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 pre-bolus voltage of the cerebral function monitor (CFM) was above or below 5 microV (representing marked reduction in cortical electrical activity). The pre-bolus ICP influenced the extent of the fall in ICP and thus the direction of the resulting change in CPP. A mean reduction in CPP was observed in both groups in which ICP was below 20 mmHg irrespective of the CFM voltage. In the subgroups with high ICP, CPP increased when CFM was not depressed and fell when CFM was below 5 microV. The effects of individual boluses varied within and between the subgroups and, occasionally, severe and unpredictable hypotension occurred. If althesin administration had been restricted to the high CFM and high ICP group, 90% of the episodes of reduced CPP would have been avoided. In fact, when cortical electrical activity is already severely depressed, further administration of hypnotic anaesthetic agents produces only small reductions in ICP and usually a fall in CPP. These findings suggest that the minimum voltage of the CFM trace is a clinically useful guide to the administration of intravenous anaesthetic agents and offers a relevant prediction of their effects on CPP.
journal_name
Intensive Care Medjournal_title
Intensive care medicineauthors
Procaccio F,Bingham RM,Hinds CJ,Prior PFdoi
10.1007/BF00257469subject
Has Abstractpub_date
1988-01-01 00:00:00pages
148-55issue
2eissn
0342-4642issn
1432-1238journal_volume
14pub_type
杂志文章abstract:PURPOSE:An International Consensus Conference proposed classifying weaning into simple, difficult, and prolonged weaning. However, the usefulness of this classification in a respiratory intensive care unit (ICU) is unknown. The aims of the study were: (1) to compare the clinical characteristics and outcomes of patients...
journal_title:Intensive care medicine
pub_type: 杂志文章
doi:10.1007/s00134-011-2179-3
更新日期:2011-05-01 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:OBJECTIVE:Our study aimed to determine the efficacy and safety of colistin in the treatment of ventilator-associated pneumonia (VAP) caused by pan-drug-resistant Pseudomonas aeruginosa or Acinetobacter baumanii. DESIGN:Pairwise, retrospective exposed-unexposed study. SETTING:Combined medical and surgical intensive ca...
journal_title:Intensive care medicine
pub_type: 杂志文章
doi:10.1007/s00134-007-0675-2
更新日期:2007-07-01 00:00:00
abstract:PURPOSE:To examine the consequences of administration of norepinephrine on muscle tissue oxygenation in severely hypotensive septic shock patients. METHODS:This was a prospective observational study conducted in a medical intensive care unit of a university hospital. We included 28 septic shock patients that received ...
journal_title:Intensive care medicine
pub_type: 杂志文章
doi:10.1007/s00134-010-2013-3
更新日期:2010-11-01 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:OBJECTIVE:Percutaneous dilatational tracheostomy is increasingly practiced in intensive care units and has a low incidence of early complications. The late effects of this procedure are still poorly known and were the focus of this study. DESIGN:Prospective descriptive clinical study. SETTING:Interdisciplinary intens...
journal_title:Intensive care medicine
pub_type: 杂志文章
doi:10.1007/BF01706200
更新日期:1995-06-01 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:OBJECTIVE:To assess procalcitonin (PCT) and C-reactive protein (CRP) plasma concentrations and clearance in nonseptic end-stage renal failure patients undergoing their first three hemodialysis sessions. DESIGN AND SETTING:Prospective observational consecutive clinical study at a university hospital. PATIENTS:The stud...
journal_title:Intensive care medicine
pub_type: 杂志文章
doi:10.1007/s00134-003-1664-8
更新日期:2003-04-01 00:00:00
abstract:OBJECTIVE:To determine the cell content and purity of Ficoll-separated peripheral blood mononuclear cells and granulocyte isolates in sepsis patients compared to healthy controls. DESIGN AND SETTING:Prospective study in the adult and pediatric intensive care departments of the Erasmus University Medical Center in the ...
journal_title:Intensive care medicine
pub_type: 杂志文章
doi:10.1007/s00134-007-0989-0
更新日期:2008-05-01 00:00:00
abstract:: ...
journal_title:Intensive care medicine
pub_type: 社论
doi:10.1007/s00134-018-5401-8
更新日期:2018-12-01 00:00:00
abstract:PURPOSE:Chronic pulmonary hypertension (PH) therapy is poorly investigated in intensive care. Our aim was to evaluate haemodynamic and neuroendocrine effects of the dual endothelin-1 (ET-1) blocker tezosentan in monocrotaline (MCT)-induced PH. METHODS:Male Wistar rats (180-200 g, n = 194) randomly received 60 mg kg(-1...
journal_title:Intensive care medicine
pub_type: 杂志文章
doi:10.1007/s00134-012-2484-5
更新日期:2012-06-01 00:00:00
abstract:OBJECTIVE:The Brugada syndrome is a clinical and electrocardiographic familial entity, which may lead to sudden cardiac death. A Brugada pattern ECG may occasionally be caused by conditions such as an overdose of tricyclic antidepressants (TCA). Toxicity of TCA frequently results in the need for critical care support. ...
journal_title:Intensive care medicine
pub_type: 杂志文章
doi:10.1007/s00134-005-0007-3
更新日期:2006-02-01 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:BACKGROUND:In patients with severe sepsis, no randomized clinical trial has tested the concept of de-escalation of empirical antimicrobial therapy. This study aimed to compare the de-escalation strategy with the continuation of an appropriate empirical treatment in those patients. METHODS:This was a multicenter non-bl...
