Abstract:
OBJECTIVE:To test the hypothesis that the rate of degradation of exogenously administered albumin is faster with bolus administration than with continuous infusion and thus that a bolus administration is less efficacious in restoring blood albumin concentration (BAC) in the hypoalbuminemic critically ill pediatric patient. DESIGN:A prospective, controlled study of two groups of patients. SETTING:Pediatric intensive care unit (PICU) of a children's hospital. PATIENTS:37 critically ill hypoalbuminemic patients (BAC < or = 2.8 g/dl), in whom no overt protein-losing disease was identified, were divided into two treatment groups and included in a 60-h study. INTERVENTIONS:18 patients were given an i.v. bolus of 1 g/kg of 25% albumin over 4 h. This treatment was repeated after 24 and 48 h. Nineteen other patients were given the same dose of 1 g/kg of 25% albumin as a continuous 24-h infusion throughout the 60-h study period. BAC along with sodium, potassium, and total and ionized calcium were measured in the serum of blood samples obtained at predetermined intervals. MEASUREMENTS AND MAIN RESULTS:A 4 h bolus of albumin resulted in an acute rise in BAC, which declined to baseline within 24 h. A continuous infusion resulted in a steady rise in BAC with 24-h levels significantly higher than baseline. The percent change in mean BAC from baseline, calculated at 12-h intervals during the 60-h study period, showed a steady increase in the continuous infusion group with a 34% increase after the first 24 h. In contrast, the 4-h bolus method resulted in major fluctuations in the BAC values with only a 14% increase (p < 0.05) after 24 h. Albumin's volume of distribution, half-life and elimination constant, calculated based on blood albumin values during the first 24 h after the bolus administration, were 0.12 +/- 0.03 l/kg, 4.6 +/- 1.8 h and 0.17 +/- 0.06 h-1, respectively. This half-life did not apply to the continuous infusion group as a steady state was not achieved after 30 h (6 half-lives), and BAC continued to rise throughout the 60-h study period. No significant changes in blood electrolytes were observed with either method. CONCLUSIONS:The half-life of exogenous albumin in the critically ill hypoalbuminemic pediatric patient is short if given as a bolus. Continuous infusion therapy appears to be more efficacious in increasing BAC over time, as the half-life with this method appears to be longer.
journal_name
Intensive Care Medjournal_title
Intensive care medicineauthors
Greissman A,Silver P,Nimkoff L,Sagy Mdoi
10.1007/BF01712175subject
Has Abstractpub_date
1996-05-01 00:00:00pages
495-9issue
5eissn
0342-4642issn
1432-1238journal_volume
22pub_type
临床试验,杂志文章abstract::A 29-year-old woman suffered a cardiac arrest, due to profound hyperkalaemia, caused by the use of a potassium-containing salt substitute. She was resuscitated, but post-hypoxic brain damage occurred. Some of the sparse literature is reviewed. ...
journal_title:Intensive care medicine
pub_type: 杂志文章,评审
doi:10.1007/BF00255641
更新日期:1988-01-01 00:00:00
abstract::The goals of management of patients with respiratory failure include improving arterial oxygenation with PEEP and red cell transfusion to maintain oxygen carrying capacity, both of which contribute to improving tissue oxygen delivery. However, standard CPD-stored blood is rapidly depleted of 2,3 diphosphoglycerate (2,...
journal_title:Intensive care medicine
pub_type: 杂志文章
doi:10.1007/BF00315364
更新日期:1986-01-01 00:00:00
abstract:OBJECTIVE:To study the pharmacokinetics and local tissue effects resulting from the intratracheal administration of preservative-free fentanyl. DESIGN:Prospective, randomized, blinded and controlled animal study. SETTING:University research laboratory. SUBJECTS:Eighteen adult male New Zealand rabbits. INTERVENTIONS...
journal_title:Intensive care medicine
pub_type: 杂志文章
doi:10.1007/BF01720719
更新日期:1996-02-01 00:00:00
abstract::Of 28 consecutive patients over 64 years old, in whom endoscopy revealed gastro-duodenal ulcers with signs of recent hemorrhage (active bleeding, non-bleeding vessel or adherent clot), 14 were randomly assigned to receive endoscopic alcoholization of the lesions preceded by intragastric instillation of norepinephrine,...
