Abstract:
OBJECTIVE:To evaluate the use of antidotal therapy in patients with an elevated digitalis concentration following chronic or acute exposure. DESIGN AND SETTING:Retrospective review of patient records over 2 years in 20 city hospitals in France. PATIENTS:Overall 838 patients with an elevated serum digitalis concentration (digoxin > 1.95ng /ml or digitoxin > 23ng /ml) were included in the study. Of these, 67 (8%) had received antidotal therapy with Fab fragments. MEASUREMENTS AND RESULTS:The relationships between previously reported prognostic criteria and use of antidotal therapy were investigated. We identified five independent factors that were associated with the use of antidotal therapy: acute overdose (OR 15.74), Fab fragment availability in the hospital (11.06), serum potassium (1.81), and heart rate (0.96). Mortality was significantly lower in Fab-treated (6%, 4/67) than untreated patients (15%, 117/770). CONCLUSIONS:Antidotal therapy is underused in patients with an elevated digitalis concentration especially in patients with chronic digitalis exposure. These patients in our series presented a higher mortality rate than patients with acute poisoning. Although they were older and tended to have a history of cardiac disease, they did not differ from patients with acute poisoning with regard to the main severity criteria and prognostic factors. The use of identical criteria for antidotal treatment after acute and chronic poisoning should help optimize outcomes. Fab fragment availability is insufficient in France but ranks only second after type of poisoning (acute or chronic) in the multivariate association with Fab treatment.
journal_name
Intensive Care Medjournal_title
Intensive care medicineauthors
Lapostolle F,Borron SW,Verdier C,Arnaud F,Couvreur J,Mégarbane B,Baud F,Adnet Fdoi
10.1007/s00134-008-1092-xsubject
Has Abstractpub_date
2008-08-01 00:00:00pages
1448-53issue
8eissn
0342-4642issn
1432-1238journal_volume
34pub_type
杂志文章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:OBJECTIVE:We compared two imipenem regimens for prevention of septic complications in patients with severe acute necrotizing pancreatitis (ANP). DESIGN AND SETTING:Prospective, randomized open clinical trial involving intensive care units of 14 Spanish Hospitals. PARTICIPANTS:92 patients with ANP. INTERVENTIONS:Imip...
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/s00134-003-1956-z
更新日期:2003-11-01 00:00:00
abstract::Results of the relationships between oxygen supply, demand, and uptake can be used to interpret cardiac output values, identify types of acute circulatory failure, guide attempts to improve cellular function, and thus prevent the development of multiple organ failure and death. Five steps in the interpretation of card...
journal_title:Intensive care medicine
pub_type: 杂志文章,评审
doi:10.1007/BF01785244
更新日期:1990-01-01 00:00:00
abstract::The treatment of severe tetanus with autonomic dysfunction is discussed, with emphasis on the use of magnesium sulphate. An exemplary case is reported, describing the inadequate response to magnesium, but the previously unreported and successful use of clonidine to control sympathetic overactivity. The properties of c...
journal_title:Intensive care medicine
pub_type: 杂志文章,评审
doi:10.1007/BF02575297
更新日期:1990-01-01 00:00:00
abstract:PURPOSE:Motion-mode (MM) echography allows precise measurement of diaphragmatic excursion when the ultrasound beam is parallel to the diaphragmatic displacement. However, proper alignment is difficult to obtain in patients after cardiac surgery; thus, measurements might be inaccurate. A new imaging modality named the a...
journal_title:Intensive care medicine
pub_type: 杂志文章,随机对照试验
doi:10.1007/s00134-014-3625-9
更新日期:2015-04-01 00:00:00
abstract:OBJECTIVE:Spasms in patients with generalized tetanus can be suppressed by a spinal intrathecal infusion of baclofen. We report on four patients and review reported cases treated by this method elsewhere. DESIGN:Intrathecal baclofen infusion was started with a bolus dose (300-500 micrograms) and continued at a steady ...
