Abstract:
OBJECTIVE:Assessing pulse pressure variation (PPV) to predict fluid responsiveness in mechanically ventilated patients with tidal volume (VT) and the impact of VT and airway driving pressure (P(plat) - PEEP) on the ability of PPV for predicting fluid responsiveness.
DESIGN:Prospective interventional study.
SETTING:ICU of a university hospital.
PATIENTS:Fifty-seven mechanically ventilated and sedated patients with acute circulatory failure requiring cardiac output (CO) measurement.
INTERVENTION:Fluid challenge was given in patients with signs of hypoperfusion (oliguria <0.5 ml kg(-1) h(-1), attempt to decrease vasopressor infusion rate). Fluid responsiveness was defined as an increase in the stroke index (SI) >or=15%. Receiver-operating characteristic (ROC) curves were generated for PPV and central venous pressure (CVP).
RESULTS:The stroke index was increased >or=15% in 41 patients (71%). At baseline, CVP was lower and PPV was higher in responders. The areas under the ROC curves of PPV and CVP were 0.77 (95% CI 0.65-0.90) and 0.76 (95% CI 0.64-0.89), respectively (P = 0.93). The best cutoff values of PPV and CVP were 7% and 9 mmHg, respectively. In 30 out of 41 responders, PPV was <13%. Using a polytomic logistic regression (P(plat)--PEEP) was the sole independent factor associated with a PPV value <13% in responders. In these responders, (P(plat)--PEEP) was journal_name journal_title authors doi subject pub_date pages issue eissn issn journal_volume pub_type
abstract:OBJECTIVE:To investigate whether ultrasound determination of the inferior vena cava diameter (IVCD) and its collapsibility index (IVCCI) could be used to optimize the fluid removal rate while avoiding hypotension during slow continuous ultrafiltration (SCUF). METHODS:Twenty-four consecutive patients [13 men and 11 wom...
journal_title:Intensive care medicine
pub_type: 杂志文章
doi:10.1007/s00134-009-1745-4
更新日期:2010-04-01 00:00:00
abstract::Changes in the inspiratory flow rate of mechanically ventilated patients can affect arterial oxygenation. Although the mechanism producing this alteration is not certain, one possible mechanism is a change in ventilation inhomogeneity. This study was performed to determine if the inspiratory flow setting would affect ...
journal_title:Intensive care medicine
pub_type: 杂志文章
doi:10.1007/BF00254316
更新日期:1984-01-01 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 evaluate the impact of two different comorbidity measures on the 6-month mortality of severely ill cancer patients. DESIGN AND SETTING:Prospective cohort study in a ten-bed oncological medical-surgical intensive care unit (ICU). PATIENTS:A total of 772 consecutive patients were included over a 45-month p...
journal_title:Intensive care medicine
pub_type: 杂志文章
doi:10.1007/s00134-005-2554-z
更新日期:2005-03-01 00:00:00
abstract:PURPOSE:To study the incidence and clinical characteristics of delayed cerebral thrombosis in bacterial meningitis patients. METHODS:We assessed the incidence and clinical characteristics of delayed cerebral thrombosis in adults with cerebrospinal fluid (CSF) culture-proven community-acquired bacterial meningitis incl...
journal_title:Intensive care medicine
pub_type: 杂志文章
doi:10.1007/s00134-012-2792-9
更新日期:2013-05-01 00:00:00
abstract:OBJECTIVE:We propose that higher airway occlusion pressure (P0.1) responses to hypercapnic challenge (HC) indicate less severe injury. The study aim was to determine whether P0.1 responses to HC were associated with successful weaning after prolonged mechanical ventilation (PMV) in patients with brainstem lesions and t...
journal_title:Intensive care medicine
pub_type: 杂志文章
doi:10.1007/s00134-008-1197-2
更新日期:2009-01-01 00:00:00
abstract:OBJECTIVE:Pressure-volume (PV) curves are recorded after induction of complete muscle paralysis, which may limit their clinical use. The feasibility of recording PV curves without paralysis has not been tested. In 19 patients with acute respiratory distress syndrome (ARDS) and no hemodynamic instability we prospectivel...
journal_title:Intensive care medicine
pub_type: 杂志文章,随机对照试验
doi:10.1007/s00134-006-0265-8
更新日期:2006-09-01 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:OBJECTIVE:To measure muscle blood flow (Qtis) and oxygen consumption (VO(2)tis) in septic and non-septic critically ill patients by near-infrared spectroscopy (NIRS). SETTING:Surgical intensive care unit of a university hospital. PATIENTS AND PARTICIPANTS:Four patients with septic shock, eight post-surgical criticall...
