Abstract:
PURPOSE:To systematically review clinical and preclinical data on hydroxyethyl starch (HES) tissue storage. METHODS:MEDLINE (PubMed) was searched and abstracts were screened using defined criteria to identify articles containing original data on HES tissue accumulation. RESULTS:Forty-eight studies were included: 37 human studies with a total of 635 patients and 11 animal studies. The most frequent indication for fluid infusion was surgery accounting for 282 patients (45.9%). HES localization in skin was shown by 17 studies, in kidney by 12, in liver by 8, and in bone marrow by 5. Additional sites of HES deposition were lymph nodes, spleen, lung, pancreas, intestine, muscle, trophoblast, and placental stroma. Among major organs the highest measured tissue concentration of HES was in the kidney. HES uptake into intracellular vacuoles was observed by 30 min after infusion. Storage was cumulative, increasing in proportion to dose, although in 15% of patients storage and associated symptoms were demonstrated at the lowest cumulative doses (0.4 g kg(-1)). Some HES deposits were extremely long-lasting, persisting for 8 years or more in skin and 10 years in kidney. Pruritus associated with HES storage was described in 17 studies and renal dysfunction in ten studies. In one included randomized trial, HES infusion produced osmotic nephrosis-like lesions indicative of HES storage (p = 0.01) and also increased the need for renal replacement therapy (odds ratio, 9.50; 95% confidence interval, 1.09-82.7; p = 0.02). The tissue distribution of HES was generally similar in animals and humans. CONCLUSIONS:Tissue storage of HES is widespread, rapid, cumulative, frequently long-lasting, and potentially harmful.
journal_name
Intensive Care Medjournal_title
Intensive care medicineauthors
Wiedermann CJ,Joannidis Mdoi
10.1007/s00134-013-3156-9subject
Has Abstractpub_date
2014-02-01 00:00:00pages
160-70issue
2eissn
0342-4642issn
1432-1238journal_volume
40pub_type
杂志文章,评审abstract:BACKGROUND:Current medical knowledge lacks specific information regarding creatine kinase (CK) elevation in influenza A pH1N1 (2009) infection. OBJECTIVES:Primary endpoints were correlation between CK at intensive care unit (ICU) admission and ICU mortality. Secondary endpoints were ICU length of stay (LOS), mechanica...
journal_title:Intensive care medicine
pub_type: 杂志文章
doi:10.1007/s00134-012-2565-5
更新日期:2012-07-01 00:00:00
abstract:OBJECTIVE:To examine the benefits and risks of vasopressin or its analog terlipressin for patients with vasodilatory shock. DATA SOURCE:We searched the CENTRAL, MEDLINE, EMBASE, and LILACS databases (up to March 2011) as well as reference lists of articles and proceedings of major meetings; we also contacted trial aut...
journal_title:Intensive care medicine
pub_type: 杂志文章,meta分析,评审
doi:10.1007/s00134-011-2407-x
更新日期:2012-01-01 00:00:00
abstract:OBJECTIVE:Antithrombin exerts direct effects on neutrophils by inhibiting chemokine-induced migration. This study examined the potency of different pharmaceutical antithrombin preparations in inhibiting neutrophil chemotaxis toward interleukin 8. METHODS:Cell migration was tested by the leading front assay in modified...
journal_title:Intensive care medicine
pub_type: 杂志文章
doi:10.1007/s00134-002-1432-1
更新日期:2002-10-01 00:00:00
abstract:PURPOSE:To assess the impact of lung ultrasound (LU) on clinical decision making in mechanically ventilated critically ill patients. METHODS:One hundred and eighty-nine patients took part in this prospective study. The patients were enrolled in the study when LU was requested by the primary physician for (1) unexplain...
journal_title:Intensive care medicine
pub_type: 杂志文章
doi:10.1007/s00134-013-3133-3
更新日期:2014-01-01 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::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::Streptococcus pneumoniae is responsible for two-thirds of ICU admissions due to community-acquired pneumonia (CAP) and is the leading cause of CAP-related death. Early death is principally due to cardiovascular collapse, whereas late death is associated with hypoxemic respiratory failure. Outcome depends on interactio...