journal_title:Intensive care medicine
pub_type: 杂志文章,评审
doi:10.1007/s001340050429
更新日期:1997-08-01 00:00:00
abstract:OBJECTIVE:Antipyrine metabolism is a "gold standard" measure of mixed cytochrome P450 (CYP) mediated drug metabolism in humans. Cytokines (e.g., interleukin-6) and nitric oxide reduce CYP 450 activity in vitro and in vivo. Because interleukin-6 and nitric oxide production increases in children with sepsis-induced multi...
journal_title:Intensive care medicine
pub_type: 杂志文章
doi:10.1007/s00134-003-1758-3
更新日期:2003-06-01 00:00:00
abstract:OBJECTIVE:To compare the ventilation achieved with chest compressions (CC) or ventilation plus compressions (VC) in a pediatric animal model of cardiac arrest. DESIGN:Randomized experimental study. SETTING:Experimental department of a University Hospital. METHODS:Twelve infant pigs with asphyxial cardiac arrest. Seq...
journal_title:Intensive care medicine
pub_type: 杂志文章
doi:10.1007/s00134-010-1777-9
更新日期:2010-04-01 00:00:00
abstract:OBJECTIVE:The primary objective was to test the hypothesis that clinical re-expansion pulmonary edema is predominantly due to increased permeability of the alveolar-capillary barrier. A secondary objective was to determine if the alveolar epithelium was functionally intact in patients with re-expansion pulmonary edema ...
journal_title:Intensive care medicine
pub_type: 杂志文章
doi:10.1007/s00134-004-2379-1
更新日期:2004-10-01 00:00:00
abstract:OBJECTIVE:To evaluate the extent to which respiratory changes in inferior vena cava (IVC) diameter can be used to predict fluid responsiveness. DESIGN:Prospective clinical study. SETTING:Hospital intensive care unit. PATIENTS:Twenty-three patients with acute circulatory failure related to sepsis and mechanically ven...
journal_title:Intensive care medicine
pub_type: 临床试验,杂志文章
doi:10.1007/s00134-004-2259-8
更新日期:2004-09-01 00:00:00
abstract:OBJECTIVE:To assess the value of the diagnosis of overt disseminated intravascular coagulation (DIC) according to the International Society on Thrombosis and Haemostasis (ISTH) criteria and that of the parameters included in the ISTH score for overt DIC in predicting day 28 mortality in intensive care patients. Also, t...
journal_title:Intensive care medicine
pub_type: 杂志文章
doi:10.1007/s00134-005-2685-2
更新日期:2005-09-01 00:00:00
abstract:PURPOSE:We conducted a retrospective cohort study in an academic tertiary care center to characterize ventilator-associated pneumonia (VAP) in pediatric patients after cardiac surgery in The Netherlands. METHODS:All patients following cardiac surgery and mechanically ventilated for ≥24 h were included. The primary out...
journal_title:Intensive care medicine
pub_type: 杂志文章
doi:10.1007/s00134-011-2349-3
更新日期:2011-10-01 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::Nosocomial pneumonia continues to represent a significant cause of morbidity and mortality in hospitalized patients. Bacteria are responsible for greater than 90% of the pneumonias, the most common isolates being aerobic Gram-negative bacilli and S. aureus. Cornerstones of treatment are intravenous antibiotics and sup...
journal_title:Intensive care medicine
pub_type: 杂志文章,评审
doi:10.1007/BF01752974
更新日期:1992-01-01 00:00:00
abstract:OBJECTIVES:Inhalation of nitric oxide (NO) selectively dilates pulmonary vessels in well-ventilated regions. Prostaglandin F2 alpha (PGF2 alpha) is a vasoconstrictor and is reported to enhance hypoxic pulmonary vasoconstriction. The objective of this study was to examine whether the combination of intravenous PGF2 alph...
