Abstract：
:The abundance of literature related to nutritional support reflects its recently recognised role in preventing metabolic complications and gut dysfunction during critical illness. However, some published studies lack relevance to critically ill patients, as a result of the selection of subjects and outcome variables, or flaws in the study design, as well as in the type, composition, timing, route of administration and amount of nutritional support given. This review will highlight these confounding factors by describing two imaginary (but typical) clinical trials and by analysing some studies published. The point at issue is that basic quality requirements, such as the formulation of a prospective hypothesis and the delineation of the effects of the reference treatment, are often lacking in many studies published. Data analysis was often found to be biased by the absence of statistical power calculation and intention-to-treat analysis. Globally, studies designed to assess the effects of nutritional support on the outcome of critically ill patients, rarely fulfil basic quality requirements and should therefore be interpreted cautiously. We suggest simple strategies or study design that will allow important questions to be answered by future clinical trials.
journal_name
Intensive Care Medjournal_title
Intensive care medicineauthors
Preiser JC,Chioléro R,Wernerman J,ESICM(European Society of Intensive Care Medicine) Working Group on Nutrition and Metabolism.doi
10.1007/s00134-002-1581-2keywords:
subject
Has Abstractpub_date
2003-02-01 00:00:00pages
156-66issue
2eissn
0342-4642issn
1432-1238journal_volume
29pub_type
杂志文章,评审abstract：OBJECTIVE:To describe a real-time ultrasound sign, the visualization of the cavity and the walls of the maxillary sinus ("sinusogram"), and to assess its correlation with total opacity of the sinus. DESIGN:Prospective clinical study. SETTING:The medical ICU of a university-affiliated hospital. PATIENTS:The significa...
journal_title：Intensive care medicine
pub_type： 杂志文章
doi：10.1007/s001340050716
更新日期：1998-10-01 00:00:00
abstract：OBJECTIVE:Assessing pulse pressure variation (PPV) to predict fluid responsiveness in mechanically ventilated patients with tidal volume (VT) and the impact of VT and airway driving pressure (P(plat) - PEEP) on the ability of PPV for predicting fluid responsiveness. DESIGN:Prospective interventional study. SETTING:IC...
journal_title：Intensive care medicine
pub_type： 杂志文章
doi：10.1007/s00134-009-1686-y
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：: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：OBJECTIVES:To measure the extent of dilution of helium-oxygen (heliox) by room air when given via high concentration reservoir mask to spontaneously breathing subjects. Substantial dilution of heliox by room air under these circumstances might alter its physical properties sufficiently to negate any potential clinical ...
journal_title：Intensive care medicine
pub_type： 杂志文章,随机对照试验
doi：10.1007/s00134-008-1064-1
更新日期：2008-08-01 00:00:00
abstract：OBJECTIVE:To measure muscle blood flow (Qtis) and oxygen consumption (VO(2)tis) in septic and non-septic critically ill patients by near-infrared spectroscopy (NIRS). SETTING:Surgical intensive care unit of a university hospital. PATIENTS AND PARTICIPANTS:Four patients with septic shock, eight post-surgical criticall...
journal_title：Intensive care medicine
pub_type： 杂志文章
doi：10.1007/s00134-003-1805-0
更新日期：2003-07-01 00:00:00
abstract：:A randomized study of 30 patients undergoing uncomplicated surgery under spinal anesthesia was conducted to assess the influence of colloids on the kinetics of plasma fibronectin and complement. Both are opsonins of the reticuloendothelial system; moreover fibronectin is concerned with host resistance against septic c...
journal_title：Intensive care medicine
pub_type： 临床试验,杂志文章,随机对照试验
doi：10.1007/BF01691428
更新日期：1991-01-01 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：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：:A cardiorespiratory monitoring system allows the measurement of FAECO2 and FECO2 in the expired air of the patient at the mouth (endtidal CO2) and in a mixing box. From these parameters, combined with the measured PACO2, the alveolo-expired (DuA = PECO2/PAECO2) and alveolar-arterial (Dua = PAECO2/PACO2) ductances whic...
journal_title：Intensive care medicine
pub_type： 杂志文章
doi：10.1007/BF01687162
更新日期：1980-08-01 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：:This report identifies some of the risk factors underlying the acquisition of hospital infections in patients admitted to Intensive Care Units (ICUs). Infection rates vary in different institutes and in different types of ICUs. Patients are particularly prone to septicaemia and respiratory infections and the underlyin...
journal_title：Intensive care medicine
pub_type： 杂志文章,评审
doi：10.1007/BF01709700
更新日期：1990-01-01 00:00:00
abstract：OBJECTIVE:Pseudomonas aeruginosa-induced lung injury is characterized not only by the alteration in lung fluid movement but also by apoptosis of lung epithelial and endothelial cells. We studied whether inhibition of apoptosis using a broad spectrum caspase inhibitor, benzyloxycarbonyl-Val-Ala-Asp fluoromethylketone (Z...
journal_title：Intensive care medicine
pub_type： 杂志文章
doi：10.1007/s00134-004-2165-0
更新日期：2004-06-01 00:00:00
abstract：OBJECTIVE:Endotracheal suctioning can cause alveolar collapse and impede ventilation. One reason is the gas flow through a single-lumen endotracheal tube (ETT) provoking a gradient between airway opening and tracheal (P(tr)) pressures. Separately extending the patient tubing limbs of a suitable ventilator into the trac...
journal_title：Intensive care medicine
pub_type： 杂志文章
doi：10.1007/s00134-004-2537-5
更新日期：2005-03-01 00:00:00
abstract：OBJECTIVE:Measurement of functional residual capacity (FRC) during mechanical ventilation is important to standardise respiratory system compliance and adjust the ventilator settings to optimise lung recruitment. In the present study we compared three methods to measure FRC. DESIGN:The bias flow nitrogen washout techn...
