Abstract：
OBJECTIVE:Candidemia is increasingly encountered in critically ill patients with a high fatality rate. The available data in the critically ill suggest that patients with prior surgery are at a higher risk than others. However, little is known about candidemia in medical settings. The main goal of this study was to compare features of candidemia in critically ill medical and surgical patients. DESIGN:Ten-year retrospective cohort study (1990-2000). SETTING:Medical and surgical intensive care units (ICUs) of a teaching hospital. PATIENTS:Fifty-one patients with at least one positive blood culture for Candida species. MAIN RESULTS:Risk factors were retrieved in all of the patients: central venous catheter (92.1%), mechanical ventilation (72.5%), prior bacterial infection (70.6%), high fungal colonization index (45.6%). Candida albicans accounts for 55% of all candidemia. The overall mortality was 60.8% (85% and 45.2% in medical and surgical patients, respectively). Independent factors associated with survival were prior surgery (hazard ratio [HR] =0.25; 0.09-0.67 95% confidence interval [CI], p<0.05), antifungal treatment (HR =0.11; 0.04-0.30 95% CI, p<0.05) and absence of neutropenia (HR =0.10; 0.02-0.45 95% CI, p<0.05). Steroids, neutropenia and high density of fungal colonization were more frequently found among medical patients compared to surgical ones. CONCLUSIONS:Candidemia occurrence is associated with a high mortality rate among critically ill patients. Differences in underlying conditions could account for the poorer outcome of the medical patients. Screening for fungal colonization could allow identification of such high-risk patients and, in turn, improve outcome.
journal_name
Intensive Care Medjournal_title
Intensive care medicineauthors
Charles PE,Doise JM,Quenot JP,Aube H,Dalle F,Chavanet P,Milesi N,Aho LS,Portier H,Blettery Bdoi
10.1007/s00134-003-2002-xkeywords:
subject
Has Abstractpub_date
2003-12-01 00:00:00pages
2162-2169issue
12eissn
0342-4642issn
1432-1238pii
10.1007/s00134-003-2002-xjournal_volume
29pub_type
杂志文章abstract：:A 16-month old baby developed severe respiratory failure because of acute laryngitis and required mechanical ventilation. Intubation was complicated by aspiration and development of chemical pneumonia. Following 4 days of treatment the child was successfully extubated. Thirty six hours after extubation the patient aga...
journal_title：Intensive care medicine
pub_type： 杂志文章
doi：10.1007/BF00256065
更新日期：1985-01-01 00:00:00
abstract：OBJECTIVE:Pressure-volume (PV) curves are recorded after induction of complete muscle paralysis, which may limit their clinical use. The feasibility of recording PV curves without paralysis has not been tested. In 19 patients with acute respiratory distress syndrome (ARDS) and no hemodynamic instability we prospectivel...
journal_title：Intensive care medicine
pub_type： 杂志文章,随机对照试验
doi：10.1007/s00134-006-0265-8
更新日期：2006-09-01 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：OBJECTIVE:There is considerable heterogeneity among randomized trials comparing high-frequency ventilation (HFV) with conventional mechanical ventilation (CMV) in premature neonates with respiratory distress syndrome. We investigated what factors explained differences in outcome among these trials. DESIGN:Meta-regress...
journal_title：Intensive care medicine
pub_type： 杂志文章,meta分析
doi：10.1007/s00134-007-0545-y
更新日期：2007-04-01 00:00:00
abstract：INTRODUCTION:Most anxiolytics and sedative regimens in the intensive care unit (ICU) impair intellectual function, reducing patient autonomy, and often add to patient morbidity. Using an ICU-validated cognitive assessment tool Adapted Cognitive Exam (ACE), we performed a comparison between dexmedetomidine (DEX) and pro...
journal_title：Intensive care medicine
pub_type： 临床试验,杂志文章,随机对照试验
doi：10.1007/s00134-010-1874-9
更新日期：2010-09-01 00:00:00
abstract：:This narrative review focuses on thoracic ultrasonography (lung and pleural) with the aim of outlining its utility for the critical care clinician. The article summarizes the applications of thoracic ultrasonography for the evaluation and management of pneumothorax, pleural effusion, acute dyspnea, pulmonary edema, pu...
