Abstract:
OBJECTIVE:Based on limited data, Candida sp. isolates from bronchoalveolar lavage (BAL) cultures in immunocompetent patients are thought to be contaminants rather than pathogens. The objective of this study was to determine the clinical significance of Candida sp. isolated from BAL cultures in critically ill trauma patients. DESIGN AND SETTING:Retrospective study in a level 1 trauma intensive care unit. PATIENTS AND PARTICIPANTS:All patients with Candida sp. isolated from BAL cultures over a 3-year period; 85 Candida positive BAL cultures from 62 patients were studied. MEASUREMENTS AND RESULTS:The primary outcomes were the incidence of Candida sp. in BAL, antifungal use, course of the possible infection, and mortality. Of 1077 BAL cultures 85 (8%) grew Candida sp., representing 64 episodes of possible Candida sp. ventilator-associated pneumonia. No colony counts exceeded the diagnostic threshold for bacterial VAP (>or=10(5) cfu/ml). Only 2 of 64 episodes (3%) were treated with systemic antifungals. Three other episodes (5%) were treated because of concomitant therapy for Candida sp. at other sites. The majority of episodes were not treated with antifungals and were considered contaminants (59/64, 92%). No patients developed subsequent candidemia, and most follow-up BALs (74%) were negative for Candida sp. Overall mortality (17%) was similar to previous patients with similar severity of injury at the study center (18%). CONCLUSIONS:The results of this study suggest that isolation of Candida sp. from BAL in quantities below the diagnostic threshold for VAP in this population does not require antifungal therapy.
journal_name
Intensive Care Medjournal_title
Intensive care medicineauthors
Wood GC,Mueller EW,Croce MA,Boucher BA,Fabian TCdoi
10.1007/s00134-005-0065-6keywords:
subject
Has Abstractpub_date
2006-04-01 00:00:00pages
599-603issue
4eissn
0342-4642issn
1432-1238journal_volume
32pub_type
杂志文章abstract:PURPOSE:The aim of this study is to examine family members' experiences of end-of-life decision-making processes in Norwegian intensive care units (ICUs) to ascertain the degree to which they felt included in the decision-making process and whether they received necessary information. Were they asked about the patient'...
journal_title:Intensive care medicine
pub_type: 杂志文章
doi:10.1007/s00134-011-2253-x
更新日期:2011-07-01 00:00:00
abstract:PURPOSE:Venous thromboembolism (VTE) is a common but often overlooked life-threatening complication of critical illness. The aim of this cross-sectional survey was to assess current practice of thromboprophylaxis as well as adherence to international guidelines. METHODS:After ethics committee approval, all intensive c...
journal_title:Intensive care medicine
pub_type: 杂志文章
doi:10.1007/s00134-012-2533-0
更新日期:2012-06-01 00:00:00
abstract:PURPOSE:To use the World Health Organisation's International Classification of Functioning to measure disability following critical illness using patient-reported outcomes. METHODS:A prospective, multicentre cohort study conducted in five metropolitan intensive care units (ICU). Participants were adults who had been a...
journal_title:Intensive care medicine
pub_type: 杂志文章,多中心研究
doi:10.1007/s00134-017-4830-0
更新日期:2017-07-01 00:00:00
abstract:PURPOSE:Inflammatory markers may have a role in predicting severity of illness of intensive care unit (ICU) patients. The aim of this study is to determine whether low eosinophil count can predict 28-day mortality in medical ICU. METHODS:A prospective study over a 4-month period. To evaluate the prognosis information ...
journal_title:Intensive care medicine
pub_type: 杂志文章
doi:10.1007/s00134-011-2170-z
更新日期:2011-07-01 00:00:00
abstract:OBJECTIVES:(a). To describe the glucose content of normal human airways secretions; (b). to observe the effects of hyperglycemia and airways inflammation on airways glucose. DESIGN:Observational studies. SETTINGS:(a). St George's Hospital Medical School; (b). diabetes mellitus outpatient clinics; (c). adult general i...
