Abstract:
:As a result of the previous shortage of tools to assess objectively the overall physiological status of the respiratory system in infants and young children, it has been difficult to measure the degree of physiological disorder or the response to therapy in respiratory diseases such as BPD, the pediatric version of ARDS, bronchiolitis, pneumonia, asthma and croup in this patient population. The newborn- four-year old child is particularly difficult to study because of their lack of cooperation and size. The recent progress in computer technology made pulmonary function testing available for this age range and opened up new possibilities for monitoring changes in disease processes affecting the respiratory system. This may improve medical management of infants and children with lung and heart diseases in particular. In 1989, Shannon [49] proposed in this Journal that the minimum physiological information needed for the intelligent use of mechanical ventilation (particularly if lower airway and/or pulmonary parenchymal disease was apparent) required the measurement of at least 4 variables: i) arterial partial pressure of carbon dioxide; ii) arterial oxygen saturation; iii) the mechanical time constant of the lung and iv) FRC. In many circumstances, arterial CO2 is approximated by alveolar (end-tidal) CO2 and the arterial oxygen saturation is obtained from pulse oximetry accurately if perfusion is adequate. The mechanical time constant and FRC are easily measured by the techniques described above and together provide important information concerning appropriate ventilator settings for a given disease. The described techniques bring new insights and awareness, but also new responsibilities in the management of infants and children with respiratory compromise. Not all of these techniques need to be applied to all infants in the ICU. Not all the assumptions upon which some of the techniques we have described are based will prove true. Any such methods which do not withstand solid scientific testing must be quickly discarded and replaced with better and (hopefully) easier methods.
journal_name
Intensive Care Medjournal_title
Intensive care medicineauthors
Hammer J,Newth CJdoi
10.1007/BF01704742subject
Has Abstractpub_date
1995-09-01 00:00:00pages
744-52issue
9eissn
0342-4642issn
1432-1238journal_volume
21pub_type
杂志文章,评审abstract:OBJECTIVES:To establish priorities for research in critical care medicine in the UK using survey and nominal group (NG) techniques. DESIGN:The senior doctor and nurse from 325 intensive care units (ICUs) in the UK were invited to contribute up to ten research questions relevant to intensive care organisation, practice...
journal_title:Intensive care medicine
pub_type: 杂志文章
doi:10.1007/s001340000628
更新日期:2000-10-01 00:00:00
abstract:OBJECTIVE:To compare some of the confirmatory investigations of brain death with clinical criteria in order to achieve the most sensitive and accurate diagnosis of brain death. DESIGN:All patients with isolated brain lesions and Glasgow Coma Scale (GCS) = 3 were subjected to neurological examination after ruling out h...
journal_title:Intensive care medicine
pub_type: 杂志文章
doi:10.1007/BF01711544
更新日期:1995-08-01 00:00:00
abstract:PURPOSE:Because non-invasive mechanical ventilation (NIV) is increasingly used, new devices, both ventilators and interfaces, have been continuously proposed for clinical use in recent years. To provide the clinicians with valuable information about ventilators and interfaces for NIV, several bench studies evaluating a...
journal_title:Intensive care medicine
pub_type: 杂志文章
doi:10.1007/s00134-011-2416-9
更新日期:2012-01-01 00:00:00
abstract:OBJECTIVES:(a) To assess whether differences in lung morphology observed in patients with adult respiratory distress syndrome (ARDS) are associated with differences in cardiorespiratory parameters, lung mechanics, and outcome. (b) To propose a new ARDS Severity Score to identify patients with a high mortality risk. DE...
journal_title:Intensive care medicine
pub_type: 杂志文章
doi:10.1007/s001340051317
更新日期:2000-08-01 00:00:00
abstract::608 patients admitted to a general Intensive Care Unit (ICU) over a 30 month period were analyzed according to the Apache II Severity of Disease Classification System on day one of admission. Hospital outcome details were available on 583 patients in the series. The mean Apache II scores for survivors (396) and non-su...
journal_title:Intensive care medicine
pub_type: 杂志文章
doi:10.1007/BF00263531
更新日期:1988-01-01 00:00:00
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 pati...
