Abstract:
OBJECTIVE:Candida spp. airway colonization could promote development of ventilator-associated pneumonia (VAP) caused by Pseudomonas aeruginosa, a potentially multidrug-resistant (MDR) bacteria, and worsen the outcome of VAP regardless of pathogen. We therefore address the question of the risk of MDR bacteria isolation within the airway of patients with suspected VAP, whether Candida spp. is present or not. DESIGN AND SETTING:Prospective observational study in a teaching hospital. PATIENTS AND METHODS:Consecutive patients with suspected VAP were included. Respiratory tract secretions were seeded on specific medium for yeast isolation in addition to standard culture. Outcome as well as presence of MDR bacteria were assessed according to fungal colonization. RESULTS:323 suspected VAP were analysed. Among these, 181 (56 %) cases presented with Candida spp. airway colonization. Colonized and noncolonized patients were similar regarding baseline characteristics, prior exposure to antibiotics and VAP severity. However, mortality rate was greater in patients with fungal airway colonization than in those without (44.2 versus 31.0 %, respectively; p = 0.02). In addition, MDR bacteria isolation was 31.5 % in patients with Candida spp. colonization versus 23.2 % in those without (p = 0.13). Moreover, Candida spp. airway colonization was one independent risk factor for MDR bacteria isolation [odds ratio (OR) = 1.79, 95 % confidence interval 1.05-3.05; p = 0.03], in addition to the time elapsed between intensive care unit (ICU) admission and VAP suspicion. CONCLUSIONS:In patients with suspected VAP, Candida spp. airway colonization is frequent and associated with increased risk for MDR bacteria isolation. This could worsen outcome and should therefore be considered when choosing an empiric antibiotic therapy.
journal_name
Intensive Care Medjournal_title
Intensive care medicineauthors
Hamet M,Pavon A,Dalle F,Pechinot A,Prin S,Quenot JP,Charles PEdoi
10.1007/s00134-012-2584-2subject
Has Abstractpub_date
2012-08-01 00:00:00pages
1272-9issue
8eissn
0342-4642issn
1432-1238journal_volume
38pub_type
杂志文章abstract::We report the case of a 72-year-old male who suffered a cardiac arrest during an early positive treadmill stress test. After successful resuscitation the patient had evidence of a gastric perforation. Because of his hemodynamic stability, lack of peritoneal signs, and prohibitively high surgical risk, a non-operative ...
journal_title:Intensive care medicine
pub_type: 杂志文章
doi:10.1007/BF01710656
更新日期:1994-07-01 00:00:00
abstract:PURPOSE:To describe the course of early organ dysfunction in a cohort of patients admitted in ICU suffering classic heatstroke. METHODS:Prospective observational single-centre cohort study with a 1-year follow-up. INTERVENTIONS:None. MEASUREMENTS AND MAIN RESULTS:Clinical and biological data of 22 patients were anal...
journal_title:Intensive care medicine
pub_type: 杂志文章
doi:10.1007/s00134-009-1500-x
更新日期:2009-08-01 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::A case of brainstem encephalitis complicated by torsade de pointes is described. The possible occurrence of ventricular arrhythmias may contribute to the mortality in this condition. We recommend the admission of patients with brainstem encephalitis to an intensive care unit, for a period of electrocardiographic monit...
journal_title:Intensive care medicine
pub_type: 杂志文章
doi:10.1007/BF00263564
更新日期:1987-01-01 00:00:00
abstract:OBJECTIVE:To characterize N-terminal pro-brain natriuretic peptide (N-proBNP) and troponin I (TnI) profile following mitral and/or aortic valve surgery and to evaluate correlations with echocardiography measures and outcome criteria. DESIGN AND SETTING:Prospective cross-controlled study in a university children's hosp...
journal_title:Intensive care medicine
pub_type: 杂志文章
doi:10.1007/s00134-008-1025-8
更新日期:2008-06-01 00:00:00
abstract::A study was conducted to evaluate repeated intrathecal injections of baclofen, without artificial ventilation, in the treatment of severe tetanus. Ten patients, 5 men and 5 women, with a mean age of 34 +/- 7 years, were included in the study. The dose of baclofen injected was 1000 micrograms between the ages of 16 and...
