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. DESIGN:Prospective study. SETTING:A 22-bed general intensive care unit (ICU). PATIENTS:Eighty-four surgical or medical ventilated patients requiring fluid challenge. INTERVENTION:A 6 ml/kg colloid fluid challenge in 30 min. MEASUREMENTS AND RESULTS:Hemodynamic measurements taken before and after fluid challenge. Patients separated into responders and nonresponders according to a 15% increase in their cardiac output. Thirty-nine patients found to be responders and 45 nonresponders. DeltaPP/DeltaP and DeltaPP were both higher in responders than in nonresponders. DeltaPP/DeltaP was a better predictor of fluid responsiveness than PP, especially for patients ventilated with Vt > or = 8 ml/kg [area under the curve (AUC) 0.88 (0.77-0.98) versus 0.75 (0.60-0.89), P < 0.01)]. In this population DeltaPP/DeltaP higher than 0.9 predicted fluid response with positive predictive value of 87% and negative predictive value of 78%. Overall DeltaPP and DeltaPP/DeltaP reliability was poor for patients ventilated with Vt < 8 ml/kg [AUC 0.63 (0.45-0.81) and 0.72 (0.55-0.88), respectively]. CONCLUSION:In this mixed ICU population PP adjusted by P is a simple index which outperforms DeltaPP for patients ventilated with Vt > or = 8 ml/kg. However, correcting DeltaPP by DeltaP still fails to predict fluid response reliably in patients ventilated with low tidal volume.
journal_name
Intensive Care Medjournal_title
Intensive care medicineauthors
Vallée F,Richard JC,Mari A,Gallas T,Arsac E,Verlaan PS,Chousterman B,Samii K,Genestal M,Fourcade Odoi
10.1007/s00134-009-1478-4subject
Has Abstractpub_date
2009-06-01 00:00:00pages
1004-10issue
6eissn
0342-4642issn
1432-1238journal_volume
35pub_type
杂志文章abstract：OBJECTIVE:To investigate plasma high-mobility group box 1 protein (HMGB1) concentration and its relationship with organ dysfunction and outcome in septic shock patients. DESIGN AND SETTING:Prospective, noninterventional study. Medical adult intensive care unit at a university hospital in France. PATIENTS:42 criticall...
journal_title：Intensive care medicine
pub_type： 杂志文章
doi：10.1007/s00134-007-0691-2
更新日期：2007-08-01 00:00:00
abstract：OBJECTIVE:To evaluate the origin of H+ ions participating in the generation of CO2 coming from sodium bicarbonate infusion during metabolic acidosis. We hypothesized that these H+ ions come from a back-titration of the main non-bicarbonate buffers present in the blood, i. e. the hemoglobin and the albumin, and thus pos...
journal_title：Intensive care medicine
pub_type： 杂志文章
doi：10.1007/s001340051204
更新日期：2000-05-01 00:00:00
abstract：OBJECTIVE:To present the efficacy and tolerability of a new oral dosage form of the calcium antagonist nitrendipine compared to nifedipine capsules in patients with hypertensive emergency. DESIGN:Multicenter randomized double blind clinical study. SETTING:23 study centres (hospitals) in Germany. PATIENTS:161 patient...
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/BF01708963
更新日期：1994-01-01 00:00:00
abstract：PURPOSE:To determine whether erythromycin is non-inferior to metoclopramide in facilitating post-pyloric placement of self-propelled spiral nasoenteric tubes (NETs) in critically ill patients. METHODS:A prospective, multicenter, open-label, parallel, and non-inferiority randomized controlled trial was conducted compar...
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/s00134-018-5466-4
更新日期：2018-12-01 00:00:00
abstract：OBJECTIVE:To examine the usefulness of preload indices obtained by transoesophageal echocardiography (TOE) for estimating stroke volume at various levels of cardiac index. DESIGN:Prospective clinical study. SETTING:Intensive care unit with surgical patients. PATIENTS:16 ventilated patients monitored via Swan-Ganz ca...
journal_title：Intensive care medicine
pub_type： 杂志文章
doi：10.1007/s001340050349
更新日期：1997-04-01 00:00:00
abstract：INTRODUCTION:The emphasis on the importance of professionalism in a recent CoBaTrICE-IT paper was impressive. However, insight into the elements of professionalism as perceived relevant for intensivists from the fellows' view, and how these are taught and learned, is limited. OBJECTIVES AND METHODS:A nationwide study ...
