Abstract:
OBJECTIVES:To analyse the clinical value of procalcitonin (PCT), C-reactive protein (CRP) and leucocyte count in the diagnosis of paediatric sepsis and in the stratification of patients according to severity. DESIGN:Prospective, observational study. SETTING:Paediatric intensive care unit (PICU). PATIENTS:Ninety-four children. MEASUREMENT AND RESULTS:Leucocyte count, PCT and CRP were measured when considered necessary during the PICU stay. Patients were classified, when PCT and CRP were measured, into one of six categories (negative, SIRS, localized infection, sepsis, severe sepsis, and septic shock) according to the definitions of the American College of Chest Physicians /Society of Critical Care Medicine. A total of 359 patient day episodes were obtained. Leucocyte count did not differ across the six diagnostic classes considered. Median plasma PCT concentrations were 0.17, 0.43, 0.79, 1.80, 15.40 and 19.13 ng/ml in negative, systemic inflammatory response syndrome (SIRS), localized infection, sepsis, severe sepsis, and septic shock groups, respectively, whereas median plasma CRP concentrations were 1.35, 3.80, 6.45, 5.70, 7.60 and 16.2 mg/dl, respectively. The area under the ROC curve for the diagnosis of septic patients was 0.532 for leucocyte count (95% CI, 0.462-0.602), 0.750 for CRP (95% CI, 0.699-0.802) and 0.912 for PCT (95% CI, 0.882-0.943). We obtained four groups using CRP values and five groups using PCT values that classified a significant percentage of patients according to the severity of the different SIRS groups. CONCLUSIONS:PCT is a better diagnostic marker of sepsis in critically ill children than CRP. The CRP, and especially PCT, may become a helpful clinical tool to stratify patients with SIRS according to disease severity.
journal_name
Intensive Care Medjournal_title
Intensive care medicineauthors
Rey C,Los Arcos M,Concha A,Medina A,Prieto S,Martinez P,Prieto Bdoi
10.1007/s00134-006-0509-7subject
Has Abstractpub_date
2007-03-01 00:00:00pages
477-84issue
3eissn
0342-4642issn
1432-1238journal_volume
33pub_type
杂志文章abstract:OBJECTIVE:To identify factors associated with mortality and prolonged ventilatory requirements in patients admitted to our paediatric intensive care unit (PICU) with tracheobronchial malacia and stenosis diagnosed by dynamic contrast bronchograms. DESIGN:Retrospective review. SETTING:Tertiary paediatric intensive car...
journal_title:Intensive care medicine
pub_type: 杂志文章
doi:10.1007/s001340000822
更新日期:2001-04-01 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:PURPOSE:Hypoxia-ischemia (HI), as a major cause of fetal brain damage, has long-lasting neurological implications. Therefore, therapeutic interventions that attenuate the neuropathological outcome of HI while also improving the neurofunctional outcome are of paramount clinical importance. The aim of this study was to i...
journal_title:Intensive care medicine
pub_type: 杂志文章
doi:10.1007/s00134-010-1913-6
更新日期:2010-09-01 00:00:00
abstract:PURPOSE:To examine the consequences of administration of norepinephrine on muscle tissue oxygenation in severely hypotensive septic shock patients. METHODS:This was a prospective observational study conducted in a medical intensive care unit of a university hospital. We included 28 septic shock patients that received ...
journal_title:Intensive care medicine
pub_type: 杂志文章
doi:10.1007/s00134-010-2013-3
更新日期:2010-11-01 00:00:00
abstract:PURPOSE:To study the association between early initiation of intra-arrest therapeutic hypothermia and neurologic outcome in out-of-hospital cardiac arrest. METHODS:A prespecified sub-analysis of the PRINCESS trial (NCT01400373) that randomized 677 bystander-witnessed cardiac arrests to transnasal evaporative intra-arr...
journal_title:Intensive care medicine
pub_type: 杂志文章
doi:10.1007/s00134-020-06024-3
更新日期:2020-07-01 00:00:00
abstract:OBJECTIVE:We undertook this study to evaluate the influence of the inspiration:expiration (I:E) ratio on intracranial pressure and cerebral perfusion in patients with acute stroke. DESIGN:Ventilated patients with acute stroke were examined under a protocol involving variations of I:E ratio from 1:2 to 1:1 to 1:2 under...
journal_title:Intensive care medicine
pub_type: 杂志文章
doi:10.1007/s00134-002-1351-1
更新日期:2002-08-01 00:00:00
abstract:OBJECTIVE:Interhospital transfers of critically ill pediatric patients in The Netherlands are accompanied by referring specialists or by specialist retrieval teams. We compared the interventions before and directly after transports and the complications and the equipment available during transports in the two groups. ...
