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-regression analysis of 15 randomized trials. MEASUREMENTS AND RESULTS:Variables were extracted to explain heterogeneity: year of publication; use of Sensormedics 3100A ventilator for HFV; time on CMV prior to start of study; gestational age; use of surfactant; high lung volume strategy in HFV; and lung protective ventilation strategy in CMV and baseline risk. Chronic lung disease (CLD) and death or CLD were outcome measures. Relative risk ratios were calculated to estimate effect sizes of explanatory variables on reported relative risks. Adjusted estimates of relative risk ratios of high lung volume strategy and lung protective ventilation strategy were 0.42 (95% CI 0.06-2.48) and 2.02 (95% CI 0.18-23.12) for CLD, respectively. The effect of gestational age was less pronounced (RRR=1.17 (95% CI 0.16-8.32) for CLD, respectively). Use of Sensormedics and prior time on CMV had the smallest effects [RRR=0.96 (95% CI 0.47-1.94) and RRR=0.85 (95% CI 0.58-1.24) for CLD, respectively)]. The same results applied to CLD or death as outcome. CONCLUSIONS:Variation in ventilation strategies that were used in trials comparing HFV with CMV in premature neonates offered the most likely explanation for the observed differences in the outcome of these trials compared with other explanatory factors.
journal_name
Intensive Care Medjournal_title
Intensive care medicineauthors
Bollen CW,Uiterwaal CS,van Vught AJdoi
10.1007/s00134-007-0545-ysubject
Has Abstractpub_date
2007-04-01 00:00:00pages
680-8issue
4eissn
0342-4642issn
1432-1238journal_volume
33pub_type
杂志文章,meta分析abstract::We describe a case of the dialysis disequilibrium syndrome (DDS) that was marked by the rapid onset of cerebral edema and the subsequent development of acute respiratory failure. The patient was treated successfully with a combination of mechanical hyperventilation and mannitol. The clinical presentation, pathogenesis...
journal_title:Intensive care medicine
pub_type: 杂志文章
doi:10.1007/s001340051214
更新日期:2000-05-01 00:00:00
abstract:OBJECTIVE:To assess the outcome of intensive care unit (ICU) treatment in patients with hematological malignancies. DESIGN AND SETTING:Retrospective cohort study in the medical ICU of a university hospital. PATIENTS:104 critically ill patients after receiving conventional chemotherapy or autologous hematopoietic stem...
journal_title:Intensive care medicine
pub_type: 杂志文章
doi:10.1007/s00134-002-1420-5
更新日期:2002-09-01 00:00:00
abstract:OBJECTIVE:To define the changes in middle cerebral artery flow velocity (Vmca) and the electroencephalogram (EEG) during rapid reduction in arterial carbon dioxide (PCO2) from acute hypercapnia. DESIGN. Human volunteer study. SETTING:University-affiliated hospital experimental laboratory. PARTICIPANTS:Nine healthy vo...
journal_title:Intensive care medicine
pub_type: 杂志文章
doi:10.1007/s00134-003-1917-6
更新日期:2003-10-01 00:00:00
abstract:OBJECTIVE:To validate a simple method avoiding discard volumes in pediatric patients with indwelling arterial and venous lines. DESIGN:Zero-discarding was achieved by passive extracorporeal arteriovenous backflow via standard single pressure transducer equipment. We tested backflow distances (10, 20 and 30 cm beyond t...
journal_title:Intensive care medicine
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1007/s001340100951
更新日期:2001-06-01 00:00:00
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...
journal_title:Intensive care medicine
pub_type: 杂志文章
doi:10.1007/s00134-006-0509-7
更新日期:2007-03-01 00:00:00
abstract:: ...
journal_title:Intensive care medicine
pub_type: 信件
doi:10.1007/s00134-018-5420-5
更新日期:2018-12-01 00:00:00
abstract:OBJECTIVE:The study was undertaken to determine if critically ill patients under mechanical ventilation could reactivate latent cytomegalovirus (CMV) in either lung or blood. DESIGN:Prospective study in critically ill patients was performed in a multidisciplinary intensive care unit in a university hospital. PATIENTS...
journal_title:Intensive care medicine
pub_type: 杂志文章
doi:10.1007/BF01709343
更新日期:1996-11-01 00:00:00
abstract:OBJECTIVE:To evaluate whether soluble triggering receptor expressed on myeloid cells 1 (sTREM-1) in CSF can serve as a biomarker for the presence of bacterial meningitis and outcome in patients with this disease. DESIGN:Retrospective study of diagnostic accuracy. SETTING AND PATIENTS:CSF was collected from 92 adults ...