journal_title：Intensive care medicine
pub_type： 杂志文章
doi：10.1007/s00134-009-1644-8
更新日期：2010-02-01 00:00:00
abstract：PURPOSE:Limited data exist on the correlation between higher flow rates of high-flow nasal cannula (HFNC) and its physiologic effects in patients with acute hypoxemic respiratory failure (AHRF). We assessed the effects of HFNC delivered at increasing flow rate on inspiratory effort, work of breathing, minute ventilatio...
journal_title：Intensive care medicine
pub_type： 杂志文章
doi：10.1007/s00134-017-4890-1
更新日期：2017-10-01 00:00:00
abstract：OBJECTIVES:To document the effect of neurocritical care, delivered by specialist staff and based on protocol-driven therapy aimed at intracranial pressure (ICP) and cerebral perfusion pressure (CPP) targets, on outcome in acute head injury. DESIGN:Retrospective record review to compare presentation, therapy and outcom...
journal_title：Intensive care medicine
pub_type： 杂志文章
doi：10.1007/s00134-002-1235-4
更新日期：2002-05-01 00:00:00
abstract：PURPOSE:To use the World Health Organisation's International Classification of Functioning to measure disability following critical illness using patient-reported outcomes. METHODS:A prospective, multicentre cohort study conducted in five metropolitan intensive care units (ICU). Participants were adults who had been a...
journal_title：Intensive care medicine
pub_type： 杂志文章,多中心研究
doi：10.1007/s00134-017-4830-0
更新日期：2017-07-01 00:00:00
abstract：PURPOSE:To evaluate the diagnostic accuracy of ultrasonography of optic nerve sheath diameter (ONSD) for assessment of intracranial hypertension. METHODS:Systematic review without language restriction based on electronic databases, with manual review of literature and conference proceedings until July 2010. Studies we...
journal_title：Intensive care medicine
pub_type： 杂志文章,meta分析,评审
doi：10.1007/s00134-011-2224-2
更新日期：2011-07-01 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：PURPOSE:Polymyxin B-immobilized hemoperfusion (PMX-HP) is an adjuvant therapy for sepsis or septic shock that clears circulating endotoxin. Prior trials have shown that PMX-HP improves surrogate endpoints. We aimed to conduct an evidence synthesis to evaluate the efficacy and safety of PMX-HP in critically ill adult pa...
journal_title：Intensive care medicine
pub_type： 杂志文章,meta分析
doi：10.1007/s00134-017-5004-9
更新日期：2018-02-01 00:00:00
abstract：:The recording of intratracheal pressure in patients breathing through a tracheostomy tube is marred by methodological problems. In model experiments it has been shown that the introduction of a recording catheter into the tracheostomy tube alters the recorded pressure by as much as 20-40%. To avoid such inaccuracy, a ...
journal_title：Intensive care medicine
pub_type： 杂志文章
doi：10.1007/BF01735176
更新日期：1990-01-01 00:00:00
abstract：:Status epilepticus is one of the most frequent neurological emergencies in the intensive care unit. Standard treatment includes intravenous barbiturates, benzodiazepines and phenytoin. However, drug coma is sometimes necessary to control refractory status epilepticus. We report such a case, successfully treated by int...
journal_title：Intensive care medicine
pub_type： 杂志文章
doi：10.1007/BF01707672
更新日期：1994-01-01 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：OBJECTIVES:Previous studies on therapeutic interventions in sepsis have assumed stability of the measure of splanchnic blood flow throughout the study. We assessed the variability of splanchnic blood flow during stable global hemodynamics in eight patients with sepsis requiring treatment with dobutamine and/or norepine...
journal_title：Intensive care medicine
pub_type： 杂志文章
doi：10.1007/s001340100980
更新日期：2001-08-01 00:00:00
abstract：OBJECTIVE:To measure water balance and changes in distribution, and the effect of giving supplementary albumin, early after a burn injury. DESIGN:Consecutive patients (matched groups) and healthy controls. SETTING:National burn unit in a Swedish university hospital. PATIENTS AND SUBJECTS:Eighteen patients with 18%-9...
journal_title：Intensive care medicine
pub_type： 杂志文章
doi：10.1007/s001340100935
更新日期：2001-05-01 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：OBJECTIVE:To identify factors associated with mortality and prolonged ventilatory requirements in patients admitted to our paediatric intensive care unit (PICU) with tracheobronchial malacia and stenosis diagnosed by dynamic contrast bronchograms. DESIGN:Retrospective review. SETTING:Tertiary paediatric intensive car...
