Abstract:
OBJECTIVE:To derive recommendations for the dosing of commonly used medications in the morbidly obese patient in the ICU. DATA SOURCES:Articles were obtained through computerized searches involving MEDLINE. The bibliographies of retrieved publications and textbooks were reviewed for additional references. STUDY SELECTION:All studies involving the pharmacokinetics or pharmacodynamics of medications in obese subjects or patients. DATA EXTRACTION:The emphasis was on studies involving morbidly obese patients but, in the absence of such data, investigations involving lesser forms of obesity were extracted. DATA SYNTHESIS:There is a paucity of data upon which to make recommendations for dosing commonly used medications in the morbidly obese patient in the ICU, although recommendations were provided based on the available information. CONCLUSIONS:There is clearly a need for more investigations involving dosing regimens of medications in the morbidly obese population. Until such studies are available, the clinician must try to derive the best dosing regimens for medications based on the limited pharmacokinetic data available for some agents and clinical judgement.
journal_name
Intensive Care Medjournal_title
Intensive care medicineauthors
Erstad BLdoi
10.1007/s00134-003-2059-6keywords:
subject
Has Abstractpub_date
2004-01-01 00:00:00pages
18-32issue
1eissn
0342-4642issn
1432-1238journal_volume
30pub_type
杂志文章,评审abstract:OBJECTIVES:Children with peripheral airways obstruction suffer the negative effects of intrinsic positive end-expiratory pressure: increased work of breathing and difficulty triggering assisted ventilatory support. We examined whether external positive end-expiratory pressure to offset intrinsic positive end-expiratory...
journal_title:Intensive care medicine
pub_type: 临床试验,杂志文章
doi:10.1007/s00134-006-0445-6
更新日期:2007-01-01 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:OBJECTIVE:The interchangeability of continuous measurement of cardiac output (CO) with the traditional bolus method in patients after cardiopulmonary bypass (CPB) is uncertain. DESIGN:Prospective observational clinical study. SETTING:A 20-bed surgical ICU at a university hospital. PATIENTS:Fourteen deeply sedated, v...
journal_title:Intensive care medicine
pub_type: 杂志文章
doi:10.1007/s00134-006-0161-2
更新日期:2006-06-01 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:PURPOSE:Critical care ultrasonography has utility for the diagnosis and management of critical illness and is in widespread use by frontline intensivists. As there is a need for research to validate and extend its utility, the Editor of Intensive Care Medicine included critical care ultrasonography as a topic in the IC...
journal_title:Intensive care medicine
pub_type: 杂志文章,评审
doi:10.1007/s00134-017-4734-z
更新日期:2017-09-01 00:00:00
abstract:PURPOSE:To test the hypothesis that RNA editing is altered in pediatric patients with cyanotic congenital heart disease (CHD) and to determine whether A-to-I RNA editing is associated with the postoperative course following cardiac surgery. Cyanotic CHD is associated with a unique pathophysiology caused by chronic hypo...
journal_title:Intensive care medicine
pub_type: 杂志文章
doi:10.1007/s00134-011-2296-z
更新日期:2011-10-01 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:OBJECTIVE:To determine the diagnostic performance of a Bayesian Decision-Support System (BDSS) for ventilator-associated pneumonia (VAP). DESIGN:A previously developed BDSS, automatically obtaining patient data from patient information systems, provides likelihood predictions of VAP. In a prospectively studied cohort ...
journal_title:Intensive care medicine
pub_type: 杂志文章
doi:10.1007/s00134-007-0728-6
更新日期:2007-08-01 00:00:00
abstract::Nine patients hospitalized for tetanus were studied under the same protocol which included two haemodynamic studies with a preload trial (PLT). The first being made during therapy (diazepam barbiturate association), on the sixth day of hospitalisation, and the second one after recovery. The comparison of the results s...
journal_title:Intensive care medicine
pub_type: 杂志文章
doi:10.1007/BF01700252
更新日期:1978-07-01 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: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:: ...
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:The long-term mortality outcome associated with sepsis and septic shock has not been well defined in a nonselected critically ill population. This study investigated the occurrence and the role of bloodstream infection (BSI) associated sepsis and septic shock at time of intensive care unit (ICU) admission on ...
journal_title:Intensive care medicine
pub_type: 杂志文章
doi:10.1007/s00134-004-2544-6
更新日期:2005-02-01 00:00:00
abstract::A hypertensive crisis with an arterial blood pressure of 280/180 mmHg developed immediately after an apparently successful removal of a phaeochromocytoma. The blood pressure could not be lowered by phentolamine and not until the administration of dihydralazine and furosemide was the systemic pressure normalized. In ad...
journal_title:Intensive care medicine
pub_type: 杂志文章
doi:10.1007/BF00315379
更新日期:1986-01-01 00:00:00
abstract::The endothelium is a highly dynamic cell layer that is involved in a multitude of physiological functions, including the control of vascular tone, the movement of cells and nutrients, the maintenance of blood fluidity and the growth of new vessels. During severe sepsis, the endothelium becomes proadhesive, procoagulan...
