Abstract:
:Diagnosis and treatment of infection is a common procedure in the clinical management of patients in the ICU. Infection in the ICU is an important area for study, but requires well-defined and proven diagnostic criteria. The diagnosis of infection, like any diagnosis, is based on probability, and diagnostic criteria are therefore selected according to the physician's objectives and the acceptable margin of error. It is easier to diagnose correctly a full-blown, severe bacterial infection than one that is just beginning, and the same criteria cannot be used to identify accurately both conditions. We should diagnose an infectious complication at the time it needs treatment, but there is often a lack of clear objectives in the diagnostic process, and up to now, few reliable criteria have been available. Before considering the sensitivity and specificity of single diagnostic procedures it is important to trace the evolution of the infection. The problem may be approached in two steps, by describing or defining (i) the minimum level of severity of a probable infection which requires/justifies specific treatment as the first end-point of the diagnosis, and (ii) the ways the diagnosis may be confirmed using the best available procedure (which might not be always available or applicable in all cases in the short term).
journal_name
Intensive Care Medjournal_title
Intensive care medicineauthors
Langer M,Pifferi S,Peta Mdoi
10.1007/BF01713977subject
Has Abstractpub_date
1994-11-01 00:00:00pages
S12-6eissn
0342-4642issn
1432-1238journal_volume
20 Suppl 4pub_type
杂志文章,评审abstract:OBJECTIVE:Fibroproliferation markers like procollagen I predict mortality in patients with acute lung injury (ALI) and acute respiratory distress syndrome (ARDS). We sought to determine whether bronchoalveolar lavage fluid (BALF) from patients with lung injury contained mediators that would activate procollagen I promo...
journal_title:Intensive care medicine
pub_type: 杂志文章
doi:10.1007/s00134-004-2503-2
更新日期:2005-01-01 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:PURPOSE:Neutrophil gelatinase-associated lipocalin (NGAL) is a promising biomarker for acute kidney injury (AKI). We evaluated the diagnostic and prognostic accuracies of plasma NGAL (pNGAL) for contrast-induced AKI (CI-AKI) in critically ill patients. METHODS:In a prospective observational study in two adult intensiv...
journal_title:Intensive care medicine
pub_type: 杂志文章
doi:10.1007/s00134-013-2826-y
更新日期:2013-05-01 00:00:00
abstract:OBJECTIVES:Controversies concerning the pivotal trial and negative results from other Drotrecogin alfa activated (DAA) trials have raised questions about its efficacy in severe sepsis patients. Based on all available evidence, our study aimed to respond to: (1) What is the current probability that DAA is not better tha...
journal_title:Intensive care medicine
pub_type: 杂志文章
doi:10.1007/s00134-008-1159-8
更新日期:2008-10-01 00:00:00
abstract:OBJECTIVE:An instrument able to estimate the direct costs of stays in Intensive Care Units (ICUs) simply would be very useful for resource allocation inside a hospital, through a global budget system. The aim of this study was to propose such a tool. DESIGN:Since 1991, a region-wide common data base has collected stan...
journal_title:Intensive care medicine
pub_type: 杂志文章
doi:10.1007/s001340050619
更新日期:1998-06-01 00:00:00
abstract:OBJECTIVE:To investigate ventilation-perfusion (VA/Q) relationships, during continuous axial rotation and in the supine position, in patients with acute lung injury (ALI) using the multiple inert gas elimination technique. DESIGN:Prospective investigation. SETTING:Eighteen-bed intensive care unit in a university hosp...
journal_title:Intensive care medicine
pub_type: 杂志文章
doi:10.1007/s001340050534
更新日期:1998-02-01 00:00:00
abstract:PURPOSE:To determine the oxygen affinity for optimal tissue oxygen delivery with a hemoglobin-hydroxyethyl starch conjugate (HRC 101). METHODS:Anesthetized rats were hemodiluted (180 ml kg(-1)) with low (P(50) approximately 70 mmHg) or high affinity (P(50) approximately 14 mmHg) HRC 101 at hemoglobin (Hb) concentratio...
