Abstract：
OBJECTIVE:To determine the prevalence, risk factors, and outcomes of critical illness neuromuscular abnormalities (CINMA). DESIGN:Systematic review. DATA SOURCES AND STUDY SELECTION:MEDLINE, EMBASE, CINAHL, and the Cochrane Library were searched for reports on adult ICU patients who were evaluated for CINMA clinically and electrophysiologically. Studies were included if they contained sufficient data to quantify the association between CINMA and relevant exposures and/or outcome variables. MEASUREMENTS AND RESULTS:CINMA was diagnosed in 655 of 1421 [46% (95% confidence interval 43-49%)] adult ICU patients enrolled in 24 studies, all with inclusion criteria of sepsis, multi-organ failure, or prolonged mechanical ventilation. Diagnostic criteria for CINMA were not uniform, and few reports unequivocally differentiated between polyneuropathy, myopathy, and mixed types of CINMA. The risk of CINMA was associated with hyperglycemia (and inversely associated with tight glycemic control), the systemic inflammatory response syndrome, sepsis, multiple organ dysfunction, renal replacement therapy, and catecholamine administration. Across studies, there was no consistent relationship between CINMA and patient age, gender, severity of illness, or use of glucocorticoids, neuromuscular blockers, aminoglycosides, or midazolam. Unadjusted mortality was not increased in the majority of patients with CINMA, but mechanical ventilation and ICU and hospital stay were prolonged. CONCLUSIONS:The risk of CINMA is nearly 50% in ICU patients with sepsis, multi-organ failure, or protracted mechanical ventilation. The association of CINMA with frequently cited CINMA risk factors (glucocorticoids, neuromuscular blockers) and with short-term survival is uncertain. Available data indicate glycemic control as a potential strategy to decrease CINMA risk.
journal_name
Intensive Care Medjournal_title
Intensive care medicineauthors
Stevens RD,Dowdy DW,Michaels RK,Mendez-Tellez PA,Pronovost PJ,Needham DMdoi
10.1007/s00134-007-0772-2subject
Has Abstractpub_date
2007-11-01 00:00:00pages
1876-91issue
11eissn
0342-4642issn
1432-1238journal_volume
33pub_type
杂志文章,评审abstract：:In 9 Goettingen minipigs we studied the effect of E. coli bacteremia on effective pulmonary capillary pressure and the longitudinal distribution of pulmonary vascular resistance. Precapillary pressure gradient (dPa) was calculated as the difference between mean pulmonary artery pressure (MPP) and effective pulmonary c...
journal_title：Intensive care medicine
pub_type： 杂志文章
doi：10.1007/BF01709400
更新日期：1990-01-01 00:00:00
abstract：OBJECTIVE:Adverse respiratory and gasometrical effects have been described in patients with acute respiratory failure (ARF) undergoing noninvasive ventilation (NIV) with standard heat and moisture exchangers (HME). We decided to evaluate respiratory parameters and arterial blood gases (ABG) of patients during NIV with ...
journal_title：Intensive care medicine
pub_type： 杂志文章,随机对照试验
doi：10.1007/s00134-010-1894-5
更新日期：2010-08-01 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:Early central venous catheter (CVC) insertion in Ebola virus disease (EVD) is a novel approach and has not previously been described. This report delineates the safety, feasibility and clinical implications of early CVC insertion as the optimum means of vascular access in patients with EVD, in the setting of a ...
journal_title：Intensive care medicine
pub_type： 杂志文章
doi：10.1007/s00134-015-3736-y
更新日期：2015-05-01 00:00:00
abstract：PURPOSE:Hyperglycaemia is common in the critically ill. The objectives of this study were to determine the prevalence of critical illness-associated hyperglycaemia (CIAH) and recognised and unrecognised diabetes in the critically ill as well as to evaluate the impact of premorbid glycaemia on the association between ac...
journal_title：Intensive care medicine
pub_type： 临床试验,杂志文章
doi：10.1007/s00134-014-3287-7
更新日期：2014-07-01 00:00:00
abstract：:Marked respiratory insufficiency was established in 20 of 91 patients with acute pancreatitis. 16 of them died, 12 from uncontrollable hypoxaemia. At postmortem the most prominent finding was microatelectasis, the occurrence of which correlated highly with the serum amylase activity. ...