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/s00134-014-3411-8
更新日期:2014-10-01 00:00:00
abstract::Thirty patients with adult respiratory distress syndrome required intermittent positive pressure ventilation; 15 survived. In 25 the syndrome followed bacterial infection or multiple injuries. From the peak upper airway pressure, the oxygen gradient and the age of the patient, an index was obtained which discriminated...
journal_title:Intensive care medicine
pub_type: 杂志文章
doi:10.1007/BF00254517
更新日期:1986-01-01 00:00:00
abstract:PURPOSE:Septic shock induces a decrease in dendritic cells (DCs) that may contribute to sepsis-induced immunosuppression. We analyzed the time course of circulating DCs in patients with septic shock and its relation to susceptibility to intensive care unit (ICU)-acquired infections. METHODS:We enrolled adult patients ...
journal_title:Intensive care medicine
pub_type: 杂志文章
doi:10.1007/s00134-011-2306-1
更新日期:2011-09-01 00:00:00
abstract:OBJECTIVE:To compare the total plasma cortisol values obtained from three widely used immunoassays and a high pressure liquid chromatography (HPLC) technique on samples obtained from patients with sepsis. DESIGN AND SETTING:Observational interventional in the general intensive care unit of a metropolitan hospital PAT...
journal_title:Intensive care medicine
pub_type: 杂志文章
doi:10.1007/s00134-006-0389-x
更新日期:2006-11-01 00:00:00
abstract:OBJECTIVE:To determine: (1) the proportion of small (<5 mm) or thrombosed internal jugular veins (IJV) and femoral veins (FV) in which catheter placement would be difficult without ultrasound guidance; (2) which position increases central vein sizes and may facilitate cannulation of these vessels. DESIGN:Prospective s...
journal_title:Intensive care medicine
pub_type: 杂志文章
doi:10.1007/s00134-007-0875-9
更新日期:2008-02-01 00:00:00
abstract:OBJECTIVE:Evaluation of an open circuit multiple breath nitrogen washout (MBNW) technique for measurement of functional residual capacity (FRC) during partial ventilatory support using corrections for gas viscosity, sampling delay time, and re-inspired nitrogen. DESIGN:Measurements in a lung model with known reference...
journal_title:Intensive care medicine
pub_type: 杂志文章
doi:10.1007/s00134-003-1677-3
更新日期:2003-05-01 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::A technique for the estimation of LVEF from first passage radionuclide angiocardiography was adapted to provide estimates of RVEF. In 17 subjects with no history of cardiovascular disease mean LVEF was 0.71 +/- 0.08 and mean RVEF 0.65 +/- 0.08. Mean values for 15 subjects with coronary artery disease but no previous h...
journal_title:Intensive care medicine
pub_type: 杂志文章
doi:10.1007/BF01683193
更新日期:1979-09-01 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: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:INTRODUCTION:Most anxiolytics and sedative regimens in the intensive care unit (ICU) impair intellectual function, reducing patient autonomy, and often add to patient morbidity. Using an ICU-validated cognitive assessment tool Adapted Cognitive Exam (ACE), we performed a comparison between dexmedetomidine (DEX) and pro...
journal_title:Intensive care medicine
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1007/s00134-010-1874-9
更新日期:2010-09-01 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::The endothelium is a highly dynamic cell layer that is involved in a multitude of physiological functions, including the control of vascular tone, the movement of cells and nutrients, the maintenance of blood fluidity and the growth of new vessels. During severe sepsis, the endothelium becomes proadhesive, procoagulan...
journal_title:Intensive care medicine
pub_type: 杂志文章,评审
doi:10.1007/s00134-010-1893-6
更新日期:2010-08-01 00:00:00
abstract::Paediatric admissions to a general ITU are briefly reviewed. Although it may not be an ideal arrangement it is suggested that children can be safely cared for in such a unit. The problems created by the child with acute upper airway obstruction are discussed to demonstrate the way in which the unit is organized to rec...
journal_title:Intensive care medicine
pub_type: 杂志文章
doi:10.1007/BF00260356
更新日期:1985-01-01 00:00:00
abstract::Administration of C1-esterase inhibitor (C1-INH) attenuates myocardial necrosis and sustains normal cardiac performance after myocardial ischemia and reperfusion in animal experiments. We report on our first experience of C1-INH application as rescue therapy in patients undergoing emergency surgical revascularization ...
journal_title:Intensive care medicine
pub_type: 杂志文章
doi:10.1007/s001340050629
更新日期:1998-06-01 00:00:00
abstract:OBJECTIVE:To characterize N-terminal pro-brain natriuretic peptide (N-proBNP) and troponin I (TnI) profile following mitral and/or aortic valve surgery and to evaluate correlations with echocardiography measures and outcome criteria. DESIGN AND SETTING:Prospective cross-controlled study in a university children's hosp...
journal_title:Intensive care medicine
pub_type: 杂志文章
doi:10.1007/s00134-008-1025-8
更新日期:2008-06-01 00:00:00
abstract::Dynamic vectorcardiography (VCG) is increasingly employed for ischaemia monitoring with the use of a computerized method for recording and on-line analysis by the calculation of trend parameters. To elucidate how well the derived electrocardiogram (dECG), calculated from the VCG, compares with the simultaneously regis...
journal_title:Intensive care medicine
pub_type: 临床试验,杂志文章
doi:10.1007/s001340050455
更新日期:1997-10-01 00:00:00