journal_title:Intensive care medicine
pub_type: 杂志文章
doi:10.1007/s00134-003-1805-0
更新日期:2003-07-01 00:00:00
abstract::There has been little research on smoking cessation after critical illness. Smokers make up a high percentage of patients admitted to intensive care (ICU) and stopping smoking is one message that should be clearly given to recovering patients. The recovery period provides an important opportunity for patients to quit ...
journal_title:Intensive care medicine
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1007/s001340101051
更新日期:2001-09-01 00:00:00
abstract:OBJECTIVE:To investigate the accuracy of eight different prognostic scores (Stiehm, Niklasson, Leclerc, Garlund, the MOC score, Tesero, the Glasgow Meningococcal Septicaemia Prognostic Score (GMSPS) and Tüyzüs) in the prediction of fatal outcome in meningococcal disease. DESIGN:Combined prospective and retrospective s...
journal_title:Intensive care medicine
pub_type: 杂志文章
doi:10.1007/BF01709565
更新日期:1996-12-01 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::The effects of 142 intravenous boluses of althesin (0.05 ml/kg) on cerebral perfusion pressure (CPP) were studied in twelve head injured comatose patients. The data were divided into those where the mean pre-bolus intracranial pressure (ICP) was above or below 20 mmHg and then subdivided into those where the minimum p...
journal_title:Intensive care medicine
pub_type: 杂志文章
doi:10.1007/BF00257469
更新日期:1988-01-01 00:00:00
abstract:OBJECTIVE:To evaluate major similarities and major differences between Western European countries in intensive care unit (ICU) nurse staffing, education, training, responsibilities, and initiative. DESIGN:A questionnaire was sent to Western European doctor members of the European Society of Intensive Care Medicine, to...
journal_title:Intensive care medicine
pub_type: 杂志文章,多中心研究
doi:10.1007/s001340050693
更新日期:1998-09-01 00:00:00
abstract:OBJECTIVE:To investigate the role of the inducible nitric oxide synthase activation-induced excess nitric oxide formation on the rate of hepatic glucose production during fully resuscitated murine septic shock. DESIGN:Prospective, controlled, randomized animal study. SETTING:University animal research laboratory. SU...
journal_title:Intensive care medicine
pub_type: 杂志文章
doi:10.1007/s00134-007-0638-7
更新日期:2007-06-01 00:00:00
abstract:OBJECTIVE:Angiopoietin-2 (Ang-2) is a potent regulator of vascular permeability and inflammation in acute lung injury and acute respiratory distress syndrome (ARDS). Genetic variants in the Ang-2 gene may lead to altered activities of Ang-2 (or ANGPT2) gene. The aim of this study was to assess if genetic variants of An...
journal_title:Intensive care medicine
pub_type: 杂志文章
doi:10.1007/s00134-009-1413-8
更新日期:2009-06-01 00:00:00
abstract:OBJECTIVES:To assess the reproducibility of respiratory dead space measurements in ventilated children. DESIGN:Prospective study. SETTING:University pediatric intensive care unit. PATIENTS:Thirty-two mechanically ventilated children (0.13-15.4 years) who were clinically stable. METHODS:The single-breath CO(2) test ...
journal_title:Intensive care medicine
pub_type: 杂志文章
doi:10.1007/s00134-004-2288-3
更新日期:2004-07-01 00:00:00
abstract:OBJECTIVE:Evaluation of low-level PEEP (5 cm H2O) and the two different CPAP trigger modes in the Bennett 7200a ventilator (demand-valve and flow-by trigger modes) on inspiratory work of breathing (Wi) during the weaning phase. DESIGN:Prospective controlled study. SETTING:The intensive care unit of a university hospi...
journal_title:Intensive care medicine
pub_type: 临床试验,杂志文章
doi:10.1007/BF01712329
更新日期:1995-11-01 00:00:00
abstract:OBJECTIVE:To compare the total plasma cortisol values obtained from three widely used immunoassays and a high pressure liquid chromatography (HPLC) technique on samples obtained from patients with sepsis. DESIGN AND SETTING:Observational interventional in the general intensive care unit of a metropolitan hospital PAT...
