Abstract：
OBJECTIVE:A readily available assessment of changes in pleural pressure would be useful for ventilator and fluid management in critically ill patients. We examined whether changes in pulmonary artery occlusion pressure (Ppao) adequately reflect respiratory changes in pleural pressure as assessed by changes in intraesophageal balloon pressure (Peso). We studied patients who had a pulmonary catheter and esophageal balloon surrounding a nasogastric tube as part of their care (n=24). We compared changes in Ppao (dPpao) to changes in Peso (dPeso) by Bland-Altman and regression analysis. Adequacy of balloon placement was assessed by performing Mueller maneuvers and adjusting the position to achieve a ratio of dPeso to change in tracheal pressure (dPtr) of 0.85 or higher. This was achieved in only 14 of the 24 subjects. We also compared dCVP to dPeso. The dPpao during spontaneous breaths and positive pressure breaths gave a good estimate of Peso but generally underestimated dPeso (bias=2.2 +8.2 and -3.9 cmH2O for the whole group). The dCVP was not as good a predictor (bias=2.9 +10.3 and -4.6). In patients who have a pulmonary artery catheter in place dPpao gives a lower estimate of changes in pleural pressure and may be more reliable than dPeso. The dCVP is a less reliable predictor than changes in pleural pressure.
journal_name
Intensive Care Medjournal_title
Intensive care medicineauthors
Bellemare P,Goldberg P,Magder SAdoi
10.1007/s00134-007-0842-5subject
Has Abstractpub_date
2007-11-01 00:00:00pages
2004-8issue
11eissn
0342-4642issn
1432-1238journal_volume
33pub_type
杂志文章abstract：BACKGROUND:Limiting the duration of invasive ventilation is an important goal in caring for critically ill patients. Several clinical trials have shown that compared to traditional care, protocols can reduce the total duration of mechanical ventilation. Computerized or automated weaning has the potential to improve wea...
journal_title：Intensive care medicine
pub_type： 杂志文章,评审
doi：10.1007/s00134-008-1154-0
更新日期：2008-10-01 00:00:00
abstract：:Male gender predisposes to severe sepsis and septic shock. This effect has been ascribed to higher levels of testosterone. The ESPNIC ARDS database was searched, to determine if there was evidence of a similar male preponderance in severe sepsis in prepubertal patients in spite of low levels of male sex hormones at th...
journal_title：Intensive care medicine
pub_type： 杂志文章
doi：10.1007/s00134-003-1948-z
更新日期：2003-10-01 00:00:00
abstract：OBJECTIVE:Infection is the most frequent cause of acute respiratory distress syndrome (ARDS). However, little is known about the influence of infection sites on ARDS. This study aimed to assess the associations of infection sites with ARDS development and mortality in critically ill infected patients. DESIGN:Prospecti...
journal_title：Intensive care medicine
pub_type： 杂志文章
doi：10.1007/s00134-010-1851-3
更新日期：2010-06-01 00:00:00
abstract：PURPOSE:The efficacy of noninvasive continuous positive airway pressure (CPAP) to improve outcomes in severe hypoxemic acute respiratory failure (hARF) due to pneumonia has not been clearly established. The aim of this study was to compare CPAP vs. oxygen therapy to reduce the risk of meeting criteria for endotracheal ...
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/s00134-014-3325-5
更新日期：2014-07-01 00:00:00
abstract：OBJECTIVE:Inhalation of high concentrations of nitric oxide (NO) has been shown to improve gas exchange and to reduce pulmonary vascular resistance in individuals with ischemia-reperfusion injury following orthotopic lung transplantation. We assessed the cardiopulmonary effects of low doses of NO in early allograft dys...
journal_title：Intensive care medicine
pub_type： 临床试验,杂志文章
doi：10.1007/s001340050741
更新日期：1998-11-01 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：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：BACKGROUND:Vasopressors are administered to critically ill patients with vasodilatory shock not responsive to volume resuscitation, and less often in cardiogenic shock, and hypovolemic shock. OBJECTIVES:The objectives are to review safety and efficacy of vasopressors, pathophysiology, agents that decrease vasopressor ...
