Abstract：
PURPOSE:Sedatives administered to critically ill children should be titrated to effect, because both under- and oversedation may have negative effects. We conducted a systematic review to examine reported incidences of under-, optimal, and oversedation in critically ill children receiving intensive care. METHODS:A systematic literature search using predefined criteria was performed in PubMed and Embase to identify all articles evaluating level of sedation in PICU patients receiving continuous sedation. Two authors independently recorded: study objective, study design, sample size, age range, details of study intervention (if applicable), sedatives used, length of sedation, sedation scale used, and incidences of optimal, under-, and oversedation as defined in the studies. RESULTS:Twenty-five studies were included. Two studies evaluated sedation level as primary study outcome; the other 23 as secondary outcomes. Together, these studies investigated 1,163 children; age range, 0-18 years. Across studies, children received many different sedative agents and sedation level was assessed with 12 different sedation scales. Optimal sedation was ascertained in 57.6 % of the observations, under sedation in 10.6 %, and oversedation in 31.8 %. CONCLUSIONS:This study suggests that sedation in the PICU is often suboptimal and seldom systematically evaluated. Oversedation is more common than undersedation. As oversedation may lead to longer hospitalization, tolerance, and withdrawal, preventing oversedation in pediatric intensive care deserves greater attention.
journal_name
Intensive Care Medjournal_title
Intensive care medicineauthors
Vet NJ,Ista E,de Wildt SN,van Dijk M,Tibboel D,de Hoog Mdoi
10.1007/s00134-013-2971-3subject
Has Abstractpub_date
2013-09-01 00:00:00pages
1524-34issue
9eissn
0342-4642issn
1432-1238journal_volume
39pub_type
杂志文章,评审abstract：PURPOSE:Assessment of the cost utility (CU) of acute renal replacement therapy (RRT) from a societal perspective during a 5-year follow-up. METHODS:This was a cross-sectional cohort study in a medical-surgical intensive care unit and an acute RRT unit of 410 consecutive patients treated with acute RRT in Helsinki Univ...
journal_title：Intensive care medicine
pub_type： 杂志文章
doi：10.1007/s00134-012-2760-4
更新日期：2013-03-01 00:00:00
abstract：OBJECTIVE:To investigate efficacy and safety of enoxaparin for catheter-related arterial thrombosis in infants with congenital heart disease. DESIGN:Prospective observational study. SETTING:Pediatric Intensive Care and Cardiology Unit at the University Children's Hospital of Zurich. PATIENTS:A cohort of 32[Symbol: s...
journal_title：Intensive care medicine
pub_type： 杂志文章
doi：10.1007/s00134-007-0718-8
更新日期：2007-11-01 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：:Membranous laryngotracheobronchitis is a very serious infection which affects the larynx, trachea and bronchi, requiring aggressive therapeutic measures. It has been recently rediscovered as a cause of disease in children. However, it is a very unusual complication of measles. Two infants with measles and membranous l...
journal_title：Intensive care medicine
pub_type： 杂志文章
doi：10.1007/BF00273547
更新日期：1985-01-01 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：: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：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：PURPOSE:The use of heat and moisture exchangers (HME) during noninvasive ventilation (NIV) can increase the work of breathing, decrease alveolar ventilation, and deliver less humidity in comparison with heated humidifiers (HH). We tested the hypothesis that the use of HH during NIV with ICU ventilators for patients wit...
