Abstract:
:Specific regulations regarding oversight of research in children vary from country to country, but most share common principles derived from major consensus documents. Whereas the permissibility of research on adults depends heavily upon the informed consent of the subject, the regulation of research in pediatrics is focused primarily upon protection of the subjects from research risks. Since patients who require intensive care are commonly at high risk for complications related to the severity of their illnesses, justifying the risks of research on critically ill children may therefore be particularly challenging. Use of an approach known as "component analysis" can be very helpful in separating the risks attributable to the medical care itself from those that should be ascribed to the research. After identifying and isolating the research interventions, a three-step approach is helpful for evaluating the "net risks" of the research: (1) Separate each component of the research into discrete interventions. (2) Any intervention for which the benefits equal or exceed the risks is ethically justified. (3) For interventions in which the risks exceed the benefits, the "net risk" for each intervention needs to be justified, as follows: (a) the interventions may not exceed the locally defined threshold for pediatric research (e.g., not greater than a minor increment more than minimal risk, as in the U.S. regulations); and (b) the scientific value of the study for improving the care of future children must be sufficient to justify the sum of the net risks of the research interventions.
journal_name
Intensive Care Medjournal_title
Intensive care medicineauthors
Truog RDdoi
10.1007/s00134-007-0917-3subject
Has Abstractpub_date
2008-01-01 00:00:00pages
198-202issue
1eissn
0342-4642issn
1432-1238journal_volume
34pub_type
杂志文章abstract:OBJECTIVE:Measurement of functional residual capacity (FRC) during controlled and especially during assisted ventilation remains a challenge in the physiological evaluation of ventilated patients. To validate a bag-in-box closed helium dilution technique allowing measurements both during pressure-controlled (PCV) and p...
journal_title:Intensive care medicine
pub_type: 杂志文章
doi:10.1007/s00134-007-0833-6
更新日期:2007-12-01 00:00:00
abstract::The aim of this investigation was to evaluate the role of ultrasonography in avoiding cranial misplacement of the tracheostomy tube and tracheal ring fractures during percutaneous dilatational tracheostomy (PDT). The tracheas of 26 consecutive ICU patients who had undergone PDT but who later died were removed en bloc ...
journal_title:Intensive care medicine
pub_type: 杂志文章
doi:10.1007/s001340000589
更新日期:2000-09-01 00:00:00
abstract:PURPOSE:Family members of patients who die in the intensive care unit (ICU) may experience symptoms of stress, anxiety, depression, posttraumatic stress disorder (PTSD), and/or prolonged grief. We evaluated whether grief symptoms were alleviated if the physician and the nurse in charge at the time of death sent the clo...
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/s00134-016-4669-9
更新日期:2017-04-01 00:00:00
abstract:PURPOSE:To determine the incidence of and risk factors for adverse cardiac events during catecholamine vasopressor therapy in surgical intensive care unit patients with cardiovascular failure. METHODS:The occurrence of any of seven predefined adverse cardiac events (prolonged elevated heart rate, tachyarrhythmia, myoc...
journal_title:Intensive care medicine
pub_type: 杂志文章
doi:10.1007/s00134-012-2531-2
更新日期:2012-06-01 00:00:00
abstract::Achievement of a mean blood pressure (MBP) target is one of the hemodynamic goals to ensure an adequate blood perfusion pressure in critically ill patients. Arterial catheter allows for a continuous and precise monitoring of arterial pressure signal. In addition to giving a precise MBP monitoring, analysis of the bloo...
journal_title:Intensive care medicine
pub_type: 杂志文章,评审
doi:10.1007/s00134-010-2092-1
更新日期:2011-03-01 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:OBJECTIVE:Nuclear factor-kappaB (NF-kappaB) is a transcription factor which plays a pivotal role in the induction of genes involved in the response to injury and inflammation. Calpain I inhibitor is a potent antioxidant which is an effective inhibitor of NF-kappaB. This study examined whether the postulate that calpain...