journal_title:Intensive care medicine
pub_type: 杂志文章
doi:10.1007/s00134-003-2066-7
更新日期:2004-02-01 00:00:00
abstract::Nine patients hospitalized for tetanus were studied under the same protocol which included two haemodynamic studies with a preload trial (PLT). The first being made during therapy (diazepam barbiturate association), on the sixth day of hospitalisation, and the second one after recovery. The comparison of the results s...
journal_title:Intensive care medicine
pub_type: 杂志文章
doi:10.1007/BF01700252
更新日期:1978-07-01 00:00:00
abstract:OBJECTIVE:The aim of this study was to identify risk factors and to describe epidemiological patterns for early-(EOB) and late-onset bacteremias (LOB) after trauma. DESIGN:A prospective study conducted on 141 consecutive trauma patients. SETTING:A general intensive care unit (ICU) of a university hospital. PATIENTS:...
journal_title:Intensive care medicine
pub_type: 杂志文章
doi:10.1007/BF01709514
更新日期:1996-08-01 00:00:00
abstract:OBJECTIVE:The aim of the study was to investigate the effect of lung volume changes on end-expiratory lung impedance change (ELIC) in mechanically ventilated patients, since we hypothesized that ELIC may be a suitable parameter to monitor lung volume change at the bedside. DESIGN:Clinical trial on patients requiring m...
journal_title:Intensive care medicine
pub_type: 临床试验,杂志文章
doi:10.1007/s00134-002-1555-4
更新日期:2003-01-01 00:00:00
abstract::608 patients admitted to a general Intensive Care Unit (ICU) over a 30 month period were analyzed according to the Apache II Severity of Disease Classification System on day one of admission. Hospital outcome details were available on 583 patients in the series. The mean Apache II scores for survivors (396) and non-su...
journal_title:Intensive care medicine
pub_type: 杂志文章
doi:10.1007/BF00263531
更新日期:1988-01-01 00:00:00
abstract:PURPOSE:To determine the global metabolomic profile as measured in circulating plasma from surviving and non-surviving patients with community-acquired pneumonia (CAP) and sepsis. METHODS:Random, outcome-stratified case-control sample from a prospective study of 1,895 patients hospitalized with CAP and sepsis. Cases (...
journal_title:Intensive care medicine
pub_type: 杂志文章,随机对照试验
doi:10.1007/s00134-013-2935-7
更新日期:2013-08-01 00:00:00
abstract:OBJECTIVE:To determine the incidence, risk factors, and outcome of barotrauma in a cohort of mechanically ventilated patients where limited tidal volumes and airway pressures were used. DESIGN AND SETTING:Prospective cohort of 361 intensive care units from 20 countries. PATIENTS AND PARTICIPANTS:A total of 5183 patie...
journal_title:Intensive care medicine
pub_type: 杂志文章,多中心研究
doi:10.1007/s00134-004-2187-7
更新日期:2004-04-01 00:00:00
abstract::During the last two decades, severe group A beta-haemolytic streptococcal infections have been defined as the "toxic strep syndrome", and have been reported not only in immunocompromised or elderly people, but also occasionally in previously healthy patients. We describe 4 patients presenting with the toxic strep synd...
journal_title:Intensive care medicine
pub_type: 杂志文章
doi:10.1007/BF01709279
更新日期:1993-01-01 00:00:00
abstract:OBJECTIVE:To provide evidence for the upregulation of endothelial nitric oxide synthase (eNOS) or inducible nitric oxide synthase (iNOS) in the assumed imbalance in the pathophysiology of rapid progressive pulmonary hypertension of the newborn (RPPHN), which is characterized by abnormal hypertrophy of the pulmonary art...
journal_title:Intensive care medicine
pub_type: 杂志文章
doi:10.1007/s00134-003-1892-y
更新日期:2003-10-01 00:00:00
abstract:OBJECTIVE:Pressure-volume (PV) curves are recorded after induction of complete muscle paralysis, which may limit their clinical use. The feasibility of recording PV curves without paralysis has not been tested. In 19 patients with acute respiratory distress syndrome (ARDS) and no hemodynamic instability we prospectivel...
journal_title:Intensive care medicine
pub_type: 杂志文章,随机对照试验
doi:10.1007/s00134-006-0265-8
更新日期:2006-09-01 00:00:00
abstract:PURPOSE:Relatives of intensive care unit (ICU) patients suffer emotional distress that impairs their ability to acquire the information they need from the staff. We sought to evaluate whether providing relatives with a list of important questions was associated with better comprehension on day 5. METHODS:Randomized, p...
journal_title:Intensive care medicine
pub_type: 杂志文章,随机对照试验
doi:10.1007/s00134-018-5423-2
更新日期:2018-11-01 00:00:00
abstract:OBJECTIVE:To determine the cell content and purity of Ficoll-separated peripheral blood mononuclear cells and granulocyte isolates in sepsis patients compared to healthy controls. DESIGN AND SETTING:Prospective study in the adult and pediatric intensive care departments of the Erasmus University Medical Center in the ...