journal_title：Intensive care medicine
pub_type： 杂志文章,评审
doi：10.1007/s00134-019-05801-z
更新日期：2019-11-01 00:00:00
abstract：:We have treated 30 patients with flail chest, with priority given to associated factors (pain, secretions retention, hemo-/pneumothorax and underlying pulmonary contusion). When this treatment was insufficient IMV + PEEP was instituted; in this group there was a 58.8% incidence of pneumonia, 47.5% of sepsis and 11.7 d...
journal_title：Intensive care medicine
pub_type： 杂志文章
doi：10.1007/BF01687161
更新日期：1980-08-01 00:00:00
abstract：PURPOSE:Meconium aspiration syndrome (MAS) is a life-threatening neonatal lung injury, whose pathophysiology has been mainly studied in animal models. In such models, pancreatic secretory phospholipase A2 (sPLA2-IB) and proinflammatory cytokines present in meconium challenge the lungs, catabolising surfactant and harmi...
journal_title：Intensive care medicine
pub_type： 杂志文章
doi：10.1007/s00134-011-2243-z
更新日期：2011-07-01 00:00:00
abstract：OBJECTIVE:To analyze the actual cost of pediatric intensive care and its different components, particularly the differences between various patient groups, with special reference to the variable cost and the elements included in it. DESIGN:Prospective, observational study. SETTING:Multidisciplinary 12-bed pediatric i...
journal_title：Intensive care medicine
pub_type： 杂志文章
doi：10.1007/s001340050320
更新日期：1997-02-01 00:00:00
abstract：PURPOSE:Information on predisposing risk factors influencing long-term survival after extracorporeal membrane oxygenation (ECMO) support remains scarce. In critically ill patients chronic obstructive pulmonary disease (COPD) is an independent risk factor for mortality and morbidity. We assessed the influence of COPD on...
journal_title：Intensive care medicine
pub_type： 杂志文章
doi：10.1007/s00134-013-2931-y
更新日期：2013-08-01 00:00:00
abstract：OBJECTIVE:Pseudomonas aeruginosa-induced lung injury is characterized not only by the alteration in lung fluid movement but also by apoptosis of lung epithelial and endothelial cells. We studied whether inhibition of apoptosis using a broad spectrum caspase inhibitor, benzyloxycarbonyl-Val-Ala-Asp fluoromethylketone (Z...
journal_title：Intensive care medicine
pub_type： 杂志文章
doi：10.1007/s00134-004-2165-0
更新日期：2004-06-01 00:00:00
abstract：OBJECTIVE:Pulmonary flow resistance is mainly determined by vessel calibres, resulting from the interaction of volume-passive distension and active vasomotion. However, quantitative information on the interplay between these counteracting forces in the lung is lacking. Therefore, we aimed at quantifying (1) the effects...
journal_title：Intensive care medicine
pub_type： 杂志文章
doi：10.1007/s001340051090
更新日期：1999-12-01 00:00:00
abstract：PURPOSE:The early diagnosis of traumatic internal carotid artery dissection (TICAD) is essential for initiating appropriate treatment and improving outcome. We searched for criteria from transcranial Doppler (TCD) measurements on admission that could be associated with subsequent TICAD diagnosis in patients with trauma...
journal_title：Intensive care medicine
pub_type： 杂志文章
doi：10.1007/s00134-010-1919-0
更新日期：2010-09-01 00:00:00
abstract：:Diagnosis and treatment of infection is a common procedure in the clinical management of patients in the ICU. Infection in the ICU is an important area for study, but requires well-defined and proven diagnostic criteria. The diagnosis of infection, like any diagnosis, is based on probability, and diagnostic criteria a...
journal_title：Intensive care medicine
pub_type： 杂志文章,评审
doi：10.1007/BF01713977
更新日期：1994-11-01 00:00:00
abstract：:We present a patient with evidence of severe intravascular hemolysis after mitral valve repair, an established method for the surgical treatment of mitral valve disease to avoid prosthesis related complications. The coincidence of this uncommon complication with hemodynamic instability due to pre-existing myocardial d...
journal_title：Intensive care medicine
pub_type： 杂志文章
doi：10.1007/BF01694714
更新日期：1993-01-01 00:00:00
abstract：OBJECTIVE:To determine what change in respiratory function occurred following prolonged and efficient continuous arteriovenous haemofiltration (CAVH) in a group of patients with multiple organ systems failure (MOSF). DESIGN:A retrospective assessment using patient notes and ICU charts. SETTING:The Intensive Care Unit...
