Abstract:
OBJECTIVES:To develop a simplified Therapeutic Intervention Scoring System (TISS) based on the TISS-28 items and to validate the new score in an independent database. DESIGN:Retrospective statistical analysis of a database and a prospective multicentre study. SETTING:Development in the database of the Foundation for Research on Intensive Care in Europe with external validation in 64 intensive care units (ICUs) of 11 European countries. MEASUREMENTS AND RESULTS:Development of NEMS on a random sample of TISS-28 items, cross validation on another random sample of TISS-28, and external validation of NEMS in comparison with TISS-28 scored by two independent raters on the day of the visit to the ICUs participating in an international study. Multivariable regression techniques, Pearson's correlation, and paired sample t-tests were used (significance at p < 0.05 level). Intraclass correlation, rate of agreement, and kappa statistics were used for interrater reliability tests. The TISS-28 items were reduced to NEMS (9 items) in a random sample of 2000 records; the means of the two scores were no different: TISS-28 26.23 +/- 10.38, NEMS 26.19 +/- 9.12, NS. Cross-validation in a random sample of 996 records; mean TISS-28 26.13 +/- 10.38, NEMS 26.17 +/- 9.38, NS; R2 = 0.76. External validation on 369 pairs of TISS-28 and NEMS has shown that the means of the two scores were no different: TISS-28 27.56 +/- 11.03, NEMS 27.02 +/- 8.98, NS; R2 = 0.59. Reliability tests have shown an "almost perfect" interrater correlation. Similar to studies correlating TISS with Simplified Acute Physiology Score (SAPS)-I and/or Acute Physiology and Chronic Health Evaluation II scores, the value of NEMS scored on the first day accounts for 30.4% of the variation of SAPS-II score. CONCLUSIONS:NEMS is a suitable therapeutic index to measure nursing workload at the ICU level. The use of NEMS is indicated for: (a) multicentre ICU studies; (b) management purposes in the general (macro) evaluation and comparison of workload at the ICU level; (c) the prediction of workload and planning of nursing staff allocation at the individual patient level.
journal_name
Intensive Care Medjournal_title
Intensive care medicineauthors
Reis Miranda D,Moreno R,Iapichino Gdoi
10.1007/s001340050406subject
Has Abstractpub_date
1997-07-01 00:00:00pages
760-5issue
7eissn
0342-4642issn
1432-1238journal_volume
23pub_type
杂志文章abstract:PURPOSE:To assess the feasibility of remifentanil-based sedation in hypoxemic acute respiratory failure (HARF) patients refusing to continue noninvasive ventilation (NPPV) for intolerance to two different interfaces-helmet and total face mask. DESIGN AND SETTING:Prospective uncontrolled clinical investigation in a 14-...
journal_title:Intensive care medicine
pub_type: 临床试验,杂志文章
doi:10.1007/s00134-010-2026-y
更新日期:2010-12-01 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::The process of fluidisation involves blowing warm air through small solid microspheres thus creating a liquid, without wetness. The warmth provides some important properties including reducing the metabolic rate in thermal injury which has a beneficial effect on mortality, modifying catabolism after surgery, providing...
journal_title:Intensive care medicine
pub_type: 杂志文章,评审
doi:10.1007/BF01701488
更新日期:1995-03-01 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:PURPOSE:Providing mechanical ventilation is challenging at supra-atmospheric pressure. The higher gas density increases resistance, reducing the flow delivered by the ventilator. A new hyperbaric ventilator (Siaretron IPER 1000) is said to compensate for these effects automatically. The aim of this bench test study was...
journal_title:Intensive care medicine
pub_type: 杂志文章
doi:10.1007/s00134-012-2590-4
更新日期:2012-08-01 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::The side effects of positive pressure ventilation on cardiovascular function are well known. However, in most clinical studies its influence on left ventricular function was examined. In the present study right ventricular (RV) performance was studied in 13 patients undergoing coronary artery bypass grafting during me...
