Abstract:
OBJECTIVES:The aim of this study was to evaluate and compare the accuracy of the percentage of infected cells (%IC) in bronchoalveolar lavage (BAL) for ventilator-associated pneumonia (VAP) diagnosis according to its onset from the initiation of mechanical ventilation. PATIENTS:One hundred and eight patients admitted to a surgical ICU were retrospectively included (1999-2001). A total of 171 cases of VAP were diagnosed on clinical, biological, chest X-ray and BAL results (threshold >/=10(4 )cfu/ml). RESULTS:The %IC significantly decreased with the timing of VAP diagnosis: 12.2+/-12.1% for VAP occurring less than 7 days after the initiation of mechanical ventilation, 7.4+/-9.2% for VAP occurring between 7 and 15 days and 4.8+/-6.4% for VAP after 15 days ( p=0.0002), despite the same number of elements and proportion of polymorphonuclear neutrophils in BAL. In addition, a relationship between the %IC and the pathogen responsible for VAP was observed for P. aeruginosa [higher for VAP <7 days than for VAP 7-15 days ( p=0.01) and VAP >15 days ( p=0.006)] and S. aureus [lower for VAP >15 days than VAP 7-15 days ( p=0.04) and VAP <7 days ( p=0.04)]. Furthermore, the %IC in BAL was lower in patients undergoing antimicrobial therapy than in patients without antibiotics ( p=0.04). Three factors were independently associated with the %IC: quantitative culture of BAL (beta=0.42, p<0.0001), ongoing antimicrobial therapy (beta= -0.21, p=0.003) and onset of VAP (beta= -0.17, p=0.01). CONCLUSIONS:A relationship between the %IC in BAL, duration of ventilation, quantitative culture of BAL and ongoing antimicrobial therapy has been proved in this study. The %IC for VAP diagnosis may not be accurate in patients with ongoing antibiotics and late onset infections (>7 days).
journal_name
Intensive Care Medjournal_title
Intensive care medicineauthors
Dupont H,Chalhoub V,Plantefève G,De Vaumas C,Kermarrec N,Paugam-Burtz C,Mantz Jdoi
10.1007/s00134-004-2323-4keywords:
subject
Has Abstractpub_date
2004-08-01 00:00:00pages
1557-63issue
8eissn
0342-4642issn
1432-1238journal_volume
30pub_type
杂志文章abstract:: ...
journal_title:Intensive care medicine
pub_type: 社论
doi:10.1007/s00134-018-5401-8
更新日期:2018-12-01 00:00:00
abstract:OBJECTIVE:Erythrocytes influence the magnitude of hypoxia-induced pulmonary artery pressure increase. It is, however, unknown to what extent haemoconcentration and haemodilution affect this response and whether intrapulmonary blood volume (and thus vessel dimensions) alters the magnitude of pressure increase. Furthermo...
journal_title:Intensive care medicine
pub_type: 杂志文章
doi:10.1007/s001340051327
更新日期:2000-08-01 00:00:00
abstract::Two hundred and seventy-three acute hemorrhagic shocks were treated in 1984 in a pre-hospital emergency care unit. Twenty patients (7%) had a paradoxical bradycardia: they were conscious, 9 of them had an undetectable systolic arterial pressure with the sphygmomanometric method but the femoral pulse was still present....
journal_title:Intensive care medicine
pub_type: 杂志文章
doi:10.1007/BF00254705
更新日期:1987-01-01 00:00:00
abstract:OBJECTIVE:To determine the influence of religious affiliation and culture on end-of-life decisions in European intensive care units (ICUs). DESIGN AND SETTING:A prospective, observational study of European ICUs was performed on consecutive patients with any limitation of therapy. Prospectively defined end-of-life prac...
journal_title:Intensive care medicine
pub_type: 杂志文章,多中心研究
doi:10.1007/s00134-007-0693-0
更新日期:2007-10-01 00:00:00
abstract:BACKGROUND:After resuscitation, asphyxiated neonates often develop poor cardiac function with hypotension, pulmonary hypertension and multiorgan ischemia. In a swine model of neonatal hypoxia-reoxygenation, effects of epinephrine, dobutamine and milrinone on systemic, pulmonary and regional hemodynamics and oxygen tran...
