Abstract:
PURPOSE:To estimate the direct and indirect (contextual) effects of the factorized constituents of selective digestive decontamination and selective oropharyngeal decontamination (SDD/SOD), being topical antibiotic (TA) and protocolized antifungal prophylaxis (PAFP), on ICU-acquired candidemia. METHODS:A broad range of ICU candidemia incidence studies were sourced to serve as points of reference. The candidemia incidence was extracted from component (control and intervention) groups decanted from studies of various designs (concurrent or non-concurrent) and whether investigating SDD/SOD versus non-TA methods of ICU infection prevention. The candidemia incidences were summarized in regression models using generalized estimating equation (GEE) methods. Groups derived from observational studies (no prevention method under study) provided an overarching external benchmark candidemia incidence for calibration. RESULTS:Within studies investigating SDD/SOD, the mean (and 95% confidence interval) candidemia incidence among concurrent component groups (40 control; 2.4%; 1.7-3.2% and 43 intervention groups; 2.4%; 1.6-3.1%), but not non-concurrent control groups (11 groups; 1.6%; 0.1-2.7%), is higher than that of the benchmark candidemia incidence derived from 54 observational groups (1.5%; 1.2-1.9%). The TA constituent within SDD/SOD has significant direct and indirect (contextual) effects in GEE models even after adjusting for the publication year and the group-wide presence of either candidemia risk factors or PAFP use. CONCLUSION:The TA constituent of SDD/SOD is associated with a contextual effect on candidemia incidence which is similar in magnitude to that of the conventional candidemia risk factors and against which PAFP partially attenuates. This increase is inapparent within individual SDD/SOD studies examined in isolation.
journal_name
Intensive Care Medjournal_title
Intensive care medicineauthors
Hurley JCdoi
10.1007/s00134-015-4004-xsubject
Has Abstractpub_date
2015-11-01 00:00:00pages
1877-85issue
11eissn
0342-4642issn
1432-1238pii
10.1007/s00134-015-4004-xjournal_volume
41pub_type
杂志文章,meta分析abstract::Two patients with severe hepatic and renal failure underwent emergency hepatic retransplantation (2nd and 6th day after transplantation). Continuous arteriovenous haemodialysis was begun before surgery and successfully performed, without any incident, during the retransplantation with a biospal (SCU/CAVH AN 69 S) devi...
journal_title:Intensive care medicine
pub_type: 杂志文章
doi:10.1007/BF01706360
更新日期:1990-01-01 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::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:To study the wishes of a sample of French patients about medical information and surrogacy, at a time when the French Ministry of Health is supporting increased patient autonomy. DESIGN:A cohort of competent patients with non-critical illnesses or injuries completed an intention-to-act questionnaire on the a...
journal_title:Intensive care medicine
pub_type: 杂志文章
doi:10.1007/s001340050011
更新日期:2000-01-01 00:00:00
abstract:OBJECTIVE:To report the first case of ARDS in children treated with nitric oxide (NO) inhalation. METHODS:A 13-months infant presented with BPD and severe hypoxemia related to RSV infection and ARDS. Inhaled NO was delivered in the ventilatory circuit of a continuous flow ventilator (Babylog 8000, Dräger) in a concent...
journal_title:Intensive care medicine
pub_type: 杂志文章
doi:10.1007/BF01711907
更新日期:1994-08-01 00:00:00
abstract:OBJECTIVE:A readily available assessment of changes in pleural pressure would be useful for ventilator and fluid management in critically ill patients. We examined whether changes in pulmonary artery occlusion pressure (Ppao) adequately reflect respiratory changes in pleural pressure as assessed by changes in intraesop...
journal_title:Intensive care medicine
pub_type: 杂志文章
doi:10.1007/s00134-007-0842-5
更新日期:2007-11-01 00:00:00
abstract::Measurements of added inspiratory work (AIW) of breathing imposed by three different CPAP systems were performed in 10 patients. One system was a continuous flow system while the two others were demand flow systems separated from respirators (Ohmeda VD 101 and Draeger CPAP 800 devices). AIW was calculated from pressur...
journal_title:Intensive care medicine
pub_type: 杂志文章
doi:10.1007/BF00292929
更新日期:1986-01-01 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: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::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:OBJECTIVE:1) To compare saline gastric tonometry monitoring with air tonometry (Tonocap) in a group of general ICU patients. 2) An in vitro investigation of the performance of other fluids used in gastric tonometry and to assess the effects of variation of temperature and carbon dioxide concentration within the range e...
journal_title:Intensive care medicine
pub_type: 临床试验,杂志文章
doi:10.1007/s001340050665
更新日期:1998-08-01 00:00:00
abstract:OBJECTIVE:To investigate the hemodynamic and metabolic effects of the peroxisome proliferator-activated receptor (PPAR)-gamma ligand and nuclear-factor (NF)-kappa B inhibitor 15-deoxy-Delta12,14-prostaglandin-J2 (15d-PGJ2) during long-term, hyperdynamic porcine endotoxemia. DESIGN:Prospective, randomized, controlled e...
journal_title:Intensive care medicine
pub_type: 杂志文章
doi:10.1007/s00134-006-0107-8
更新日期:2006-05-01 00:00:00
abstract:OBJECTIVES:To study the pattern of lung emptying and expiratory resistance in mechanically ventilated patients with chronic obstructive pulmonary disease (COPD). DESIGN:A prospective physiological study. SETTING:A 12-bed Intensive Care Unit. PATIENTS:Ten patients with acute exacerbation of COPD. INTERVENTIONS:At th...
