Abstract:
OBJECTIVE:To compare the effectiveness of 70-mg and 200-mg doses of intravenous erythromycin in improving gastric emptying in critically ill patients. DESIGN:Gastric emptying was measured on consecutive days; day 1 (pre-treatment), day 2 (post-treatment) after an intravenous infusion of either 70 or 200 mg erythromycin or saline placebo (0.9%), in a randomized double-blind fashion. SETTING:Mixed medical/surgical intensive care unit, tertiary referral. PATIENTS AND PARTICIPANTS:Thirty-five randomly selected, mechanically ventilated, enterally fed critically ill patients (median APACHE II score 19 on admission). INTERVENTIONS:On day 2 either 70 or 200 mg erythromycin or saline was administered intravenously over 20 min. MEASUREMENTS AND RESULTS:Gastric emptying was measured using the [13C]octanoic acid breath test. The gastric emptying coefficient (GEC) and half-emptying time (t1/2) were calculated from the area under the 13CO2-recovery curve. Pre-treatment gastric emptying measurements were similar in all three patient groups. Treatment with both doses of erythromycin significantly reduced the gastric t1/2: 70 mg, 98 min (IQR 88-112); 200 mg, 86 min (75-104); vs. placebo, 122 min (102-190) (p<0.05). The GEC was higher with both doses of erythromycin: 70 mg, 3.8 (3.3-4.0); 200 mg, 4.0 (3.6-4.2); vs. placebo, 2.9 (2.5-3.7) (p<0.05). There was no difference in gastric emptying post-treatment between the two doses of erythromycin. The effect of erythromycin was greatest in patients with delayed gastric emptying. CONCLUSIONS:Treatment with 70 and 200 mg intravenous erythromycin are equally effective in accelerating gastric emptying in the critically ill.
journal_name
Intensive Care Medjournal_title
Intensive care medicineauthors
Ritz MA,Chapman MJ,Fraser RJ,Finnis ME,Butler RN,Cmielewski P,Davidson GP,Rea Ddoi
10.1007/s00134-005-2663-8keywords:
subject
Has Abstractpub_date
2005-07-01 00:00:00pages
949-54issue
7eissn
0342-4642issn
1432-1238journal_volume
31pub_type
临床试验,杂志文章,随机对照试验abstract:OBJECTIVE:To describe the use of volumetric capnography, a plot of expired CO(2) concentration against expired volume, in monitoring fibrinolytic treatment of major pulmonary embolism. DESIGN AND SETTING:Two case reports in the emergency department of a teaching hospital. PATIENTS:Two conscious and spontaneously brea...
journal_title:Intensive care medicine
pub_type: 杂志文章
doi:10.1007/s00134-004-2444-9
更新日期:2004-11-01 00:00:00
abstract:OBJECTIVE:The immediate overwhelming release of inflammatory mediators in septic shock is rapidly followed by strong anti-inflammatory responses inducing a state of immunosuppression. The patients who survive the initial hyper-inflammatory step of septic shock but subsequently die may be those who do not recover from i...
journal_title:Intensive care medicine
pub_type: 杂志文章
doi:10.1007/s00134-006-0204-8
更新日期:2006-08-01 00:00:00
abstract:OBJECTIVES:Previous studies on therapeutic interventions in sepsis have assumed stability of the measure of splanchnic blood flow throughout the study. We assessed the variability of splanchnic blood flow during stable global hemodynamics in eight patients with sepsis requiring treatment with dobutamine and/or norepine...
journal_title:Intensive care medicine
pub_type: 杂志文章
doi:10.1007/s001340100980
更新日期:2001-08-01 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::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: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 ...
journal_title:Intensive care medicine
pub_type: 杂志文章
doi:10.1007/s00134-004-2323-4
更新日期:2004-08-01 00:00:00
abstract:PURPOSE:This study explored differences in end-of-life (EOL) decisions and respect for patient autonomy of religious members versus those only affiliated to that particular religion (affiliated is a member without strong religious feelings). METHODS:In 2005 structured questionnaires regarding EOL decisions were distri...