journal_title:Intensive care medicine
pub_type: 杂志文章
doi:10.1007/s00134-004-2328-z
更新日期:2004-08-01 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:PURPOSE:Reporting neurodevelopmental outcome of 8-year-old children treated with neonatal extracorporeal membrane oxygenation (ECMO). METHODS:In a follow-up study in 135 8-year-old children who received neonatal ECMO between 1996 and 2001 we assessed intelligence (Revised Amsterdam Intelligence Test), concentration (B...
journal_title:Intensive care medicine
pub_type: 杂志文章,多中心研究
doi:10.1007/s00134-013-2973-1
更新日期:2013-09-01 00:00:00
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::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:PURPOSE:Extracorporeal life support (ECLS) is used for patients with refractory heart failure with or without respiratory failure. This temporary support is provided by blood pumps which are connected to large vessels. Bleeding episodes are a typical complication in patients with ECLS. Recently, several studies illustr...
journal_title:Intensive care medicine
pub_type: 杂志文章
doi:10.1007/s00134-011-2370-6
更新日期:2012-01-01 00:00:00
abstract::Extracorporeal life support (ECLS) can support gas exchange in patients with the acute respiratory distress syndrome (ARDS). During ECLS, venous blood is drained from a central vein via a cannula, pumped through a semipermeable membrane that permits diffusion of oxygen and carbon dioxide, and returned via a cannula to...
journal_title:Intensive care medicine
pub_type: 杂志文章,评审
doi:10.1007/s00134-020-06290-1
更新日期:2020-12-01 00:00:00
abstract::The goals of management of patients with respiratory failure include improving arterial oxygenation with PEEP and red cell transfusion to maintain oxygen carrying capacity, both of which contribute to improving tissue oxygen delivery. However, standard CPD-stored blood is rapidly depleted of 2,3 diphosphoglycerate (2,...
journal_title:Intensive care medicine
pub_type: 杂志文章
doi:10.1007/BF00315364
更新日期:1986-01-01 00:00:00
abstract::Myxoedema coma is a medical emergency with high mortality. In this study, clinical response and plasma variations of thyroid hormones were analysed in 7 patients, 6 presenting with myxoedema coma and one with myxoedema ileus. These patients were treated with intravenous or oral l-thyroxine (l-T4). 1000 mu l-T4 iv were...
journal_title:Intensive care medicine
pub_type: 杂志文章
doi:10.1007/BF01708403
更新日期:1991-01-01 00:00:00
abstract:OBJECTIVE:To determine the frequency and the eventual clinical characteristics of nosocomial sinusitis with anaerobic bacteria isolation in patients in the intensive care unit (ICU). DESIGN:Retrospective study. SETTING:A 12-bed medical ICU in a teaching hospital. PATIENTS:30 adult patients with documented nosocomial...
journal_title:Intensive care medicine
pub_type: 杂志文章
doi:10.1007/s001340051013
更新日期:1999-10-01 00:00:00
abstract::Conventional indices of tissue perfusion after surgery involving cardiopulmonary bypass (CPB) may not accurately reflect disordered cell metabolism. Venous hypercarbia leading to an increased veno-arterial difference in CO2 tensions (V-aCO2 gradient) has been shown to reflect critical reductions in systemic and pulmon...
journal_title:Intensive care medicine
pub_type: 杂志文章
doi:10.1007/BF01716189
更新日期:1991-01-01 00:00:00
abstract::The process of fluidisation involves blowing warm air through small solid microspheres thus creating a liquid, without wetness. The warmth provides some important properties including reducing the metabolic rate in thermal injury which has a beneficial effect on mortality, modifying catabolism after surgery, providing...