journal_title：Intensive care medicine
pub_type： 杂志文章
doi：10.1007/BF01694361
更新日期：1992-01-01 00:00:00
abstract：OBJECTIVE:Intracerebral hemorrhage (ICH) is associated with a high mortality. The present study sought to determine the incidence of spontaneous ICH in an intensive care unit (ICU) and associated factors. DESIGN:A 6 year retrospective study. SETTING:A general ICU in a university hospital. PATIENTS:All ICU patients d...
journal_title：Intensive care medicine
pub_type： 杂志文章
doi：10.1007/s001340050788
更新日期：1999-01-01 00:00:00
abstract：:The metabolic changes associated with critical illness involve several pathways acting at different steps of the utilization of nutritive substrates. The understanding of the role of these pathways and of their complex regulation has led to the development of new strategies for the metabolic and nutritional management...
journal_title：Intensive care medicine
pub_type： 杂志文章
doi：10.1007/s00134-002-1512-2
更新日期：2002-11-01 00:00:00
abstract：:In order to evaluate the in vitro activity of fleroxacin against nosocomial gram-negative organisms, 263 multiresistant gram-negative bacilli (203 Enterobacteriaceae and 60 non-fermenting gram-negative bacilli) were isolated from adult patients with nosocomial infections. The different patterns of resistance to eight ...
journal_title：Intensive care medicine
pub_type： 杂志文章
doi：10.1007/s001340050675
更新日期：1998-08-01 00:00:00
abstract：BACKGROUND:After resuscitation, asphyxiated neonates often develop poor cardiac function with hypotension, pulmonary hypertension and multiorgan ischemia. In a swine model of neonatal hypoxia-reoxygenation, effects of epinephrine, dobutamine and milrinone on systemic, pulmonary and regional hemodynamics and oxygen tran...
journal_title：Intensive care medicine
pub_type： 杂志文章
doi：10.1007/s00134-010-1820-x
更新日期：2010-06-01 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：PURPOSE:To assess the effects of alveolar recruitment maneuvers (ARMs) on clinical outcomes in patients with acute respiratory distress syndrome (ARDS). METHODS:We conducted a search of the MEDLINE, EMBASE, LILACS, CINAHL, CENTRAL, Scopus, and Web of Science (from inception to July 2014) databases for all (i.e. no lan...
journal_title：Intensive care medicine
pub_type： 杂志文章,meta分析,评审
doi：10.1007/s00134-014-3413-6
更新日期：2014-09-01 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：OBJECTIVE:To investigate the involvement of intestinal angiotensin II type 2 receptors in the outcome of acute severe hypovolemia as well as systemic and regional mesenteric hemodynamics and intestinal mucosal functions in anesthetized pigs. DESIGN AND SETTING:Prospective, interventional animal study in a university r...
journal_title：Intensive care medicine
pub_type： 杂志文章
doi：10.1007/s00134-005-2686-1
更新日期：2005-08-01 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：OBJECTIVE:This study was undertaken to determine the delay of extubation attributable to ventilator-associated pneumonia (VAP) in comparison to other complications and complexity of surgery after repair of congenital heart lesions in neonates and children. METHODS:Cohort study in a pediatric intensive care unit of a t...
journal_title：Intensive care medicine
pub_type： 杂志文章
doi：10.1007/s001340051285
更新日期：2000-07-01 00:00:00
abstract：OBJECTIVE:To determine the adequate site of activated coagulation time (ACT) measurement during continuous haemodiafiltration (CHDF) using nafamostat mesilate. DESIGN:Prospective, consecutive, clinical study. SETTING:An intensive care unit of a general hospital. PATIENTS:Ten patients with acute organ failure includi...
journal_title：Intensive care medicine
pub_type： 临床试验,杂志文章
doi：10.1007/s001340050892
更新日期：1999-05-01 00:00:00
abstract：OBJECTIVE:Invasive candidiasis (IC) outcomes in intensive care units (ICUs) could be improved by the early administration of antifungals. The Candida Score (CS) prediction rule has been proposed for the selection of patients who could develop IC. Procalcitonin (PCT) levels allow prompt identification of sepsis, but the...
journal_title：Intensive care medicine
pub_type： 杂志文章
doi：10.1007/s00134-009-1623-0
更新日期：2009-12-01 00:00:00