journal_title:Intensive care medicine
pub_type: 杂志文章
doi:10.1007/s00134-006-0240-4
更新日期:2006-08-01 00:00:00
abstract::Induced hypothermia can be used to protect the brain from post-ischemic and traumatic neurological injury. Potential clinical applications and the available evidence are discussed in a separate paper. This review focuses on the practical aspects of cooling and physiological changes induced by hypothermia, as well as t...
journal_title:Intensive care medicine
pub_type: 杂志文章,评审
doi:10.1007/s00134-003-2151-y
更新日期:2004-05-01 00:00:00
abstract:OBJECTIVES:To examine whether urgent orotracheal intubation (OI) can induce bacteremia. To find predictive factors for post-intubation bacteremia. DESIGN:Prospective observational study. SETTING:Seventeen-bed medical intensive care unit in a university hospital. PATIENTS:Sixty-eight adult intensive care patients und...
journal_title:Intensive care medicine
pub_type: 杂志文章
doi:10.1007/s001340000841
更新日期:2001-02-01 00:00:00
abstract:OBJECTIVES:Children with peripheral airways obstruction suffer the negative effects of intrinsic positive end-expiratory pressure: increased work of breathing and difficulty triggering assisted ventilatory support. We examined whether external positive end-expiratory pressure to offset intrinsic positive end-expiratory...
journal_title:Intensive care medicine
pub_type: 临床试验,杂志文章
doi:10.1007/s00134-006-0445-6
更新日期:2007-01-01 00:00:00
abstract:OBJECTIVES:To assess the markers of perfusion which best discriminate survivors from non-survivors of childhood sepsis and to compare the information derived from gastric tonometry with conventionally measured haemodynamic and laboratory parameters. DESIGN:Prospective clinical study of children with sepsis syndrome or...
journal_title:Intensive care medicine
pub_type: 杂志文章
doi:10.1007/s001340050394
更新日期:1997-06-01 00:00:00
abstract:PURPOSE:Mechanical ventilation with lower tidal volumes (≤6 ml/kg of predicted body weight, PBW) could benefit patients without acute respiratory distress syndrome (ARDS). However, tidal volume reduction could be associated with increased patient discomfort and sedation needs, and consequent longer duration of ventilat...
journal_title:Intensive care medicine
pub_type: 杂志文章,meta分析,评审
doi:10.1007/s00134-014-3318-4
更新日期:2014-07-01 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:OBJECTIVE:Comparison of side effects (fever shivering and/or allergic reactions, collapse, symptomatic hypocalcaemia) of the different substitution fluids used during therapeutical plasmapheresis. DESIGN:Multicentric retrospective comparative study designed to explore the side effects due to the replacements fluids (a...
journal_title:Intensive care medicine
pub_type: 杂志文章,多中心研究
doi:10.1007/s001340050595
更新日期:1998-05-01 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:OBJECTIVE:To apply the modified pediatric RIFLE criteria for severity of acute kidney injury (AKI) to pediatric burn ICU patients and to evaluate the overall incidence of AKI, risk factors for AKI and influence of AKI on outcome. DESIGN:Retrospective, descriptive cohort study. SETTING:10-bed burn PICU facility. PATI...
journal_title:Intensive care medicine
pub_type: 杂志文章
doi:10.1007/s00134-009-1638-6
更新日期:2009-12-01 00:00:00
abstract:: ...
journal_title:Intensive care medicine
pub_type: 杂志文章
doi:10.1007/s00134-018-5280-z
更新日期:2018-12-01 00:00:00
abstract:INTRODUCTION:Faecal peritonitis (FP) is a common cause of sepsis and admission to the intensive care unit (ICU). The Genetics of Sepsis and Septic Shock in Europe (GenOSept) project is investigating the influence of genetic variation on the host response and outcomes in a large cohort of patients with sepsis admitted t...
journal_title:Intensive care medicine
pub_type: 杂志文章,多中心研究
doi:10.1007/s00134-013-3158-7
更新日期:2014-02-01 00:00:00
abstract::Central venous catheters (CVCs) are widely used in critically ill patients in intensive care units. However, infectious complications are common and may limit their utility. We critically review the literature to determine the impact of CVC design and composition, insertion site selection, insertion procedures, care a...
