Abstract:
PURPOSE:Fluid overload is a risk factor for poor outcome in intensive care; thus volume loading should be tailored towards patients who are likely to increase stroke volume. We aimed to evaluate the paediatric predictive ability (stroke volume increase of at least 15 % after fluid bolus) of novel and established volumetric and dynamic haemodynamic variables, and assess the influence of baseline contractility on response. METHODS:We assessed 142 volume loading episodes (10 ml/kg crystalloid) in 100 critically ill ventilated children, median (interquartile) weight 10 (5.6-15) kg. Eight advanced haemodynamic variables were assessed using two commercially available devices. Systemic ventricular contractility was measured as the maximum rate of systolic arterial pressure rise. RESULTS:Overall, predictive ability was poor, with volumetric variables performing better than dynamic (area under receiver operating characteristic curves ranged from 0.53 to 0.67). The best predictor was total end-diastolic volume index; however, this did not increase in a consistent way with volume loading, with change post volume being weakly related to baseline values (r = -0.19, p = 0.02). A multivariable model quantified the importance of contractility in stroke volume response. Children with high baseline contractility (≥75th centile) typically achieved a positive stroke volume response when end-diastolic volume values changed by 10-15 ml/m(2.6), whereas patients with low contractility (≤25th centile) typically required end-diastolic volume increases of 35-40 ml/m(2.6). CONCLUSIONS:Current paediatric predictors of volume response perform poorly; prediction may be improved if baseline contractility is taken into account.
journal_name
Intensive Care Medjournal_title
Intensive care medicineauthors
Saxena R,Durward A,Steeley S,Murdoch IA,Tibby SMdoi
10.1007/s00134-015-4075-8subject
Has Abstractpub_date
2015-12-01 00:00:00pages
2161-9issue
12eissn
0342-4642issn
1432-1238pii
10.1007/s00134-015-4075-8journal_volume
41pub_type
杂志文章abstract:OBJECTIVE:To investigate the regional partial pressure of oxygen (PO2) and partial pressure of carbon dioxide (PCO2) of the perfluorocarbon liquid (PpfcO2, PpfcCO2) during partial liquid ventilation (PLV). DESIGN:Prospective, controlled study. SETTING:A research laboratory at a university medical center. SUBJECTS:Th...
journal_title:Intensive care medicine
pub_type: 杂志文章
doi:10.1007/s001340000706
更新日期:2001-01-01 00:00:00
abstract:OBJECTIVE:To examine the phenomenon of inappropriate triggering caused by an in-line suction catheter. DESIGN:We used a test lung to assess inappropriate triggering in four ventilators with both pressure and flow triggering. RESULTS:With pressure triggering, inappropriate triggering occurred only in the presence of P...
journal_title:Intensive care medicine
pub_type: 杂志文章
doi:10.1007/s00134-002-1239-0
更新日期:2002-04-01 00:00:00
abstract::The side effects of positive pressure ventilation on cardiovascular function are well known. However, in most clinical studies its influence on left ventricular function was examined. In the present study right ventricular (RV) performance was studied in 13 patients undergoing coronary artery bypass grafting during me...
journal_title:Intensive care medicine
pub_type: 杂志文章
doi:10.1007/BF00256962
更新日期:1988-01-01 00:00:00
abstract:PURPOSE:Type 1 angiotensin II (AT1) receptor antagonists have anti-inflammatory effects in vitro and in patients. The purpose of this study was to investigate whether losartan (LOS), an AT1 receptor antagonist, reduces lung damage by inhibiting the induction of high mobility group box 1 (HMGB1) protein and cytokines by...
journal_title:Intensive care medicine
pub_type: 杂志文章
doi:10.1007/s00134-009-1545-x
更新日期:2009-08-01 00:00:00
abstract::Conventional PEEP ventilation has been recently reported to be deleterious in some cases of ARF with unilateral pneumonia. In such respect, two cases of unilateral bacterial pneumonia were intubated with a Carlens tracheal tube. Measurement of tidal volume, static compliance, and functional residual capacity of each l...
journal_title:Intensive care medicine
pub_type: 杂志文章
doi:10.1007/BF01683935
更新日期:1979-11-01 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:PURPOSE:The efficacy of noninvasive continuous positive airway pressure (CPAP) to improve outcomes in severe hypoxemic acute respiratory failure (hARF) due to pneumonia has not been clearly established. The aim of this study was to compare CPAP vs. oxygen therapy to reduce the risk of meeting criteria for endotracheal ...