journal_title:Intensive care medicine
pub_type: 杂志文章
doi:10.1007/s00134-010-1820-x
更新日期:2010-06-01 00:00:00
abstract:OBJECTIVE:A case-control comparison of Doppler guidance on the success rate of central venous cannulation in patients with normal or reduced intracranial compliance. DESIGN:A single operator performed central venous access procedures with continuous wave Doppler guidance. It was used on patients on a ventilator. The p...
journal_title:Intensive care medicine
pub_type: 临床试验,杂志文章
doi:10.1007/s00134-003-1862-4
更新日期:2003-09-01 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:: ...
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:Sepsis-evoked myocardial dysfunction is possibly due to decreased myofilament calcium sensitivity, and a calcium sensitizer may thus specifically improve contractility in sepsis by enhancing myofilament calcium sensitivity. We examined whether the calcium sensitizer levosimendan mitigates myocardial dysfuncti...
journal_title:Intensive care medicine
pub_type: 杂志文章
doi:10.1007/s00134-003-1879-8
更新日期:2003-10-01 00:00:00
abstract:PURPOSE:To assess the feasibility of remifentanil-based sedation in hypoxemic acute respiratory failure (HARF) patients refusing to continue noninvasive ventilation (NPPV) for intolerance to two different interfaces-helmet and total face mask. DESIGN AND SETTING:Prospective uncontrolled clinical investigation in a 14-...
journal_title:Intensive care medicine
pub_type: 临床试验,杂志文章
doi:10.1007/s00134-010-2026-y
更新日期:2010-12-01 00:00:00
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:INTRODUCTION:The concept of weaning-induced cardiac dysfunction emerged 26 years ago with the publication of a clinical study conducted by François Lemaire and collaborators. OBJECTIVES:One objective of this article is to remember the results and the historical context under which our pivotal study was conducted. Anot...
journal_title:Intensive care medicine
pub_type: 历史文章,杂志文章,评审
doi:10.1007/s00134-014-3334-4
更新日期:2014-08-01 00:00:00
abstract::A 17-year-old patient with Shone's disease had to be readmitted to the hospital 3 months after implantation of an artificial aortic valve because of extreme mitral insufficiency with consecutive pulmonary edema and hepatic dysfunction. He had been orally anticoagulated and presented with a high international normalize...
journal_title:Intensive care medicine
pub_type: 杂志文章
doi:10.1007/s001340051023
更新日期:1999-10-01 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 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::Arterial catheterization is the second most common invasive procedure performed in the intensive care unit. Despite the ubiquity of the procedure, complications including failure to place the catheter occur. While many clinicians are familiar with the use of ultrasound (US) guidance to decrease complication rates of c...
journal_title:Intensive care medicine
pub_type: 杂志文章,评审
doi:10.1007/s00134-009-1699-6
更新日期:2010-02-01 00:00:00
abstract:BACKGROUND:Invasive candidiasis and candidemia are frequently encountered in the nosocomial setting particularly in the intensive care unit (ICU). OBJECTIVE AND METHODS:To review the current management of invasive candidiasis and candidemia in non-neutropenic adult ICU patients based on a review of the literature and ...
journal_title:Intensive care medicine
pub_type: 杂志文章,评审
doi:10.1007/s00134-008-1339-6
更新日期:2009-02-01 00:00:00
abstract:OBJECTIVE:To investigate nasal nitric oxide (NO) excretion, pulmonary NO excretion, and autoinhalation of nasally released NO at rest compared with that during moderate exercise in smokers and non-smokers. DESIGN:Prospective observational study. SETTING:University laboratory. PARTICIPANTS:Fourteen healthy adult volu...
journal_title:Intensive care medicine
pub_type: 杂志文章
doi:10.1007/s001340051172
更新日期:2000-04-01 00:00:00
abstract:OBJECTIVE:To assess the effect of partial liquid ventilation with perfluorocarbons on hemodynamics and gas exchange in large pigs with induced acute lung injury (ALI). DESIGN:Randomized, prospective, double-control, experimental study. Experimental intensive care unit of a university. MATERIALS:Eighteen large pigs (5...
