Abstract:
PURPOSE:During neurally adjusted ventilatory assist (NAVA) the ventilator is driven by the patients electrical activation of the diaphragm (EAdi), detected by a special esophageal catheter. A reliable positioning of the EAdi-catheter is mandatory to trace a representative EAdi signal. We aimed to determine whether a formula that is based on the measurement from nose to ear lobe to xiphoid process of the sternum (NEX distance) modified for EAdi-catheter placement (NEX(mod)) is sufficient for predicting the accurate catheter position. METHODS:Twenty-six patients were enrolled in this study. The optimal EAdi-catheter position (OPT) was defined by: (1) stable EAdi signal, (2) electrical activity highlighted in central leads of the catheter positioning tool, and (3) absence of p-wave in distal lead. Afterwards NEX(mod) was calculated and compared to the OPT finding. RESULTS:At NEX(mod) the EAdi signal was suitable for running NAVA in 18 out of 25 patients (72%). NEX(mod) was identical with OPT in four patients (16%). NAVA was possible in all patients at OPT. Median OPT position was 2 cm caudal of the NEX(mod) ranging from 3 cm too cranial to a position 12 cm too caudal (P < 0.01). In one patient excluded from further analysis EAdi-catheter placement led to the diagnosis of bilateral injury of the phrenic nerves. CONCLUSIONS:EAdi-catheter placement based on the NEX(mod) formula allows running NAVA in about two-thirds of all patients. The additional tools provided are efficient and facilitate the correct positioning of the EAdi-catheter for neurally adjusted ventilatory assist.
journal_name
Intensive Care Medjournal_title
Intensive care medicineauthors
Barwing J,Ambold M,Linden N,Quintel M,Moerer Odoi
10.1007/s00134-009-1587-0subject
Has Abstractpub_date
2009-10-01 00:00:00pages
1809-14issue
10eissn
0342-4642issn
1432-1238journal_volume
35pub_type
杂志文章abstract:OBJECTIVE:To compare haemodynamic and gas exchange effects after either atracurium or pancuronium given to ventilated neonates with respiratory failure. DESIGN:In this prospective study neonates were alternately assigned to receive either atracurium or pancuronium, intravenously. SETTING:Paediatric and neonatal ICU i...
journal_title:Intensive care medicine
pub_type: 杂志文章
doi:10.1007/BF01724880
更新日期:1993-01-01 00:00:00
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 clinicall...
journal_title:Intensive care medicine
pub_type: 杂志文章,评审
doi:10.1007/s00134-007-0772-2
更新日期:2007-11-01 00:00:00
abstract:OBJECTIVE:The liver plays a key role in the inflammatory response during major surgery or infection. The influence of age on liver function and hepatic acute phase protein (APP) synthesis should be serially studied in elderly patients undergoing major abdominal surgery. DESIGN AND SETTING:Prospective and descriptive s...
journal_title:Intensive care medicine
pub_type: 杂志文章
doi:10.1007/s00134-001-1126-0
更新日期:2001-11-01 00:00:00
abstract::In alcoholic patients, metabolic acidosis can be related to lactate acidosis associated with sepsis or thiamine deficiency, ketoacidosis, methanol or ethylene glycol poisoning. High resolution proton nuclear magnetic resonance (NMR) can be used to detect abnormal organic acid metabolites in urine or serum from patient...
journal_title:Intensive care medicine
pub_type: 杂志文章
doi:10.1007/s001340100892
更新日期:2001-04-01 00:00:00
abstract:OBJECTIVE:To evaluate the efficiency of a new device developed to remove obstructions from endotracheal tubes (ETT) in mechanically ventilated patients. DESIGN:Open study in mechanically ventilated sedated and paralyzed ICU patients. SETTING:General ICU and Laboratory of Respiratory Mechanics of the University of Rom...
journal_title:Intensive care medicine
pub_type: 临床试验,杂志文章
doi:10.1007/BF01705724
更新日期:1994-11-01 00:00:00
abstract::During a 3-year period, a clinical diagnosis of invasive candidosis was made in 8 out of 2054 consecutive surgical intensive care unit (ICU) patients. These patients were retrospectively matched with 16 control patients who underwent similar surgical procedures and had a similar clinical course except for negative Can...
journal_title:Intensive care medicine
pub_type: 杂志文章
doi:10.1007/s001340100891
更新日期:2001-05-01 00:00:00
abstract:OBJECTIVE:An investigation into the incidence of post-operative complications after thoracic surgery with 3 different physiotherapy masks. DESIGN:A prospective, consecutive, randomized comparison. SETTING:Department of Thoracic and Heart Surgery at a University Hospital. The treatments were performed by experienced a...
