Abstract:
OBJECTIVE:The aim of this study was to identify risk factors and to describe epidemiological patterns for early-(EOB) and late-onset bacteremias (LOB) after trauma. DESIGN:A prospective study conducted on 141 consecutive trauma patients. SETTING:A general intensive care unit (ICU) of a university hospital. PATIENTS:All multiple trauma patients admitted to our general intensive care unit (ICU) from December 1990 to May 1992 were prospectively enrolled in the study. The following information was collected for each patient and recorded in a computer database: demography, severity of trauma according to the Abbreviated Injury Scale (AIS), severity of coma according to the Glasgow Coma Scale (GCS), presence of pneumothorax, pulmonary contusion, rib fractures, hemothorax, and abdominal trauma, use of mechanical ventilation, and placement of central venous catheters. Bacteremias were defined as EOB when onset occurred within 96 h after trauma, and as LOB when appearing after 96 h from trauma. RESULTS:Thirty-seven patients developed bacteremia during their ICU stay (26%): 11 (29.7%) EOB and 26 (70.3%) LOB. Gram-positive cocci were isolated more frequently in EOB than in LOB (chi 2 = 4.1, P = 0.04). The risk of EOB was significantly increased by the presence of pulmonary contusion [relative risk (RR) 15.0; confidence interval (CI) 1.99-113.25], pneumonia before the onset of bacteremia (RR 3.56; CI 1.17-10.69), AIS score greater than 32 and an abdominal injury score greater than 9 (RR 3.11; CI 1.02-9.49), while intravascular catheters and mechanical ventilation did not represent risk factors for EOB. LOB had a very different pattern and their risk was significantly increased by exposure to intravascular catheters (RR 4.96; CI 1.23-19.94) and to mechanical ventilation lasting more than 7 days (RR 3.6; CI 1.6-8.1). CONCLUSIONS:Scoring with the AIS of the abdominal and thoracic trauma at admission to the ICU appears a useful tool for identifying trauma patients at increased risk of EOB. A rigorous policy of catheter placement and maintenance as a means of reducing late bacteremias in trauma patients is essential.
journal_name
Intensive Care Medjournal_title
Intensive care medicineauthors
Antonelli M,Moro ML,D'Errico RR,Conti G,Bufi M,Gasparetto Adoi
10.1007/BF01709514subject
Has Abstractpub_date
1996-08-01 00:00:00pages
735-41issue
8eissn
0342-4642issn
1432-1238journal_volume
22pub_type
杂志文章abstract:OBJECTIVE:To determine the presence of tricuspid regurgitation (TR) in patients affected by acute lung injury (ALI) and the adult respiratory distress syndrome (ARDS) during mechanical ventilation with positive end-expiratory pressure (PEEP). DESIGN:A prospective clinical study. SETTING:10-bed general intensive care ...
journal_title:Intensive care medicine
pub_type: 临床试验,杂志文章
doi:10.1007/s001340050419
更新日期:1997-08-01 00:00:00
abstract::The abundance of literature related to nutritional support reflects its recently recognised role in preventing metabolic complications and gut dysfunction during critical illness. However, some published studies lack relevance to critically ill patients, as a result of the selection of subjects and outcome variables, ...
journal_title:Intensive care medicine
pub_type: 杂志文章,评审
doi:10.1007/s00134-002-1581-2
更新日期:2003-02-01 00:00:00
abstract:OBJECTIVE:Real-time measurement of stroke volume variation by arterial pulse contour analysis (SVV) is useful in predicting volume responsiveness and monitoring volume therapy in mechanically ventilated patients. This study investigated the influence of the depth of tidal volume (V(t)) on SVV both during the state of f...
journal_title:Intensive care medicine
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1007/s00134-003-1649-7
更新日期:2003-03-01 00:00:00
abstract:PURPOSE:To evaluate the diagnostic accuracy of ultrasonography of optic nerve sheath diameter (ONSD) for assessment of intracranial hypertension. METHODS:Systematic review without language restriction based on electronic databases, with manual review of literature and conference proceedings until July 2010. Studies we...
journal_title:Intensive care medicine
pub_type: 杂志文章,meta分析,评审
doi:10.1007/s00134-011-2224-2
更新日期:2011-07-01 00:00:00
abstract:OBJECTIVE:Evaluation of the distribution and antibiotic susceptibility of the aerobic gram-negative bacilli (AGNB) isolated from patients in intensive care units (ICU study). DESIGN AND SETTING:Microbiological study carried out in 1991 in 39 teaching hospitals. A standardized method was used to determine the minimum i...