journal_title:Intensive care medicine
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1007/BF01724799
更新日期:1990-01-01 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
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:PURPOSE:To investigate the relationship between hemoglobin (Hgb) and brain tissue oxygen tension (PbtO(2)) after severe traumatic brain injury (TBI) and to examine its impact on outcome. METHODS:This was a retrospective analysis of a prospective cohort of severe TBI patients whose PbtO(2) was monitored. The relationsh...
journal_title:Intensive care medicine
pub_type: 杂志文章
doi:10.1007/s00134-012-2593-1
更新日期:2012-09-01 00:00:00
abstract:OBJECTIVE:To describe the beliefs and attitudes of intensive care unit (ICU) nurses toward visiting, visiting hours, and open visiting policies in critical care settings. DESIGN:A descriptive, cross-sectional, multicenter survey. SETTING:Seventeen hospitals in Flanders (Dutch-speaking Belgium), including 30 ICUs. Six...
journal_title:Intensive care medicine
pub_type: 杂志文章
doi:10.1007/s00134-007-0599-x
更新日期:2007-06-01 00:00:00
abstract:OBJECTIVES:Trunk position at 45 degrees from the horizontal is associated with a decreased risk of gastroesophageal aspiration. The objectives of this study were to determine the accuracy of trunk flexion estimates compared to a reference standard measurement, and to determine agreement about trunk flexion among ICU cl...
journal_title:Intensive care medicine
pub_type: 杂志文章
doi:10.1007/s00134-002-1225-6
更新日期:2002-03-01 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:To determine the clinical impact of bedside colonoscopy for critically ill patients with acute lower gastrointestinal (GI) bleeding. DESIGN AND SETTING:A 3-year retrospective analysis (chart review). Medical intensive care unit (ICU) of a 1,312-bed tertiary-care center in Taiwan. PATIENTS AND PARTICIPANTS:F...
journal_title:Intensive care medicine
pub_type: 杂志文章
doi:10.1007/s00134-005-2604-6
更新日期:2005-05-01 00:00:00
abstract:PURPOSE:In critically ill pediatric patients, fluid overload (FO) >10% has been identified as a threshold for possible interventions, including initiation of continuous renal replacement therapy (CRRT). However, multiple definitions have been reported, and there remains no consensus method for FO calculation. The goal ...
journal_title:Intensive care medicine
pub_type: 杂志文章
doi:10.1007/s00134-012-2503-6
更新日期:2012-04-01 00:00:00
abstract:OBJECTIVE:To analyze the effect of endothelin-1 on pulmonary arterial and venous contractile force in vitro and on up- and downstream pulmonary vascular resistance in vivo under sham and endotoxemic conditions in pigs. MATERIALS AND METHODS:In vitro: paired preparations of pulmonary arteries and veins were mounted in ...
journal_title:Intensive care medicine
pub_type: 杂志文章
doi:10.1007/s00134-007-0980-9
更新日期:2008-05-01 00:00:00
abstract::Achievement of a mean blood pressure (MBP) target is one of the hemodynamic goals to ensure an adequate blood perfusion pressure in critically ill patients. Arterial catheter allows for a continuous and precise monitoring of arterial pressure signal. In addition to giving a precise MBP monitoring, analysis of the bloo...
journal_title:Intensive care medicine
pub_type: 杂志文章,评审
doi:10.1007/s00134-010-2092-1
更新日期:2011-03-01 00:00:00
abstract:OBJECTIVE:To assess the impact of hemodynamic variables on the outcome of critically ill patients in septic shock and to identify the optimal threshold values related to outcome with special reference to continuously monitored mean arterial pressure (MAP) and mixed venous oxygen saturation (SvO2). DESIGN AND SETTING:R...
journal_title:Intensive care medicine
pub_type: 杂志文章
doi:10.1007/s00134-005-2688-z
更新日期:2005-08-01 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
abstract::In the first study 6 patients with raised intracranial pressure due to brain oedema following head injury were given dihydroergotamine because of low perfusion pressure. The intracranial pressure fell simultaneously with the increase in arterial pressure. The intracranial pressure fell from 24 +/- 2 mmHg by a maximum ...
journal_title:Intensive care medicine
pub_type: 杂志文章
doi:10.1007/BF00273564
更新日期:1989-01-01 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:To measure the effect of intense neuromuscular blockade (NMB) on oxygen consumption (VO(2)) in deeply sedated and mechanically ventilated children on the first day after complex congenital cardiac surgery. DESIGN:Prospective clinical interventional study. SETTING:Pediatric intensive care unit of an universi...