journal_title:Intensive care medicine
pub_type: 杂志文章
doi:10.1007/s00134-012-2554-8
更新日期:2012-07-01 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:Sedatives administered to critically ill children should be titrated to effect, because both under- and oversedation may have negative effects. We conducted a systematic review to examine reported incidences of under-, optimal, and oversedation in critically ill children receiving intensive care. METHODS:A sys...
journal_title:Intensive care medicine
pub_type: 杂志文章,评审
doi:10.1007/s00134-013-2971-3
更新日期:2013-09-01 00:00:00
abstract:OBJECTIVE:To compare outcome prediction using the Multiple Organ Dysfunction Score (MODS) and the Sequential Organ Failure Assessment (SOFA), two of the systems most commonly used to evaluate organ dysfunction in the intensive care unit (ICU). DESIGN:Prospective, observational study. SETTING:Thirty-one-bed, universit...
journal_title:Intensive care medicine
pub_type: 杂志文章
doi:10.1007/s00134-002-1491-3
更新日期:2002-11-01 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:OBJECTIVE:To assess the effects of intravenous fish oil fat emulsion on the metabolic alterations induced by lipopolysaccharide (LPS) challenge in healthy volunteers. DESIGN:Two groups of eight healthy subjects were randomized to receive either two pharmacological doses of intravenous FO fat emulsion or no treatment. ...
journal_title:Intensive care medicine
pub_type: 杂志文章,随机对照试验
doi:10.1007/s00134-007-0591-5
更新日期:2007-05-01 00:00:00
abstract:OBJECTIVE:To evaluate the nursing time required for difficult-to-wean patients in a dedicated weaning center (WC) and to examine the correlation of the nursing time with nursing workload (NW) scores and with clinical severity and dependency. SETTING:Four-bed WC of a pulmonary rehabilitation department. INTERVENTION:N...
journal_title:Intensive care medicine
pub_type: 杂志文章
doi:10.1007/s001340051249
更新日期:2000-06-01 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:OBJECTIVE:Pulmonary flow resistance is mainly determined by vessel calibres, resulting from the interaction of volume-passive distension and active vasomotion. However, quantitative information on the interplay between these counteracting forces in the lung is lacking. Therefore, we aimed at quantifying (1) the effects...
journal_title:Intensive care medicine
pub_type: 杂志文章
doi:10.1007/s001340051090
更新日期:1999-12-01 00:00:00
abstract:OBJECTIVE:To determine the effects of increasing dosages of continuously infused arginine-vasopressin (AVP) on mucosal tissue oxygen tension and oxygen supply in an auto-perfused, innervated jejunal segment in an acute endotoxic porcine model. DESIGN:Prospective, randomized, experimental study. SETTING:University hos...
journal_title:Intensive care medicine
pub_type: 杂志文章
doi:10.1007/s00134-005-2858-z
更新日期:2006-01-01 00:00:00
abstract::In a randomized clinical trial the prophylactic effects of locally administered antimicrobials on quantitative colonization and respiratory infections were studied in intubated patients with an expected period of mechanical ventilation of greater than 6 days. Nineteen patients received 50 mg of polymyxin B and 80 mg o...
journal_title:Intensive care medicine
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1007/BF00254795
更新日期:1987-01-01 00:00:00
abstract:BACKGROUND:Adult studies evaluating corticosteroids have found varied efficacy. One study showing mortality benefit utilized fludrocortisone (FLU) and hydrocortisone (HC) (Effect of treatment with low doses of hydrocortisone and fludrocortisone on mortality in patients with septic shock. JAMA 288:862-871, 2002). Use of...
journal_title:Intensive care medicine
pub_type: 杂志文章
doi:10.1007/s00134-010-2090-3
更新日期:2011-03-01 00:00:00
abstract::Streptococcus pneumoniae is responsible for two-thirds of ICU admissions due to community-acquired pneumonia (CAP) and is the leading cause of CAP-related death. Early death is principally due to cardiovascular collapse, whereas late death is associated with hypoxemic respiratory failure. Outcome depends on interactio...