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/s00134-013-3145-z
更新日期：2014-02-01 00:00:00
abstract：OBJECTIVE:In contrast to indocyanine green (ICG) blood clearance, the plasma disappearance rate (PDR) of ICG does not require absolute ICG blood concentrations and today can be assessed transcutaneously. In this study, we analyzed the relation between ICG disappearance rate and ICG blood clearance as parameters of live...
journal_title：Intensive care medicine
pub_type： 杂志文章
doi：10.1007/s00134-006-0109-6
更新日期：2006-05-01 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：:The process of fluidisation involves blowing warm air through small solid microspheres thus creating a liquid, without wetness. The warmth provides some important properties including reducing the metabolic rate in thermal injury which has a beneficial effect on mortality, modifying catabolism after surgery, providing...
journal_title：Intensive care medicine
pub_type： 杂志文章,评审
doi：10.1007/BF01701488
更新日期：1995-03-01 00:00:00
abstract：OBJECTIVE:To validate a simple method avoiding discard volumes in pediatric patients with indwelling arterial and venous lines. DESIGN:Zero-discarding was achieved by passive extracorporeal arteriovenous backflow via standard single pressure transducer equipment. We tested backflow distances (10, 20 and 30 cm beyond t...
journal_title：Intensive care medicine
pub_type： 临床试验,杂志文章,随机对照试验
doi：10.1007/s001340100951
更新日期：2001-06-01 00:00:00
abstract：OBJECTIVE:Five commercially available oesophageal balloon catheters (OBCs) were tested to evaluate the accuracy in transmitting fast-changing pressure signals which can be observed, for example, during phrenic nerve stimulation. SETTING:Research laboratory of a university hospital. METHOD:The OBCs tested varied in le...
journal_title：Intensive care medicine
pub_type： 杂志文章
doi：10.1007/s001340051182
更新日期：2000-04-01 00:00:00
abstract：OBJECTIVE:To measure the effects of rapid permissive hypercapnia on hemodynamics and gas exchange in patients with acute respiratory distress syndrome (ARDS). DESIGN:Prospective study. SETTING:18-bed, medical intensive care unit, university hospital. PATIENTS:11 mechanically ventilated ARDS patients. INTERVENTION:P...
journal_title：Intensive care medicine
pub_type： 临床试验,杂志文章
doi：10.1007/BF01712235
更新日期：1996-03-01 00:00:00
abstract：OBJECTIVE:To validate the TRISS method as an audit system on a group of patients with severe trauma admitted to an Italian general intensive care unit (ICU). DESIGN:Prospective, cohort study of consecutive admissions to the ICU. SETTING:A 6-bed general ICU in a 500-bed general hospital. PATIENTS:190 patients with se...
journal_title：Intensive care medicine
pub_type： 杂志文章
doi：10.1007/BF02044120
更新日期：1996-09-01 00:00:00
abstract：OBJECTIVE:To assess the effects of the association of positive end-expiratory pressure (PEEP) with different inflation volumes (V(T)'s) on passive lung deflation and alveolar recruitment in ARDS patients. DESIGN:Clinical study using PEEP with two different V(T)'s and analyzing whether passive lung deflation and alveol...
journal_title：Intensive care medicine
pub_type： 杂志文章
doi：10.1007/s001340051275
更新日期：2000-07-01 00:00:00
abstract：:In order to evaluate the in vitro activity of fleroxacin against nosocomial gram-negative organisms, 263 multiresistant gram-negative bacilli (203 Enterobacteriaceae and 60 non-fermenting gram-negative bacilli) were isolated from adult patients with nosocomial infections. The different patterns of resistance to eight ...
journal_title：Intensive care medicine
pub_type： 杂志文章
doi：10.1007/s001340050675
更新日期：1998-08-01 00:00:00
abstract：OBJECTIVE:A case-control comparison of Doppler guidance on the success rate of central venous cannulation in patients with normal or reduced intracranial compliance. DESIGN:A single operator performed central venous access procedures with continuous wave Doppler guidance. It was used on patients on a ventilator. The p...
journal_title：Intensive care medicine
pub_type： 临床试验,杂志文章
doi：10.1007/s00134-003-1862-4
更新日期：2003-09-01 00:00:00
abstract：OBJECTIVE:To examine variables associated with postextubation respiratory distress in chronic obstructive pulmonary disease (COPD) patients. DESIGN:Prospective, clinical investigation. SETTING:Intensive care unit of a university hospital. PATIENTS:Forty COPD patients, considered ready for extubation. MEASUREMENTS A...