journal_title:Intensive care medicine
pub_type: 杂志文章
doi:10.1007/BF00256962
更新日期:1988-01-01 00:00:00
abstract:PURPOSE:Ventricular-arterial (V-A) decoupling decreases myocardial efficiency and is exacerbated by tachycardia that increases static arterial elastance (Ea). We thus investigated the effects of heart rate (HR) reduction on Ea in septic shock patients using the beta-blocker esmolol. We hypothesized that esmolol improve...
journal_title:Intensive care medicine
pub_type: 杂志文章
doi:10.1007/s00134-016-4351-2
更新日期:2016-10-01 00:00:00
abstract::Production of beta-lactamases is the most important means of bacterial resistance to beta-lactam antibiotics. The traditional, plasmid-mediated beta-lactamases were initially confined to Enterobacteriaceae but have now spread to other genera and species including Pseudomonas aeruginosa, Haemophilus influenzae, and Nei...
journal_title:Intensive care medicine
pub_type: 杂志文章,评审
doi:10.1007/BF01745244
更新日期:1994-07-01 00:00:00
abstract:PURPOSE:We compared 1 versus 0.5 microg/kg bolus remifentanil versus placebo in alleviating pain due to chest drain removal. Effects on sedation, respiratory rate (RR), oxygen saturation, heart rate (HR) and blood pressure were also evaluated. METHODS:Sixty patients following cardiac surgery were enrolled in this pros...
journal_title:Intensive care medicine
pub_type: 杂志文章,随机对照试验
doi:10.1007/s00134-010-1836-2
更新日期:2010-08-01 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:OBJECTIVE:To compare haemodynamic and gas exchange effects after either atracurium or pancuronium given to ventilated neonates with respiratory failure. DESIGN:In this prospective study neonates were alternately assigned to receive either atracurium or pancuronium, intravenously. SETTING:Paediatric and neonatal ICU i...
journal_title:Intensive care medicine
pub_type: 杂志文章
doi:10.1007/BF01724880
更新日期:1993-01-01 00:00:00
abstract:PURPOSE:To study the association between early initiation of intra-arrest therapeutic hypothermia and neurologic outcome in out-of-hospital cardiac arrest. METHODS:A prespecified sub-analysis of the PRINCESS trial (NCT01400373) that randomized 677 bystander-witnessed cardiac arrests to transnasal evaporative intra-arr...
journal_title:Intensive care medicine
pub_type: 杂志文章
doi:10.1007/s00134-020-06024-3
更新日期:2020-07-01 00:00:00
abstract:OBJECTIVES:(1) To demonstrate that metabolic parameters are better indicators of tissue hypoxia than regional and whole oxygen consumption (VO(2)). (2) To compare intramucosal pH (pHi) in different gastrointestinal segments. DESIGN:Prospective, interventional study. SETTING:Research laboratory at a university center....
journal_title:Intensive care medicine
pub_type: 杂志文章
doi:10.1007/s00134-001-1138-9
更新日期:2001-12-01 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: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:Limited data exist on the correlation between higher flow rates of high-flow nasal cannula (HFNC) and its physiologic effects in patients with acute hypoxemic respiratory failure (AHRF). We assessed the effects of HFNC delivered at increasing flow rate on inspiratory effort, work of breathing, minute ventilatio...
journal_title:Intensive care medicine
pub_type: 杂志文章
doi:10.1007/s00134-017-4890-1
更新日期:2017-10-01 00:00:00
abstract::Arterial blood ketone body ratio, reflecting hepatic mitochondrial redox state, was measured in 26 brain-dead patients who were hypotensive but hemodynamically stable. All of them had substantially normal hepatic function. In 18 of the patients, blood ketone body ratio was maintained within the normal range in spite o...
journal_title:Intensive care medicine
pub_type: 杂志文章
doi:10.1007/BF01691432
更新日期:1991-01-01 00:00:00
abstract:OBJECTIVE:To determine the cell content and purity of Ficoll-separated peripheral blood mononuclear cells and granulocyte isolates in sepsis patients compared to healthy controls. DESIGN AND SETTING:Prospective study in the adult and pediatric intensive care departments of the Erasmus University Medical Center in the ...