journal_title:Intensive care medicine
pub_type: 杂志文章
doi:10.1007/BF01709840
更新日期:1992-01-01 00:00:00
abstract:OBJECTIVE:Hospital mortality of patients with septic multiorgan failure (MOF) is still around 95%. The present study investigates whether this high mortality could be significantly reduced by the addition of sequential hemofiltration (SH) with bicarbonate hemodialysis (HD) to the currently used life supportive measures...
journal_title:Intensive care medicine
pub_type: 杂志文章
doi:10.1007/BF01726531
更新日期:1995-02-01 00:00:00
abstract:PURPOSE:To test the hypothesis that a carbamylated EPO-FC fusion protein (cEPO-FC) or recombinant human erythropoietin (rhEPO) would protect against kidney ischemia/reperfusion (I/R) injury in pigs with atherosclerosis. METHODS:Anesthetized and mechanically ventilated animals received cEPO-FC (50 μg kg(-1)), rhEPO (5,...
journal_title:Intensive care medicine
pub_type: 杂志文章
doi:10.1007/s00134-012-2766-y
更新日期:2013-03-01 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:OBJECTIVES:To establish priorities for research in critical care medicine in the UK using survey and nominal group (NG) techniques. DESIGN:The senior doctor and nurse from 325 intensive care units (ICUs) in the UK were invited to contribute up to ten research questions relevant to intensive care organisation, practice...
journal_title:Intensive care medicine
pub_type: 杂志文章
doi:10.1007/s001340000628
更新日期:2000-10-01 00:00:00
abstract:PURPOSE:This study explored differences in end-of-life (EOL) decisions and respect for patient autonomy of religious members versus those only affiliated to that particular religion (affiliated is a member without strong religious feelings). METHODS:In 2005 structured questionnaires regarding EOL decisions were distri...
journal_title:Intensive care medicine
pub_type: 杂志文章
doi:10.1007/s00134-012-2554-8
更新日期:2012-07-01 00:00:00
abstract:OBJECTIVE:To evaluate the efficacy of minitracheotomy (MT) insertion for intratracheal oxygen insufflation (ITO2) on arterial blood gases and survival in patients with respiratory failure from chronic lung disease. DESIGN:Open, prospective clinical study. SETTING:A 12-bed medical intensive care unit in a non-universi...
journal_title:Intensive care medicine
pub_type: 临床试验,杂志文章
doi:10.1007/BF01709545
更新日期:1996-12-01 00:00:00
abstract:OBJECTIVE:To compare some of the confirmatory investigations of brain death with clinical criteria in order to achieve the most sensitive and accurate diagnosis of brain death. DESIGN:All patients with isolated brain lesions and Glasgow Coma Scale (GCS) = 3 were subjected to neurological examination after ruling out h...
journal_title:Intensive care medicine
pub_type: 杂志文章
doi:10.1007/BF01711544
更新日期:1995-08-01 00:00:00
abstract:OBJECTIVE:To investigate the involvement of intestinal angiotensin II type 2 receptors in the outcome of acute severe hypovolemia as well as systemic and regional mesenteric hemodynamics and intestinal mucosal functions in anesthetized pigs. DESIGN AND SETTING:Prospective, interventional animal study in a university r...
journal_title:Intensive care medicine
pub_type: 杂志文章
doi:10.1007/s00134-005-2686-1
更新日期:2005-08-01 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: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
abstract:OBJECTIVE:Sepsis-evoked myocardial dysfunction is possibly due to decreased myofilament calcium sensitivity, and a calcium sensitizer may thus specifically improve contractility in sepsis by enhancing myofilament calcium sensitivity. We examined whether the calcium sensitizer levosimendan mitigates myocardial dysfuncti...
journal_title:Intensive care medicine
pub_type: 杂志文章
doi:10.1007/s00134-003-1879-8
更新日期:2003-10-01 00:00:00
abstract:OBJECTIVE:To describe a real-time ultrasound sign, the visualization of the cavity and the walls of the maxillary sinus ("sinusogram"), and to assess its correlation with total opacity of the sinus. DESIGN:Prospective clinical study. SETTING:The medical ICU of a university-affiliated hospital. PATIENTS:The significa...
journal_title:Intensive care medicine
pub_type: 杂志文章
doi:10.1007/s001340050716
更新日期:1998-10-01 00:00:00
abstract:: ...
journal_title:Intensive care medicine
pub_type: 信件
doi:10.1007/s00134-018-5420-5
更新日期:2018-12-01 00:00:00
abstract::We studied the influence of ventilatory frequency (1-5 Hz), tidal volume, lung volume and body position on the end-expiratory alveolar-to-tracheal pressure difference during high-frequency jet ventilation (HFJV) in Yorkshire piglets. The animals were anesthetized and paralysed. Alveolar pressure was estimated with the...