journal_title:Intensive care medicine
pub_type: 杂志文章
doi:10.1007/s00134-009-1532-2
更新日期:2009-11-01 00:00:00
abstract::Recombinant activated factor VII (rFVIIa, 'NovoSeven') is indicated for the treatment of spontaneous and surgical bleeding in patients with haemophilia A or B with antibodies to factors VIII or IX (FVIII or FIX) worldwide, and in patients with acquired haemophilia in Europe. In vitro cell models have demonstrated that...
journal_title:Intensive care medicine
pub_type: 杂志文章,评审
doi:10.1007/s00134-002-1469-1
更新日期:2002-10-01 00:00:00
abstract:OBJECTIVE:To evaluate the incidence and the circumstances of a moderate increase in serum creatinine early after elective abdominal aortic surgery. DESIGN:Prospective clinical observational study. SETTING:Surgical intensive care unit in a university hospital. PATIENTS:Two hundred and fifteen consecutive adult patien...
journal_title:Intensive care medicine
pub_type: 杂志文章
doi:10.1007/s00134-003-1958-x
更新日期:2003-10-01 00:00:00
abstract:OBJECTIVE:Pressure measurements at the level of the right atrium are commonly used in clinical anesthesia and the intensive care unit (ICU). There is growing interest in the use of peripheral venous sites for estimating central venous pressure (CVP). This study compared bias, precision, and covariance in simultaneous m...
journal_title:Intensive care medicine
pub_type: 临床试验,杂志文章
doi:10.1007/s00134-003-2052-0
更新日期:2004-04-01 00:00:00
abstract::Nosocomial infections are a major problem in intensive care patients. Thirty-nine patients, requiring intensive care for 5 days or more (mean 15.8 days) were prospectively investigated, to determine the relation between colonisation and nosocomial infection. Thrice weekly, cultures from the oropharynx, respiratory and...
journal_title:Intensive care medicine
pub_type: 杂志文章
doi:10.1007/BF00255792
更新日期:1987-01-01 00:00:00
abstract:OBJECTIVE:To investigate the correlation between microalbuminuria and extravascular lung water in patients in septic shock who require mechanical ventilation for severe respiratory failure. DESIGN AND SETTING:Prospective, observational, clinical study in the 20-bed intensive care unit of a university hospital. PATIEN...
journal_title:Intensive care medicine
pub_type: 杂志文章
doi:10.1007/s00134-003-1651-0
更新日期:2003-03-01 00:00:00
abstract::We studied the effect of thiopental loading during resuscitation of 53 patients following cardiopulmonary arrest and compared the outcome with that found in 54 patients treated conventionally in the 30 previous months. Thiopental therapy (10 mg/kg i.v.) was begun within 30 min of the arrest once hemodynamic stability ...
journal_title:Intensive care medicine
pub_type: 临床试验,杂志文章
doi:10.1007/BF00265112
更新日期:1987-01-01 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: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:PURPOSE:This prospective observational study aimed at describing prescription patterns of tigecycline and patient outcomes in 26 French intensive care units (ICU). METHODS:Data of consecutive cases of adult patients treated with tigecycline were collected from the initiation until 7 days after the end of treatment. Re...
journal_title:Intensive care medicine
pub_type: 杂志文章,多中心研究
doi:10.1007/s00134-014-3323-7
更新日期:2014-07-01 00:00:00
abstract::We compare two patients admitted after near drowning. Both presented a severe metabolic acidosis, but only one of them developed an acute pulmonary edema with hypoxemia. An increase of lipid peroxides associated with a reduction of vitamin E concentration has been observed in this later patient. Lipid peroxidation, on...
journal_title:Intensive care medicine
pub_type: 杂志文章
doi:10.1007/BF00254776
更新日期:1985-01-01 00:00:00
abstract::The process of surgical decision making is based on both general principles that are amenable to evaluation using rigorous techniques of clinical research and the intangible element of surgical judgment that seeks to apply those principles to the care of an individual patient. The role of surgical judgment is inescapa...