journal_title：Intensive care medicine
pub_type： 杂志文章,评审
doi：10.1007/s00134-019-05725-8
更新日期：2019-09-01 00:00:00
abstract：PURPOSE:Although low doses of oxygen (FiO2 <0.50) are considered nontoxic, recent studies have shown that even lower doses increase pulmonary inflammatory mediators. We aimed to evaluate the acute effects of reducing FiO2 on pulmonary inflammation in mechanically ventilated patients without respiratory failure. METHOD...
journal_title：Intensive care medicine
pub_type： 杂志文章
doi：10.1007/s00134-012-2801-z
更新日期：2013-04-01 00:00:00
abstract：OBJECTIVE:To present the efficacy and tolerability of a new oral dosage form of the calcium antagonist nitrendipine compared to nifedipine capsules in patients with hypertensive emergency. DESIGN:Multicenter randomized double blind clinical study. SETTING:23 study centres (hospitals) in Germany. PATIENTS:161 patient...
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/BF01708963
更新日期：1994-01-01 00:00:00
abstract：PURPOSE:Ventricular-arterial (V-A) decoupling decreases myocardial efficiency and is exacerbated by tachycardia that increases static arterial elastance (Ea). We thus investigated the effects of heart rate (HR) reduction on Ea in septic shock patients using the beta-blocker esmolol. We hypothesized that esmolol improve...
journal_title：Intensive care medicine
pub_type： 杂志文章
doi：10.1007/s00134-016-4351-2
更新日期：2016-10-01 00:00:00
abstract：:A total of 6178 persons with out-of-hospital (70%) and in hospital (30%) cardiac arrests from the first of January 1982 until the end of 1989 were reviewed retrospectively with respect to 4 variables, contributing to a score for specific prediction of poor prognosis (cut-off point: greater than 3 points). These includ...
journal_title：Intensive care medicine
pub_type： 杂志文章
doi：10.1007/BF01706419
更新日期：1992-01-01 00:00:00
abstract：OBJECTIVE:To investigate the sources of hemorrhage and use of endoscopic hemostasis in patients with clinically significant upper gastrointestinal (UGI) hemorrhage after admission to the intensive care unit (ICU). DESIGN AND SETTING:Prospective study, 123 beds of ICU in a 1,629-bed medical center. MEASUREMENTS AND RE...
journal_title：Intensive care medicine
pub_type： 杂志文章
doi：10.1007/s00134-003-1921-x
更新日期：2003-10-01 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：OBJECTIVE:To evaluate whether helium-oxygen mixture reduces inspiratory work of breathing (WOB) in sedated, paralyzed, and mechanically ventilated patients with acute exacerbation of chronic obstructive pulmonary disease (COPD). DESIGN AND SETTING:Open, prospective, randomized, crossover study in the medical intensive...
journal_title：Intensive care medicine
pub_type： 临床试验,杂志文章,随机对照试验
doi：10.1007/s00134-003-1911-z
更新日期：2003-10-01 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:To characterize the perceived utilization of physical restraint (PR) in mechanically ventilated intensive care unit (ICU) patients and to identify clinical and structural factors influencing PR use. METHODS:A questionnaire was personally handed to one intensivist in 130 ICUs in France then collected on-site 2 ...
journal_title：Intensive care medicine
pub_type： 杂志文章
doi：10.1007/s00134-012-2715-9
更新日期：2013-01-01 00:00:00
abstract：:Placement of a Swan-Ganz catheter can cause many complications. This case report presents a new complication of Swan-Ganz catheter insertion--placement of the Swan-Ganz catheter tip in the coronary sinus. ...
journal_title：Intensive care medicine
pub_type： 杂志文章
doi：10.1007/BF00254707
更新日期：1987-01-01 00:00:00
abstract：:In critically ill patients, it is frequently challenging to identify who will benefit from admission to the intensive care unit and life-sustaining interventions when the chances of a meaningful outcome are unclear. In addition, the acute illness not only affects the patients but also family members or surrogates who ...
journal_title：Intensive care medicine
pub_type： 杂志文章,评审
doi：10.1007/s00134-018-5339-x
更新日期：2018-09-01 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：INTRODUCTION:Faecal peritonitis (FP) is a common cause of sepsis and admission to the intensive care unit (ICU). The Genetics of Sepsis and Septic Shock in Europe (GenOSept) project is investigating the influence of genetic variation on the host response and outcomes in a large cohort of patients with sepsis admitted t...