journal_title:Intensive care medicine
pub_type: 杂志文章
doi:10.1007/s00134-007-0989-0
更新日期:2008-05-01 00:00:00
abstract:OBJECTIVE:To compare the total plasma cortisol values obtained from three widely used immunoassays and a high pressure liquid chromatography (HPLC) technique on samples obtained from patients with sepsis. DESIGN AND SETTING:Observational interventional in the general intensive care unit of a metropolitan hospital PAT...
journal_title:Intensive care medicine
pub_type: 杂志文章
doi:10.1007/s00134-006-0389-x
更新日期:2006-11-01 00:00:00
abstract:OBJECTIVE:To determine the steady-state plasma and epithelial lining fluid (ELF) concentrations of ceftazidime administered in continuous infusion to critically ill patients with severe nosocomial pneumonia. DESIGN:Prospective, open-label study. SETTING:An intensive care unit and research ward in a university hospita...
journal_title:Intensive care medicine
pub_type: 临床试验,杂志文章
doi:10.1007/s00134-004-2171-2
更新日期:2004-05-01 00:00:00
abstract:: ...
journal_title:Intensive care medicine
pub_type: 杂志文章
doi:10.1007/s00134-018-5063-6
更新日期:2018-12-01 00:00:00
abstract:PURPOSE:To determine whether, during mechanical ventilation, an optimal positive end-expiratory pressure (PEEP) can be identified by measurement of regional tidal volume and compliance [V (T(reg)), C (RS(reg))]. METHODS:Sixteen anaesthetized intubated neonatal piglets underwent a stepwise vital capacity manoeuvre perf...
journal_title:Intensive care medicine
pub_type: 杂志文章
doi:10.1007/s00134-010-1995-1
更新日期:2010-11-01 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:OBJECTIVE:Lung injury is a severe complication of acute pancreatitis that increases the mortality rate of the disease. The pathophysiology of acute pancreatitis has been studied in several experimental models, but the kinetics of pulmonary complications in relation to the pancreatic disease is not completely understood...
journal_title:Intensive care medicine
pub_type: 杂志文章
doi:10.1007/s00134-006-0264-9
更新日期:2006-11-01 00:00:00
abstract::The case of an 11-year-old boy who suffered second and third degree burns to 78% of his body is reported. The large doses of morphine used as analgesia resulted in severe side effects: ventilatory dependence, impairment of gastrointestinal function and psychological disturbance. Intravenous lignocaine was added withou...
journal_title:Intensive care medicine
pub_type: 杂志文章
doi:10.1007/BF01712245
更新日期:1996-03-01 00:00:00
abstract:OBJECTIVE:To evaluate the effect of terlipressin on oxygenation, PaO2/FIO2, heart rate, mean arterial pressure, and mortality in children with septic shock refractory to high doses of dopamine/dobutamine and adrenaline. DESIGN AND SETTING:A randomized, nonblind study in the pediatric intensive care unit of a universit...
journal_title:Intensive care medicine
pub_type: 杂志文章,随机对照试验
doi:10.1007/s00134-007-0971-x
更新日期:2008-03-01 00:00:00
abstract:OBJECTIVE:To study the wishes of a sample of French patients about medical information and surrogacy, at a time when the French Ministry of Health is supporting increased patient autonomy. DESIGN:A cohort of competent patients with non-critical illnesses or injuries completed an intention-to-act questionnaire on the a...
journal_title:Intensive care medicine
pub_type: 杂志文章
doi:10.1007/s001340050011
更新日期:2000-01-01 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:OBJECTIVE:We compared two imipenem regimens for prevention of septic complications in patients with severe acute necrotizing pancreatitis (ANP). DESIGN AND SETTING:Prospective, randomized open clinical trial involving intensive care units of 14 Spanish Hospitals. PARTICIPANTS:92 patients with ANP. INTERVENTIONS:Imip...
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/s00134-003-1956-z
更新日期:2003-11-01 00:00:00