journal_title:Intensive care medicine
pub_type: 杂志文章,评审
doi:10.1007/s00134-010-1893-6
更新日期:2010-08-01 00:00:00
abstract:BACKGROUND:In critical illness, serum total cortisol (TC) may not adequately reflect adrenal function because of reduced cortisol-binding globulin (CBG). AIM:To evaluate adrenal function of critically ill children, using free cortisol index (FCI), calculated free cortisol (cFC), and TC levels. METHODS:Thirty-two crit...
journal_title:Intensive care medicine
pub_type: 杂志文章
doi:10.1007/s00134-009-1480-x
更新日期:2009-07-01 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:PURPOSE:To provide recommendations and standard operating procedures for intensive care units and hospital preparedness for an influenza pandemic. METHODS:Based on a literature review and expert opinion, a Delphi process was used to define the essential topics. RESULTS:Key recommendations include: Hospitals should in...
journal_title:Intensive care medicine
pub_type: 指南,杂志文章,评审
doi:10.1007/s00134-010-1759-y
更新日期:2010-03-01 00:00:00
abstract:PURPOSE:To test the hypothesis that a carbamylated EPO-FC fusion protein (cEPO-FC) or recombinant human erythropoietin (rhEPO) would protect against kidney ischemia/reperfusion (I/R) injury in pigs with atherosclerosis. METHODS:Anesthetized and mechanically ventilated animals received cEPO-FC (50 μg kg(-1)), rhEPO (5,...
journal_title:Intensive care medicine
pub_type: 杂志文章
doi:10.1007/s00134-012-2766-y
更新日期:2013-03-01 00:00:00
abstract:PURPOSE:To study the association between early initiation of intra-arrest therapeutic hypothermia and neurologic outcome in out-of-hospital cardiac arrest. METHODS:A prespecified sub-analysis of the PRINCESS trial (NCT01400373) that randomized 677 bystander-witnessed cardiac arrests to transnasal evaporative intra-arr...
journal_title:Intensive care medicine
pub_type: 杂志文章
doi:10.1007/s00134-020-06024-3
更新日期:2020-07-01 00:00:00
abstract:PURPOSE:Common opioids for analgesia and sedation of mechanically ventilated infants may tend to accumulate and cause prolonged sedation with an unpredictable extubation time. Remifentanil is a promising option due to its unique pharmacokinetic properties, which seem to be valid in adults as well as in infants. METHOD...
journal_title:Intensive care medicine
pub_type: 杂志文章,随机对照试验
doi:10.1007/s00134-012-2532-1
更新日期:2012-06-01 00:00:00
abstract:OBJECTIVE:To compare the effects of patient-initiated, pressure-regulated, volume-controlled ventilation (PRVC) with pressure-preset intermittent mandatory ventilation (IMV) in neonates with respiratory failure. DESIGN:Randomised, prospective study. SETTING:Intensive care unit (14 beds) in a 300-bed paediatric teachi...
journal_title:Intensive care medicine
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1007/s001340050441
更新日期:1997-09-01 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: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 investigate whether serum procalcitonin (PCT) levels could be useful to differentiate between systemic infection and the activity of the underlying disease in autoimmune disease. METHODS:In 18 patients with systemic lupus erythematodes (SLE) and 35 patients with systemic antineutrophil cytoplasmic antibod...
journal_title:Intensive care medicine
pub_type: 杂志文章
doi:10.1007/BF02900738
更新日期:2000-03-01 00:00:00
abstract::We compare two patients admitted after near drowning. Both presented a severe metabolic acidosis, but only one of them developed an acute pulmonary edema with hypoxemia. An increase of lipid peroxides associated with a reduction of vitamin E concentration has been observed in this later patient. Lipid peroxidation, on...
journal_title:Intensive care medicine
pub_type: 杂志文章
doi:10.1007/BF00254776
更新日期:1985-01-01 00:00:00
abstract:BACKGROUND:Posterior reversible encephalopathy syndrome (PRES) is a well-recognized clinico-neuroradiological transient condition. Early recognition is of paramount importance for prompt control of blood pressure or removal of precipitating factors and treatment of epileptic seizures or status epilepticus. Delay in the...
journal_title:Intensive care medicine
pub_type: 杂志文章,评审
doi:10.1007/s00134-006-0459-0
更新日期:2007-02-01 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:INTRODUCTION:The purpose of a scientific paper is to communicate results and within the paper this applies especially to the presentation of data. It is the universal practice in medical journals to present statistical results using tables. Good tables are an integral part of the manuscript. To help researchers communi...
journal_title:Intensive care medicine
pub_type: 杂志文章
doi:10.1007/s00134-014-3248-1
更新日期:2014-05-01 00:00:00
abstract:PURPOSE:To assess the impact of lung ultrasound (LU) on clinical decision making in mechanically ventilated critically ill patients. METHODS:One hundred and eighty-nine patients took part in this prospective study. The patients were enrolled in the study when LU was requested by the primary physician for (1) unexplain...
journal_title:Intensive care medicine
pub_type: 杂志文章
doi:10.1007/s00134-013-3133-3
更新日期:2014-01-01 00:00:00