Abstract：
OBJECTIVE:To assess the value of the diagnosis of overt disseminated intravascular coagulation (DIC) according to the International Society on Thrombosis and Haemostasis (ISTH) criteria and that of the parameters included in the ISTH score for overt DIC in predicting day 28 mortality in intensive care patients. Also, to assess the value of the components of the score in the diagnosis of overt DIC. DESIGN AND SETTING:Retrospective clinical study in a university hospital intensive care unit. PATIENTS AND PARTICIPANTS:494 consecutive patients admitted in the ICU between January 2002 and October 2003. MEASUREMENTS AND RESULTS:Clinical and laboratory data, including hemostatic parameters, were collected from computerized databases and patient files. Altogether 19% (95/494) of the patients fulfilled the criteria for overt DIC. Their day 28 mortality rate was higher than that of patients without overt DIC (40% vs. 16%). The lowest platelet count (area under curve, AUC, 0.910), highest plasma D-dimer (AUC 0.846), lowest antithrombin (AUC 0.823), and Owren-type prothrombin time activity (AUC 0.797) discriminated well the patients with and without overt DIC, whereas plasma fibrinogen (AUC 0.690) had poor discriminative power. No patient with the diagnosis of overt DIC had decreased plasma fibrinogen. Day-1 SOFA and APACHE II score, the first CRP measurement, and the lowest antithrombin were independent predictors of day 28 mortality. CONCLUSIONS:The diagnosis of overt DIC was not an independent predictor of day 28 mortality. In ICU patients plasma antithrombin seems a promising candidate in the panel of indicators for overt DIC whereas the value of plasma fibrinogen is in doubt.
journal_name
Intensive Care Medjournal_title
Intensive care medicineauthors
Sivula M,Tallgren M,Pettilä Vdoi
10.1007/s00134-005-2685-2keywords:
subject
Has Abstractpub_date
2005-09-01 00:00:00pages
1209-14issue
9eissn
0342-4642issn
1432-1238journal_volume
31pub_type
杂志文章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：:The side effects of positive pressure ventilation on cardiovascular function are well known. However, in most clinical studies its influence on left ventricular function was examined. In the present study right ventricular (RV) performance was studied in 13 patients undergoing coronary artery bypass grafting during me...
journal_title：Intensive care medicine
pub_type： 杂志文章
doi：10.1007/BF00256962
更新日期：1988-01-01 00:00:00
abstract：:In alcoholic patients, metabolic acidosis can be related to lactate acidosis associated with sepsis or thiamine deficiency, ketoacidosis, methanol or ethylene glycol poisoning. High resolution proton nuclear magnetic resonance (NMR) can be used to detect abnormal organic acid metabolites in urine or serum from patient...
journal_title：Intensive care medicine
pub_type： 杂志文章
doi：10.1007/s001340100892
更新日期：2001-04-01 00:00:00
abstract：OBJECTIVE:Brain death may induce cardiac dysfunction. In potential organ donors measurements of N-terminal pro-brain natriuretic peptide (NT-proBNP) and circulating cardiac troponins T and I (cTnT and cTnI), alone or in combination, are performed to investigate the accuracy of these biomarkers for early diagnosis of le...
journal_title：Intensive care medicine
pub_type： 杂志文章
doi：10.1007/s00134-007-0601-7
更新日期：2007-06-01 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：PURPOSE:Reporting neurodevelopmental outcome of 8-year-old children treated with neonatal extracorporeal membrane oxygenation (ECMO). METHODS:In a follow-up study in 135 8-year-old children who received neonatal ECMO between 1996 and 2001 we assessed intelligence (Revised Amsterdam Intelligence Test), concentration (B...
journal_title：Intensive care medicine
pub_type： 杂志文章,多中心研究
doi：10.1007/s00134-013-2973-1
更新日期：2013-09-01 00:00:00
abstract：OBJECTIVE:To explore the consequences of helium/oxygen (He/O(2)) inhalation on respiratory mechanics, gas exchange, and ventilation-perfusion (VA/Q) relationships in an animal model of severe induced bronchospasm during mechanical ventilation. DESIGN:Prospective, interventional study. SETTING:Experimental animal labo...