journal_title:Intensive care medicine
pub_type: 杂志文章
doi:10.1007/BF01699228
更新日期:1996-10-01 00:00:00
abstract:INTRODUCTION:The emphasis on the importance of professionalism in a recent CoBaTrICE-IT paper was impressive. However, insight into the elements of professionalism as perceived relevant for intensivists from the fellows' view, and how these are taught and learned, is limited. OBJECTIVES AND METHODS:A nationwide study ...
journal_title:Intensive care medicine
pub_type: 杂志文章
doi:10.1007/s00134-009-1644-8
更新日期:2010-02-01 00:00:00
abstract:OBJECTIVES:Critical illness increases the tendency to both coagulation and bleeding, complicating anticoagulation for continuous renal replacement therapy (CRRT). We analyzed strategies for anticoagulation in CRRT concerning implementation, efficacy and safety to provide evidence-based recommendations for clinical prac...
journal_title:Intensive care medicine
pub_type: 杂志文章,meta分析,评审
doi:10.1007/s00134-005-0044-y
更新日期:2006-02-01 00:00:00
abstract:OBJECTIVE:To compare isoflurane with midazolam for prolonged sedation in ventilated patients. DESIGN:Randomised controlled study. SETTING:General intensive care unit in university teaching hospital. PATIENTS:Sixty patients aged 17-80 years who required mechanical ventilation for more than 24 h. INTERVENTIONS:Sedati...
journal_title:Intensive care medicine
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1007/BF01694344
更新日期:1992-01-01 00:00:00
abstract:OBJECTIVE:Evaluating the prevalence, risk factors and prevention of pressure ulcers in Dutch intensive care units (ICUs). DESIGN:Cross-sectional design. SETTING:ICUs of acute care hospitals that participated in the 1998 and 1999 national prevalence surveys. Data were collected on 1 day in each year. PATIENTS:Eight h...
journal_title:Intensive care medicine
pub_type: 杂志文章
doi:10.1007/s001340101061
更新日期:2001-10-01 00:00:00
abstract::A young woman with long-standing systemic lupus erythematosus and rheumatic fever presented with deteriorating renal function. She had severe gastritis treated with cimetidine and received methylprednisolone when her blood cultures were repeatedly negative. She developed spontaneous bruising and bleeding from venepunc...
journal_title:Intensive care medicine
pub_type: 杂志文章
doi:10.1007/BF01724803
更新日期:1990-01-01 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 determine the value of procalcitonin (PCT) in the early diagnosis (and differentiation) of patients with SIRS, sepsis, severe sepsis, and septic shock in comparison to C-reactive protein (CRP), white blood cell and thrombocyte count, and APACHE-II score (AP-II). DESIGN:Prospective cohort study including a...
journal_title:Intensive care medicine
pub_type: 杂志文章
doi:10.1007/BF02900728
更新日期:2000-03-01 00:00:00
abstract:OBJECTIVE:To investigate the effect of respiratory physiotherapy on the prevention and treatment of ventilator-associated pneumonia (VAP) for adults in an intensive care unit (ICU) with an acquired brain injury (ABI). DESIGN AND SETTING:Two-part, prospective, randomised controlled trial. PATIENTS:A total of 144 subje...
journal_title:Intensive care medicine
pub_type: 杂志文章,随机对照试验
doi:10.1007/s00134-008-1278-2
更新日期:2009-02-01 00:00:00
abstract:OBJECTIVES:We investigated the effect of different levels of continuous positive airway pressure (CPAP) on the cricothyroid (CT; a tensor muscle of the vocal folds) and posterior cricoarytenoid (PCA; sole abductor muscle of the vocal folds) muscles in dogs. DESIGN:Prospective, controlled animal study. SUBJECTS:Nine m...
journal_title:Intensive care medicine
pub_type: 杂志文章
doi:10.1007/BF01709524
更新日期:1996-08-01 00:00:00
abstract:PURPOSE:Clinical examination is often the first step to diagnose shock and estimate cardiac index. In the Simple Intensive Care Studies-I, we assessed the association and diagnostic performance of clinical signs for estimation of cardiac index in critically ill patients. METHODS:In this prospective, single-centre coho...
journal_title:Intensive care medicine
pub_type: 杂志文章
doi:10.1007/s00134-019-05527-y
更新日期:2019-02-01 00:00:00
abstract:OBJECTIVE:To investigate the relationship between cytokines and the inflammatory responses in patients with out-of-hospital cardiac arrest, we examined the changes of cytokines as well as alterations in the markers of neutrophil activation, platelet and endothelial activation, and endothelial injury. DESIGN:Prospectiv...
