances of a moderate increase in serum creatinine early after elective abdominal aortic surgery. DESIGN:Prospective clinical observational study. SETTING:Surgical intensive care unit in a university hospital. PATIENTS:Two hundred and fifteen consecutive adult patien...
journal_title:Intensive care medicine
pub_type: 杂志文章
doi:10.1007/s00134-003-1958-x
更新日期:2003-10-01 00:00:00
abstract:OBJECTIVES:To assess the markers of perfusion which best discriminate survivors from non-survivors of childhood sepsis and to compare the information derived from gastric tonometry with conventionally measured haemodynamic and laboratory parameters. DESIGN:Prospective clinical study of children with sepsis syndrome or...
journal_title:Intensive care medicine
pub_type: 杂志文章
doi:10.1007/s001340050394
更新日期:1997-06-01 00:00:00
abstract:OBJECTIVE:To describe the use of volumetric capnography, a plot of expired CO(2) concentration against expired volume, in monitoring fibrinolytic treatment of major pulmonary embolism. DESIGN AND SETTING:Two case reports in the emergency department of a teaching hospital. PATIENTS:Two conscious and spontaneously brea...
journal_title:Intensive care medicine
pub_type: 杂志文章
doi:10.1007/s00134-004-2444-9
更新日期:2004-11-01 00:00:00
abstract:PURPOSE:To determine whether, during mechanical ventilation, an optimal positive end-expiratory pressure (PEEP) can be identified by measurement of regional tidal volume and compliance [V (T(reg)), C (RS(reg))]. METHODS:Sixteen anaesthetized intubated neonatal piglets underwent a stepwise vital capacity manoeuvre perf...
journal_title:Intensive care medicine
pub_type: 杂志文章
doi:10.1007/s00134-010-1995-1
更新日期:2010-11-01 00:00:00
abstract:OBJECTIVE:To compare some of the confirmatory investigations of brain death with clinical criteria in order to achieve the most sensitive and accurate diagnosis of brain death. DESIGN:All patients with isolated brain lesions and Glasgow Coma Scale (GCS) = 3 were subjected to neurological examination after ruling out h...
journal_title:Intensive care medicine
pub_type: 杂志文章
doi:10.1007/BF01711544
更新日期:1995-08-01 00:00:00
abstract:OBJECTIVE:Alterations in coagulation, including elevated pulmonary and systemic concentrations of urokinase, are frequent in patients with acute lung injury (ALI). Urokinase potentiates neutrophil activation and contributes to the severity of pulmonary injury in preclinical models of ALI. The objective of this study wa...
journal_title:Intensive care medicine
pub_type: 杂志文章,多中心研究
doi:10.1007/s00134-007-0930-6
更新日期:2008-02-01 00:00:00