Abstract：
OBJECTIVE:The aim of the study was to explore trends and changes in sedation practices for mechanically ventilated patients in Danish intensive care units (ICUs) and to compare sedation practices in 1997 and 2003. DESIGN:The study was a follow-up survey with a descriptive and comparative cross-sectional multicenter design. SETTING:Questionnaires were mailed in January 2003 to all Danish ICUs providing mechanical ventilation (n=48). PARTICIPANTS:One head physician at each ICU in Denmark. INTERVENTIONS, MEASUREMENTS, AND RESULTS: Thirty-nine questionnaires were returned, yielding a response rate of 81%, representing 82% of Danish ICU beds. The main findings were a significant increase in the use of sedation scoring systems and a significant reduction of sedation and analgesia in relation to various modalities of mechanical ventilation and disease groups. Other important findings were a significant reduction in the use of benzodiazepines and opioids and a significant increase in the use of propofol in relation to all ventilator modes. The administration routes of sedative agents remained unchanged. CONCLUSIONS:Sedatives and analgesics are still widely used in Danish ICUs. The trend is toward lighter sedation along with a shift from benzodiazepines toward propofol and from morphine toward fentanyl given by continuous infusion. More attention needs to be directed toward sedation standards and scoring systems in order to reduce the risk associated with sedation in mechanically ventilated patients.
journal_name
Intensive Care Medjournal_title
Intensive care medicineauthors
Egerod I,Christensen BV,Johansen Ldoi
10.1007/s00134-005-2856-1keywords:
subject
Has Abstractpub_date
2006-01-01 00:00:00pages
60-6issue
1eissn
0342-4642issn
1432-1238journal_volume
32pub_type
杂志文章,多中心研究abstract：:Physicians are increasingly involved in how their critically ill patients die [72]. The more this happens, the more physicians will have to understand not only how their own backgrounds and biases influence their medical management, but also the cultural and religious backgrounds of the patient and surrogate [72, 73]....
journal_title：Intensive care medicine
pub_type： 杂志文章,评审
doi：10.1007/s001340000641
更新日期：2000-10-01 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：OBJECTIVE:The objective was to identify factors associated with thrombocytopenia and to assess to what extent thrombocytopenia increases bleeding complications in liver transplant patients. DESIGN:Retrospective study. SETTING:Surgical intensive care unit in a university hospital. PATIENTS:One hundred and sixty-one p...
journal_title：Intensive care medicine
pub_type： 杂志文章
doi：10.1007/s00134-003-1727-x
更新日期：2003-05-01 00:00:00
abstract：OBJECTIVE:Measurement of functional residual capacity (FRC) during mechanical ventilation is important to standardise respiratory system compliance and adjust the ventilator settings to optimise lung recruitment. In the present study we compared three methods to measure FRC. DESIGN:The bias flow nitrogen washout techn...
journal_title：Intensive care medicine
pub_type： 杂志文章
doi：10.1007/s00134-003-2028-0
更新日期：2004-01-01 00:00:00
abstract：:Helicobacter pylori is estimated to infect over 50% of the world's population, the majority of whom are asymptomatic. Although most research to date has focused on local gastroduodenal disease manifestations, the potential impact of H. pylori infection and the associated chronic active inflammation on systemic disease...
journal_title：Intensive care medicine
pub_type： 杂志文章,评审
doi：10.1007/s00134-003-1838-4
更新日期：2003-11-01 00:00:00
abstract：UNLABELLED:Admission of cancer patients with serious medical complications to the ICU remains controversial primarily because of the high short-term mortality rates in these patients. However, the cancer patient population is heterogeneous regarding age, underlying conditions, and curability of their disease, suggestin...
journal_title：Intensive care medicine
pub_type： 杂志文章
doi：10.1007/s001340051350
更新日期：2000-12-01 00:00:00
abstract：OBJECTIVE:Organophosphate toxicity is the leading cause of morbidity and death in poisoning by insecticides. The clinical symptoms of pesticide toxicity range from the classic cholinergic syndrome to flaccid paralysis and intractable seizures. The mainstays of therapy are atropine, oximes, benzodiazepines and supportiv...
journal_title：Intensive care medicine
pub_type： 杂志文章
doi：10.1007/s00134-005-0051-z
更新日期：2006-03-01 00:00:00
abstract：OBJECTIVE:The efficacy of interferon gamma therapy in reducing infection and improving outcome from infection in patients sustaining major injury was examined. DESIGN:Randomized double-blind placebo control trial SETTING:Nine level one university affiliated trauma centers in the United States. PATIENTS AND PARTICIPA...