journal_title:Intensive care medicine
pub_type: 杂志文章
doi:10.1007/BF01706322
更新日期:1990-01-01 00:00:00
abstract::The effects of continuous and supplementary bolus dose administration of etomidate have been investigated in ten artificially ventilated patients in traumatic coma. Continuous infusion of etomidate (5-25 micrograms/kg/min) proved to be a practical and safe means of sedating these patients and appeared to control moder...
journal_title:Intensive care medicine
pub_type: 杂志文章
doi:10.1007/BF01692549
更新日期:1983-01-01 00:00:00
abstract:PURPOSE:Neutrophil gelatinase-associated lipocalin (NGAL) is a promising biomarker for acute kidney injury (AKI). We evaluated the diagnostic and prognostic accuracies of plasma NGAL (pNGAL) for contrast-induced AKI (CI-AKI) in critically ill patients. METHODS:In a prospective observational study in two adult intensiv...
journal_title:Intensive care medicine
pub_type: 杂志文章
doi:10.1007/s00134-013-2826-y
更新日期:2013-05-01 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:PURPOSE:We assessed feasibility and safety of extracorporeal carbon dioxide removal (ECCO2R) to facilitate ultra-protective ventilation (VT 4 mL/kg and PPLAT ≤ 25 cmH2O) in patients with moderate acute respiratory distress syndrome (ARDS). METHODS:Prospective multicenter international phase 2 study. Primary endpoint w...
journal_title:Intensive care medicine
pub_type: 杂志文章,多中心研究
doi:10.1007/s00134-019-05567-4
更新日期:2019-05-01 00:00:00
abstract:PURPOSE:Sepsis and its progression are known to have a major influence on the coagulation system. Current coagulation tests are of limited use when assessing coagulation in sepsis patients. This study aims to assess the potential for a new functional biomarker of clot microstructure, fractal dimension, to identify chan...
journal_title:Intensive care medicine
pub_type: 杂志文章
doi:10.1007/s00134-016-4496-z
更新日期:2016-12-01 00:00:00
abstract::Extracorporeal CO2-removal (EC-CO2-R) using a membrane lung system was applied for 12 and 20 days respectively in two young men with adult respiratory distress syndrome (ARDS). Neuropathological examination revealed only moderate hypoxic changes of unusual distribution. In the first case nerve cell loss in Sommer's se...
journal_title:Intensive care medicine
pub_type: 杂志文章
doi:10.1007/BF00263553
更新日期:1987-01-01 00:00:00
abstract:OBJECTIVE:There are a number of potential etiologies of severe bleeding encountered in the intensive care unit. Although rare, acquired hemophilia is one such etiology that often presents with major bleeding requiring intensive care. Despite the introduction of effective treatments, the reported mortality rate of patie...
journal_title:Intensive care medicine
pub_type: 杂志文章,评审
doi:10.1007/s00134-011-2258-5
更新日期:2011-08-01 00:00:00
abstract:BACKGROUND:It remains uncertain why immunocompetent patients with bacterial community-acquired pneumonia (CAP) die, in spite of adequate antibiotics. METHODS:This is a secondary analysis of the CAPUCI database which was a prospective observational multicentre study. Two hundred and twelve immunocompetent patients admi...
journal_title:Intensive care medicine
pub_type: 杂志文章
doi:10.1007/s00134-008-1363-6
更新日期:2009-03-01 00:00:00
abstract::In the past two years several guidelines for suggested components of emergency medical systems for children have been suggested, and for the first time, specific standards of pediatric trauma care have also been formulated. The American Academy of Pediatrics new Provisional Committee on Emergency Medicine has been cha...
journal_title:Intensive care medicine
pub_type: 杂志文章
doi:10.1007/BF00260888
更新日期:1989-01-01 00:00:00
abstract:OBJECTIVE:An instrument able to estimate the direct costs of stays in Intensive Care Units (ICUs) simply would be very useful for resource allocation inside a hospital, through a global budget system. The aim of this study was to propose such a tool. DESIGN:Since 1991, a region-wide common data base has collected stan...
journal_title:Intensive care medicine
pub_type: 杂志文章
doi:10.1007/s001340050619
更新日期:1998-06-01 00:00:00