journal_title:Intensive care medicine
pub_type: 杂志文章,评审
doi:10.1007/BF01701488
更新日期:1995-03-01 00:00:00
abstract:OBJECTIVE:To determine the clinical impact of bedside colonoscopy for critically ill patients with acute lower gastrointestinal (GI) bleeding. DESIGN AND SETTING:A 3-year retrospective analysis (chart review). Medical intensive care unit (ICU) of a 1,312-bed tertiary-care center in Taiwan. PATIENTS AND PARTICIPANTS:F...
journal_title:Intensive care medicine
pub_type: 杂志文章
doi:10.1007/s00134-005-2604-6
更新日期:2005-05-01 00:00:00
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 pat...
journal_title:Intensive care medicine
pub_type: 杂志文章
doi:10.1007/s00134-005-0065-6
更新日期:2006-04-01 00:00:00
abstract:OBJECTIVE:To compare isoflurane with midazolam for prolonged sedation in ventilated patients. DESIGN:Randomised controlled study. SETTING:General intensive care unit in university teaching hospital. PATIENTS:Sixty patients aged 17-80 years who required mechanical ventilation for more than 24 h. INTERVENTIONS:Sedati...
journal_title:Intensive care medicine
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1007/BF01694344
更新日期:1992-01-01 00:00:00
abstract:OBJECTIVE:To evaluate the ability of DeltaPP/DeltaP [pulse pressure variations (DeltaPP) adjusted by alveolar pressure variations (DeltaP = Pplat-PEEPtot)] in predicting fluid responsiveness, to compare its accuracy to that of DeltaPP used alone and to evaluate the influence of tidal volume (Vt) on these two indices. ...
journal_title:Intensive care medicine
pub_type: 杂志文章
doi:10.1007/s00134-009-1478-4
更新日期:2009-06-01 00:00:00
abstract:: ...
journal_title:Intensive care medicine
pub_type: 信件
doi:10.1007/s00134-018-5180-2
更新日期:2018-06-01 00:00:00
abstract::We report a fatal case of a child presenting Reye's syndrome associated with a variety of arrhythmias and ischemia-like ST-T ECG changes. At autopsy, fatty infiltration and patchy myocytolysis were detected in sections of the heart. This case report emphasizes cardiac involvement in Reye's syndrome and the possible me...
journal_title:Intensive care medicine
pub_type: 杂志文章
doi:10.1007/BF01728333
更新日期:1996-01-01 00:00:00
abstract::Values obtained for cardiac output (CO) were compared using thermodilution (TD) with those obtained using bioimpedance (Bi) as measured using the Bomed NCCOM3 (Revision 6) in 28 consecutive patients in the first 24 h after coronary artery bypass surgery (CABS). In 46 paired measurements made in the first 12 h after CA...
journal_title:Intensive care medicine
pub_type: 杂志文章
doi:10.1007/BF01720674
更新日期:1991-01-01 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 whether health-related quality of life (HRQL) in survivors of acute renal failure (ARF) occurring in intensive care is predictable from data available at the time of acute illness. DESIGN AND SETTING:Prospective pilot study in academic intensive care units. PATIENTS AND METHODS:Patients requiri...
journal_title:Intensive care medicine
pub_type: 杂志文章
doi:10.1007/s00134-003-1837-5
更新日期:2003-09-01 00:00:00
abstract:PURPOSE:We evaluated the impact of increasing tidal volume (V (t)), decreased chest wall compliance, and left ventricular (LV) contractility during intermittent positive-pressure ventilation (IPPV) on the relation between pulse pressure (PP) and LV stroke volume (SV(LV)) variation (PPV and SVV, respectively), and intra...
journal_title:Intensive care medicine
pub_type: 杂志文章
doi:10.1007/s00134-011-2304-3
更新日期:2011-10-01 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 determine: (1) the proportion of small (<5 mm) or thrombosed internal jugular veins (IJV) and femoral veins (FV) in which catheter placement would be difficult without ultrasound guidance; (2) which position increases central vein sizes and may facilitate cannulation of these vessels. DESIGN:Prospective s...
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