journal_title：Intensive care medicine
pub_type： 杂志文章,多中心研究
doi：10.1007/s00134-013-3158-7
更新日期：2014-02-01 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：: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：PURPOSE:Early central venous catheter (CVC) insertion in Ebola virus disease (EVD) is a novel approach and has not previously been described. This report delineates the safety, feasibility and clinical implications of early CVC insertion as the optimum means of vascular access in patients with EVD, in the setting of a ...
journal_title：Intensive care medicine
pub_type： 杂志文章
doi：10.1007/s00134-015-3736-y
更新日期：2015-05-01 00:00:00
abstract：OBJECTIVE:To investigate the role of the inducible nitric oxide synthase activation-induced excess nitric oxide formation on the rate of hepatic glucose production during fully resuscitated murine septic shock. DESIGN:Prospective, controlled, randomized animal study. SETTING:University animal research laboratory. SU...
journal_title：Intensive care medicine
pub_type： 杂志文章
doi：10.1007/s00134-007-0638-7
更新日期：2007-06-01 00:00:00
abstract：OBJECTIVE:To investigate the effects of some acid-base abnormalities on blood capacity of transporting CO(2). DESIGN:Prospective study. SETTING:General and Cardiosurgical ICUs of a University hospital. PATIENTS:Six groups of ten patients characterized by: metabolic alkalosis; respiratory alkalosis; absence of acid-b...
journal_title：Intensive care medicine
pub_type： 杂志文章
doi：10.1007/s00134-002-1259-9
更新日期：2002-05-01 00:00:00
abstract：OBJECTIVE:To analyze the effects of polymyxin B-immobilized fiber (PMX-F) on bone resorption in septic patients. DESIGN AND SETTING:Observational prospective study in intensive care units of a general hospital. PATIENTS AND PARTICIPANTS:25 patients with severe sepsis and 20 healthy controls. MEASUREMENTS AND RESULTS...
journal_title：Intensive care medicine
pub_type： 临床试验,杂志文章,随机对照试验
doi：10.1007/s00134-004-2357-7
更新日期：2004-09-01 00:00:00
abstract：OBJECTIVE:To explore translation, conversion and definition ambiguities, when using severity scoring systems in patients admitted to intensive care units (ICUs). DESIGN:A prospective study of the prognosis of acute renal failure in ICUs. SETTING:The study was conducted in 20 French ICUs. PATIENTS:360 patients presen...
journal_title：Intensive care medicine
pub_type： 杂志文章
doi：10.1007/BF01705416
更新日期：1995-04-01 00:00:00
abstract：PURPOSE:Polymyxin B-immobilized hemoperfusion (PMX-HP) is an adjuvant therapy for sepsis or septic shock that clears circulating endotoxin. Prior trials have shown that PMX-HP improves surrogate endpoints. We aimed to conduct an evidence synthesis to evaluate the efficacy and safety of PMX-HP in critically ill adult pa...
journal_title：Intensive care medicine
pub_type： 杂志文章,meta分析
doi：10.1007/s00134-017-5004-9
更新日期：2018-02-01 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：OBJECTIVE:To clarify the effects of hypercapnia (increased PaCO2) on gastric mucosal oxygenation during anaesthesia in dogs. DESIGN:Prospective, controlled animal study. SETTING:Experimental research laboratory of an university hospital. SUBJECTS:Six chronically instrumented dogs. INTERVENTIONS:Dogs were anaestheti...
journal_title：Intensive care medicine
pub_type： 杂志文章
doi：10.1007/s00134-008-1183-8
更新日期：2008-10-01 00:00:00
abstract：PURPOSE:Acute kidney injury (AKI) frequently occurs in critically ill patients and often precipitates use of renal replacement therapy (RRT). However, the ideal circumstances for whether and when to start RRT remain unclear. We performed evidence synthesis of the available literature to evaluate the value of biomarkers...
journal_title：Intensive care medicine
pub_type： 杂志文章,评审
doi：10.1007/s00134-018-5126-8
更新日期：2018-03-01 00:00:00