journal_title:Intensive care medicine
pub_type: 临床试验,杂志文章
doi:10.1007/BF01712175
更新日期:1996-05-01 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:This study assessed parameters of free radical damage to biomolecules, mitochondrial superoxide production, superoxide dismutase, and catalase activities and their relationship to sepsis mortality. DESIGN AND SETTING:Prospective animal study in a university laboratory for experimental. SUBJECTS:140 male Wis...
journal_title:Intensive care medicine
pub_type: 杂志文章
doi:10.1007/s00134-003-1789-9
更新日期:2003-10-01 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::The use of induced hypertension in head injury patients is controversial. We present the case of a 19-year-old man admitted with severe head trauma after a road accident and describe the beneficial effects that increasing arterial blood pressure had on the cerebral perfusion pressure, cerebral blood flow and jugular b...
journal_title:Intensive care medicine
pub_type: 杂志文章,评审
doi:10.1007/s001340050997
更新日期:1999-09-01 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:PURPOSE:We conducted a retrospective cohort study in an academic tertiary care center to characterize ventilator-associated pneumonia (VAP) in pediatric patients after cardiac surgery in The Netherlands. METHODS:All patients following cardiac surgery and mechanically ventilated for ≥24 h were included. The primary out...
journal_title:Intensive care medicine
pub_type: 杂志文章
doi:10.1007/s00134-011-2349-3
更新日期:2011-10-01 00:00:00
abstract:OBJECTIVE:To report the first case of ARDS in children treated with nitric oxide (NO) inhalation. METHODS:A 13-months infant presented with BPD and severe hypoxemia related to RSV infection and ARDS. Inhaled NO was delivered in the ventilatory circuit of a continuous flow ventilator (Babylog 8000, Dräger) in a concent...
journal_title:Intensive care medicine
pub_type: 杂志文章
doi:10.1007/BF01711907
更新日期:1994-08-01 00:00:00
abstract:OBJECTIVE:To identify objective trends of the course of illness that might be used as benchmarks in the auditing of the organization/performance of Intensive Care Units (ICU). DESIGN:Retrospective analysis. PATIENTS AND SETTING:A group of 12,615 patients and 55,464 patient-days prospectively collected in 89 ICUs of 1...
journal_title:Intensive care medicine
pub_type: 杂志文章
doi:10.1007/s00134-002-1331-5
更新日期:2002-07-01 00:00:00
abstract::We report the case of a 72-year-old male who suffered a cardiac arrest during an early positive treadmill stress test. After successful resuscitation the patient had evidence of a gastric perforation. Because of his hemodynamic stability, lack of peritoneal signs, and prohibitively high surgical risk, a non-operative ...
journal_title:Intensive care medicine
pub_type: 杂志文章
doi:10.1007/BF01710656
更新日期:1994-07-01 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:Acute kidney injury (AKI) frequently occurs in critically ill patients and often precipitates use of renal replacement therapy (RRT). However, the ideal circumstances for whether and when to start RRT remain unclear. We performed evidence synthesis of the available literature to evaluate the value of biomarkers...
journal_title:Intensive care medicine
pub_type: 杂志文章,评审
doi:10.1007/s00134-018-5126-8
更新日期:2018-03-01 00:00:00
abstract:OBJECTIVE:To investigate the effectiveness of an enhanced software Model Predictive Control (eMPC) algorithm for intravenous insulin infusion, targeted at tight glucose control in critically ill patients, over 72 h, in two intensive care units with different management protocols. DESIGN:Comparison with standard care i...
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/s00134-008-1236-z
更新日期:2009-01-01 00:00:00
abstract:OBJECTIVE:To determine the reliability of estimating arterial CO(2) pressure (PaCO(2)) using a recently introduced transcutaneous CO(2) pressure (PtcCO(2)) monitor in severe obese patients. DESIGN:Observational and interventional study. SETTING:District hospital with respiratory ward and bariatric surgery unit. PATI...
journal_title:Intensive care medicine
pub_type: 杂志文章
doi:10.1007/s00134-008-1078-8
更新日期:2008-07-01 00:00:00
abstract:OBJECTIVE:To examine the usefulness of preload indices obtained by transoesophageal echocardiography (TOE) for estimating stroke volume at various levels of cardiac index. DESIGN:Prospective clinical study. SETTING:Intensive care unit with surgical patients. PATIENTS:16 ventilated patients monitored via Swan-Ganz ca...
