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. DESIGN:35 (18 surgical and 17 nonsurgical) patients, with 3 or more organ failures, had daily sessions of zero balance SH, for periods ranging from 2-22 days. MEASUREMENTS AND RESULTS:SH induced significant improvement of PaO2/100 FIO2, Apache II score, MAP, as well as blood chemistry in survivors. Dying patients had less marked improvement of blood oxygenation, non-significant changes in other variables, in addition to low MAP before and after SH, as well as marked hemodynamic unstability during the procedure. The observed hospital mortality was 38% for the surgical group, and 35.3% for the medical patients (n.s.). CONCLUSIONS:Mortality observed in this retrospective, uncontrolled study was significantly lower than that currently observed with conventional supportive therapy, with or without the addition of other forms of blood purification, e.g. CAVH and CAVHD. This improvement in results appears to be related to the property of SH to completely clear 90% of the blood from mediators of inflammation in only one passage through the hemofilter, and to better tolerance of HD done using bicarbonate buffer. A definite evaluation of this technique will be eventually reached by a programmed, appropriate sample size study, which is out of reach for one individual ICU.
journal_name
Intensive Care Medjournal_title
Intensive care medicineauthors
Gotloib L,Shostak A,Lev A,Fudin R,Jaichenko Jdoi
10.1007/BF01726531subject
Has Abstractpub_date
1995-02-01 00:00:00pages
104-11issue
2eissn
0342-4642issn
1432-1238journal_volume
21pub_type
杂志文章abstract:OBJECTIVE:Five commercially available oesophageal balloon catheters (OBCs) were tested to evaluate the accuracy in transmitting fast-changing pressure signals which can be observed, for example, during phrenic nerve stimulation. SETTING:Research laboratory of a university hospital. METHOD:The OBCs tested varied in le...
journal_title:Intensive care medicine
pub_type: 杂志文章
doi:10.1007/s001340051182
更新日期:2000-04-01 00:00:00
abstract:PURPOSE:Early central venous catheter (CVC) insertion in Ebola virus disease (EVD) is a novel approach and has not previously been described. This report delineates the safety, feasibility and clinical implications of early CVC insertion as the optimum means of vascular access in patients with EVD, in the setting of a ...
journal_title:Intensive care medicine
pub_type: 杂志文章
doi:10.1007/s00134-015-3736-y
更新日期:2015-05-01 00:00:00
abstract::In the past two years several guidelines for suggested components of emergency medical systems for children have been suggested, and for the first time, specific standards of pediatric trauma care have also been formulated. The American Academy of Pediatrics new Provisional Committee on Emergency Medicine has been cha...
journal_title:Intensive care medicine
pub_type: 杂志文章
doi:10.1007/BF00260888
更新日期:1989-01-01 00:00:00
abstract::Measurements of added inspiratory work (AIW) of breathing imposed by three different CPAP systems were performed in 10 patients. One system was a continuous flow system while the two others were demand flow systems separated from respirators (Ohmeda VD 101 and Draeger CPAP 800 devices). AIW was calculated from pressur...
journal_title:Intensive care medicine
pub_type: 杂志文章
doi:10.1007/BF00292929
更新日期:1986-01-01 00:00:00
abstract:OBJECTIVE:To validate the TRISS method as an audit system on a group of patients with severe trauma admitted to an Italian general intensive care unit (ICU). DESIGN:Prospective, cohort study of consecutive admissions to the ICU. SETTING:A 6-bed general ICU in a 500-bed general hospital. PATIENTS:190 patients with se...
journal_title:Intensive care medicine
pub_type: 杂志文章
doi:10.1007/BF02044120
更新日期:1996-09-01 00:00:00
abstract::Factors influencing nitrogen balance during total parenteral nutrition have been investigated in 34 critically ill injured patients studied during the first 6 days after trauma. Basal nitrogen balance was severely negative (-0.26 +/- 0.12 (SD) g X kg-1), but improved consistently during treatment. Nitrogen intake prov...
