Abstract:
PURPOSE:To assess the ability of quantitative pupillometry [using the Neurological Pupil index (NPi)] to predict an unfavorable neurological outcome after cardiac arrest (CA). METHODS:We performed a prospective international multicenter study (10 centers) in adult comatose CA patients. Quantitative NPi and standard manual pupillary light reflex (sPLR)-blinded to clinicians and outcome assessors-were recorded in parallel from day 1 to 3 after CA. Primary study endpoint was to compare the value of NPi versus sPLR to predict 3-month Cerebral Performance Category (CPC), dichotomized as favorable (CPC 1-2: full recovery or moderate disability) versus unfavorable outcome (CPC 3-5: severe disability, vegetative state, or death). RESULTS:At any time between day 1 and 3, an NPi ≤ 2 (n = 456 patients) had a 51% (95% CI 49-53) negative predictive value and a 100% positive predictive value [PPV; 0% (0-2) false-positive rate], with a 100% (98-100) specificity and 32% (27-38) sensitivity for the prediction of unfavorable outcome. Compared with NPi, sPLR had significantly lower PPV and significantly lower specificity (p < 0.001 at day 1 and 2; p = 0.06 at day 3). The combination of NPi ≤ 2 with bilaterally absent somatosensory evoked potentials (SSEP; n = 188 patients) provided higher sensitivity [58% (49-67) vs. 48% (39-57) for SSEP alone], with comparable specificity [100% (94-100)]. CONCLUSIONS:Quantitative NPi had excellent ability to predict an unfavorable outcome from day 1 after CA, with no false positives, and significantly higher specificity than standard manual pupillary examination. The addition of NPi to SSEP increased sensitivity of outcome prediction, while maintaining 100% specificity.
journal_name
Intensive Care Medjournal_title
Intensive care medicineauthors
Oddo M,Sandroni C,Citerio G,Miroz JP,Horn J,Rundgren M,Cariou A,Payen JF,Storm C,Stammet P,Taccone FSdoi
10.1007/s00134-018-5448-6subject
Has Abstractpub_date
2018-12-01 00:00:00pages
2102-2111issue
12eissn
0342-4642issn
1432-1238pii
10.1007/s00134-018-5448-6journal_volume
44pub_type
杂志文章,多中心研究abstract:PURPOSE:Gastrointestinal motility can be impaired by serious illness or medications, compromising enteral feeding in critical care patients. We compared small bowel transit time and morphology in neurosurgical critical care (ICU) patients with those in healthy subjects. METHODS:We evaluated small intestinal transit ti...
journal_title:Intensive care medicine
pub_type: 杂志文章
doi:10.1007/s00134-009-1415-6
更新日期:2009-06-01 00:00:00
abstract:OBJECTIVE:Angiopoietin-2 (Ang-2) is a potent regulator of vascular permeability and inflammation in acute lung injury and acute respiratory distress syndrome (ARDS). Genetic variants in the Ang-2 gene may lead to altered activities of Ang-2 (or ANGPT2) gene. The aim of this study was to assess if genetic variants of An...
journal_title:Intensive care medicine
pub_type: 杂志文章
doi:10.1007/s00134-009-1413-8
更新日期:2009-06-01 00:00:00
abstract:OBJECTIVE:To compare outcome prediction using the Multiple Organ Dysfunction Score (MODS) and the Sequential Organ Failure Assessment (SOFA), two of the systems most commonly used to evaluate organ dysfunction in the intensive care unit (ICU). DESIGN:Prospective, observational study. SETTING:Thirty-one-bed, universit...
journal_title:Intensive care medicine
pub_type: 杂志文章
doi:10.1007/s00134-002-1491-3
更新日期:2002-11-01 00:00:00
abstract:BACKGROUND:Invasive candidiasis and candidemia are frequently encountered in the nosocomial setting particularly in the intensive care unit (ICU). OBJECTIVE AND METHODS:To review the current management of invasive candidiasis and candidemia in non-neutropenic adult ICU patients based on a review of the literature and ...
journal_title:Intensive care medicine
pub_type: 杂志文章,评审
doi:10.1007/s00134-008-1339-6
更新日期:2009-02-01 00:00:00
abstract::We investigated the levels of auto-PEEP and dynamic hyperinflation during high frequency jet ventilation (HFJV) and controlled mechanical ventilation (CMV) in six patients with chronic obstructive pulmonary disease within the first 36 h of acute exacerbation. The comparative evaluation was performed at similar conditi...