journal_title：Intensive care medicine
pub_type： 杂志文章
doi：10.1007/s00134-003-1779-y
更新日期：2003-09-01 00:00:00
abstract：OBJECTIVE:Percutaneous dilatational tracheostomy is increasingly practiced in intensive care units and has a low incidence of early complications. The late effects of this procedure are still poorly known and were the focus of this study. DESIGN:Prospective descriptive clinical study. SETTING:Interdisciplinary intens...
journal_title：Intensive care medicine
pub_type： 杂志文章
doi：10.1007/BF01706200
更新日期：1995-06-01 00:00:00
abstract：OBJECTIVE:To study the pharmacokinetics and local tissue effects resulting from the intratracheal administration of preservative-free fentanyl. DESIGN:Prospective, randomized, blinded and controlled animal study. SETTING:University research laboratory. SUBJECTS:Eighteen adult male New Zealand rabbits. INTERVENTIONS...
journal_title：Intensive care medicine
pub_type： 杂志文章
doi：10.1007/BF01720719
更新日期：1996-02-01 00:00:00
abstract：OBJECTIVE:To compare the short-term effects of adaptive support ventilation (ASV), an advanced closed-loop mode, with conventional volume or pressure-control ventilation in patients passively ventilated for acute respiratory failure. DESIGN:Prospective crossover interventional multicenter trial. SETTING:Six European ...
journal_title：Intensive care medicine
pub_type： 杂志文章,多中心研究
doi：10.1007/s00134-010-1917-2
更新日期：2010-08-01 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：OBJECTIVE:On hospital admission, the morphology of the central pulmonary artery thromboemboli is an independent predictor of 30-day mortality in patients with massive pulmonary embolism (MPE). This may be due to the differential susceptibility of thromboemboli to thrombolysis. The aim of this study was to assess haemod...
journal_title：Intensive care medicine
pub_type： 杂志文章
doi：10.1007/s00134-004-2314-5
更新日期：2004-08-01 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：: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：:As part of a nationwide evaluation of intensive care, we examined patient- and hospital-related factors which could influence the patterns of utilization of arterial cannulae and central venous and pulmonary artery catheters. We also studied the possible impact of these interventions on the short-term outcome among 14...
journal_title：Intensive care medicine
pub_type： 杂志文章
doi：10.1007/BF01713935
更新日期：1991-01-01 00:00:00
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 SELEC...
journal_title：Intensive care medicine
pub_type： 杂志文章,评审
doi：10.1007/s00134-003-2059-6
更新日期：2004-01-01 00:00:00
abstract：OBJECTIVE:To evaluate the extent to which respiratory changes in inferior vena cava (IVC) diameter can be used to predict fluid responsiveness. DESIGN:Prospective clinical study. SETTING:Hospital intensive care unit. PATIENTS:Twenty-three patients with acute circulatory failure related to sepsis and mechanically ven...
journal_title：Intensive care medicine
pub_type： 临床试验,杂志文章
doi：10.1007/s00134-004-2259-8
更新日期：2004-09-01 00:00:00
abstract：PURPOSE:Family members of patients who die in the intensive care unit (ICU) may experience symptoms of stress, anxiety, depression, posttraumatic stress disorder (PTSD), and/or prolonged grief. We evaluated whether grief symptoms were alleviated if the physician and the nurse in charge at the time of death sent the clo...