journal_title:Intensive care medicine
pub_type: 杂志文章
doi:10.1007/BF01700657
更新日期:1995-12-01 00:00:00
abstract:OBJECTIVE:To evaluate compliance with recommended patient-care practices for the prevention of hospital-acquired infections (HAI) in the intensive care unit (ICU). DESIGN:European descriptive survey by questionnaire mailed to all the directors of ICUs. PATIENTS AND PARTICIPANTS:A total of 1642 general ICUs with more ...
journal_title:Intensive care medicine
pub_type: 杂志文章
doi:10.1007/BF02044110
更新日期:1996-09-01 00:00:00
abstract:OBJECTIVE:The association of acute-phase reaction and outcome of patients with acute vascular diseases is controversial. The prognostic value of admission C-reactive protein (CRP) in patients with acute aortic aneurysm or dissection has not yet been investigated. DESIGN AND SETTING:Cohort study including 255 consecuti...
journal_title:Intensive care medicine
pub_type: 杂志文章
doi:10.1007/s00134-002-1299-1
更新日期:2002-06-01 00:00:00
abstract::To examine the right ventricular response to acute respiratory failure, serial studies of biventricular performance were analysed in 34 such patients, specifically detailing the role of associated underlying disease. During the initial study, the 34 patients with acute respiratory failure had a higher right ventricula...
journal_title:Intensive care medicine
pub_type: 杂志文章
doi:10.1007/BF00256963
更新日期:1988-01-01 00:00:00
abstract::In hypoxia sensitive cells and tissues, the rates of glucose and O2 consumption are inversely related (Pasteur Effect). Under O2 limiting conditions the demands for glucose (glycogen) in such cells may drastically rise as a means for maintaining ATP turnover close to normoxic rates; nevertheless ion and electrical pot...
journal_title:Intensive care medicine
pub_type: 杂志文章
doi:10.1007/BF00254926
更新日期:1986-01-01 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::The Editor-in-Chief has retracted this article [1] because a number of studies included in this review [2, 3, 4] (originally cited as references 98, 128, 129) have since been retracted. Consequently, this has rendered the content of the review unreliable. ...
journal_title:Intensive care medicine
pub_type: 杂志文章,撤回出版物
doi:10.1007/s00134-020-06068-5
更新日期:2020-06-01 00:00:00
abstract:PURPOSE:Sepsis and its progression are known to have a major influence on the coagulation system. Current coagulation tests are of limited use when assessing coagulation in sepsis patients. This study aims to assess the potential for a new functional biomarker of clot microstructure, fractal dimension, to identify chan...
journal_title:Intensive care medicine
pub_type: 杂志文章
doi:10.1007/s00134-016-4496-z
更新日期:2016-12-01 00:00:00
abstract::Type III procollagen N-peptides (PIIINPs) are believed to be released in stoichiometric amounts as type III collagen molecules are secreted from cells. We hypothesized that if the human lung actively produces type III collagen a detectable transpulmonary gradient in PIIINPs would exist in normal individuals that might...
journal_title:Intensive care medicine
pub_type: 杂志文章
doi:10.1007/BF01706477
更新日期:1992-01-01 00:00:00
abstract:OBJECTIVE:To determine the incidence rates of hospital acquired infections (HAI) during the first 14 days after ICU discharge after treatment during ICU-stay with Selective Decontamination of the Digestive tract (SDD), Selective Oropharyngeal Decontamination (SOD) or Standard Care (SC). DESIGN:Prospective observationa...
journal_title:Intensive care medicine
pub_type: 杂志文章
doi:10.1007/s00134-009-1554-9
更新日期:2009-09-01 00:00:00
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:To determine the presence of tricuspid regurgitation (TR) in patients affected by acute lung injury (ALI) and the adult respiratory distress syndrome (ARDS) during mechanical ventilation with positive end-expiratory pressure (PEEP). DESIGN:A prospective clinical study. SETTING:10-bed general intensive care ...
journal_title:Intensive care medicine
pub_type: 临床试验,杂志文章
doi:10.1007/s001340050419
更新日期:1997-08-01 00:00:00