Abstract:
PURPOSE:To investigate the relationship between hemoglobin (Hgb) and brain tissue oxygen tension (PbtO(2)) after severe traumatic brain injury (TBI) and to examine its impact on outcome. METHODS:This was a retrospective analysis of a prospective cohort of severe TBI patients whose PbtO(2) was monitored. The relationship between Hgb-categorized into four quartiles (≤9; 9-10; 10.1-11; >11 g/dl)-and PbtO(2) was analyzed using mixed-effects models. Anemia with compromised PbtO(2) was defined as episodes of Hgb ≤ 9 g/dl with simultaneous PbtO(2) < 20 mmHg. Outcome was assessed at 30 days using the Glasgow outcome score (GOS), dichotomized as favorable (GOS 4-5) vs. unfavorable (GOS 1-3). RESULTS:We analyzed 474 simultaneous Hgb and PbtO(2) samples from 80 patients (mean age 44 ± 20 years, median GCS 4 (3-7)). Using Hgb > 11 g/dl as the reference level, and controlling for important physiologic covariates (CPP, PaO(2), PaCO(2)), Hgb ≤ 9 g/dl was the only Hgb level that was associated with lower PbtO(2) (coefficient -6.53 (95 % CI -9.13; -3.94), p < 0.001). Anemia with simultaneous PbtO(2) < 20 mmHg, but not anemia alone, increased the risk of unfavorable outcome (odds ratio 6.24 (95 % CI 1.61; 24.22), p = 0.008), controlling for age, GCS, Marshall CT grade, and APACHE II score. CONCLUSIONS:In this cohort of severe TBI patients whose PbtO(2) was monitored, a Hgb level no greater than 9 g/dl was associated with compromised PbtO(2). Anemia with simultaneous compromised PbtO(2), but not anemia alone, was a risk factor for unfavorable outcome, irrespective of injury severity.
journal_name
Intensive Care Medjournal_title
Intensive care medicineauthors
Oddo M,Levine JM,Kumar M,Iglesias K,Frangos S,Maloney-Wilensky E,Le Roux PDdoi
10.1007/s00134-012-2593-1subject
Has Abstractpub_date
2012-09-01 00:00:00pages
1497-504issue
9eissn
0342-4642issn
1432-1238journal_volume
38pub_type
杂志文章abstract:OBJECTIVE:Pressure measurements at the level of the right atrium are commonly used in clinical anesthesia and the intensive care unit (ICU). There is growing interest in the use of peripheral venous sites for estimating central venous pressure (CVP). This study compared bias, precision, and covariance in simultaneous m...
journal_title:Intensive care medicine
pub_type: 临床试验,杂志文章
doi:10.1007/s00134-003-2052-0
更新日期:2004-04-01 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:PURPOSE:Motivated by a new randomized trial (the PEPTIC trial) that raised the issue of an increase in mortality with proton pump inhibitors (PPIs) relative to histamine-2 receptor antagonists (H2RAs), we updated our prior systematic review and network meta-analysis (NMA) addressing the impact of pharmacological gastro...
journal_title:Intensive care medicine
pub_type: 杂志文章,评审
doi:10.1007/s00134-020-06209-w
更新日期:2020-11-01 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 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:BACKGROUND:After resuscitation, asphyxiated neonates often develop poor cardiac function with hypotension, pulmonary hypertension and multiorgan ischemia. In a swine model of neonatal hypoxia-reoxygenation, effects of epinephrine, dobutamine and milrinone on systemic, pulmonary and regional hemodynamics and oxygen tran...
journal_title:Intensive care medicine
pub_type: 杂志文章
doi:10.1007/s00134-010-1820-x
更新日期:2010-06-01 00:00:00
abstract:OBJECTIVES:(1) To demonstrate that metabolic parameters are better indicators of tissue hypoxia than regional and whole oxygen consumption (VO(2)). (2) To compare intramucosal pH (pHi) in different gastrointestinal segments. DESIGN:Prospective, interventional study. SETTING:Research laboratory at a university center....
journal_title:Intensive care medicine
pub_type: 杂志文章
doi:10.1007/s00134-001-1138-9
更新日期:2001-12-01 00:00:00
abstract:OBJECTIVE:To investigate nasal nitric oxide (NO) excretion, pulmonary NO excretion, and autoinhalation of nasally released NO at rest compared with that during moderate exercise in smokers and non-smokers. DESIGN:Prospective observational study. SETTING:University laboratory. PARTICIPANTS:Fourteen healthy adult volu...