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/s00134-016-4669-9
更新日期：2017-04-01 00:00:00
abstract：PURPOSE:To develop a liver function-related risk prediction tool to identify acute-on-chronic liver failure patients at greatest risk of in-hospital mortality. METHODS:The LiFe (liver, injury, failure, evaluation) score, was constructed based on the opinions of 157 intensivists within the European Society for Intensiv...
journal_title：Intensive care medicine
pub_type： 杂志文章,多中心研究
doi：10.1007/s00134-015-4203-5
更新日期：2016-03-01 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:To determine the clinical epidemiology of invasive group A streptococcal disease (IGASD) and identify predictors of admissions into an intensive care unit (ICU). DESIGN:A cross-sectional study. SETTING:Retrospective review of data. PATIENTS:A total of 204 patients hospitalized throughout the state of Flori...
journal_title：Intensive care medicine
pub_type： 杂志文章
doi：10.1007/s00134-002-1538-5
更新日期：2002-12-01 00:00:00
abstract：:A 63-year-old man underwent distal oesophagectomy and proximal gastrectomy. Postoperatively, controlled ventilation was necessary for 53 days because of anastomotic leakage. Multiple sedative regimens proved to be inadequate. By contrast, a fentanyl-midazolam combination with continuous supplementation of clonidine 0....
journal_title：Intensive care medicine
pub_type： 杂志文章
doi：10.1007/BF01705163
更新日期：1990-01-01 00:00:00
abstract：PURPOSE:To estimate the direct and indirect (contextual) effects of the factorized constituents of selective digestive decontamination and selective oropharyngeal decontamination (SDD/SOD), being topical antibiotic (TA) and protocolized antifungal prophylaxis (PAFP), on ICU-acquired candidemia. METHODS:A broad range o...
journal_title：Intensive care medicine
pub_type： 杂志文章,meta分析
doi：10.1007/s00134-015-4004-x
更新日期：2015-11-01 00:00:00
abstract：:Values obtained for cardiac output (CO) were compared using thermodilution (TD) with those obtained using bioimpedance (Bi) as measured using the Bomed NCCOM3 (Revision 6) in 28 consecutive patients in the first 24 h after coronary artery bypass surgery (CABS). In 46 paired measurements made in the first 12 h after CA...
journal_title：Intensive care medicine
pub_type： 杂志文章
doi：10.1007/BF01720674
更新日期：1991-01-01 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：:Pulmonary artery (PA) catheterization is now a routine procedure in the care of critically ill patients. We report a case in which a pulmonary artery catheter was a major factor in the demise of a patient who developed adult respiratory distress syndrome following a septic abortion. ...
journal_title：Intensive care medicine
pub_type： 杂志文章
doi：10.1007/BF00295990
更新日期：1989-01-01 00:00:00
abstract：:Plasma colloid osmotic pressure (COP) has been calculated from both serum albumin concentration and plasma total protein concentration. These values have been compared to those measured directly using a membrane-transducer oncometer in a group of normal subjects, in a group of critically-ill patients with a variety of...
journal_title：Intensive care medicine
pub_type： 杂志文章
doi：10.1007/BF00254796
更新日期：1987-01-01 00:00:00
abstract：PURPOSE:An International Consensus Conference proposed classifying weaning into simple, difficult, and prolonged weaning. However, the usefulness of this classification in a respiratory intensive care unit (ICU) is unknown. The aims of the study were: (1) to compare the clinical characteristics and outcomes of patients...
journal_title：Intensive care medicine
pub_type： 杂志文章
doi：10.1007/s00134-011-2179-3
更新日期：2011-05-01 00:00:00
abstract：OBJECTIVES:(1) To demonstrate that metabolic parameters are better indicators of tissue hypoxia than regional and whole oxygen consumption (VO(2)). (2) To compare intramucosal pH (pHi) in different gastrointestinal segments. DESIGN:Prospective, interventional study. SETTING:Research laboratory at a university center....
journal_title：Intensive care medicine
pub_type： 杂志文章
doi：10.1007/s00134-001-1138-9
更新日期：2001-12-01 00:00:00
abstract：BACKGROUND:Vasopressors are administered to critically ill patients with vasodilatory shock not responsive to volume resuscitation, and less often in cardiogenic shock, and hypovolemic shock. OBJECTIVES:The objectives are to review safety and efficacy of vasopressors, pathophysiology, agents that decrease vasopressor ...
journal_title：Intensive care medicine
pub_type： 杂志文章,评审
doi：10.1007/s00134-019-05801-z
更新日期：2019-11-01 00:00:00
