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 intensive care unit in a 300-bed teaching hospital. PATIENTS:A consecutive group of critically ill patients who underwent percutaneous tracheostomy between Nov. 90 and March 93, surviving at least 2 months after decannulation. MEASUREMENTS AND RESULTS:There were 17 patients fulfilling the inclusion criteria and 16 of them were seen and examined. The follow-up protocol required a formal standardized patient interview, a physical examination of the stoma site and a fiberoptic laryngotracheoscopy. Results of these sub-tests and overall outcome rating were standardized and expressed as good, moderate or poor. Subjective rating was good in all patients. All denied suffering from any side effects of their tracheostomy. Clinical examination revealed neither stridor nor hoarseness in any of the patients. Most of the scars were whitish and less than 1 cm in length, a few were sunken in, none had adhesions. In 15 patients the clinical result was good and in one, moderate (whitish, sunken-in scar, longer than 2 cm). Ten patients underwent tracheoscopy, while 6 did not. There were no signs of significant stenosis or tracheomalacia. In 8 patients with minor findings results were scored as good, while 2 were classified as moderate (combination of swelling and scar formation of a string-like membrane). The overall rating was good in 13 patients (81%) and moderate in 3 patients (19%). There were no poor outcomes. CONCLUSIONS:Late outcome of percutaneous dilatational tracheostomy in critically ill patients is mostly good. Pending further studies, the use of this technique in intensive care units appears justified.
journal_name
Intensive Care Medjournal_title
Intensive care medicineauthors
Fischler MP,Kuhn M,Cantieni R,Frutiger Adoi
10.1007/BF01706200subject
Has Abstractpub_date
1995-06-01 00:00:00pages
475-81issue
6eissn
0342-4642issn
1432-1238journal_volume
21pub_type
杂志文章abstract::Total extracorporeal lung assist (ECLA) requires a bypass flow approaching cardiac output. Recirculation of venous blood through the oxygenator is minimized with a veno-right ventricular cannulation technique which separates venous drainage from returned oxygenated blood. A case of posttraumatic ARDS was treated with ...
journal_title:Intensive care medicine
pub_type: 杂志文章
doi:10.1007/BF01691426
更新日期:1991-01-01 00:00:00
abstract:OBJECTIVES:To measure plasma levels and pharmacokinetics of cefpirome in critically ill septic patients with normal renal function. To use the pharmacokinetic model to simulate alternate dosing regimens and identify those that predict sustained levels. DESIGN AND SETTING:A prospective, open-label, descriptive study in...
journal_title:Intensive care medicine
pub_type: 杂志文章
doi:10.1007/s001340000741
更新日期:2001-02-01 00:00:00
abstract::In hypoxia sensitive cells and tissues, the rates of glucose and O2 consumption are inversely related (Pasteur Effect). Under O2 limiting conditions the demands for glucose (glycogen) in such cells may drastically rise as a means for maintaining ATP turnover close to normoxic rates; nevertheless ion and electrical pot...
journal_title:Intensive care medicine
pub_type: 杂志文章
doi:10.1007/BF00254926
更新日期:1986-01-01 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: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::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 present our observation of the development of a rare nail deformity in the prolonged course of disease of a critically ill patient with a pulmonary abscess. DESIGN:Case report. SETTING:Tertiary referral, 16-bed, level I surgical ICU in an academic hospital. PATIENT:A 48-year-old Caucasian male was treat...
journal_title:Intensive care medicine
pub_type: 杂志文章
doi:10.1007/s001340000679
更新日期:2000-11-01 00:00:00
abstract:: ...
journal_title:Intensive care medicine
pub_type: 信件
doi:10.1007/s00134-018-5180-2
更新日期:2018-06-01 00:00:00
abstract:OBJECTIVE:To evaluate the physiological effects of decannulation on breathing patterns and respiratory mechanics by comparing mouth breathing (MB) to tracheal breathing (TB) in tracheostomized patients. DESIGN AND SETTING:Prospective cross-over study in a critical and neuromuscular care unit. PATIENTS AND METHODS:Nin...