journal_title:Intensive care medicine
pub_type: 杂志文章,评审
doi:10.1007/s00134-006-0182-x
更新日期:2006-07-01 00:00:00
abstract:PURPOSE:We set out to summarize the current challenges in academic conflict of interest. METHODS:This is a narrative review by a multidisciplinary, multinational panel of academic officers including deans of medical/pharmacy schools. RESULTS AND CONCLUSIONS:Disclosing conflict of interest has become the appropriate p...
journal_title:Intensive care medicine
pub_type: 杂志文章,评审
doi:10.1007/s00134-018-5458-4
更新日期:2019-01-01 00:00:00
abstract::The goals of management of patients with respiratory failure include improving arterial oxygenation with PEEP and red cell transfusion to maintain oxygen carrying capacity, both of which contribute to improving tissue oxygen delivery. However, standard CPD-stored blood is rapidly depleted of 2,3 diphosphoglycerate (2,...
journal_title:Intensive care medicine
pub_type: 杂志文章
doi:10.1007/BF00315364
更新日期:1986-01-01 00:00:00
abstract:OBJECTIVES:Trunk position at 45 degrees from the horizontal is associated with a decreased risk of gastroesophageal aspiration. The objectives of this study were to determine the accuracy of trunk flexion estimates compared to a reference standard measurement, and to determine agreement about trunk flexion among ICU cl...
journal_title:Intensive care medicine
pub_type: 杂志文章
doi:10.1007/s00134-002-1225-6
更新日期:2002-03-01 00:00:00
abstract:RATIONALE:Delirium incidence in intensive care unit (ICU) patients is high and associated with poor outcome. Identification of high-risk patients may facilitate its prevention. PURPOSE:To develop and validate a model based on data available at ICU admission to predict delirium development during a patient's complete I...
journal_title:Intensive care medicine
pub_type: 杂志文章,多中心研究
doi:10.1007/s00134-015-3777-2
更新日期:2015-06-01 00:00:00
abstract:PURPOSE:Rapid shallow breathing may occur at any time during spontaneous breathing trials (SBT), questioning the utility of a single determination of the rapid shallow breathing index (RSBI). We hypothesize that change in RSBI during SBT may more accurately predict successful extubation than a single determination. ME...
journal_title:Intensive care medicine
pub_type: 杂志文章
doi:10.1007/s00134-009-1735-6
更新日期:2010-03-01 00:00:00
abstract:OBJECTIVE:The aim of this study was to identify risk factors and to describe epidemiological patterns for early-(EOB) and late-onset bacteremias (LOB) after trauma. DESIGN:A prospective study conducted on 141 consecutive trauma patients. SETTING:A general intensive care unit (ICU) of a university hospital. PATIENTS:...
journal_title:Intensive care medicine
pub_type: 杂志文章
doi:10.1007/BF01709514
更新日期:1996-08-01 00:00:00
abstract:OBJECTIVE:Do-not-resuscitate orders (DNR orders) and advance directives (AD) have been developed and their use by patients is increasing. The objective of the study was to evaluate the compliance with patient's wishes and doctors' and nurses' agreement on decision-making in the treatment of elderly patients from a cros...
journal_title:Intensive care medicine
pub_type: 杂志文章
doi:10.1007/s001340000602
更新日期:2000-09-01 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::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::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:Measurement of functional residual capacity (FRC) during mechanical ventilation is important to standardise respiratory system compliance and adjust the ventilator settings to optimise lung recruitment. In the present study we compared three methods to measure FRC. DESIGN:The bias flow nitrogen washout techn...
journal_title:Intensive care medicine
pub_type: 杂志文章
doi:10.1007/s00134-003-2028-0
更新日期:2004-01-01 00:00:00
abstract:INTRODUCTION:The purpose of a scientific paper is to communicate results and within the paper this applies especially to the presentation of data. It is the universal practice in medical journals to present statistical results using tables. Good tables are an integral part of the manuscript. To help researchers communi...