journal_title:Intensive care medicine
pub_type: 杂志文章
doi:10.1007/s00134-008-1252-z
更新日期:2008-12-01 00:00:00
abstract:OBJECTIVE:To evaluate various treatment strategies in critically ill patients with ischaemic acute renal failure, there is a need for reliable bedside measurements of total renal blood flow (RBF), glomerular filtration rate (GFR) and renal oxygen consumption without the need for urine collection. DESIGN:The continuous...
journal_title:Intensive care medicine
pub_type: 临床试验,杂志文章
doi:10.1007/s00134-004-2380-8
更新日期:2004-09-01 00:00:00
abstract::A 46-year-old man was diagnosed clinically brain dead after sustaining head trauma. The patient was in deep coma, brain nerves were unresponsive and spontaneous breathing was absent. However, EEG showed well preserved activity, but no reactivity to external stimuli. EEG activity disappeared within 40 h. BAEP were high...
journal_title:Intensive care medicine
pub_type: 杂志文章
doi:10.1007/BF02425159
更新日期:1995-01-01 00:00:00
abstract:BACKGROUND:Ornithine alpha-ketoglutarate (OKG) has proved to be efficient in restoring glutamine (Gln) pools which are strongly depleted in hypercatabolic patients. Since its two components, alpha-ketoglutarate (alphaKG) and ornithine (Orn), give rise to glutamate (Glu), they are both considered as Gln precursors. The ...
journal_title:Intensive care medicine
pub_type: 杂志文章
doi:10.1007/s00134-006-0511-0
更新日期:2007-03-01 00:00:00
abstract:OBJECTIVE:To assess the effects of intravenous fish oil fat emulsion on the metabolic alterations induced by lipopolysaccharide (LPS) challenge in healthy volunteers. DESIGN:Two groups of eight healthy subjects were randomized to receive either two pharmacological doses of intravenous FO fat emulsion or no treatment. ...
journal_title:Intensive care medicine
pub_type: 杂志文章,随机对照试验
doi:10.1007/s00134-007-0591-5
更新日期:2007-05-01 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:PURPOSE:We assessed feasibility and safety of extracorporeal carbon dioxide removal (ECCO2R) to facilitate ultra-protective ventilation (VT 4 mL/kg and PPLAT ≤ 25 cmH2O) in patients with moderate acute respiratory distress syndrome (ARDS). METHODS:Prospective multicenter international phase 2 study. Primary endpoint w...
journal_title:Intensive care medicine
pub_type: 杂志文章,多中心研究
doi:10.1007/s00134-019-05567-4
更新日期:2019-05-01 00:00:00
abstract::A cardiorespiratory monitoring system allows the measurement of FAECO2 and FECO2 in the expired air of the patient at the mouth (endtidal CO2) and in a mixing box. From these parameters, combined with the measured PACO2, the alveolo-expired (DuA = PECO2/PAECO2) and alveolar-arterial (Dua = PAECO2/PACO2) ductances whic...
journal_title:Intensive care medicine
pub_type: 杂志文章
doi:10.1007/BF01687162
更新日期:1980-08-01 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:PURPOSE:To describe the course of early organ dysfunction in a cohort of patients admitted in ICU suffering classic heatstroke. METHODS:Prospective observational single-centre cohort study with a 1-year follow-up. INTERVENTIONS:None. MEASUREMENTS AND MAIN RESULTS:Clinical and biological data of 22 patients were anal...
journal_title:Intensive care medicine
pub_type: 杂志文章
doi:10.1007/s00134-009-1500-x
更新日期:2009-08-01 00:00:00
abstract:OBJECTIVE:Acute hypoxemic respiratory failure (AHRF) is a common reason for emergency pediatric intensive care. An objective assessment of disease severity from acute physiological parameters would be of value in clinical practice and in the design of clinical trials. We hypothesised that there was a difference in the ...
journal_title:Intensive care medicine
pub_type: 杂志文章
doi:10.1007/s001340050647
更新日期:1998-07-01 00:00:00
abstract:OBJECTIVE:To clarify the risk of secondary exposure of medical staff to sarin vapor in the emergency room, and to warn emergency room staffs of the hazard. DESIGN:Retrospective observational survey. SETTING:Emergency department of a university hospital in a metropolitan area of Japan. PARTICIPANTS:Fifteen doctors tr...
journal_title:Intensive care medicine
pub_type: 杂志文章
doi:10.1007/BF01700667
更新日期:1995-12-01 00:00:00