journal_title：Intensive care medicine
pub_type： 临床试验,杂志文章
doi：10.1007/s001340050762
更新日期：1998-12-01 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：OBJECTIVE:This study was undertaken to determine the delay of extubation attributable to ventilator-associated pneumonia (VAP) in comparison to other complications and complexity of surgery after repair of congenital heart lesions in neonates and children. METHODS:Cohort study in a pediatric intensive care unit of a t...
journal_title：Intensive care medicine
pub_type： 杂志文章
doi：10.1007/s001340051285
更新日期：2000-07-01 00:00:00
abstract：OBJECTIVE:To evaluate the nursing time required for difficult-to-wean patients in a dedicated weaning center (WC) and to examine the correlation of the nursing time with nursing workload (NW) scores and with clinical severity and dependency. SETTING:Four-bed WC of a pulmonary rehabilitation department. INTERVENTION:N...
journal_title：Intensive care medicine
pub_type： 杂志文章
doi：10.1007/s001340051249
更新日期：2000-06-01 00:00:00
abstract：:Marked respiratory insufficiency was established in 20 of 91 patients with acute pancreatitis. 16 of them died, 12 from uncontrollable hypoxaemia. At postmortem the most prominent finding was microatelectasis, the occurrence of which correlated highly with the serum amylase activity. ...
journal_title：Intensive care medicine
pub_type： 杂志文章
doi：10.1007/BF01683069
更新日期：1977-08-01 00:00:00
abstract：:The World Health Organization defines overweight and obesity as the condition where excess or abnormal fat accumulation increases risks to health. The prevalence of obesity is increasing worldwide and is around 20% in ICU patients. Adipose tissue is highly metabolically active, and especially visceral adipose tissue h...
journal_title：Intensive care medicine
pub_type： 杂志文章,评审
doi：10.1007/s00134-019-05594-1
更新日期：2019-06-01 00:00:00
abstract：OBJECTIVE:Infection is the most frequent cause of acute respiratory distress syndrome (ARDS). However, little is known about the influence of infection sites on ARDS. This study aimed to assess the associations of infection sites with ARDS development and mortality in critically ill infected patients. DESIGN:Prospecti...
journal_title：Intensive care medicine
pub_type： 杂志文章
doi：10.1007/s00134-010-1851-3
更新日期：2010-06-01 00:00:00
abstract：OBJECTIVE:To obtain insight into the occurrence of brain death and the potential for brain dead and controlled non-heart-beating organ donors (CNHB) in patients with traumatic brain injury (TBI), subarachnoid haemorrhage (SAH) and intracerebral haemorrhage (ICH) in a large neurosurgical serving area (2.1 million inhabi...
journal_title：Intensive care medicine
pub_type： 杂志文章
doi：10.1007/s00134-005-0001-9
更新日期：2006-02-01 00:00:00
abstract：:A case of bilateral pseudoaneurysms of the pulmonary arteries caused by blunt chest injury is presented. Although this is a very rare complication, this entity should always be suspected in a patient with hemoptysis and a radiodensity on chest radiograph following chest injury. Selection of operative procedures should...
journal_title：Intensive care medicine
pub_type： 杂志文章,评审
doi：10.1007/BF01706428
更新日期：1992-01-01 00:00:00
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：PURPOSE:Hyperglycaemia is common in the critically ill. The objectives of this study were to determine the prevalence of critical illness-associated hyperglycaemia (CIAH) and recognised and unrecognised diabetes in the critically ill as well as to evaluate the impact of premorbid glycaemia on the association between ac...
journal_title：Intensive care medicine
pub_type： 临床试验,杂志文章
doi：10.1007/s00134-014-3287-7
更新日期：2014-07-01 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
