Abstract:
OBJECTIVE:To identify objective trends of the course of illness that might be used as benchmarks in the auditing of the organization/performance of Intensive Care Units (ICU). DESIGN:Retrospective analysis. PATIENTS AND SETTING:A group of 12,615 patients and 55,464 patient-days prospectively collected in 89 ICUs of 12 European countries. METHODS:The complexity of daily care in the ICU was classified as high (HT) or low (LT), according to six activities registered in NEMS,a daily therapeutic index for ICUs. RESULTS:Six trends of clinical course were identified: LT during the whole ICU stay (5,424 patients, mortality 1.8%); HT (3,480 patients, mortality 30.4%); HT followed by LT (2,781 patients, mortality 2.8%); LT followed by HT (197 patients, mortality 39.1%); finally, LT/HT/LT in 298 patients (mortality 10.5%); and HT/LT/HT (mortality 20.1%) in 438 patients. A group of 930 patients had the complexity of treatment increased (mortality 21.1%) and 3,711 patients received both treatments. Low-care before high-care periods had a mean duration of 2.2 +/- 3.5 days, low-care after high-care 2.7 +/- 3.1 days, and between two high-care periods 2.1 +/- 2.2 days. A group of 1,538 'surgical scheduled' patients only received LT, whereas 2,231 received HT (whether or not exclusively). Overall ICU mortality rate was low (3%) and the length of stay short, regardless of diagnosis and complexity of care received. CONCLUSIONS:The use of therapeutic indexes help to classify the daily complexity of ICU care. The classification can be used as an indicator of clinical performance and resource utilization.
journal_name
Intensive Care Medjournal_title
Intensive care medicineauthors
Iapichino G,Radrizzani D,Ferla L,Pezzi A,Porta F,Zanforlin G,Miranda DRdoi
10.1007/s00134-002-1331-5keywords:
subject
Has Abstractpub_date
2002-07-01 00:00:00pages
985-9issue
7eissn
0342-4642issn
1432-1238journal_volume
28pub_type
杂志文章abstract:OBJECTIVE:Real-time measurement of stroke volume variation by arterial pulse contour analysis (SVV) is useful in predicting volume responsiveness and monitoring volume therapy in mechanically ventilated patients. This study investigated the influence of the depth of tidal volume (V(t)) on SVV both during the state of f...
journal_title:Intensive care medicine
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1007/s00134-003-1649-7
更新日期:2003-03-01 00:00:00
abstract:OBJECTIVE:To determine whether a goal-directed terlipressin infusion increases mean arterial pressure without causing a pulmonary vasopressive effect and whether this response impacts on key parameters of oxygen transport in healthy and endotoxemic sheep. DESIGN AND SETTING:Prospective controlled trial in a university...
journal_title:Intensive care medicine
pub_type: 杂志文章
doi:10.1007/s00134-002-1546-5
更新日期:2003-02-01 00:00:00
abstract:OBJECTIVE:In normal subjects cerebral CO2 vasoreactivity is measured during spontaneous hyperventilation, breathholding, or adding CO2 to inspiratory gases. The correlation between CO2 and cerebral blood flow may, however, be invalidated by the effects of a modified respiratory pattern on venous return, sympathovagal b...
journal_title:Intensive care medicine
pub_type: 临床试验,杂志文章
doi:10.1007/s001340051239
更新日期:2000-06-01 00:00:00
abstract::Surgical principles of early excision of devitalized tissue and prompt wound closure which govern the management of all traumatic injuries have been developed in the primary treatment of burns. Topical and systemic antibodies which delay wound infection and control invasive sepsis provide an initial period of two to t...
journal_title:Intensive care medicine
pub_type: 杂志文章,评审
doi:10.1007/BF01687263
更新日期:1981-01-01 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:PURPOSE:To examine the consequences of administration of norepinephrine on muscle tissue oxygenation in severely hypotensive septic shock patients. METHODS:This was a prospective observational study conducted in a medical intensive care unit of a university hospital. We included 28 septic shock patients that received ...
journal_title:Intensive care medicine
pub_type: 杂志文章
doi:10.1007/s00134-010-2013-3
更新日期:2010-11-01 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::In order to evaluate the in vitro activity of fleroxacin against nosocomial gram-negative organisms, 263 multiresistant gram-negative bacilli (203 Enterobacteriaceae and 60 non-fermenting gram-negative bacilli) were isolated from adult patients with nosocomial infections. The different patterns of resistance to eight ...