journal_title:Intensive care medicine
pub_type: 杂志文章
doi:10.1007/BF02575298
更新日期:1990-01-01 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:PURPOSE:Extracorporeal membrane oxygenation (ECMO) can support oxygenation and carbon dioxide elimination in severe lung failure. Usually it is accompanied by controlled mechanical ventilation. Neurally adjusted ventilatory assist (NAVA) is a new mode of ventilation triggered by the diaphragmatic electrical activity an...
journal_title:Intensive care medicine
pub_type: 杂志文章
doi:10.1007/s00134-010-1982-6
更新日期:2010-12-01 00:00:00
abstract:OBJECTIVES:To measure the extent of dilution of helium-oxygen (heliox) by room air when given via high concentration reservoir mask to spontaneously breathing subjects. Substantial dilution of heliox by room air under these circumstances might alter its physical properties sufficiently to negate any potential clinical ...
journal_title:Intensive care medicine
pub_type: 杂志文章,随机对照试验
doi:10.1007/s00134-008-1064-1
更新日期:2008-08-01 00:00:00
abstract:BACKGROUND:In critical illness, serum total cortisol (TC) may not adequately reflect adrenal function because of reduced cortisol-binding globulin (CBG). AIM:To evaluate adrenal function of critically ill children, using free cortisol index (FCI), calculated free cortisol (cFC), and TC levels. METHODS:Thirty-two crit...
journal_title:Intensive care medicine
pub_type: 杂志文章
doi:10.1007/s00134-009-1480-x
更新日期:2009-07-01 00:00:00
abstract::Risk of critical illness is determined both by genetic and environmental influences, particularly those relating to infectious and cardiovascular diseases. Physiologically-based scoring systems cannot measure prior risk because they do not quantify physiological reserve independently of the acute illness. Genetic prof...
journal_title:Intensive care medicine
pub_type: 杂志文章,评审
doi:10.1007/s001340051120
更新日期:2000-01-01 00:00:00
abstract:PURPOSE:Severe acute pancreatitis (SAP) remains a life-threatening disease with classic etiology of systemic inflammatory response and mortality between 30 and 50 %. The aim of the present study is to compare two different treatment strategies of goal-directed hemodynamic management and evaluate their impact on surviva...
journal_title:Intensive care medicine
pub_type: 杂志文章
doi:10.1007/s00134-012-2775-x
更新日期:2013-04-01 00:00:00
abstract::Two hundred and seventy-three acute hemorrhagic shocks were treated in 1984 in a pre-hospital emergency care unit. Twenty patients (7%) had a paradoxical bradycardia: they were conscious, 9 of them had an undetectable systolic arterial pressure with the sphygmomanometric method but the femoral pulse was still present....
journal_title:Intensive care medicine
pub_type: 杂志文章
doi:10.1007/BF00254705
更新日期:1987-01-01 00:00:00
abstract:OBJECTIVE:To evaluate compliance with recommended patient-care practices for the prevention of hospital-acquired infections (HAI) in the intensive care unit (ICU). DESIGN:European descriptive survey by questionnaire mailed to all the directors of ICUs. PATIENTS AND PARTICIPANTS:A total of 1642 general ICUs with more ...
journal_title:Intensive care medicine
pub_type: 杂志文章
doi:10.1007/BF02044110
更新日期:1996-09-01 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: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::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 determine the value of procalcitonin (PCT) in the early diagnosis (and differentiation) of patients with SIRS, sepsis, severe sepsis, and septic shock in comparison to C-reactive protein (CRP), white blood cell and thrombocyte count, and APACHE-II score (AP-II). DESIGN:Prospective cohort study including a...
journal_title:Intensive care medicine
pub_type: 杂志文章
doi:10.1007/BF02900728
更新日期:2000-03-01 00:00:00
abstract:PURPOSE:Acute kidney injury (AKI) frequently occurs in critically ill patients and often precipitates use of renal replacement therapy (RRT). However, the ideal circumstances for whether and when to start RRT remain unclear. We performed evidence synthesis of the available literature to evaluate the value of biomarkers...
journal_title:Intensive care medicine
pub_type: 杂志文章,评审
doi:10.1007/s00134-018-5126-8
更新日期:2018-03-01 00:00:00
abstract:OBJECTIVE:To describe Enterococcus faecalis colonisation and endocarditis in 5 intensive care patients after treatment with selective decontamination (SDD). SETTING:Intensive care unit (ICU) in a general hospital. PATIENTS:The patients were admitted to the ICU because of adult respiratory distress syndrome, polytraum...