journal_title:Intensive care medicine
pub_type: 指南,杂志文章,实务指引,评审
doi:10.1007/pl00003797
更新日期:2001-01-01 00:00:00
abstract:PURPOSE:To assess the impact of lung ultrasound (LU) on clinical decision making in mechanically ventilated critically ill patients. METHODS:One hundred and eighty-nine patients took part in this prospective study. The patients were enrolled in the study when LU was requested by the primary physician for (1) unexplain...
journal_title:Intensive care medicine
pub_type: 杂志文章
doi:10.1007/s00134-013-3133-3
更新日期:2014-01-01 00:00:00
abstract:OBJECTIVE:To determine the incidence rates of hospital acquired infections (HAI) during the first 14 days after ICU discharge after treatment during ICU-stay with Selective Decontamination of the Digestive tract (SDD), Selective Oropharyngeal Decontamination (SOD) or Standard Care (SC). DESIGN:Prospective observationa...
journal_title:Intensive care medicine
pub_type: 杂志文章
doi:10.1007/s00134-009-1554-9
更新日期:2009-09-01 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:OBJECTIVE:To investigate whether the addition of intrapulmonary percussive ventilation to the usual chest physiotherapy improves gas exchange and lung mechanics in tracheostomized patients. DESIGN AND SETTING:Randomized multicenter trial in two weaning centers in northern Italy. PATIENTS AND PARTICIPANTS:46 tracheost...
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/s00134-006-0427-8
更新日期:2006-12-01 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:OBJECTIVE:To determine the relation of malnutrition and underlying diagnosis to the length of stay in the Intensive Care Unit (ICU) and to mortality after lung transplantation (LTX). DESIGN:Retrospective ICU chart review. SETTING:Cardiothoracic ICU in a University hospital. PATIENTS:Fifty-one consecutive patients wh...
journal_title:Intensive care medicine
pub_type: 杂志文章
doi:10.1007/BF01709333
更新日期:1996-11-01 00:00:00
abstract:PURPOSE:To test the hypothesis that a carbamylated EPO-FC fusion protein (cEPO-FC) or recombinant human erythropoietin (rhEPO) would protect against kidney ischemia/reperfusion (I/R) injury in pigs with atherosclerosis. METHODS:Anesthetized and mechanically ventilated animals received cEPO-FC (50 μg kg(-1)), rhEPO (5,...
journal_title:Intensive care medicine
pub_type: 杂志文章
doi:10.1007/s00134-012-2766-y
更新日期:2013-03-01 00:00:00
abstract:OBJECTIVE:The long-term mortality outcome associated with sepsis and septic shock has not been well defined in a nonselected critically ill population. This study investigated the occurrence and the role of bloodstream infection (BSI) associated sepsis and septic shock at time of intensive care unit (ICU) admission on ...
journal_title:Intensive care medicine
pub_type: 杂志文章
doi:10.1007/s00134-004-2544-6
更新日期:2005-02-01 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
abstract:INTRODUCTION:Trials of tight glucose control have compared measures of central tendency, such as average blood glucose, and yielded conflicting results. Other metrics, such as standard deviation, reflect different properties of glucose control and are also associated with changes in outcome. It is possible, therefore, ...
journal_title:Intensive care medicine
pub_type: 杂志文章
doi:10.1007/s00134-010-2103-2
更新日期:2011-03-01 00:00:00
abstract::The use of ultrasonography has become increasingly popular in the everyday management of critically ill patients. It has been demonstrated to be a safe and handy bedside tool that allows rapid hemodynamic assessment and visualization of the thoracic, abdominal and major vessels structures. More recently, M-mode ultras...
journal_title:Intensive care medicine
pub_type: 杂志文章,评审
doi:10.1007/s00134-013-2823-1
更新日期:2013-05-01 00:00:00
abstract:OBJECTIVE:To assess the prevalence of relative adrenal insufficiency in patients successfully resuscitated after cardiac arrest, and its prognostic role in post-resuscitation disease. DESIGN AND SETTING:A prospective observational single-center study in a medical intensive care unit. PATIENTS:64 patients hospitalised...
journal_title:Intensive care medicine
pub_type: 杂志文章
doi:10.1007/s00134-005-2603-7
更新日期:2005-05-01 00:00:00