journal_title:Intensive care medicine
pub_type: 杂志文章
doi:10.1007/s00134-002-1545-6
更新日期:2002-12-01 00:00:00
abstract::The original version of this article unfortunately contained a mistake. ...
journal_title:Intensive care medicine
pub_type: 杂志文章,已发布勘误
doi:10.1007/s00134-020-06009-2
更新日期:2020-05-01 00:00:00
abstract:INTRODUCTION:Extracorporeal carbon dioxide removal (ECCO2R) has been proposed for hypercapnic respiratory failure in chronic obstructive pulmonary disease (COPD) exacerbations, to avoid intubation or reduce length of invasive ventilation. Balance of risks, efficacy, and benefits of ECCO2R in patients with COPD is uncle...
journal_title:Intensive care medicine
pub_type: 杂志文章,评审
doi:10.1007/s00134-015-3921-z
更新日期:2015-10-01 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::A hypertensive crisis with an arterial blood pressure of 280/180 mmHg developed immediately after an apparently successful removal of a phaeochromocytoma. The blood pressure could not be lowered by phentolamine and not until the administration of dihydralazine and furosemide was the systemic pressure normalized. In ad...
journal_title:Intensive care medicine
pub_type: 杂志文章
doi:10.1007/BF00315379
更新日期:1986-01-01 00:00:00
abstract:OBJECTIVES:To analyse the clinical value of procalcitonin (PCT), C-reactive protein (CRP) and leucocyte count in the diagnosis of paediatric sepsis and in the stratification of patients according to severity. DESIGN:Prospective, observational study. SETTING:Paediatric intensive care unit (PICU). PATIENTS:Ninety-four...
journal_title:Intensive care medicine
pub_type: 杂志文章
doi:10.1007/s00134-006-0509-7
更新日期:2007-03-01 00:00:00
abstract:PURPOSE:Little evidence of increased thrombotic risk is available in COVID-19 patients. Our purpose was to assess thrombotic risk in severe forms of SARS-CoV-2 infection. METHODS:All patients referred to 4 intensive care units (ICUs) from two centers of a French tertiary hospital for acute respiratory distress syndrom...
journal_title:Intensive care medicine
pub_type: 杂志文章,多中心研究
doi:10.1007/s00134-020-06062-x
更新日期:2020-06-01 00:00:00
abstract::We report a case of fatal septic shock, with hyperlactatemia and blood cultures positive for Streptococcus pneumoniae, in a 70-year-old patient. On two occasions (5 days, and 2 days before the patient's death), the relationship between oxygen delivery (DO2) and consumption (VO2) was examined in conjunction with two pr...
journal_title:Intensive care medicine
pub_type: 杂志文章
doi:10.1007/s001340050300
更新日期:1997-01-01 00:00:00
abstract:OBJECTIVE:To determine the adequate site of activated coagulation time (ACT) measurement during continuous haemodiafiltration (CHDF) using nafamostat mesilate. DESIGN:Prospective, consecutive, clinical study. SETTING:An intensive care unit of a general hospital. PATIENTS:Ten patients with acute organ failure includi...
journal_title:Intensive care medicine
pub_type: 临床试验,杂志文章
doi:10.1007/s001340050892
更新日期:1999-05-01 00:00:00
abstract:OBJECTIVE:To investigate the effects of nicotinamide (NIC), an inhibitor of poly(ADP-ribose) synthetase (PARS), on intestinal and liver perfusion, O2 kinetics, and energy metabolism over 24 h of hyperdynamic porcine endotoxemia. DESIGN:Prospective, randomized, controlled experimental study with repeated measures. SET...