journal_title:Intensive care medicine
pub_type: 杂志文章
doi:10.1007/s00134-007-0989-0
更新日期:2008-05-01 00:00:00
abstract:PURPOSE:This prospective observational study aimed at describing prescription patterns of tigecycline and patient outcomes in 26 French intensive care units (ICU). METHODS:Data of consecutive cases of adult patients treated with tigecycline were collected from the initiation until 7 days after the end of treatment. Re...
journal_title:Intensive care medicine
pub_type: 杂志文章,多中心研究
doi:10.1007/s00134-014-3323-7
更新日期:2014-07-01 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::We report a case of hyperinflation induced isorythmic atrio-ventricular dissociation with circulatory failure in a patient with chronic obstructive pulmonary disease. The arrythmia was successfully treated by applying "pressure support ventilation" (PSV: 20 cmH2O) which, by decreasing the respiratory rate and increasi...
journal_title:Intensive care medicine
pub_type: 杂志文章
doi:10.1007/BF00263868
更新日期:1989-01-01 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
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doi:10.1007/s00134-002-1538-5
更新日期:2002-12-01 00:00:00
abstract::Clearly the main determinant of outcome in severe acute pancreatitis is the extent of pancreatic necrosis and the subsequent risk for the development of infected necrosis. A thorough assessment using appropriate scoring systems and the early use of dynamic contrast-enhanced CT will highlight those patients likely to b...
journal_title:Intensive care medicine
pub_type: 杂志文章,评审
doi:10.1007/s001340050808
更新日期:1999-02-01 00:00:00
abstract:OBJECTIVE:Blood O(2) saturation and lactate concentration gradients from superior vena cava (SVC) to pulmonary artery (PA) occur in critically ill patients. These gradients (DeltaSO(2) and Delta[Lac]) may be positive or negative. We tested the hypothesis that positive DeltaSO(2) and Delta[Lac] are associated with impro...
journal_title:Intensive care medicine
pub_type: 杂志文章,多中心研究
doi:10.1007/s00134-008-1128-2
更新日期:2008-09-01 00:00:00
abstract:PURPOSE:Computerized clinical decision support systems (CDSS) for intensive insulin therapy (IIT) generate recommendations using blood glucose (BG) values manually transcribed from testing devices to computers, a potential source of error. We quantified the frequency and effect of blood glucose transcription mismatches...
journal_title:Intensive care medicine
pub_type: 杂志文章
doi:10.1007/s00134-010-1868-7
更新日期:2010-09-01 00:00:00
abstract:OBJECTIVE:To report the occurrence of life-threatening hyperkalaemia following treatment with therapeutic thiopentone coma. SETTING:The neurosurgical intensive care units of Royal North Shore Hospital and Liverpool Hospital, Sydney, Australia. PATIENTS:Three patients treated with theraputic thiopentone coma. One pati...
journal_title:Intensive care medicine
pub_type: 杂志文章
doi:10.1007/s00134-002-1399-y
更新日期:2002-09-01 00:00:00
abstract:OBJECTIVE:Pulmonary hypertension is a characteristic feature of acute respiratory distress syndrome (ARDS) and contributes to mortality. Administration of sildenafil in ambulatory patients with pulmonary hypertension improves oxygenation and ameliorates pulmonary hypertension. Our aim was to determine whether sildenafi...
journal_title:Intensive care medicine
pub_type: 临床试验,杂志文章,多中心研究
doi:10.1007/s00134-010-1754-3
更新日期:2010-05-01 00:00:00
abstract::Two patients with chest injuries, flail chest and respiratory failure were mechanically ventilated by a system composed of 2 Bennett respirators and an independent source of gas. This system provides high-frequency positive pressure ventilation (HFPPV), low-frequency conventional mechanical ventilation (LFCMV) and hig...
journal_title:Intensive care medicine
pub_type: 杂志文章
doi:10.1007/BF00259437
更新日期:1984-01-01 00:00:00
abstract:PURPOSE:Rapid shallow breathing may occur at any time during spontaneous breathing trials (SBT), questioning the utility of a single determination of the rapid shallow breathing index (RSBI). We hypothesize that change in RSBI during SBT may more accurately predict successful extubation than a single determination. ME...
journal_title:Intensive care medicine
pub_type: 杂志文章
doi:10.1007/s00134-009-1735-6
更新日期:2010-03-01 00:00:00
abstract:PURPOSE:The clinical significance of septic myocardial dysfunction is controversial, a fact that may be explained by the influence of loading conditions. Many indices may be useful to characterize cardiac function during septic shock, but their feasibility and physiological coherence in the clinical setting are unknown...
journal_title:Intensive care medicine
pub_type: 杂志文章
doi:10.1007/s00134-017-4698-z
更新日期:2017-05-01 00:00:00