journal_title:Intensive care medicine
pub_type: 杂志文章
doi:10.1007/s00134-014-3248-1
更新日期:2014-05-01 00:00:00
abstract:OBJECTIVE:To investigate the morphological changes in the liver in patients with organ failure and hyperbilirubinemia and to correlate them to the outcome. DESIGN:A case series prospective study. SETTING:Intensive care units of two general hospitals. PATIENTS:Twelve patients in organ failure with predominant hepatic...
journal_title:Intensive care medicine
pub_type: 杂志文章
doi:10.1007/BF01708095
更新日期:1996-06-01 00:00:00
abstract:OBJECTIVE:To describe the use of volumetric capnography, a plot of expired CO(2) concentration against expired volume, in monitoring fibrinolytic treatment of major pulmonary embolism. DESIGN AND SETTING:Two case reports in the emergency department of a teaching hospital. PATIENTS:Two conscious and spontaneously brea...
journal_title:Intensive care medicine
pub_type: 杂志文章
doi:10.1007/s00134-004-2444-9
更新日期:2004-11-01 00:00:00
abstract:OBJECTIVE:Antipyrine metabolism is a "gold standard" measure of mixed cytochrome P450 (CYP) mediated drug metabolism in humans. Cytokines (e.g., interleukin-6) and nitric oxide reduce CYP 450 activity in vitro and in vivo. Because interleukin-6 and nitric oxide production increases in children with sepsis-induced multi...
journal_title:Intensive care medicine
pub_type: 杂志文章
doi:10.1007/s00134-003-1758-3
更新日期:2003-06-01 00:00:00
abstract:OBJECTIVE:To evaluate trends in mortality and related factors among trauma patients who developed acute respiratory distress syndrome (ARDS). STUDY:Observational study based on data prospectively gathered in computerized trauma registry. SETTING:Trauma intensive care unit (ICU) of 48 beds in level I trauma center. P...
journal_title:Intensive care medicine
pub_type: 杂志文章
doi:10.1007/s001340100955
更新日期:2001-07-01 00:00:00
abstract:OBJECTIVE:We tested the hypothesis that synchronization to patient effort during intermittent mandatory ventilation (SIMV), when compared to conventional unsynchronized intermittent mandatory ventilation (IMV), will decrease energy expenditure, as reflected by decreased oxygen consumption (VO2). DESIGN:We used a four-...
journal_title:Intensive care medicine
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1007/s001340050359
更新日期:1997-04-01 00:00:00
abstract:OBJECTIVE:Erythrocytes influence the magnitude of hypoxia-induced pulmonary artery pressure increase. It is, however, unknown to what extent haemoconcentration and haemodilution affect this response and whether intrapulmonary blood volume (and thus vessel dimensions) alters the magnitude of pressure increase. Furthermo...
journal_title:Intensive care medicine
pub_type: 杂志文章
doi:10.1007/s001340051327
更新日期:2000-08-01 00:00:00
abstract:OBJECTIVE:Alterations in coagulation, including elevated pulmonary and systemic concentrations of urokinase, are frequent in patients with acute lung injury (ALI). Urokinase potentiates neutrophil activation and contributes to the severity of pulmonary injury in preclinical models of ALI. The objective of this study wa...
journal_title:Intensive care medicine
pub_type: 杂志文章,多中心研究
doi:10.1007/s00134-007-0930-6
更新日期:2008-02-01 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::Diagnosis and treatment of infection is a common procedure in the clinical management of patients in the ICU. Infection in the ICU is an important area for study, but requires well-defined and proven diagnostic criteria. The diagnosis of infection, like any diagnosis, is based on probability, and diagnostic criteria a...
journal_title:Intensive care medicine
pub_type: 杂志文章,评审
doi:10.1007/BF01713977
更新日期:1994-11-01 00:00:00
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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: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