journal_title:Intensive care medicine
pub_type: 杂志文章
doi:10.1007/s001340050675
更新日期:1998-08-01 00:00:00
abstract::We have treated 30 patients with flail chest, with priority given to associated factors (pain, secretions retention, hemo-/pneumothorax and underlying pulmonary contusion). When this treatment was insufficient IMV + PEEP was instituted; in this group there was a 58.8% incidence of pneumonia, 47.5% of sepsis and 11.7 d...
journal_title:Intensive care medicine
pub_type: 杂志文章
doi:10.1007/BF01687161
更新日期:1980-08-01 00:00:00
abstract::Recombinant activated factor VII (rFVIIa, 'NovoSeven') is indicated for the treatment of spontaneous and surgical bleeding in patients with haemophilia A or B with antibodies to factors VIII or IX (FVIII or FIX) worldwide, and in patients with acquired haemophilia in Europe. In vitro cell models have demonstrated that...
journal_title:Intensive care medicine
pub_type: 杂志文章,评审
doi:10.1007/s00134-002-1469-1
更新日期:2002-10-01 00:00:00
abstract:PURPOSE:The early diagnosis of traumatic internal carotid artery dissection (TICAD) is essential for initiating appropriate treatment and improving outcome. We searched for criteria from transcranial Doppler (TCD) measurements on admission that could be associated with subsequent TICAD diagnosis in patients with trauma...
journal_title:Intensive care medicine
pub_type: 杂志文章
doi:10.1007/s00134-010-1919-0
更新日期:2010-09-01 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 evaluate the effect of different infusion pump models on continuity of drug delivery during vertical displacement of syringe pumps. DESIGN:Zero-drug delivery time (ZDDT), retrograde aspiration volume, and infusion bolus were recorded using the same syringe in three different models of syringe pump after l...
journal_title:Intensive care medicine
pub_type: 杂志文章
doi:10.1007/s001340000784
更新日期:2001-01-01 00:00:00
abstract:OBJECTIVE:To determine what change in respiratory function occurred following prolonged and efficient continuous arteriovenous haemofiltration (CAVH) in a group of patients with multiple organ systems failure (MOSF). DESIGN:A retrospective assessment using patient notes and ICU charts. SETTING:The Intensive Care Unit...
journal_title:Intensive care medicine
pub_type: 杂志文章
doi:10.1007/BF01694361
更新日期:1992-01-01 00:00:00
abstract:OBJECTIVE:To assess the effects of the cyclooxygenase inhibitor diclofenac in a canine model of pulmonary occlusion and reperfusion of the left lower lobe (LLL). DESIGN:Twelve adult beagle dogs (13-17 kg) were randomly assigned to a control group (n = 6) and a diclofenac-treated group (n = 6). Animals in the treatment...
journal_title:Intensive care medicine
pub_type: 杂志文章
doi:10.1007/BF01700965
更新日期:1995-10-01 00:00:00
abstract::Knowledge translation is an important step for translational research. In this issue of Intensive Care Medicine, a new mini-series of basic research-related reviews is published. Three invited reviews focus on the role of extracellular matrix in ventilator-induced lung injury and mechanotransduction. The major challen...
journal_title:Intensive care medicine
pub_type: 评论,社论
doi:10.1007/s00134-007-0965-8
更新日期:2008-04-01 00:00:00
abstract:PURPOSE:Clinical examination is often the first step to diagnose shock and estimate cardiac index. In the Simple Intensive Care Studies-I, we assessed the association and diagnostic performance of clinical signs for estimation of cardiac index in critically ill patients. METHODS:In this prospective, single-centre coho...
journal_title:Intensive care medicine
pub_type: 杂志文章
doi:10.1007/s00134-019-05527-y
更新日期:2019-02-01 00:00:00
abstract:OBJECTIVE:To determine the reliability of estimating arterial CO(2) pressure (PaCO(2)) using a recently introduced transcutaneous CO(2) pressure (PtcCO(2)) monitor in severe obese patients. DESIGN:Observational and interventional study. SETTING:District hospital with respiratory ward and bariatric surgery unit. PATI...
journal_title:Intensive care medicine
pub_type: 杂志文章
doi:10.1007/s00134-008-1078-8
更新日期:2008-07-01 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::Induced hypothermia can be used to protect the brain from post-ischemic and traumatic neurological injury. Potential clinical applications and the available evidence are discussed in a separate paper. This review focuses on the practical aspects of cooling and physiological changes induced by hypothermia, as well as t...
journal_title:Intensive care medicine
pub_type: 杂志文章,评审
doi:10.1007/s00134-003-2151-y
更新日期:2004-05-01 00:00:00
abstract:OBJECTIVE:To determine the incidence, risk factors, and outcome of barotrauma in a cohort of mechanically ventilated patients where limited tidal volumes and airway pressures were used. DESIGN AND SETTING:Prospective cohort of 361 intensive care units from 20 countries. PATIENTS AND PARTICIPANTS:A total of 5183 patie...