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/s00134-014-3325-5
更新日期:2014-07-01 00:00:00
abstract:OBJECTIVES:Children with peripheral airways obstruction suffer the negative effects of intrinsic positive end-expiratory pressure: increased work of breathing and difficulty triggering assisted ventilatory support. We examined whether external positive end-expiratory pressure to offset intrinsic positive end-expiratory...
journal_title:Intensive care medicine
pub_type: 临床试验,杂志文章
doi:10.1007/s00134-006-0445-6
更新日期:2007-01-01 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 assess the role of antipseudomonal agents on Pseudomonas aeruginosa colonization and acquisition of resistance. DESIGN:Prospective cohort study. SETTING:Two medical intensive care units. PATIENTS AND PARTICIPANTS:346 patients admitted for >or= 48 h. INTERVENTION:Analysis of data from an 8-month study c...
journal_title:Intensive care medicine
pub_type: 杂志文章
doi:10.1007/s00134-008-1326-y
更新日期:2009-03-01 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:OBJECTIVE:To evaluate major similarities and major differences between Western European countries in intensive care unit (ICU) nurse staffing, education, training, responsibilities, and initiative. DESIGN:A questionnaire was sent to Western European doctor members of the European Society of Intensive Care Medicine, to...
journal_title:Intensive care medicine
pub_type: 杂志文章,多中心研究
doi:10.1007/s001340050693
更新日期:1998-09-01 00:00:00
abstract::Helicobacter pylori is estimated to infect over 50% of the world's population, the majority of whom are asymptomatic. Although most research to date has focused on local gastroduodenal disease manifestations, the potential impact of H. pylori infection and the associated chronic active inflammation on systemic disease...
journal_title:Intensive care medicine
pub_type: 杂志文章,评审
doi:10.1007/s00134-003-1838-4
更新日期:2003-11-01 00:00:00
abstract:PURPOSE:Assessing feasibility and physiological effects of sedation with sevoflurane, administered with the anesthetic conserving device (AnaConDa), in comparison with propofol and remifentanil. METHODS:Seventeen patients undergoing mechanical ventilation underwent sedation with sevoflurane delivered with AnaConDa (ph...
journal_title:Intensive care medicine
pub_type: 临床试验,杂志文章
doi:10.1007/s00134-009-1414-7
更新日期:2009-07-01 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:To evaluate a least squares fitting technique for the purpose of measuring total respiratory compliance (Crs) and resistance (Rrs) in patients submitted to partial ventilatory support, without the need for esophageal pressure measurement. DESIGN:Prospective, randomized study. SETTING:A general ICU of a Univ...
journal_title:Intensive care medicine
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1007/BF01707409
更新日期:1995-05-01 00:00:00
abstract:OBJECTIVES:Circulating levels of the proinflammatory mediator High Mobility Group Box Protein 1 (HMGB1) are increased in septic patients and may contribute to sepsis-induced organ dysfunction. Although HMGB1 has been shown to activate neutrophils from healthy volunteers, the responses of neutrophils from septic patient...
journal_title:Intensive care medicine
pub_type: 杂志文章
doi:10.1007/s00134-007-0748-2
更新日期:2007-10-01 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: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:PURPOSE:The aim of our study was to explore, using an innovative method, the effect of temporal changes in the mortality prediction performance of an existing model on the quality of care assessment. The prognostic model (rSAPS-II) was a recalibrated Simplified Acute Physiology Score-II model developed for very elderly...