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/BF01743725
更新日期：1996-10-01 00:00:00
abstract：:An 18-month-old male infant presented with hypoglycemic coma and clinical signs of bronchopneumonia. He was suspected of suffering from septic shock. The patient progressed to irreversible multiple organ failure before the diagnosis of adrenal crisis was established. Plasma levels of ACTH and cortisol remained undetec...
journal_title：Intensive care medicine
pub_type： 杂志文章
doi：10.1007/s001340050021
更新日期：2000-01-01 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：BACKGROUND:We determined the effects of two antibiotic policies (predominance of either beta-lactam antibiotics or fluroquinolones) on acquisition with third-generation cephalosporin-resistant Enterobacteriaceae (CRE) and fluoroquinolone-resistant CRE (FCRE) in two ICUs, with monitoring of other variables that may infl...
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/s00134-009-1714-y
更新日期：2010-03-01 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：PURPOSE:Severe acute pancreatitis (SAP) remains a life-threatening disease with classic etiology of systemic inflammatory response and mortality between 30 and 50 %. The aim of the present study is to compare two different treatment strategies of goal-directed hemodynamic management and evaluate their impact on surviva...
journal_title：Intensive care medicine
pub_type： 杂志文章
doi：10.1007/s00134-012-2775-x
更新日期：2013-04-01 00:00:00
abstract：:Arrhythmias are extremely common early after AMI. An arrhythmia is defined by exclusion, either because the sequence of myocardial depolarisation is other than normal or because certain arbitrary limits are exceeded. It follows that the term "arrhythmia" encompasses a complex heterogenous group. Although arrhythmias a...
journal_title：Intensive care medicine
pub_type： 杂志文章
doi：10.1007/BF01683131
更新日期：1978-01-01 00:00:00
abstract：PURPOSE:Recalibration and determining discriminative power, internationally, of the existing delirium prediction model (PRE-DELIRIC) for intensive care patients. METHODS:A prospective multicenter cohort study was performed in eight intensive care units (ICUs) in six countries. The ten predictors (age, APACHE-II, urgen...
journal_title：Intensive care medicine
pub_type： 杂志文章,多中心研究
doi：10.1007/s00134-013-3202-7
更新日期：2014-03-01 00:00:00
abstract：:A randomized study of 30 patients undergoing uncomplicated surgery under spinal anesthesia was conducted to assess the influence of colloids on the kinetics of plasma fibronectin and complement. Both are opsonins of the reticuloendothelial system; moreover fibronectin is concerned with host resistance against septic c...
journal_title：Intensive care medicine
pub_type： 临床试验,杂志文章,随机对照试验
doi：10.1007/BF01691428
更新日期：1991-01-01 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：:The recording of intratracheal pressure in patients breathing through a tracheostomy tube is marred by methodological problems. In model experiments it has been shown that the introduction of a recording catheter into the tracheostomy tube alters the recorded pressure by as much as 20-40%. To avoid such inaccuracy, a ...
journal_title：Intensive care medicine
pub_type： 杂志文章
doi：10.1007/BF01735176
更新日期：1990-01-01 00:00:00
abstract：OBJECTIVE:To investigate the effect of respiratory physiotherapy on the prevention and treatment of ventilator-associated pneumonia (VAP) for adults in an intensive care unit (ICU) with an acquired brain injury (ABI). DESIGN AND SETTING:Two-part, prospective, randomised controlled trial. PATIENTS:A total of 144 subje...