journal_title:Intensive care medicine
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1007/BF01690551
更新日期:1993-01-01 00:00:00
abstract:OBJECTIVE:To determine the clinical epidemiology of invasive group A streptococcal disease (IGASD) and identify predictors of admissions into an intensive care unit (ICU). DESIGN:A cross-sectional study. SETTING:Retrospective review of data. PATIENTS:A total of 204 patients hospitalized throughout the state of Flori...
journal_title:Intensive care medicine
pub_type: 杂志文章
doi:10.1007/s00134-002-1538-5
更新日期:2002-12-01 00:00:00
abstract:OBJECTIVE:We undertook this study to evaluate the influence of the inspiration:expiration (I:E) ratio on intracranial pressure and cerebral perfusion in patients with acute stroke. DESIGN:Ventilated patients with acute stroke were examined under a protocol involving variations of I:E ratio from 1:2 to 1:1 to 1:2 under...
journal_title:Intensive care medicine
pub_type: 杂志文章
doi:10.1007/s00134-002-1351-1
更新日期:2002-08-01 00:00:00
abstract:OBJECTIVE:Short-latency somatosensory evoked potential (SSEP) monitoring has been reported to be useful in predicting neurological outcome in patients with cardiac arrest and hypoxic-ischemic encephalopathy. To obtain the immediate data of SSEP and evaluate the relationship between the presence of cortical activity and...
journal_title:Intensive care medicine
pub_type: 杂志文章
doi:10.1007/s001340100984
更新日期:2001-07-01 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 available instruments for assessing delirium in critically ill adults that have undergone validity testing and provide clinicians with strategies to incorporate these instruments into clinical practice. DESIGN:Medline (1966-September 2006) was searched using the key words: delirium, cognitive dysf...
journal_title:Intensive care medicine
pub_type: 杂志文章,评审
doi:10.1007/s00134-007-0603-5
更新日期:2007-06-01 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:PURPOSE:To describe changes in hemodynamic variables, sedation, and pain score after discontinuation of prolonged infusions of dexmedetomidine in a pediatric population of critically ill cardiac patients. METHODS:Retrospective case series of patients who received continuous infusions of dexmedetomidine for longer than...
journal_title:Intensive care medicine
pub_type: 杂志文章
doi:10.1007/s00134-011-2441-8
更新日期:2012-02-01 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 determine the presence of tricuspid regurgitation (TR) in patients affected by acute lung injury (ALI) and the adult respiratory distress syndrome (ARDS) during mechanical ventilation with positive end-expiratory pressure (PEEP). DESIGN:A prospective clinical study. SETTING:10-bed general intensive care ...
journal_title:Intensive care medicine
pub_type: 临床试验,杂志文章
doi:10.1007/s001340050419
更新日期:1997-08-01 00:00:00
abstract:OBJECTIVE:The interchangeability of continuous measurement of cardiac output (CO) with the traditional bolus method in patients after cardiopulmonary bypass (CPB) is uncertain. DESIGN:Prospective observational clinical study. SETTING:A 20-bed surgical ICU at a university hospital. PATIENTS:Fourteen deeply sedated, v...
journal_title:Intensive care medicine
pub_type: 杂志文章
doi:10.1007/s00134-006-0161-2
更新日期:2006-06-01 00:00:00
abstract:OBJECTIVE:To investigate whether the respiratory variation in inferior vena cava diameter (DeltaD(IVC)) could be related to fluid responsiveness in mechanically ventilated patients. DESIGN:Prospective clinical study. SETTING:Medical ICU of a non-university hospital. PATIENTS:Mechanically ventilated patients with sep...
journal_title:Intensive care medicine
pub_type: 杂志文章
doi:10.1007/s00134-004-2233-5
更新日期:2004-09-01 00:00:00
abstract::We report the intensive care management of 23 children (age 3-15 years) following orthotopic heart (HT) and combined heart and lung transplantation (HLT) performed at our 2 institutes between February 1985 and August 1989. Cyclosporin A, azathioprine and steroids were given as routine immunosuppression, whilst anti-th...
journal_title:Intensive care medicine
pub_type: 杂志文章
doi:10.1007/BF01711219
更新日期:1990-01-01 00:00:00
abstract:OBJECTIVES:Circulating levels of the proinflammatory mediator High Mobility Group Box Protein 1 (HMGB1) are increased in septic patients and may contribute to sepsis-induced organ dysfunction. Although HMGB1 has been shown to activate neutrophils from healthy volunteers, the responses of neutrophils from septic patient...
journal_title:Intensive care medicine
pub_type: 杂志文章
doi:10.1007/s00134-007-0748-2
更新日期:2007-10-01 00:00:00
abstract:BACKGROUND:Candidemia is a life-threatening infection in the ICU whose prognosis is highly dependent on the stage at which it is recognized. Procalcitonin (PCT) levels have been shown to accurately distinguish between bacteremia and noninfectious inflammatory states in critically ill patients with clinical signs of sep...