journal_title:Intensive care medicine
pub_type: 杂志文章
doi:10.1007/BF01701478
更新日期:1995-03-01 00:00:00
abstract::The acute respiratory distress syndrome (ARDS) continues as a contributor to the morbidity and mortality of patients in intensive care units throughout the world, imparting tremendous human and financial costs. During the last ten years there has been a decline in ARDS mortality without a clear explanation. The Americ...
journal_title:Intensive care medicine
pub_type: 共识发展会议,杂志文章,评审
doi:10.1007/s001340050585
更新日期:1998-04-01 00:00:00
abstract:OBJECTIVE:The aim of this prospective study was to evaluate the value of sinus echography results to directly indicate a transnasal puncture in intubated patients with suspicion of nosocomial maxillary sinusitis. DESIGN:prospective clinical investigation. SETTING:medical intensive care unit. PATIENTS:sixty patients ...
journal_title:Intensive care medicine
pub_type: 杂志文章
doi:10.1007/s00134-006-0152-3
更新日期:2006-06-01 00:00:00
abstract:PURPOSE:Bioactive NO carriers in circulating blood formed during NO inhalation selectively distribute blood flow to areas in need, and may thus improve collateral perfusion to the area-at-risk in acute myocardial infarction (AMI). Here, we tested the hypothesis that NO inhalation during the ischemic phase of AMI may im...
journal_title:Intensive care medicine
pub_type: 杂志文章
doi:10.1007/s00134-012-2605-1
更新日期:2012-08-01 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:OBJECTIVE:To determine the prevalence and the prognostic significance of microalbuminuria in patients after aneurysmal subarachnoid hemorrhage (SAH). DESIGN:Prospective and observational clinical study. SETTING:Multidisciplinary intensive care unit. PATIENTS:Fifty-one consecutive patients who underwent aneurysm clip...
journal_title:Intensive care medicine
pub_type: 杂志文章
doi:10.1007/s00134-007-0617-z
更新日期:2007-06-01 00:00:00
abstract:OBJECTIVE:The study was undertaken to determine if critically ill patients under mechanical ventilation could reactivate latent cytomegalovirus (CMV) in either lung or blood. DESIGN:Prospective study in critically ill patients was performed in a multidisciplinary intensive care unit in a university hospital. PATIENTS...
journal_title:Intensive care medicine
pub_type: 杂志文章
doi:10.1007/BF01709343
更新日期:1996-11-01 00:00:00
abstract::One hundred consecutive patients were interviewed between the 3rd and 7th days, inclusive, of their discharge from an intensive care unit to a general ward. The patients' recall of events related to their admission to the ICU was generally poor, and 41% of them felt that they had been confused at some time during thei...
journal_title:Intensive care medicine
pub_type: 杂志文章
doi:10.1007/BF01686054
更新日期:1979-05-01 00:00:00
abstract:OBJECTIVE:To explore translation, conversion and definition ambiguities, when using severity scoring systems in patients admitted to intensive care units (ICUs). DESIGN:A prospective study of the prognosis of acute renal failure in ICUs. SETTING:The study was conducted in 20 French ICUs. PATIENTS:360 patients presen...
journal_title:Intensive care medicine
pub_type: 杂志文章
doi:10.1007/BF01705416
更新日期:1995-04-01 00:00:00
abstract::The effect of plasma exchange (PE) was evaluated in 4 patients with rhabdomyolysis. A single 21 PE produced a transient fall of creatinine phosphokinase and did not prevent renal failure. Theoretically PE would need to be performed very frequently to remove toxins in appropriate amounts. Since renal failure in myoglob...
journal_title:Intensive care medicine
pub_type: 杂志文章
doi:10.1007/BF00273565
更新日期:1989-01-01 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:OBJECTIVES:The aim of this study was to evaluate and compare the accuracy of the percentage of infected cells (%IC) in bronchoalveolar lavage (BAL) for ventilator-associated pneumonia (VAP) diagnosis according to its onset from the initiation of mechanical ventilation. PATIENTS:One hundred and eight patients admitted ...
journal_title:Intensive care medicine
pub_type: 杂志文章
doi:10.1007/s00134-004-2323-4
更新日期:2004-08-01 00:00:00