journal_title：Intensive care medicine
pub_type： 杂志文章,随机对照试验
doi：10.1007/s00134-008-1278-2
更新日期：2009-02-01 00:00:00
abstract：OBJECTIVE:To define the different types of costs incurred in the care of critically ill patients and to describe some of the most commonly used methods for measuring and allocating these costs. DESIGN:Literature review. Definitions for opportunity, direct and indirect, fixed, variable, marginal, and total costs are de...
journal_title：Intensive care medicine
pub_type： 杂志文章,评审
doi：10.1007/s00134-002-1279-5
更新日期：2002-06-01 00:00:00
abstract：:A case of brainstem encephalitis complicated by torsade de pointes is described. The possible occurrence of ventricular arrhythmias may contribute to the mortality in this condition. We recommend the admission of patients with brainstem encephalitis to an intensive care unit, for a period of electrocardiographic monit...
journal_title：Intensive care medicine
pub_type： 杂志文章
doi：10.1007/BF00263564
更新日期：1987-01-01 00:00:00
abstract：PURPOSE:Motion-mode (MM) echography allows precise measurement of diaphragmatic excursion when the ultrasound beam is parallel to the diaphragmatic displacement. However, proper alignment is difficult to obtain in patients after cardiac surgery; thus, measurements might be inaccurate. A new imaging modality named the a...
journal_title：Intensive care medicine
pub_type： 杂志文章,随机对照试验
doi：10.1007/s00134-014-3625-9
更新日期：2015-04-01 00:00:00
abstract：:Status epilepticus is one of the most frequent neurological emergencies in the intensive care unit. Standard treatment includes intravenous barbiturates, benzodiazepines and phenytoin. However, drug coma is sometimes necessary to control refractory status epilepticus. We report such a case, successfully treated by int...
journal_title：Intensive care medicine
pub_type： 杂志文章
doi：10.1007/BF01707672
更新日期：1994-01-01 00:00:00
abstract：:We report the case of a 72-year-old male who suffered a cardiac arrest during an early positive treadmill stress test. After successful resuscitation the patient had evidence of a gastric perforation. Because of his hemodynamic stability, lack of peritoneal signs, and prohibitively high surgical risk, a non-operative ...
journal_title：Intensive care medicine
pub_type： 杂志文章
doi：10.1007/BF01710656
更新日期：1994-07-01 00:00:00
abstract：:Extracorporeal CO2-removal (EC-CO2-R) using a membrane lung system was applied for 12 and 20 days respectively in two young men with adult respiratory distress syndrome (ARDS). Neuropathological examination revealed only moderate hypoxic changes of unusual distribution. In the first case nerve cell loss in Sommer's se...
journal_title：Intensive care medicine
pub_type： 杂志文章
doi：10.1007/BF00263553
更新日期：1987-01-01 00:00:00
abstract：PURPOSE:Little is known on the incidence of discomfort during the end-of-life of intensive care unit (ICU) patients and the impact of sedation on such discomfort. The aim of this study was to assess the incidence of discomfort events according to levels of sedation. METHODS:Post-hoc analysis of an observational prospe...
journal_title：Intensive care medicine
pub_type： 杂志文章
doi：10.1007/s00134-020-05930-w
更新日期：2020-06-01 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: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：PURPOSE:Pneumonia associated with invasive mechanical ventilation (IMV) is one of the indicator infections of the German Nosocomial Infection Surveillance System. In 2005 surveillance was extended to include pneumonia associated with noninvasive ventilation (NIV). The aim of this study was to determine the utilization ...
journal_title：Intensive care medicine
pub_type： 杂志文章
doi：10.1007/s00134-010-1863-z
更新日期：2010-06-01 00:00:00
abstract：OBJECTIVE:To evaluate the efficacy of different lung recruitment maneuvers using electric impedance tomography. DESIGN AND SETTING:Experimental study in animal model of acute lung injury in an animal research laboratory. SUBJECTS:Fourteen pigs with saline lavage induced lung injury. INTERVENTIONS:Lung volume, region...
journal_title：Intensive care medicine
pub_type： 杂志文章
doi：10.1007/s00134-005-2799-6
更新日期：2005-12-01 00:00:00