journal_title:Intensive care medicine
pub_type: 临床试验,杂志文章
doi:10.1007/s001340050907
更新日期:1999-06-01 00:00:00
abstract:OBJECTIVE:To evaluate the perceived health and cognitive status in survivors of chronic obstructive pulmonary disease (COPD) exacerbations requiring mechanical ventilation. DESIGN AND SETTING:Prospective controlled cohort study in a respiratory intermediate intensive care unit. PATIENTS:Sixty-three COPD patients at t...
journal_title:Intensive care medicine
pub_type: 临床试验,杂志文章
doi:10.1007/s00134-001-1165-6
更新日期:2002-02-01 00:00:00
abstract::The treatment of severe tetanus with autonomic dysfunction is discussed, with emphasis on the use of magnesium sulphate. An exemplary case is reported, describing the inadequate response to magnesium, but the previously unreported and successful use of clonidine to control sympathetic overactivity. The properties of c...
journal_title:Intensive care medicine
pub_type: 杂志文章,评审
doi:10.1007/BF02575297
更新日期:1990-01-01 00:00:00
abstract:OBJECTIVE:To evaluate the effect of different infusion pump models on continuity of drug delivery during vertical displacement of syringe pumps. DESIGN:Zero-drug delivery time (ZDDT), retrograde aspiration volume, and infusion bolus were recorded using the same syringe in three different models of syringe pump after l...
journal_title:Intensive care medicine
pub_type: 杂志文章
doi:10.1007/s001340000784
更新日期:2001-01-01 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: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:We evaluated whether oscillatory compliance (C(X5)) measured by forced oscillation technique (FOT) at 5 Hz may be useful for positive end-expiratory pressure (PEEP) optimisation. METHODS:We studied seven pigs in which lung injury was induced by broncho-alveolar lavage. The animals were ventilated in volume con...
journal_title:Intensive care medicine
pub_type: 杂志文章
doi:10.1007/s00134-011-2211-7
更新日期:2011-06-01 00:00:00
abstract::A 17-year-old patient with Shone's disease had to be readmitted to the hospital 3 months after implantation of an artificial aortic valve because of extreme mitral insufficiency with consecutive pulmonary edema and hepatic dysfunction. He had been orally anticoagulated and presented with a high international normalize...
journal_title:Intensive care medicine
pub_type: 杂志文章
doi:10.1007/s001340051023
更新日期:1999-10-01 00:00:00
abstract:OBJECTIVE:To determine the influence of religious affiliation and culture on end-of-life decisions in European intensive care units (ICUs). DESIGN AND SETTING:A prospective, observational study of European ICUs was performed on consecutive patients with any limitation of therapy. Prospectively defined end-of-life prac...
journal_title:Intensive care medicine
pub_type: 杂志文章,多中心研究
doi:10.1007/s00134-007-0693-0
更新日期:2007-10-01 00:00:00
abstract::Membranous laryngotracheobronchitis is a very serious infection which affects the larynx, trachea and bronchi, requiring aggressive therapeutic measures. It has been recently rediscovered as a cause of disease in children. However, it is a very unusual complication of measles. Two infants with measles and membranous l...
journal_title:Intensive care medicine
pub_type: 杂志文章
doi:10.1007/BF00273547
更新日期:1985-01-01 00:00:00
abstract:OBJECTIVE:Antipyrine metabolism is a "gold standard" measure of mixed cytochrome P450 (CYP) mediated drug metabolism in humans. Cytokines (e.g., interleukin-6) and nitric oxide reduce CYP 450 activity in vitro and in vivo. Because interleukin-6 and nitric oxide production increases in children with sepsis-induced multi...
journal_title:Intensive care medicine
pub_type: 杂志文章
doi:10.1007/s00134-003-1758-3
更新日期:2003-06-01 00:00:00
abstract::We report a case of hyperinflation induced isorythmic atrio-ventricular dissociation with circulatory failure in a patient with chronic obstructive pulmonary disease. The arrythmia was successfully treated by applying "pressure support ventilation" (PSV: 20 cmH2O) which, by decreasing the respiratory rate and increasi...
journal_title:Intensive care medicine
pub_type: 杂志文章
doi:10.1007/BF00263868
更新日期:1989-01-01 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:PURPOSE:The intravenous fluid 6% hydroxyethyl starch (130/0.4) (6% HES 130/0.4) is used widely for resuscitation but there is limited information on its efficacy and safety. A large-scale multi-centre randomised controlled trial (CHEST) in critically ill patients is currently underway comparing fluid resuscitation with...
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/s00134-010-2117-9
更新日期:2011-05-01 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