journal_title:Intensive care medicine
pub_type: 杂志文章,评审
doi:10.1007/s00134-006-0182-x
更新日期:2006-07-01 00:00:00
abstract::Neuromuscular blocking agents (NMBAs) inhibit patient-initiated active breath and the risk of high tidal volumes and consequent high transpulmonary pressure swings, and minimize patient/ ventilator asynchrony in acute respiratory distress syndrome (ARDS). Minimization of volutrauma and ventilator-induced lung injury (...
journal_title:Intensive care medicine
pub_type: 杂志文章,评审
doi:10.1007/s00134-020-06297-8
更新日期:2020-12-01 00:00:00
abstract::A case of aspiration pneumonitis during Caesarean section is described. The patient was treated with high-level continuous positive airway pressure (CPAP) resulting in marked improvement and discharge from the Intensive Care Unit 44 hours after the aspiration had occurred. ...
journal_title:Intensive care medicine
pub_type: 杂志文章
doi:10.1007/BF01757304
更新日期:1980-05-01 00:00:00
abstract::Since the introduction of synchronized intermittent mandatory ventilation (SIMV) several advantages have been attributed to this ventilatory mode, one of them being a more homogeneous distribution of ventilation and perfusion than during controlled mechanical ventilation (CMV). Up to now no data are available to confi...
journal_title:Intensive care medicine
pub_type: 杂志文章
doi:10.1007/BF01704716
更新日期:1991-01-01 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::Malaria remains today one of the major health problems in the tropics with increased morbidity and mortality. The most serious complications are caused by Plasmodium falciparum, which, in contrast to the benign malarias, may progress to a life-threatening multi-system disease. Our case concerns a young woman in the 14...
journal_title:Intensive care medicine
pub_type: 杂志文章
doi:10.1007/s001340050939
更新日期:1999-07-01 00:00:00
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, ...
journal_title:Intensive care medicine
pub_type: 杂志文章,评审
doi:10.1007/s00134-002-1581-2
更新日期:2003-02-01 00:00:00
abstract:BACKGROUND:In patients with severe sepsis, no randomized clinical trial has tested the concept of de-escalation of empirical antimicrobial therapy. This study aimed to compare the de-escalation strategy with the continuation of an appropriate empirical treatment in those patients. METHODS:This was a multicenter non-bl...
journal_title:Intensive care medicine
pub_type: 杂志文章,多中心研究,随机对照试验
doi:10.1007/s00134-014-3411-8
更新日期:2014-10-01 00:00:00
abstract:BACKGROUND:The systemic inflammatory response syndrome (SIRS) may be triggered by endotoxin. Humans have antibodies directed against the core of endotoxin (endotoxin core antibodies, EndoCAb) that appear to be protective following surgery and in sepsis. We hypothesised that children with elevated antibodies to endotoxi...
journal_title:Intensive care medicine
pub_type: 杂志文章
doi:10.1007/s00134-005-0019-z
更新日期:2006-02-01 00:00:00
abstract::The treatment of severe tetanus with autonomic dysfunction is discussed, with emphasis on the use of magnesium sulphate. An exemplary case is reported, describing the inadequate response to magnesium, but the previously unreported and successful use of clonidine to control sympathetic overactivity. The properties of c...
journal_title:Intensive care medicine
pub_type: 杂志文章,评审
doi:10.1007/BF02575297
更新日期:1990-01-01 00:00:00
abstract:OBJECTIVE:Infection is the most frequent cause of acute respiratory distress syndrome (ARDS). However, little is known about the influence of infection sites on ARDS. This study aimed to assess the associations of infection sites with ARDS development and mortality in critically ill infected patients. DESIGN:Prospecti...
journal_title:Intensive care medicine
pub_type: 杂志文章
doi:10.1007/s00134-010-1851-3
更新日期:2010-06-01 00:00:00
abstract::Hepatic encephalopathy is a complex neuropsychiatric syndrome associated with acute, subacute and chronic liver failure, involving increased neural inhibition by activation of the GABA/benzodiazepine inhibitory neurotransmitter system. Improvement by GABA and benzodiazepine receptor antagonists as well as by chloride ...
journal_title:Intensive care medicine
pub_type: 杂志文章,评审
doi:10.1007/BF01731153
更新日期:1991-01-01 00:00:00