journal_title:Intensive care medicine
pub_type: 杂志文章
doi:10.1007/s00134-003-1961-2
更新日期:2003-12-01 00:00:00
abstract:OBJECTIVE:To assess the relationship between the base deficit value in the immediate postoperative period of coronary surgery for cardiopulmonary bypass and the length of stay in the ICU. DESIGN AND SETTING:Prospective descriptive study in the department of anesthesia and cardiovascular surgery of a university hospita...
journal_title:Intensive care medicine
pub_type: 杂志文章
doi:10.1007/s00134-002-1587-9
更新日期:2003-02-01 00:00:00
abstract:OBJECTIVE:To evaluate the influence of changes in alveolar ventilation on the following tonometry-derived variables: gastric intramucosal CO2 tension (PtCO2), gastric arterial CO2 tension difference (PgapCO2), gastric intramucosal pH (pHi) and arterial pH-pHi difference (pHgap). DESIGN:Clinical prospective study. SET...
journal_title:Intensive care medicine
pub_type: 临床试验,杂志文章
doi:10.1007/s001340050834
更新日期:1999-03-01 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::Pneumonia caused by herpes simplex virus type 1 (HSV1) is rare and occurs in severely immunosuppressed patients. HSV1 can be detected in bronchoalveolar lavage (BAL) from patients presenting with respiratory failure, but its direct effect on disease is difficult to prove. We demonstrate the causative role of HSV1 in t...
journal_title:Intensive care medicine
pub_type: 杂志文章
doi:10.1007/s001340050339
更新日期:1997-03-01 00:00:00
abstract:OBJECTIVE:To compare some of the confirmatory investigations of brain death with clinical criteria in order to achieve the most sensitive and accurate diagnosis of brain death. DESIGN:All patients with isolated brain lesions and Glasgow Coma Scale (GCS) = 3 were subjected to neurological examination after ruling out h...
journal_title:Intensive care medicine
pub_type: 杂志文章
doi:10.1007/BF01711544
更新日期:1995-08-01 00:00:00
abstract:PURPOSE:To establish the baseline prescribing error rate in a tertiary paediatric intensive care unit (PICU) and to determine the impact of a zero tolerance prescribing (ZTP) policy incorporating a dedicated prescribing area and daily feedback of prescribing errors. METHODS:A prospective, non-blinded, observational st...
journal_title:Intensive care medicine
pub_type: 杂志文章
doi:10.1007/s00134-012-2660-7
更新日期:2012-11-01 00:00:00
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journal_title:Intensive care medicine
pub_type: 杂志文章
doi:10.1007/s00134-007-0875-9
更新日期:2008-02-01 00:00:00
abstract:OBJECTIVE:Pressure measurements at the level of the right atrium are commonly used in clinical anesthesia and the intensive care unit (ICU). There is growing interest in the use of peripheral venous sites for estimating central venous pressure (CVP). This study compared bias, precision, and covariance in simultaneous m...
journal_title:Intensive care medicine
pub_type: 临床试验,杂志文章
doi:10.1007/s00134-003-2052-0
更新日期:2004-04-01 00:00:00
abstract:OBJECTIVE:To evaluate trends in mortality and related factors among trauma patients who developed acute respiratory distress syndrome (ARDS). STUDY:Observational study based on data prospectively gathered in computerized trauma registry. SETTING:Trauma intensive care unit (ICU) of 48 beds in level I trauma center. P...
journal_title:Intensive care medicine
pub_type: 杂志文章
doi:10.1007/s001340100955
更新日期:2001-07-01 00:00:00
abstract::The spread of a multi-resistant glucose-acidifying Acinetobacter calcoaceticus strain in a community hospital was studied. After admission of a colonized patient to the hospital the strain was found in clinical specimens from ICU patients and subsequently from several of these patients after transfer to medical wards....
journal_title:Intensive care medicine
pub_type: 杂志文章
doi:10.1007/BF01058568
更新日期:1989-01-01 00:00:00
abstract::Knowledge translation is an important step for translational research. In this issue of Intensive Care Medicine, a new mini-series of basic research-related reviews is published. Three invited reviews focus on the role of extracellular matrix in ventilator-induced lung injury and mechanotransduction. The major challen...