journal_title:Intensive care medicine
pub_type: 杂志文章
doi:10.1007/s00134-006-0306-3
更新日期:2006-10-01 00:00:00
abstract:OBJECTIVES:To analyse the clinical value of procalcitonin (PCT), C-reactive protein (CRP) and leucocyte count in the diagnosis of paediatric sepsis and in the stratification of patients according to severity. DESIGN:Prospective, observational study. SETTING:Paediatric intensive care unit (PICU). PATIENTS:Ninety-four...
journal_title:Intensive care medicine
pub_type: 杂志文章
doi:10.1007/s00134-006-0509-7
更新日期:2007-03-01 00:00:00
abstract:OBJECTIVE:We examined in rabbits the effects of more than 48 h of mechanical ventilation on the contractile properties and fiber type adaptations of the respiratory muscles. DESIGN AND SETTING:Experimental prospective study in a university laboratory. ANIMALS AND INTERVENTIONS:Nineteen rabbits were randomly allocated...
journal_title:Intensive care medicine
pub_type: 杂志文章
doi:10.1007/s00134-002-1548-3
更新日期:2003-01-01 00:00:00
abstract:OBJECTIVE:To evaluate the efficacy of different lung recruitment maneuvers using electric impedance tomography. DESIGN AND SETTING:Experimental study in animal model of acute lung injury in an animal research laboratory. SUBJECTS:Fourteen pigs with saline lavage induced lung injury. INTERVENTIONS:Lung volume, region...
journal_title:Intensive care medicine
pub_type: 杂志文章
doi:10.1007/s00134-005-2799-6
更新日期:2005-12-01 00:00:00
abstract:OBJECTIVE:To report the occurrence of life-threatening hyperkalaemia following treatment with therapeutic thiopentone coma. SETTING:The neurosurgical intensive care units of Royal North Shore Hospital and Liverpool Hospital, Sydney, Australia. PATIENTS:Three patients treated with theraputic thiopentone coma. One pati...
journal_title:Intensive care medicine
pub_type: 杂志文章
doi:10.1007/s00134-002-1399-y
更新日期:2002-09-01 00:00:00
abstract:OBJECTIVE:To investigate the effects of nicotinamide (NIC), an inhibitor of poly(ADP-ribose) synthetase (PARS), on intestinal and liver perfusion, O2 kinetics, and energy metabolism over 24 h of hyperdynamic porcine endotoxemia. DESIGN:Prospective, randomized, controlled experimental study with repeated measures. SET...
journal_title:Intensive care medicine
pub_type: 杂志文章
doi:10.1007/s001340000842
更新日期:2001-03-01 00:00:00
abstract:PURPOSE:Critically ill patients often require CT scans. Adverse events (AE) can occur during intra-hospital transport (IHT). The aim of this prospective study was to determine the diagnostic and therapeutic yield and the safety of CT scans in ICU patients. METHODS:All ICU patients having a CT scan for diagnostic purpo...
journal_title:Intensive care medicine
pub_type: 杂志文章,多中心研究
doi:10.1007/s00134-014-3592-1
更新日期:2015-03-01 00:00:00
abstract:OBJECTIVE:To investigate the effects of prone positioning on systemic hemodynamics, intra-abdominal pressure (IAP), plasma disappearance rate of indocyanine green (PDR(ICG)), and gastric intramucosal to arterial PCO2 difference (Pi-aCO2). DESIGN AND SETTING:Prospective randomized study in the intensive care unit of a ...
journal_title:Intensive care medicine
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1007/s00134-001-1166-5
更新日期:2002-01-01 00:00:00
abstract:PURPOSE:We compared 1 versus 0.5 microg/kg bolus remifentanil versus placebo in alleviating pain due to chest drain removal. Effects on sedation, respiratory rate (RR), oxygen saturation, heart rate (HR) and blood pressure were also evaluated. METHODS:Sixty patients following cardiac surgery were enrolled in this pros...
journal_title:Intensive care medicine
pub_type: 杂志文章,随机对照试验
doi:10.1007/s00134-010-1836-2
更新日期:2010-08-01 00:00:00
abstract:OBJECTIVE:To investigate the effect of respiratory physiotherapy on the prevention and treatment of ventilator-associated pneumonia (VAP) for adults in an intensive care unit (ICU) with an acquired brain injury (ABI). DESIGN AND SETTING:Two-part, prospective, randomised controlled trial. PATIENTS:A total of 144 subje...
journal_title:Intensive care medicine
pub_type: 杂志文章,随机对照试验
doi:10.1007/s00134-008-1278-2
更新日期:2009-02-01 00:00:00