journal_title:Intensive care medicine
pub_type: 杂志文章
doi:10.1007/s001340000842
更新日期:2001-03-01 00:00:00
abstract:BACKGROUND:After resuscitation, asphyxiated neonates often develop poor cardiac function with hypotension, pulmonary hypertension and multiorgan ischemia. In a swine model of neonatal hypoxia-reoxygenation, effects of epinephrine, dobutamine and milrinone on systemic, pulmonary and regional hemodynamics and oxygen tran...
journal_title:Intensive care medicine
pub_type: 杂志文章
doi:10.1007/s00134-010-1820-x
更新日期:2010-06-01 00:00:00
abstract:PURPOSE:To evaluate the association between acute respiratory distress syndrome (ARDS) onset time and prognosis. METHODS:Patients with moderate to severe ARDS (N = 876) were randomly assigned into derivation (N = 520) and validation (N = 356) datasets. Both 28-day and 60-day survival times after ARDS onset were analyz...
journal_title:Intensive care medicine
pub_type: 杂志文章,多中心研究
doi:10.1007/s00134-016-4638-3
更新日期:2017-03-01 00:00:00
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journal_title:Intensive care medicine
pub_type: 杂志文章
doi:10.1007/s00134-002-1299-1
更新日期:2002-06-01 00:00:00
abstract::Activation of the complement system within the lung can lead to acute pulmonary damage and dysfunction. Based on a variety of experimental models it is now apparent that lung injury is related to complement-induced generation of oxygen derived free radicals from neutrophils and from macrophages. In addition to the oxy...
journal_title:Intensive care medicine
pub_type: 杂志文章
doi:10.1007/BF00315362
更新日期:1986-01-01 00:00:00
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journal_title:Intensive care medicine
pub_type: 杂志文章
doi:10.1007/s00134-015-4064-y
更新日期:2016-02-01 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::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::The case of an 11-year-old boy who suffered second and third degree burns to 78% of his body is reported. The large doses of morphine used as analgesia resulted in severe side effects: ventilatory dependence, impairment of gastrointestinal function and psychological disturbance. Intravenous lignocaine was added withou...
journal_title:Intensive care medicine
pub_type: 杂志文章
doi:10.1007/BF01712245
更新日期:1996-03-01 00:00:00
abstract:OBJECTIVE:To validate a simple method avoiding discard volumes in pediatric patients with indwelling arterial and venous lines. DESIGN:Zero-discarding was achieved by passive extracorporeal arteriovenous backflow via standard single pressure transducer equipment. We tested backflow distances (10, 20 and 30 cm beyond t...
journal_title:Intensive care medicine
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1007/s001340100951
更新日期:2001-06-01 00:00:00
abstract:OBJECTIVE:To evaluate the origin of H+ ions participating in the generation of CO2 coming from sodium bicarbonate infusion during metabolic acidosis. We hypothesized that these H+ ions come from a back-titration of the main non-bicarbonate buffers present in the blood, i. e. the hemoglobin and the albumin, and thus pos...
journal_title:Intensive care medicine
pub_type: 杂志文章
doi:10.1007/s001340051204
更新日期:2000-05-01 00:00:00
abstract:OBJECTIVE:Pulmonary endothelial activation caused by high pulmonary capillary pressures may be involved in the pathogenesis of cardiogenic pulmonary edema (CPE). We studied soluble selectins and soluble ICAM-1 as markers of cell activation in the systemic and pulmonary circulation of patients with respiratory failure (...
journal_title:Intensive care medicine
pub_type: 杂志文章
doi:10.1007/s001340000843
更新日期:2001-03-01 00:00:00
abstract:OBJECTIVE:To determine the steady-state trough serum and epithelial lining fluid (ELF) concentrations of teicoplanin 12 mg/kg per day in critically ill patients with ventilator associated pneumonia. DESIGN AND SETTING:Prospective, pharmacokinetic study in the surgical intensive care unit in a university hospital. PAT...
journal_title:Intensive care medicine
pub_type: 杂志文章
doi:10.1007/s00134-006-0136-3
更新日期:2006-05-01 00:00:00