journal_title:Intensive care medicine
pub_type: 杂志文章
doi:10.1007/s00134-011-2390-2
更新日期:2012-01-01 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:PURPOSE:We assessed outcomes in brain-injured patients after implementation of a multi-faceted approach to reduce respiratory complications in intensive care units. METHODS:Prospective nationwide before-after trial. Consecutive adults with acute brain injury requiring mechanical ventilation for ≥24 h in 20 French inte...
journal_title:Intensive care medicine
pub_type: 杂志文章,多中心研究
doi:10.1007/s00134-017-4764-6
更新日期:2017-07-01 00:00:00
abstract:OBJECTIVES:Controversy over the optimal intravenous fluid for volume resuscitation continues unabated. Our objectives were to characterize the demographics of physicians who prescribe intravenous colloids and determine factors that enter into their decision to choose a colloid. DESIGN:Questionnaire with 61 items. PAR...
journal_title:Intensive care medicine
pub_type: 杂志文章
doi:10.1007/s00134-002-1337-z
更新日期:2002-07-01 00:00:00
abstract:OBJECTIVE:Adverse respiratory and gasometrical effects have been described in patients with acute respiratory failure (ARF) undergoing noninvasive ventilation (NIV) with standard heat and moisture exchangers (HME). We decided to evaluate respiratory parameters and arterial blood gases (ABG) of patients during NIV with ...
journal_title:Intensive care medicine
pub_type: 杂志文章,随机对照试验
doi:10.1007/s00134-010-1894-5
更新日期:2010-08-01 00:00:00
abstract:OBJECTIVE:Definition of the changes in the activators of plasminogen, u-PA and t-PA, and examination of the possible generation of plasmin in the circulation in overwhelming sepsis. DESIGN:Serial blood analysis starting 4 h after development of symptoms of toxic shock syndrome. SETTING:Intensive care unit. PATIENT:A...
journal_title:Intensive care medicine
pub_type: 杂志文章
doi:10.1007/s001340050561
更新日期:1998-03-01 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::Of 28 consecutive patients over 64 years old, in whom endoscopy revealed gastro-duodenal ulcers with signs of recent hemorrhage (active bleeding, non-bleeding vessel or adherent clot), 14 were randomly assigned to receive endoscopic alcoholization of the lesions preceded by intragastric instillation of norepinephrine,...
journal_title:Intensive care medicine
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1007/BF01724799
更新日期:1990-01-01 00:00:00
abstract:OBJECTIVE:Endotoxin administration to humans is a common means to study systemic inflammation. Worldwide, thousands of volunteers have received endotoxin, and adverse events are rarely reported. The aim of this report was to increase awareness of specific risks of the intravenous administration of endotoxin to human vo...
journal_title:Intensive care medicine
pub_type: 杂志文章
doi:10.1007/s00134-004-2477-0
更新日期:2004-12-01 00:00:00
abstract::A cardiorespiratory monitoring system allows the measurement of FAECO2 and FECO2 in the expired air of the patient at the mouth (endtidal CO2) and in a mixing box. From these parameters, combined with the measured PACO2, the alveolo-expired (DuA = PECO2/PAECO2) and alveolar-arterial (Dua = PAECO2/PACO2) ductances whic...
journal_title:Intensive care medicine
pub_type: 杂志文章
doi:10.1007/BF01687162
更新日期:1980-08-01 00:00:00
abstract:OBJECTIVE:To study the influence of continuous administration of heparin on platelet function in intensive care patients. DESIGN:Prospective, serial investigation. SETTING:Clinical investigation on a surgical and neurosurgical intensive care unit in a university hospital. PATIENTS:The study included 45 patients: 15 ...
journal_title:Intensive care medicine
pub_type: 杂志文章
doi:10.1007/s001340050374
更新日期:1997-05-01 00:00:00