journal_title：Intensive care medicine
pub_type： 杂志文章
doi：10.1007/s001340000822
更新日期：2001-04-01 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：:Recombinant activated factor VII (rFVIIa, 'NovoSeven') is indicated for the treatment of spontaneous and surgical bleeding in patients with haemophilia A or B with antibodies to factors VIII or IX (FVIII or FIX) worldwide, and in patients with acquired haemophilia in Europe. In vitro cell models have demonstrated that...
journal_title：Intensive care medicine
pub_type： 杂志文章,评审
doi：10.1007/s00134-002-1469-1
更新日期：2002-10-01 00:00:00
abstract：INTRODUCTION:Most anxiolytics and sedative regimens in the intensive care unit (ICU) impair intellectual function, reducing patient autonomy, and often add to patient morbidity. Using an ICU-validated cognitive assessment tool Adapted Cognitive Exam (ACE), we performed a comparison between dexmedetomidine (DEX) and pro...
journal_title：Intensive care medicine
pub_type： 临床试验,杂志文章,随机对照试验
doi：10.1007/s00134-010-1874-9
更新日期：2010-09-01 00:00:00
abstract：OBJECTIVE:Capillary leakage syndrome (CLS) is a frequent complication in sepsis, characterized by loss of intravasal fluids leading to generalized edema and hemodynamic instability despite massive fluid therapy. In spite of its importance no standardized diagnostic criteria are available for CLS. DESIGN:Prospective cl...
journal_title：Intensive care medicine
pub_type： 杂志文章
doi：10.1007/s001340000601
更新日期：2000-09-01 00:00:00
abstract：OBJECTIVE:To evaluate the incidence and the circumstances of a moderate increase in serum creatinine early after elective abdominal aortic surgery. DESIGN:Prospective clinical observational study. SETTING:Surgical intensive care unit in a university hospital. PATIENTS:Two hundred and fifteen consecutive adult patien...
journal_title：Intensive care medicine
pub_type： 杂志文章
doi：10.1007/s00134-003-1958-x
更新日期：2003-10-01 00:00:00
abstract：OBJECTIVE:To present a concise history of tracheostomy and tracheal intubation for the approximately forty centuries from their earliest description around 2000 BC until the middle of the twentieth century, at which time a proliferation of advances marked the beginning of the modern era of anesthesiology. DATA SOURCES...
journal_title：Intensive care medicine
pub_type： 历史文章,杂志文章
doi：10.1007/s00134-007-0931-5
更新日期：2008-02-01 00:00:00
abstract：:A 17-year-old patient with Shone's disease had to be readmitted to the hospital 3 months after implantation of an artificial aortic valve because of extreme mitral insufficiency with consecutive pulmonary edema and hepatic dysfunction. He had been orally anticoagulated and presented with a high international normalize...
journal_title：Intensive care medicine
pub_type： 杂志文章
doi：10.1007/s001340051023
更新日期：1999-10-01 00:00:00
abstract：OBJECTIVE:Inhalation of nitric oxide (NO) can improve oxygenation and decrease mean pulmonary artery pressure (MPAP) in patients with the acute respiratory distress syndrome (ARDS). It is not known whether inhaled NO exerts a similar effect in hypoxemic patients with chronic obstructive pulmonary disease (COPD). DESIG...
journal_title：Intensive care medicine
pub_type： 杂志文章
doi：10.1007/s001340050290
更新日期：1997-01-01 00:00:00
abstract：:The use of induced hypertension in head injury patients is controversial. We present the case of a 19-year-old man admitted with severe head trauma after a road accident and describe the beneficial effects that increasing arterial blood pressure had on the cerebral perfusion pressure, cerebral blood flow and jugular b...
journal_title：Intensive care medicine
pub_type： 杂志文章,评审
doi：10.1007/s001340050997
更新日期：1999-09-01 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：:Owing to an oversight by the authors, Figure 2 in this article was not the version intended for publication. The correct Figure 2, reproduced here, features footnote symbols and Figure 2b includes three studies as described in the main text. ...
journal_title：Intensive care medicine
pub_type： 杂志文章,已发布勘误
doi：10.1007/s00134-018-5055-6
更新日期：2018-02-01 00:00:00