journal_title：Intensive care medicine
pub_type： 杂志文章
doi：10.1007/s00134-003-2028-0
更新日期：2004-01-01 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：:A retrospective study of the medical records of 115 consecutive cases of meningococcal disease with 11 fatalities was carried out in order to evaluate the power of 15 clinical and laboratory variables available on admission in predicting a fatal outcome. On linear discriminant analysis, six variables showed a signific...
journal_title：Intensive care medicine
pub_type： 杂志文章
doi：10.1007/BF00261740
更新日期：1986-01-01 00:00:00
abstract：OBJECTIVE:To measure the effects of rapid permissive hypercapnia on hemodynamics and gas exchange in patients with acute respiratory distress syndrome (ARDS). DESIGN:Prospective study. SETTING:18-bed, medical intensive care unit, university hospital. PATIENTS:11 mechanically ventilated ARDS patients. INTERVENTION:P...
journal_title：Intensive care medicine
pub_type： 临床试验,杂志文章
doi：10.1007/BF01712235
更新日期：1996-03-01 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：OBJECTIVE:To test the feasibility of the transcardiac conductance (TCC) method for continuous, on-line measurement of absolute left ventricular (LV) volume and to validate the method by comparison with biplane angiography. DESIGN AND SETTING:Prospective clinical feasibility and validation study in a cardiac catheteriz...
journal_title：Intensive care medicine
pub_type： 临床试验,杂志文章
doi：10.1007/s00134-004-2300-y
更新日期：2004-07-01 00:00:00
abstract：:Central venous catheters (CVCs) are widely used in critically ill patients in intensive care units. However, infectious complications are common and may limit their utility. We critically review the literature to determine the impact of CVC design and composition, insertion site selection, insertion procedures, care a...
journal_title：Intensive care medicine
pub_type： 杂志文章,评审
doi：10.1007/BF01726542
更新日期：1995-02-01 00:00:00
abstract：OBJECTIVES:To develop a simplified Therapeutic Intervention Scoring System (TISS) based on the TISS-28 items and to validate the new score in an independent database. DESIGN:Retrospective statistical analysis of a database and a prospective multicentre study. SETTING:Development in the database of the Foundation for ...
journal_title：Intensive care medicine
pub_type： 杂志文章
doi：10.1007/s001340050406
更新日期：1997-07-01 00:00:00
abstract：OBJECTIVE:To evaluate whether soluble triggering receptor expressed on myeloid cells 1 (sTREM-1) in CSF can serve as a biomarker for the presence of bacterial meningitis and outcome in patients with this disease. DESIGN:Retrospective study of diagnostic accuracy. SETTING AND PATIENTS:CSF was collected from 92 adults ...
journal_title：Intensive care medicine
pub_type： 杂志文章
doi：10.1007/s00134-006-0240-4
更新日期：2006-08-01 00:00:00
abstract：OBJECTIVE:The aim of the study was to explore trends and changes in sedation practices for mechanically ventilated patients in Danish intensive care units (ICUs) and to compare sedation practices in 1997 and 2003. DESIGN:The study was a follow-up survey with a descriptive and comparative cross-sectional multicenter de...
journal_title：Intensive care medicine
pub_type： 杂志文章,多中心研究
doi：10.1007/s00134-005-2856-1
更新日期：2006-01-01 00:00:00
abstract：:Dynamic vectorcardiography (VCG) is increasingly employed for ischaemia monitoring with the use of a computerized method for recording and on-line analysis by the calculation of trend parameters. To elucidate how well the derived electrocardiogram (dECG), calculated from the VCG, compares with the simultaneously regis...
journal_title：Intensive care medicine
pub_type： 临床试验,杂志文章
doi：10.1007/s001340050455
更新日期：1997-10-01 00:00:00
abstract：BACKGROUND:Limiting the duration of invasive ventilation is an important goal in caring for critically ill patients. Several clinical trials have shown that compared to traditional care, protocols can reduce the total duration of mechanical ventilation. Computerized or automated weaning has the potential to improve wea...
journal_title：Intensive care medicine
pub_type： 杂志文章,评审
doi：10.1007/s00134-008-1154-0
更新日期：2008-10-01 00:00:00
abstract：OBJECTIVE:To describe the clinical course of quinine-induced disseminated intravascular coagulation (DIC) and review all previous cases reported in the medical literature. DESIGN:Case report/literature review. SETTING:University teaching hospital medical ICU. PATIENTS:One patient in whom thrombocytopenia, coagulopat...
journal_title：Intensive care medicine
pub_type： 杂志文章,评审
doi：10.1007/s00134-003-1732-0
更新日期：2003-06-01 00:00:00
abstract：OBJECTIVES:Critical illness increases the tendency to both coagulation and bleeding, complicating anticoagulation for continuous renal replacement therapy (CRRT). We analyzed strategies for anticoagulation in CRRT concerning implementation, efficacy and safety to provide evidence-based recommendations for clinical prac...
journal_title：Intensive care medicine
pub_type： 杂志文章,meta分析,评审
doi：10.1007/s00134-005-0044-y
更新日期：2006-02-01 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 assess procalcitonin (PCT) and C-reactive protein (CRP) plasma concentrations and clearance in nonseptic end-stage renal failure patients undergoing their first three hemodialysis sessions. DESIGN AND SETTING:Prospective observational consecutive clinical study at a university hospital. PATIENTS:The stud...
journal_title：Intensive care medicine
pub_type： 杂志文章
doi：10.1007/s00134-003-1664-8
更新日期：2003-04-01 00:00:00