journal_title:Intensive care medicine
pub_type: 杂志文章
doi:10.1007/s001340050349
更新日期:1997-04-01 00:00:00
abstract:OBJECTIVE:To determine what change in respiratory function occurred following prolonged and efficient continuous arteriovenous haemofiltration (CAVH) in a group of patients with multiple organ systems failure (MOSF). DESIGN:A retrospective assessment using patient notes and ICU charts. SETTING:The Intensive Care Unit...
journal_title:Intensive care medicine
pub_type: 杂志文章
doi:10.1007/BF01694361
更新日期:1992-01-01 00:00:00
abstract::Plasma colloid osmotic pressure (COP) has been calculated from both serum albumin concentration and plasma total protein concentration. These values have been compared to those measured directly using a membrane-transducer oncometer in a group of normal subjects, in a group of critically-ill patients with a variety of...
journal_title:Intensive care medicine
pub_type: 杂志文章
doi:10.1007/BF00254796
更新日期:1987-01-01 00:00:00
abstract:PURPOSE:Information on predisposing risk factors influencing long-term survival after extracorporeal membrane oxygenation (ECMO) support remains scarce. In critically ill patients chronic obstructive pulmonary disease (COPD) is an independent risk factor for mortality and morbidity. We assessed the influence of COPD on...
journal_title:Intensive care medicine
pub_type: 杂志文章
doi:10.1007/s00134-013-2931-y
更新日期:2013-08-01 00:00:00
abstract:OBJECTIVE:The immediate overwhelming release of inflammatory mediators in septic shock is rapidly followed by strong anti-inflammatory responses inducing a state of immunosuppression. The patients who survive the initial hyper-inflammatory step of septic shock but subsequently die may be those who do not recover from i...
journal_title:Intensive care medicine
pub_type: 杂志文章
doi:10.1007/s00134-006-0204-8
更新日期:2006-08-01 00:00:00
abstract:OBJECTIVE:To study plasma concentrations of interleukin 6 (IL-6) and interleukin 8 (IL-8) in patients with splanchnic hypoxia, as documented by gastric intramucosal measurements (pH-i), during major abdominal surgery and the relationship between IL-6 and IL-8 concentrations and postoperative complications as well as cl...
journal_title:Intensive care medicine
pub_type: 杂志文章
doi:10.1007/s001340050575
更新日期:1998-04-01 00:00:00
abstract:OBJECTIVE:Antithrombin exerts direct effects on neutrophils by inhibiting chemokine-induced migration. This study examined the potency of different pharmaceutical antithrombin preparations in inhibiting neutrophil chemotaxis toward interleukin 8. METHODS:Cell migration was tested by the leading front assay in modified...
journal_title:Intensive care medicine
pub_type: 杂志文章
doi:10.1007/s00134-002-1432-1
更新日期:2002-10-01 00:00:00
abstract::The effects of continuous and supplementary bolus dose administration of etomidate have been investigated in ten artificially ventilated patients in traumatic coma. Continuous infusion of etomidate (5-25 micrograms/kg/min) proved to be a practical and safe means of sedating these patients and appeared to control moder...
journal_title:Intensive care medicine
pub_type: 杂志文章
doi:10.1007/BF01692549
更新日期:1983-01-01 00:00:00
abstract:PURPOSE:Septic shock-induced disseminated intravascular coagulopathy (DIC) contributes to multiple organ failure. Mechanisms governing vascular responses to open occurrence of DIC have not yet been established. Circulating plasma microparticles (MPs), released upon cell stress, constitute a catalytic procoagulant surfa...
journal_title:Intensive care medicine
pub_type: 临床试验,杂志文章,多中心研究
doi:10.1007/s00134-013-2993-x
更新日期:2013-10-01 00:00:00
abstract:OBJECTIVE:To measure muscle blood flow (Qtis) and oxygen consumption (VO(2)tis) in septic and non-septic critically ill patients by near-infrared spectroscopy (NIRS). SETTING:Surgical intensive care unit of a university hospital. PATIENTS AND PARTICIPANTS:Four patients with septic shock, eight post-surgical criticall...
journal_title:Intensive care medicine
pub_type: 杂志文章
doi:10.1007/s00134-003-1805-0
更新日期:2003-07-01 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