journal_title:Intensive care medicine
pub_type: 杂志文章,多中心研究
doi:10.1007/s00134-004-2187-7
更新日期:2004-04-01 00:00:00
abstract:PURPOSE:Hyperglycaemia is common in the critically ill. The objectives of this study were to determine the prevalence of critical illness-associated hyperglycaemia (CIAH) and recognised and unrecognised diabetes in the critically ill as well as to evaluate the impact of premorbid glycaemia on the association between ac...
journal_title:Intensive care medicine
pub_type: 临床试验,杂志文章
doi:10.1007/s00134-014-3287-7
更新日期:2014-07-01 00:00:00
abstract:PURPOSE:Recalibration and determining discriminative power, internationally, of the existing delirium prediction model (PRE-DELIRIC) for intensive care patients. METHODS:A prospective multicenter cohort study was performed in eight intensive care units (ICUs) in six countries. The ten predictors (age, APACHE-II, urgen...
journal_title:Intensive care medicine
pub_type: 杂志文章,多中心研究
doi:10.1007/s00134-013-3202-7
更新日期:2014-03-01 00:00:00
abstract:OBJECTIVE:To investigate the morphological changes in the liver in patients with organ failure and hyperbilirubinemia and to correlate them to the outcome. DESIGN:A case series prospective study. SETTING:Intensive care units of two general hospitals. PATIENTS:Twelve patients in organ failure with predominant hepatic...
journal_title:Intensive care medicine
pub_type: 杂志文章
doi:10.1007/BF01708095
更新日期:1996-06-01 00:00:00
abstract:BACKGROUND:Peripherally inserted central venous catheters (PICC) have been proposed as an alternative to central venous catheters (CVC). The aim of this study was to determine the thrombosis rate in relation to PICC placement in patients discharged from the intensive care unit (ICU). METHODS:Data of patients admitted ...
journal_title:Intensive care medicine
pub_type: 杂志文章
doi:10.1007/s00134-010-2043-x
更新日期:2011-02-01 00:00:00
abstract::Sixteen anaesthetized rabbits were subjected to tracheostomy and lung damage produced by the instillation of 4.5 ml/kg hydrochloric acid (pH 1.5) into the trachea. Half of the animals were ventilated with a positive end-expiratory pressure (PEEP) of 3 cmH2O and half with a PEEP of 10 cmH2O for 5 h, the mean airway pre...
journal_title:Intensive care medicine
pub_type: 杂志文章
doi:10.1007/BF01705044
更新日期:1992-01-01 00:00:00
abstract:PURPOSE:Neutrophil gelatinase-associated lipocalin (NGAL) is a promising biomarker for acute kidney injury (AKI). We evaluated the diagnostic and prognostic accuracies of plasma NGAL (pNGAL) for contrast-induced AKI (CI-AKI) in critically ill patients. METHODS:In a prospective observational study in two adult intensiv...
journal_title:Intensive care medicine
pub_type: 杂志文章
doi:10.1007/s00134-013-2826-y
更新日期:2013-05-01 00:00:00
abstract:OBJECTIVE:We examined in rabbits the effects of more than 48 h of mechanical ventilation on the contractile properties and fiber type adaptations of the respiratory muscles. DESIGN AND SETTING:Experimental prospective study in a university laboratory. ANIMALS AND INTERVENTIONS:Nineteen rabbits were randomly allocated...
journal_title:Intensive care medicine
pub_type: 杂志文章
doi:10.1007/s00134-002-1548-3
更新日期:2003-01-01 00:00:00
abstract:OBJECTIVE:The Sonoclot analyser provides global measurement of haemostasis, including plasma coagulation, platelet function and fibrinolysis. Benefits of its use in cardiovascular and hepatic surgery are well-documented and it may be useful in managing obstetric complications. The aim of this study was to determine ran...
journal_title:Intensive care medicine
pub_type: 杂志文章
doi:10.1007/s001340050047
更新日期:2000-02-01 00:00:00
abstract::Factors influencing nitrogen balance during total parenteral nutrition have been investigated in 34 critically ill injured patients studied during the first 6 days after trauma. Basal nitrogen balance was severely negative (-0.26 +/- 0.12 (SD) g X kg-1), but improved consistently during treatment. Nitrogen intake prov...
journal_title:Intensive care medicine
pub_type: 杂志文章
doi:10.1007/BF00256262
更新日期:1984-01-01 00:00:00