journal_title:Intensive care medicine
pub_type: 杂志文章,评审
doi:10.1007/BF01726542
更新日期:1995-02-01 00:00:00
abstract:OBJECTIVE:To investigate the regional partial pressure of oxygen (PO2) and partial pressure of carbon dioxide (PCO2) of the perfluorocarbon liquid (PpfcO2, PpfcCO2) during partial liquid ventilation (PLV). DESIGN:Prospective, controlled study. SETTING:A research laboratory at a university medical center. SUBJECTS:Th...
journal_title:Intensive care medicine
pub_type: 杂志文章
doi:10.1007/s001340000706
更新日期:2001-01-01 00:00:00
abstract:OBJECTIVES:Diagnosing persistent acute kidney injury (AKI) as opposed to transient AKI in critically ill patients may help physicians in making treatment decisions. This diagnosis relies chiefly on urinary indices, which may be of limited value or difficult to obtain. We assessed the performance of the Doppler renal re...
journal_title:Intensive care medicine
pub_type: 杂志文章
doi:10.1007/s00134-010-2050-y
更新日期:2011-01-01 00:00:00
abstract:INTRODUCTION:A prospective physiological study was performed in 12 paediatric patients with acute moderate hypercapnic respiratory insufficiency to assess the ability of noninvasive positive pressure ventilation (NPPV) to unload the respiratory muscles and improve gas exchange. MATERIALS AND METHODS:Breathing pattern,...
journal_title:Intensive care medicine
pub_type: 临床试验,杂志文章
doi:10.1007/s00134-008-1202-9
更新日期:2008-12-01 00:00:00
abstract:PURPOSE:Sepsis is a major health burden worldwide. Preclinical investigations in animals and retrospective studies in patients have suggested that inhibition of platelets may improve the outcome of sepsis. In this study we investigated whether chronic antiplatelet therapy impacts on the presentation and outcome of seps...
journal_title:Intensive care medicine
pub_type: 杂志文章
doi:10.1007/s00134-015-4171-9
更新日期:2016-03-01 00:00:00
abstract::Sixteen anaesthetized rabbits were subjected to tracheostomy and lung damage produced by the instillation of 4.5 ml/kg hydrochloric acid (pH 1.5) into the trachea. Half of the animals were ventilated with a positive end-expiratory pressure (PEEP) of 3 cmH2O and half with a PEEP of 10 cmH2O for 5 h, the mean airway pre...
journal_title:Intensive care medicine
pub_type: 杂志文章
doi:10.1007/BF01705044
更新日期:1992-01-01 00:00:00
abstract:OBJECTIVES:To establish a preliminary list of critical incidents (CIs) associated with mechanical ventilation and to describe a CI reporting method. DESIGN:A list of CIs was established based on a consensus among ICU caregivers. The list was compared to CIs collected prospectively during a predefined study period. SE...
journal_title:Intensive care medicine
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1007/s00134-002-1251-4
更新日期:2002-04-01 00:00:00
abstract:PURPOSE:Acute heart failure (AHF) causes high burden of mortality, morbidity, and repeated hospitalizations worldwide. This guidance paper describes the tailored treatment approaches of different clinical scenarios of AHF and CS, focusing on the needs of professionals working in intensive care settings. RESULTS:Tissue...
journal_title:Intensive care medicine
pub_type: 杂志文章,评审
doi:10.1007/s00134-015-4041-5
更新日期:2016-02-01 00:00:00
abstract:OBJECTIVE:There is still a lack of knowledge on the age-dependent relation between a reduction in cerebral perfusion pressure (CPP) and compromised brain perfusion leading to excessive transmitter release and brain damage cascades. The hypothesis is that an age-dependent lower threshold of cerebral blood flow (CBF) aut...
journal_title:Intensive care medicine
pub_type: 杂志文章
doi:10.1007/s00134-010-1846-0
更新日期:2010-06-01 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:PURPOSE:Frail patients are known to experience poor outcomes. Nevertheless, we know less about how frailty manifests itself in patients' physiology during critical illness and how it affects resource use in intensive care units (ICU). We aimed to assess the association of frailty with short-term outcomes and organ supp...
journal_title:Intensive care medicine
pub_type: 杂志文章,多中心研究
doi:10.1007/s00134-018-5342-2
更新日期:2018-09-01 00:00:00