journal_title:Intensive care medicine
pub_type: 杂志文章
doi:10.1007/s001340051172
更新日期:2000-04-01 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:OBJECTIVE:Atracurium besylate and laudanosine cause excitement and seizures when introduced into the central nervous system of laboratory animals. We examined the modulation of lipid-protein interaction in the lipid environment of rat brain synaptosomal plasma membrane (SPM)-bound enzymes as a possible mechanism leadin...
journal_title:Intensive care medicine
pub_type: 杂志文章
doi:10.1007/s001340050605
更新日期:1998-05-01 00:00:00
abstract::An 18-month-old male infant presented with hypoglycemic coma and clinical signs of bronchopneumonia. He was suspected of suffering from septic shock. The patient progressed to irreversible multiple organ failure before the diagnosis of adrenal crisis was established. Plasma levels of ACTH and cortisol remained undetec...
journal_title:Intensive care medicine
pub_type: 杂志文章
doi:10.1007/s001340050021
更新日期:2000-01-01 00:00:00
abstract:OBJECTIVE:A closed suction system (CS) maintains connection with the mechanical ventilator during tracheal suctioning and is claimed to limit loss in lung volume and oxygenation. We compared changes in lung volume, oxygenation, airway pressure and hemodynamics during endotracheal suctioning performed with CS and with 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/s001340100897
更新日期:2001-04-01 00:00:00
abstract::In critically ill patients, it is frequently challenging to identify who will benefit from admission to the intensive care unit and life-sustaining interventions when the chances of a meaningful outcome are unclear. In addition, the acute illness not only affects the patients but also family members or surrogates who ...
journal_title:Intensive care medicine
pub_type: 杂志文章,评审
doi:10.1007/s00134-018-5339-x
更新日期:2018-09-01 00:00:00
abstract:OBJECTIVE:To evaluate clinical and microbiologic characteristics, modalities of treatment and outcome of patients with cervical necrotizing fasciitis admitted to our institution. DESIGN:Retrospective clinical investigation. PATIENTS AND METHODS:We reviewed the charts of 20 consecutive patients hospitalized in our Int...
journal_title:Intensive care medicine
pub_type: 杂志文章
doi:10.1007/s001340050959
更新日期:1999-08-01 00:00:00
abstract:OBJECTIVE:Pseudomonas aeruginosa-induced lung injury is characterized not only by the alteration in lung fluid movement but also by apoptosis of lung epithelial and endothelial cells. We studied whether inhibition of apoptosis using a broad spectrum caspase inhibitor, benzyloxycarbonyl-Val-Ala-Asp fluoromethylketone (Z...
journal_title:Intensive care medicine
pub_type: 杂志文章
doi:10.1007/s00134-004-2165-0
更新日期:2004-06-01 00:00:00
abstract::Fifteen polytrauma patients with asymmetric pulmonary contusion were treated with differential lung ventilation (DLV) for a mean of 106 hours (range 24-298, median 83). The differential time constant (Tc), compliance (Ct), inspiratory and expiratory airway resistance (Rawinsp, Rawexp) and peak-airway pressure (Pawpeak...
journal_title:Intensive care medicine
pub_type: 杂志文章
doi:10.1007/BF00255602
更新日期:1989-01-01 00:00:00
abstract:OBJECTIVE:To derive recommendations for the dosing of commonly used medications in the morbidly obese patient in the ICU. DATA SOURCES:Articles were obtained through computerized searches involving MEDLINE. The bibliographies of retrieved publications and textbooks were reviewed for additional references. STUDY SELEC...
journal_title:Intensive care medicine
pub_type: 杂志文章,评审
doi:10.1007/s00134-003-2059-6
更新日期:2004-01-01 00:00:00
abstract:: ...
journal_title:Intensive care medicine
pub_type: 评论,社论
doi:10.1007/s00134-018-5498-9
更新日期:2019-01-01 00:00:00
abstract::Although colitis is often seen in critically all patients who have received multiple broad-spectrum antibiotics, there are no reports describing severe sepsis as a result of Clostridium difficile infection. We describe three cases of severe sepsis with local intestinal Clostridium difficile infection as the only ident...