journal_title:Intensive care medicine
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1007/s00134-004-2255-z
更新日期:2004-07-01 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: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:OBJECTIVE:The evaluation of incidences and relating factors of severe persisting critical illness polyneuropathy (CIP) in survivors of multiple organ failure (MOF). DESIGN:Prospective study with an entry period of 24 months. Electrophysiological studies for the diagnosis of CIP were performed 1 or 2 days before the pa...
journal_title:Intensive care medicine
pub_type: 杂志文章
doi:10.1007/s001340050471
更新日期:1997-11-01 00:00:00
abstract::During the last two decades, severe group A beta-haemolytic streptococcal infections have been defined as the "toxic strep syndrome", and have been reported not only in immunocompromised or elderly people, but also occasionally in previously healthy patients. We describe 4 patients presenting with the toxic strep synd...
journal_title:Intensive care medicine
pub_type: 杂志文章
doi:10.1007/BF01709279
更新日期:1993-01-01 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:OBJECTIVE:To assess the relationship between the base deficit value in the immediate postoperative period of coronary surgery for cardiopulmonary bypass and the length of stay in the ICU. DESIGN AND SETTING:Prospective descriptive study in the department of anesthesia and cardiovascular surgery of a university hospita...
journal_title:Intensive care medicine
pub_type: 杂志文章
doi:10.1007/s00134-002-1587-9
更新日期:2003-02-01 00:00:00
abstract:OBJECTIVES:Processed EEG monitoring has been suggested for sedation depth evaluation in intensive care unit (ICU) patients. The present study investigated the efficacy of two processed EEG monitors using SEF90% or SEF95% and BIS to differentiate between conscious (Ramsay score 4) and unconscious sedation (Ramsay score ...
journal_title:Intensive care medicine
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1007/s001340000761
更新日期:2001-01-01 00:00:00
abstract:PURPOSE:Polymyxin B-immobilized hemoperfusion (PMX-HP) is an adjuvant therapy for sepsis or septic shock that clears circulating endotoxin. Prior trials have shown that PMX-HP improves surrogate endpoints. We aimed to conduct an evidence synthesis to evaluate the efficacy and safety of PMX-HP in critically ill adult pa...
journal_title:Intensive care medicine
pub_type: 杂志文章,meta分析
doi:10.1007/s00134-017-5004-9
更新日期:2018-02-01 00:00:00
abstract::Intravenous bolus endotoxin elicits a marked but transient increase in plasma TxB2 and 6-keto-PGF1 alpha in a large number of species. A smaller, delayed and more prolonged increase in TxB2 and 6-keto-PGF1 alpha are reported in animals with septic shock, i.e., those with fecal peritonitis or cecal ligation. Thromboxan...
journal_title:Intensive care medicine
pub_type: 杂志文章,评审
doi:10.1007/BF00254925
更新日期:1986-01-01 00:00:00
abstract:OBJECTIVE:Based on limited data, Candida sp. isolates from bronchoalveolar lavage (BAL) cultures in immunocompetent patients are thought to be contaminants rather than pathogens. The objective of this study was to determine the clinical significance of Candida sp. isolated from BAL cultures in critically ill trauma pat...
journal_title:Intensive care medicine
pub_type: 杂志文章
doi:10.1007/s00134-005-0065-6
更新日期:2006-04-01 00:00:00
abstract:OBJECTIVE:To assess the effects of the cyclooxygenase inhibitor diclofenac in a canine model of pulmonary occlusion and reperfusion of the left lower lobe (LLL). DESIGN:Twelve adult beagle dogs (13-17 kg) were randomly assigned to a control group (n = 6) and a diclofenac-treated group (n = 6). Animals in the treatment...
journal_title:Intensive care medicine
pub_type: 杂志文章
doi:10.1007/BF01700965
更新日期:1995-10-01 00:00:00
abstract:OBJECTIVE:To determine the presence of tricuspid regurgitation (TR) in patients affected by acute lung injury (ALI) and the adult respiratory distress syndrome (ARDS) during mechanical ventilation with positive end-expiratory pressure (PEEP). DESIGN:A prospective clinical study. SETTING:10-bed general intensive care ...
journal_title:Intensive care medicine
pub_type: 临床试验,杂志文章
doi:10.1007/s001340050419
更新日期:1997-08-01 00:00:00
abstract:OBJECTIVE:To determine the frequency and the eventual clinical characteristics of nosocomial sinusitis with anaerobic bacteria isolation in patients in the intensive care unit (ICU). DESIGN:Retrospective study. SETTING:A 12-bed medical ICU in a teaching hospital. PATIENTS:30 adult patients with documented nosocomial...
journal_title:Intensive care medicine
pub_type: 杂志文章
doi:10.1007/s001340051013
更新日期:1999-10-01 00:00:00
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:Postoperative pneumonia is a potentially devastating complication associated with high mortality in intensive care unit (ICU)-patients. One of the major predisposing factors is the perioperative occurrence of atelectatic formations in non-dependent lung areas. Perioperative ventilation/perfusion mismatch due ...
journal_title:Intensive care medicine
pub_type: 杂志文章
doi:10.1007/s00134-008-1122-8
更新日期:2008-10-01 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::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