journal_title:Intensive care medicine
pub_type: 杂志文章
doi:10.1007/s00134-006-0389-x
更新日期:2006-11-01 00:00:00
abstract::A retrospective study of the medical records of 115 consecutive cases of meningococcal disease with 11 fatalities was carried out in order to evaluate the power of 15 clinical and laboratory variables available on admission in predicting a fatal outcome. On linear discriminant analysis, six variables showed a signific...
journal_title:Intensive care medicine
pub_type: 杂志文章
doi:10.1007/BF00261740
更新日期:1986-01-01 00:00:00
abstract:PURPOSE:To assess the ability of quantitative pupillometry [using the Neurological Pupil index (NPi)] to predict an unfavorable neurological outcome after cardiac arrest (CA). METHODS:We performed a prospective international multicenter study (10 centers) in adult comatose CA patients. Quantitative NPi and standard ma...
journal_title:Intensive care medicine
pub_type: 杂志文章,多中心研究
doi:10.1007/s00134-018-5448-6
更新日期:2018-12-01 00:00:00
abstract:OBJECTIVE:To investigate the regional partial pressure of oxygen (PO2) and partial pressure of carbon dioxide (PCO2) of the perfluorocarbon liquid (PpfcO2, PpfcCO2) during partial liquid ventilation (PLV). DESIGN:Prospective, controlled study. SETTING:A research laboratory at a university medical center. SUBJECTS:Th...
journal_title:Intensive care medicine
pub_type: 杂志文章
doi:10.1007/s001340000706
更新日期:2001-01-01 00:00:00
abstract::Two hundred and seventy-three acute hemorrhagic shocks were treated in 1984 in a pre-hospital emergency care unit. Twenty patients (7%) had a paradoxical bradycardia: they were conscious, 9 of them had an undetectable systolic arterial pressure with the sphygmomanometric method but the femoral pulse was still present....
journal_title:Intensive care medicine
pub_type: 杂志文章
doi:10.1007/BF00254705
更新日期:1987-01-01 00:00:00
abstract::Type III procollagen N-peptides (PIIINPs) are believed to be released in stoichiometric amounts as type III collagen molecules are secreted from cells. We hypothesized that if the human lung actively produces type III collagen a detectable transpulmonary gradient in PIIINPs would exist in normal individuals that might...
journal_title:Intensive care medicine
pub_type: 杂志文章
doi:10.1007/BF01706477
更新日期:1992-01-01 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 provide evidence for the upregulation of endothelial nitric oxide synthase (eNOS) or inducible nitric oxide synthase (iNOS) in the assumed imbalance in the pathophysiology of rapid progressive pulmonary hypertension of the newborn (RPPHN), which is characterized by abnormal hypertrophy of the pulmonary art...
journal_title:Intensive care medicine
pub_type: 杂志文章
doi:10.1007/s00134-003-1892-y
更新日期:2003-10-01 00:00:00
abstract::Physicians are increasingly involved in how their critically ill patients die [72]. The more this happens, the more physicians will have to understand not only how their own backgrounds and biases influence their medical management, but also the cultural and religious backgrounds of the patient and surrogate [72, 73]....
journal_title:Intensive care medicine
pub_type: 杂志文章,评审
doi:10.1007/s001340000641
更新日期:2000-10-01 00:00:00
abstract:OBJECTIVE:To determine the impact of missing Acute Physiology Score (APS) values on risk-adjusted mortality. DESIGN:Retrospective review of prospectively collected Acute Physiology and Chronic Health Evaluation (APACHE) III database. SETTING:The intensive care units (ICUs) of an academic medical center. PATIENTS:38,...
journal_title:Intensive care medicine
pub_type: 杂志文章
doi:10.1007/s00134-005-2751-9
更新日期:2005-11-01 00:00:00
abstract:PURPOSE:This prospective observational study aimed at describing prescription patterns of tigecycline and patient outcomes in 26 French intensive care units (ICU). METHODS:Data of consecutive cases of adult patients treated with tigecycline were collected from the initiation until 7 days after the end of treatment. Re...
journal_title:Intensive care medicine
pub_type: 杂志文章,多中心研究
doi:10.1007/s00134-014-3323-7
更新日期:2014-07-01 00:00:00
abstract:PURPOSE:To provide recommendations and standard operating procedures for intensive care unit and hospital preparations for an influenza pandemic or mass disaster with a specific focus on essential equipment, pharmaceuticals and supplies. METHODS:Based on a literature review and expert opinion, a Delphi process was use...
journal_title:Intensive care medicine
pub_type: 指南,杂志文章
doi:10.1007/s00134-010-1763-2
更新日期:2010-04-01 00:00:00