journal_title:Intensive care medicine
pub_type: 杂志文章
doi:10.1007/BF00256262
更新日期:1984-01-01 00:00:00
abstract:PURPOSE:Evidence of variation in mortality after surgery may indicate preventable postoperative death. We sought to determine if regional differences in outcome were present in surgical patients admitted to critical care in the UK. METHODS:We extracted data on admission characteristics, case mix and outcome of all pat...
journal_title:Intensive care medicine
pub_type: 杂志文章
doi:10.1007/s00134-015-3980-1
更新日期:2015-10-01 00:00:00
abstract:PURPOSE:The aim of our study was to analyze changes in the consumption of MRSA-active antibiotics and in the burden of methicillin-resistant S. aureus (MRSA) over a period of 9 years in a network of German intensive care units (ICU). METHODS:Data from 55 ICUs in Germany were analyzed from 2001 through 2009. The term "...
journal_title:Intensive care medicine
pub_type: 杂志文章
doi:10.1007/s00134-011-2335-9
更新日期:2011-10-01 00:00:00
abstract::The article "Accumulation of hydroxyethyl starch in human and animal tissues: a systematic review", written by Christian J. Wiedermann and Michael Joannidis, was originally published Online First without Open Access. ...
journal_title:Intensive care medicine
pub_type: 已发布勘误
doi:10.1007/s00134-020-06269-y
更新日期:2020-10-14 00:00:00
abstract:OBJECTIVE:We assessed the methodological trial quality of individual randomized controlled studies on chlorhexidine silver sulfadiazine impregnated catheters and the effect on catheter-related infection (CRI). DESIGN:Only the studies identified in the Medline database from 1966 to December 2001 were considered, abstra...
journal_title:Intensive care medicine
pub_type: 杂志文章,meta分析
doi:10.1007/s00134-003-1646-x
更新日期:2003-03-01 00:00:00
abstract:OBJECTIVE:The role of critical care pharmacists in the United States has recently been documented; however, little information exists about the role of international critical care pharmacists. The objective of this study was to describe the duties and activities of international pharmacists who practice in critical car...
journal_title:Intensive care medicine
pub_type: 杂志文章
doi:10.1007/s00134-007-0918-2
更新日期:2008-03-01 00:00:00
abstract:OBJECTIVE:To assess the relationship between the base deficit value in the immediate postoperative period of coronary surgery for cardiopulmonary bypass and the length of stay in the ICU. DESIGN AND SETTING:Prospective descriptive study in the department of anesthesia and cardiovascular surgery of a university hospita...
journal_title:Intensive care medicine
pub_type: 杂志文章
doi:10.1007/s00134-002-1587-9
更新日期:2003-02-01 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: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:RATIONALE:Acute respiratory distress syndrome (ARDS) is frequently associated with hemodynamic instability which appears as the main factor associated with mortality. Shock is driven by pulmonary hypertension, deleterious effects of mechanical ventilation (MV) on right ventricular (RV) function, and associated-sepsis. ...
journal_title:Intensive care medicine
pub_type: 杂志文章,评审
doi:10.1007/s00134-016-4326-3
更新日期:2016-05-01 00:00:00
abstract:: ...
journal_title:Intensive care medicine
pub_type: 杂志文章
doi:10.1007/s00134-018-5280-z
更新日期:2018-12-01 00:00:00
abstract:OBJECTIVE:To present the efficacy and tolerability of a new oral dosage form of the calcium antagonist nitrendipine compared to nifedipine capsules in patients with hypertensive emergency. DESIGN:Multicenter randomized double blind clinical study. SETTING:23 study centres (hospitals) in Germany. PATIENTS:161 patient...
journal_title:Intensive care medicine
pub_type: 临床试验,杂志文章,多中心研究,随机对照试验
doi:10.1007/BF01708963
更新日期:1994-01-01 00:00:00
abstract:OBJECTIVES:(a). To describe the glucose content of normal human airways secretions; (b). to observe the effects of hyperglycemia and airways inflammation on airways glucose. DESIGN:Observational studies. SETTINGS:(a). St George's Hospital Medical School; (b). diabetes mellitus outpatient clinics; (c). adult general i...
journal_title:Intensive care medicine
pub_type: 杂志文章
doi:10.1007/s00134-003-1961-2
更新日期:2003-12-01 00:00:00
abstract:PURPOSE:Family members of patients who die in the intensive care unit (ICU) may experience symptoms of stress, anxiety, depression, posttraumatic stress disorder (PTSD), and/or prolonged grief. We evaluated whether grief symptoms were alleviated if the physician and the nurse in charge at the time of death sent the clo...