journal_title:Intensive care medicine
pub_type: 评论,社论
doi:10.1007/s00134-007-0965-8
更新日期:2008-04-01 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: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::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:OBJECTIVE:The role of haemofiltration as an adjunctive treatment of sepsis remains a contentious issue. To address the role of dose and to explore the biological effects of haemofiltration we compared the effects of standard and high-volume haemofiltration (HVHF) in a peritonitis-induced model of porcine septic shock. ...
journal_title:Intensive care medicine
pub_type: 杂志文章
doi:10.1007/s00134-008-1318-y
更新日期:2009-02-01 00:00:00
abstract:PURPOSE:Limited data exist on the correlation between higher flow rates of high-flow nasal cannula (HFNC) and its physiologic effects in patients with acute hypoxemic respiratory failure (AHRF). We assessed the effects of HFNC delivered at increasing flow rate on inspiratory effort, work of breathing, minute ventilatio...
journal_title:Intensive care medicine
pub_type: 杂志文章
doi:10.1007/s00134-017-4890-1
更新日期:2017-10-01 00:00:00
abstract::The World Health Organization defines overweight and obesity as the condition where excess or abnormal fat accumulation increases risks to health. The prevalence of obesity is increasing worldwide and is around 20% in ICU patients. Adipose tissue is highly metabolically active, and especially visceral adipose tissue h...
journal_title:Intensive care medicine
pub_type: 杂志文章,评审
doi:10.1007/s00134-019-05594-1
更新日期:2019-06-01 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
abstract:PURPOSE:Chronic pulmonary hypertension (PH) therapy is poorly investigated in intensive care. Our aim was to evaluate haemodynamic and neuroendocrine effects of the dual endothelin-1 (ET-1) blocker tezosentan in monocrotaline (MCT)-induced PH. METHODS:Male Wistar rats (180-200 g, n = 194) randomly received 60 mg kg(-1...
journal_title:Intensive care medicine
pub_type: 杂志文章
doi:10.1007/s00134-012-2484-5
更新日期:2012-06-01 00:00:00
abstract:INTRODUCTION:Most anxiolytics and sedative regimens in the intensive care unit (ICU) impair intellectual function, reducing patient autonomy, and often add to patient morbidity. Using an ICU-validated cognitive assessment tool Adapted Cognitive Exam (ACE), we performed a comparison between dexmedetomidine (DEX) and pro...
journal_title:Intensive care medicine
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1007/s00134-010-1874-9
更新日期:2010-09-01 00:00:00
abstract::Fifteen polytrauma patients with asymmetric pulmonary contusion were treated with differential lung ventilation (DLV) for a mean of 106 hours (range 24-298, median 83). The differential time constant (Tc), compliance (Ct), inspiratory and expiratory airway resistance (Rawinsp, Rawexp) and peak-airway pressure (Pawpeak...
journal_title:Intensive care medicine
pub_type: 杂志文章
doi:10.1007/BF00255602
更新日期:1989-01-01 00:00:00
abstract:OBJECTIVE:To compare the effectiveness of traditional and online teaching methods for educating anesthesiology residents in the principles and practice of difficult airway management. DESIGN:Prospective, randomized, controlled trial. SETTING:University hospital. PARTICIPANTS:Two randomly selected groups, each contai...
journal_title:Intensive care medicine
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1007/s00134-005-2561-0
更新日期:2005-04-01 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::A 65-year-old man developed postsurgical septic shock, unresponsive to plasma volume expansion and administration of dopamine and dobutamine. A continuous norepinephrine infusion was then started and the dose increased to 0.62 micrograms.kg-1.min-1 until the mean arterial pressure was 70 mmHg. Prior to and during the ...
journal_title:Intensive care medicine
pub_type: 杂志文章
doi:10.1007/BF02575309
更新日期:1990-01-01 00:00:00
abstract:OBJECTIVE:Angiopoietin-2 (Ang-2) is a potent regulator of vascular permeability and inflammation in acute lung injury and acute respiratory distress syndrome (ARDS). Genetic variants in the Ang-2 gene may lead to altered activities of Ang-2 (or ANGPT2) gene. The aim of this study was to assess if genetic variants of An...
journal_title:Intensive care medicine
pub_type: 杂志文章
doi:10.1007/s00134-009-1413-8
更新日期:2009-06-01 00:00:00