journal_title:Intensive care medicine
pub_type: 杂志文章
doi:10.1007/BF02044130
更新日期:1996-09-01 00:00:00
abstract:OBJECTIVE:The pressure-volume (P/V) curve has been proposed as a tool to adjust the ventilatory settings in cases of acute respiratory distress syndrome (ARDS). The aim of this study was to test the influence of P/V tracing methodology on the presence and value of the upper inflection point (UIP). METHODS:In 13 medica...
journal_title:Intensive care medicine
pub_type: 杂志文章
doi:10.1007/s00134-002-1293-7
更新日期:2002-07-01 00:00:00
abstract:OBJECTIVE:To assess the safety and efficacy of sustained inflations (SI) as lung recruitment maneuvers (RMs) in ventilated pediatric intensive care unit (PICU) patients. DESIGN:Observational, prospective data collection. SETTING:Tertiary-care PICU. PATIENTS AND PARTICIPANTS:Thirty-two consecutive ventilated pediatri...
journal_title:Intensive care medicine
pub_type: 杂志文章
doi:10.1007/s00134-007-0764-2
更新日期:2007-10-01 00:00:00
abstract:OBJECTIVE:We perform an ethical analysis of European Union Directive 2001/20/EC on the simplification and harmonization of guidelines regarding good clinical practice in the conduct of clinical trials involving drugs. BACKGROUND:The Directive provides guidance on protecting incapacitated subjects who participate in dr...
journal_title:Intensive care medicine
pub_type: 杂志文章
doi:10.1007/s00134-004-2367-5
更新日期:2004-09-01 00:00:00
abstract:PURPOSE:Little is known on the incidence of discomfort during the end-of-life of intensive care unit (ICU) patients and the impact of sedation on such discomfort. The aim of this study was to assess the incidence of discomfort events according to levels of sedation. METHODS:Post-hoc analysis of an observational prospe...
journal_title:Intensive care medicine
pub_type: 杂志文章
doi:10.1007/s00134-020-05930-w
更新日期:2020-06-01 00:00:00
abstract::Plasma colloid osmotic pressure (COP) has been calculated from both serum albumin concentration and plasma total protein concentration. These values have been compared to those measured directly using a membrane-transducer oncometer in a group of normal subjects, in a group of critically-ill patients with a variety of...
journal_title:Intensive care medicine
pub_type: 杂志文章
doi:10.1007/BF00254796
更新日期:1987-01-01 00:00:00
abstract:OBJECTIVES:(a). To describe the glucose content of normal human airways secretions; (b). to observe the effects of hyperglycemia and airways inflammation on airways glucose. DESIGN:Observational studies. SETTINGS:(a). St George's Hospital Medical School; (b). diabetes mellitus outpatient clinics; (c). adult general i...
journal_title:Intensive care medicine
pub_type: 杂志文章
doi:10.1007/s00134-003-1961-2
更新日期:2003-12-01 00:00:00
abstract:OBJECTIVE:Inhalation of high concentrations of nitric oxide (NO) has been shown to improve gas exchange and to reduce pulmonary vascular resistance in individuals with ischemia-reperfusion injury following orthotopic lung transplantation. We assessed the cardiopulmonary effects of low doses of NO in early allograft dys...
journal_title:Intensive care medicine
pub_type: 临床试验,杂志文章
doi:10.1007/s001340050741
更新日期:1998-11-01 00:00:00
abstract:PURPOSE:Sepsis is a major health burden worldwide. Preclinical investigations in animals and retrospective studies in patients have suggested that inhibition of platelets may improve the outcome of sepsis. In this study we investigated whether chronic antiplatelet therapy impacts on the presentation and outcome of seps...
journal_title:Intensive care medicine
pub_type: 杂志文章
doi:10.1007/s00134-015-4171-9
更新日期:2016-03-01 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::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:BACKGROUND:Vasopressors are administered to critically ill patients with vasodilatory shock not responsive to volume resuscitation, and less often in cardiogenic shock, and hypovolemic shock. OBJECTIVES:The objectives are to review safety and efficacy of vasopressors, pathophysiology, agents that decrease vasopressor ...
journal_title:Intensive care medicine
pub_type: 杂志文章,评审
doi:10.1007/s00134-019-05801-z
更新日期:2019-11-01 00:00:00