journal_title：Intensive care medicine
pub_type： 杂志文章
doi：10.1007/BF01683069
更新日期：1977-08-01 00:00:00
abstract：OBJECTIVE:To investigate the relationship between cytokines and the inflammatory responses in patients with out-of-hospital cardiac arrest, we examined the changes of cytokines as well as alterations in the markers of neutrophil activation, platelet and endothelial activation, and endothelial injury. DESIGN:Prospectiv...
journal_title：Intensive care medicine
pub_type： 临床试验,杂志文章
doi：10.1007/s001340050907
更新日期：1999-06-01 00:00:00
abstract：:Acute renal failure in critically ill patients is seldom an isolated problem but is more usually associated with multiple organ failure. When choosing an extracorporeal kidney replacement therapy, these other failing organs must be taken into account. Therefore the choice of an artificial kidney in patients requiring ...
journal_title：Intensive care medicine
pub_type： 杂志文章,评审
doi：10.1007/BF00261492
更新日期：1989-01-01 00:00:00
abstract：:The pharmacokinetics of theophylline and ethylenediamine were examined in 6 patients with septicaemia and multiorgan failure (MOF). The patients received a bolus injection of 4 mg/kg aminophylline. Aminophylline is the ethylenediamine salt of theophylline. The clearance of theophylline was reduced in all our patients ...
journal_title：Intensive care medicine
pub_type： 杂志文章
doi：10.1007/BF01690768
更新日期：1991-01-01 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：:Arterial blood ketone body ratio, reflecting hepatic mitochondrial redox state, was measured in 26 brain-dead patients who were hypotensive but hemodynamically stable. All of them had substantially normal hepatic function. In 18 of the patients, blood ketone body ratio was maintained within the normal range in spite o...
journal_title：Intensive care medicine
pub_type： 杂志文章
doi：10.1007/BF01691432
更新日期：1991-01-01 00:00:00
abstract：:In the first study 6 patients with raised intracranial pressure due to brain oedema following head injury were given dihydroergotamine because of low perfusion pressure. The intracranial pressure fell simultaneously with the increase in arterial pressure. The intracranial pressure fell from 24 +/- 2 mmHg by a maximum ...
journal_title：Intensive care medicine
pub_type： 杂志文章
doi：10.1007/BF00273564
更新日期：1989-01-01 00:00:00
abstract：OBJECTIVE:The role of critical care pharmacists in the United States has recently been documented; however, little information exists about the role of international critical care pharmacists. The objective of this study was to describe the duties and activities of international pharmacists who practice in critical car...
journal_title：Intensive care medicine
pub_type： 杂志文章
doi：10.1007/s00134-007-0918-2
更新日期：2008-03-01 00:00:00
abstract：OBJECTIVE:To compare outcome prediction using the Multiple Organ Dysfunction Score (MODS) and the Sequential Organ Failure Assessment (SOFA), two of the systems most commonly used to evaluate organ dysfunction in the intensive care unit (ICU). DESIGN:Prospective, observational study. SETTING:Thirty-one-bed, universit...
journal_title：Intensive care medicine
pub_type： 杂志文章
doi：10.1007/s00134-002-1491-3
更新日期：2002-11-01 00:00:00
abstract：BACKGROUND:Invasive candidiasis and candidemia are frequently encountered in the nosocomial setting particularly in the intensive care unit (ICU). OBJECTIVE AND METHODS:To review the current management of invasive candidiasis and candidemia in non-neutropenic adult ICU patients based on a review of the literature and ...
journal_title：Intensive care medicine
pub_type： 杂志文章,评审
doi：10.1007/s00134-008-1339-6
更新日期：2009-02-01 00:00:00
abstract：OBJECTIVE:Five commercially available oesophageal balloon catheters (OBCs) were tested to evaluate the accuracy in transmitting fast-changing pressure signals which can be observed, for example, during phrenic nerve stimulation. SETTING:Research laboratory of a university hospital. METHOD:The OBCs tested varied in le...
journal_title：Intensive care medicine
pub_type： 杂志文章
doi：10.1007/s001340051182
更新日期：2000-04-01 00:00:00
abstract：OBJECTIVE:To describe the use of volumetric capnography, a plot of expired CO(2) concentration against expired volume, in monitoring fibrinolytic treatment of major pulmonary embolism. DESIGN AND SETTING:Two case reports in the emergency department of a teaching hospital. PATIENTS:Two conscious and spontaneously brea...