journal_title:Intensive care medicine
pub_type: 杂志文章
doi:10.1007/BF01709742
更新日期:1996-07-01 00:00:00
abstract:PURPOSE:Clinical examination is often the first step to diagnose shock and estimate cardiac index. In the Simple Intensive Care Studies-I, we assessed the association and diagnostic performance of clinical signs for estimation of cardiac index in critically ill patients. METHODS:In this prospective, single-centre coho...
journal_title:Intensive care medicine
pub_type: 杂志文章
doi:10.1007/s00134-019-05527-y
更新日期:2019-02-01 00:00:00
abstract::As a result of the previous shortage of tools to assess objectively the overall physiological status of the respiratory system in infants and young children, it has been difficult to measure the degree of physiological disorder or the response to therapy in respiratory diseases such as BPD, the pediatric version of AR...
journal_title:Intensive care medicine
pub_type: 杂志文章,评审
doi:10.1007/BF01704742
更新日期:1995-09-01 00:00:00
abstract:OBJECTIVE:To obtain insight into the occurrence of brain death and the potential for brain dead and controlled non-heart-beating organ donors (CNHB) in patients with traumatic brain injury (TBI), subarachnoid haemorrhage (SAH) and intracerebral haemorrhage (ICH) in a large neurosurgical serving area (2.1 million inhabi...
journal_title:Intensive care medicine
pub_type: 杂志文章
doi:10.1007/s00134-005-0001-9
更新日期:2006-02-01 00:00:00
abstract:OBJECTIVE:To test the hypothesis whether PMN-Elastase in bronchoalveolar lavage fluid (BALF) could reflect neutrophil activity in the lower respiratory tract. DESIGN:Prospectively, morphologic findings of acute and chronic inflammation in the transbronchial lung biopsy specimens were compared with the numbers of neutr...
journal_title:Intensive care medicine
pub_type: 杂志文章
doi:10.1007/BF01720908
更新日期:1994-05-01 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: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:: ...
journal_title:Intensive care medicine
pub_type: 社论
doi:10.1007/s00134-018-5129-5
更新日期:2018-11-01 00:00:00
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journal_title:Intensive care medicine
pub_type: 杂志文章
doi:10.1007/s00134-005-2679-0
更新日期:2005-08-01 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::A 65-year-old man developed postsurgical septic shock, unresponsive to plasma volume expansion and administration of dopamine and dobutamine. A continuous norepinephrine infusion was then started and the dose increased to 0.62 micrograms.kg-1.min-1 until the mean arterial pressure was 70 mmHg. Prior to and during the ...
journal_title:Intensive care medicine
pub_type: 杂志文章
doi:10.1007/BF02575309
更新日期:1990-01-01 00:00:00
abstract::Optimal fluid management is one of the main challenges in the care of the critically ill. However, the physiological parameters that are commonly monitored and used to guide fluid management are often inadequate and even misleading. From 1987 to 1989 we published four experimental studies which described a method for ...
journal_title:Intensive care medicine
pub_type: 杂志文章,评审
doi:10.1007/s00134-014-3285-9
更新日期:2014-06-01 00:00:00
abstract:OBJECTIVE:To assess whether monitoring of bladder epithelial oxygen tension (BEOT) would provide an indication of regional (renal) organ perfusion in an exsanguination/fluid repletion animal model. DESIGN:Prospective non-randomized laboratory study. SETTING:Research laboratory. INTERVENTIONS:Eight anaesthetised, spo...
journal_title:Intensive care medicine
pub_type: 杂志文章
doi:10.1007/BF01700454
更新日期:1996-04-01 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::Helicobacter pylori is estimated to infect over 50% of the world's population, the majority of whom are asymptomatic. Although most research to date has focused on local gastroduodenal disease manifestations, the potential impact of H. pylori infection and the associated chronic active inflammation on systemic disease...
journal_title:Intensive care medicine
pub_type: 杂志文章,评审
doi:10.1007/s00134-003-1838-4
更新日期:2003-11-01 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