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/s00134-016-4669-9
更新日期:2017-04-01 00:00:00
abstract:OBJECTIVES:Processed EEG monitoring has been suggested for sedation depth evaluation in intensive care unit (ICU) patients. The present study investigated the efficacy of two processed EEG monitors using SEF90% or SEF95% and BIS to differentiate between conscious (Ramsay score 4) and unconscious sedation (Ramsay score ...
journal_title:Intensive care medicine
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1007/s001340000761
更新日期:2001-01-01 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 nasal nitric oxide (NO) excretion, pulmonary NO excretion, and autoinhalation of nasally released NO at rest compared with that during moderate exercise in smokers and non-smokers. DESIGN:Prospective observational study. SETTING:University laboratory. PARTICIPANTS:Fourteen healthy adult volu...
journal_title:Intensive care medicine
pub_type: 杂志文章
doi:10.1007/s001340051172
更新日期:2000-04-01 00:00:00
abstract:PURPOSE:To assess the generalisability of published clinical risk predictive models for invasive candidiasis in ICU patients. METHODS:The performance characteristics of published clinical risk factor-only and Candida colonisation-only predictive models for invasive candidiasis were assessed in a multicentre cohort of ...
journal_title:Intensive care medicine
pub_type: 杂志文章,多中心研究
doi:10.1007/s00134-009-1619-9
更新日期:2009-12-01 00:00:00
abstract:OBJECTIVES:To assess the reproducibility of respiratory dead space measurements in ventilated children. DESIGN:Prospective study. SETTING:University pediatric intensive care unit. PATIENTS:Thirty-two mechanically ventilated children (0.13-15.4 years) who were clinically stable. METHODS:The single-breath CO(2) test ...
journal_title:Intensive care medicine
pub_type: 杂志文章
doi:10.1007/s00134-004-2288-3
更新日期:2004-07-01 00:00:00
abstract:OBJECTIVES:To assess the markers of perfusion which best discriminate survivors from non-survivors of childhood sepsis and to compare the information derived from gastric tonometry with conventionally measured haemodynamic and laboratory parameters. DESIGN:Prospective clinical study of children with sepsis syndrome or...
journal_title:Intensive care medicine
pub_type: 杂志文章
doi:10.1007/s001340050394
更新日期:1997-06-01 00:00:00
abstract:OBJECTIVE:To assess the safety and efficacy of sustained inflations (SI) as lung recruitment maneuvers (RMs) in ventilated pediatric intensive care unit (PICU) patients. DESIGN:Observational, prospective data collection. SETTING:Tertiary-care PICU. PATIENTS AND PARTICIPANTS:Thirty-two consecutive ventilated pediatri...
journal_title:Intensive care medicine
pub_type: 杂志文章
doi:10.1007/s00134-007-0764-2
更新日期:2007-10-01 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: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:We report the first patient to developed abdominal compartment syndrome (ACS) with intrahepatic portal venous gas (IHPVG) and pneumatosis cystoides intestinalis following emergency upper gastrointestinal endoscopy. CASE PRESENTATION:A 53-year-old man underwent an emergency upper gastrointestinal endoscopy fo...
journal_title:Intensive care medicine
pub_type: 信件
doi:10.1007/s00134-002-1492-2
更新日期:2002-11-01 00:00:00
abstract::A case of brainstem encephalitis complicated by torsade de pointes is described. The possible occurrence of ventricular arrhythmias may contribute to the mortality in this condition. We recommend the admission of patients with brainstem encephalitis to an intensive care unit, for a period of electrocardiographic monit...
journal_title:Intensive care medicine
pub_type: 杂志文章
doi:10.1007/BF00263564
更新日期:1987-01-01 00:00:00