journal_title：Intensive care medicine
pub_type： 杂志文章
doi：10.1007/s00134-004-2444-9
更新日期：2004-11-01 00:00:00
abstract：OBJECTIVE:To determine if the plasma levels of three endothelial-specific proteins, von Willebrand factor (vWF), tissue factor pathway inhibitor (TFPI) and thrombomodulin (TM) may be useful in predicting the development of acute respiratory distress syndrome (ARDS). DESIGN:Blood samples were obtained from normal healt...
journal_title：Intensive care medicine
pub_type： 杂志文章
doi：10.1007/s001340051054
更新日期：1999-11-01 00:00:00
abstract：OBJECTIVE:While using a transcutaneous system for assessment of liver function by indocyanine green plasma disappearance rate (ICG-PDR) in critically ill patients, we compared the agreement between ICG-PDR obtained by the recommended standard ICG dosage (0.5 mg/kg) and a reduced dosage (0.25 mg/kg). DESIGN:Clinical st...
journal_title：Intensive care medicine
pub_type： 临床试验,杂志文章,随机对照试验
doi：10.1007/s00134-003-2091-6
更新日期：2004-03-01 00:00:00
abstract：:The process of surgical decision making is based on both general principles that are amenable to evaluation using rigorous techniques of clinical research and the intangible element of surgical judgment that seeks to apply those principles to the care of an individual patient. The role of surgical judgment is inescapa...
journal_title：Intensive care medicine
pub_type： 指南,杂志文章,实务指引,评审
doi：10.1007/pl00003797
更新日期：2001-01-01 00:00:00
abstract：:Peritoneal dialysis was used in experimental lactic acidosis caused by hypoxia for the removal of endogenous lactate. Two types of dialysis fluid, with and without vasodilator sodium nitroprusside, added intraperitoneally were used. The addition of sodium nitroprusside increased peritoneal the clearance of lactate as ...
journal_title：Intensive care medicine
pub_type： 杂志文章
doi：10.1007/BF01709725
更新日期：1981-01-01 00:00:00
abstract：:We examined the incidence, diagnosis and therapy of acute adrenal insufficiency, secondary to adrenal hemorrhage. This insufficiency resulted in temperature irregularities. hemodynamic instability, and a large volume resuscitation requirement post-operatively. The case illustrates that a high level of suspicion should...
journal_title：Intensive care medicine
pub_type： 杂志文章
doi：10.1007/BF01704704
更新日期：1994-01-01 00:00:00
abstract：OBJECTIVE:To evaluate clinical and microbiologic characteristics, modalities of treatment and outcome of patients with cervical necrotizing fasciitis admitted to our institution. DESIGN:Retrospective clinical investigation. PATIENTS AND METHODS:We reviewed the charts of 20 consecutive patients hospitalized in our Int...
journal_title：Intensive care medicine
pub_type： 杂志文章
doi：10.1007/s001340050959
更新日期：1999-08-01 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：:The effects of continuous and supplementary bolus dose administration of etomidate have been investigated in ten artificially ventilated patients in traumatic coma. Continuous infusion of etomidate (5-25 micrograms/kg/min) proved to be a practical and safe means of sedating these patients and appeared to control moder...
journal_title：Intensive care medicine
pub_type： 杂志文章
doi：10.1007/BF01692549
更新日期：1983-01-01 00:00:00
abstract：PURPOSE:Previous observational studies have inconsistently associated early hyperoxia with worse outcomes after cardiac arrest, and have methodological limitations. We tested this association using a high-resolution database controlling for multiple disease-specific markers of severity of illness and care processes. M...
journal_title：Intensive care medicine
pub_type： 杂志文章
doi：10.1007/s00134-014-3555-6
更新日期：2015-01-01 00:00:00
abstract：PURPOSE:The aim of our study was to explore, using an innovative method, the effect of temporal changes in the mortality prediction performance of an existing model on the quality of care assessment. The prognostic model (rSAPS-II) was a recalibrated Simplified Acute Physiology Score-II model developed for very elderly...
journal_title：Intensive care medicine
pub_type： 杂志文章
doi：10.1007/s00134-011-2390-2
更新日期：2012-01-01 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:Sepsis and its progression are known to have a major influence on the coagulation system. Current coagulation tests are of limited use when assessing coagulation in sepsis patients. This study aims to assess the potential for a new functional biomarker of clot microstructure, fractal dimension, to identify chan...
journal_title：Intensive care medicine
pub_type： 杂志文章
doi：10.1007/s00134-016-4496-z
更新日期：2016-12-01 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
