Abstract:
OBJECTIVE:Spasms in patients with generalized tetanus can be suppressed by a spinal intrathecal infusion of baclofen. We report on four patients and review reported cases treated by this method elsewhere. DESIGN:Intrathecal baclofen infusion was started with a bolus dose (300-500 micrograms) and continued at a steady rate of 500-1000 micrograms/day. The dose was increased in daily steps as needed. RESULTS:Doses of baclofen of 500, 1000, or 2000 micrograms/day were effective in three patients, while 1500 micrograms/day was insufficient in the fourth. Bradycardia and hypotonia occurred in one patient at a dose of 2000 micrograms/day but resolved after the dose was reduced to 1500 micrograms/day. Another patient developed hypotonia when a bolus of 500 micrograms was given after a steady infusion of 1500 micrograms/day. Voluntary movements were preserved in one and returned in two patients when sedation, induced by initial diazepam infusions, receded. The fourth patient needed diazepam during most of the treatment with intrathecal baclofen and required mechanical ventilation while being treated with baclofen. CONCLUSIONS:A catheter position higher than T11 would possibly have yielded better results. It may be necessary to adapt the dose during the course of the illness. The preservation of respiratory drive and voluntary movements is the main advantage of treating tetanus with intrathecal baclofen. Additionally it helps to reduce sympathetic hyperactivity. Mortality may thereby be reduced.
journal_name
Intensive Care Medjournal_title
Intensive care medicineauthors
Dressnandt J,Konstanzer A,Weinzierl FX,Pfab R,Klingelhöfer Jdoi
10.1007/s001340050429subject
Has Abstractpub_date
1997-08-01 00:00:00pages
896-902issue
8eissn
0342-4642issn
1432-1238journal_volume
23pub_type
杂志文章,评审abstract::A 29-year-old woman was admitted to the Rouen University Hospital for attempted suicide by ingestion of a carbamate insecticide (Temik G, containing 10% aldicarb). Cardio-respiratory arrest occurred at the second hour and acute necrotic hemorrhagic pancreatitis on the second day. Further evolution was uneventful, and ...
journal_title:Intensive care medicine
pub_type: 杂志文章
doi:10.1007/BF02425057
更新日期:1994-01-01 00:00:00
abstract:: ...
journal_title:Intensive care medicine
pub_type: 社论
doi:10.1007/s00134-018-5401-8
更新日期:2018-12-01 00:00:00
abstract:OBJECTIVE:Our study aimed to determine the efficacy and safety of colistin in the treatment of ventilator-associated pneumonia (VAP) caused by pan-drug-resistant Pseudomonas aeruginosa or Acinetobacter baumanii. DESIGN:Pairwise, retrospective exposed-unexposed study. SETTING:Combined medical and surgical intensive ca...
journal_title:Intensive care medicine
pub_type: 杂志文章
doi:10.1007/s00134-007-0675-2
更新日期:2007-07-01 00:00:00
abstract:INTRODUCTION:Extracorporeal carbon dioxide removal (ECCO2R) has been proposed for hypercapnic respiratory failure in chronic obstructive pulmonary disease (COPD) exacerbations, to avoid intubation or reduce length of invasive ventilation. Balance of risks, efficacy, and benefits of ECCO2R in patients with COPD is uncle...
journal_title:Intensive care medicine
pub_type: 杂志文章,评审
doi:10.1007/s00134-015-3921-z
更新日期:2015-10-01 00:00:00
abstract:OBJECTIVES:To measure plasma levels and pharmacokinetics of cefpirome in critically ill septic patients with normal renal function. To use the pharmacokinetic model to simulate alternate dosing regimens and identify those that predict sustained levels. DESIGN AND SETTING:A prospective, open-label, descriptive study in...
journal_title:Intensive care medicine
pub_type: 杂志文章
doi:10.1007/s001340000741
更新日期:2001-02-01 00:00:00
abstract::Owing to an oversight by the authors, Figure 2 in this article was not the version intended for publication. The correct Figure 2, reproduced here, features footnote symbols and Figure 2b includes three studies as described in the main text. ...
journal_title:Intensive care medicine
pub_type: 杂志文章,已发布勘误
doi:10.1007/s00134-018-5055-6
更新日期:2018-02-01 00:00:00
abstract:OBJECTIVE:To characterize N-terminal pro-brain natriuretic peptide (N-proBNP) and troponin I (TnI) profile following mitral and/or aortic valve surgery and to evaluate correlations with echocardiography measures and outcome criteria. DESIGN AND SETTING:Prospective cross-controlled study in a university children's hosp...
journal_title:Intensive care medicine
pub_type: 杂志文章
doi:10.1007/s00134-008-1025-8
更新日期:2008-06-01 00:00:00
abstract:BACKGROUND:In patients with severe sepsis, no randomized clinical trial has tested the concept of de-escalation of empirical antimicrobial therapy. This study aimed to compare the de-escalation strategy with the continuation of an appropriate empirical treatment in those patients. METHODS:This was a multicenter non-bl...
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/s00134-014-3411-8
更新日期:2014-10-01 00:00:00
abstract::In order to evaluate the in vitro activity of fleroxacin against nosocomial gram-negative organisms, 263 multiresistant gram-negative bacilli (203 Enterobacteriaceae and 60 non-fermenting gram-negative bacilli) were isolated from adult patients with nosocomial infections. The different patterns of resistance to eight ...
journal_title:Intensive care medicine
pub_type: 杂志文章
doi:10.1007/s001340050675
更新日期:1998-08-01 00:00:00
abstract::Recent advances in analytical electrochemistry have provided highly selective potassium ion exchangers and robust polymeric membranes that can be used to measure the potassium activity in plasma or whole blood. The relationship between the activity measurement and the more familiar concentration measurement is explore...
journal_title:Intensive care medicine
pub_type: 杂志文章
doi:10.1007/BF01684390
更新日期:1978-04-01 00:00:00
abstract:OBJECTIVE:To examine variables associated with postextubation respiratory distress in chronic obstructive pulmonary disease (COPD) patients. DESIGN:Prospective, clinical investigation. SETTING:Intensive care unit of a university hospital. PATIENTS:Forty COPD patients, considered ready for extubation. MEASUREMENTS A...
journal_title:Intensive care medicine
pub_type: 临床试验,杂志文章
doi:10.1007/s001340050762
更新日期:1998-12-01 00:00:00
abstract::We studied the effect of thiopental loading during resuscitation of 53 patients following cardiopulmonary arrest and compared the outcome with that found in 54 patients treated conventionally in the 30 previous months. Thiopental therapy (10 mg/kg i.v.) was begun within 30 min of the arrest once hemodynamic stability ...
journal_title:Intensive care medicine
pub_type: 临床试验,杂志文章
doi:10.1007/BF00265112
更新日期:1987-01-01 00:00:00
abstract:PURPOSE:Some patients presenting with acute respiratory failure and meeting the Berlin criteria for acute respiratory distress syndrome (ARDS) lack exposure to common risk factors (CRF). These so-called ARDS mimickers often lack histological diffuse alveolar damage. We aimed to describe such ARDS mimickers lacking CRF ...
journal_title:Intensive care medicine
pub_type: 杂志文章
doi:10.1007/s00134-015-4064-y
更新日期:2016-02-01 00:00:00
abstract:PURPOSE:Plasma immunoglobulin concentrations are acutely altered in critically ill patients with sepsis. However, the association between immunoglobulin levels on the day of sepsis diagnosis and subsequent mortality is inconsistent. METHODS:Systematic review of studies that report immunoglobulin measurements and morta...
journal_title:Intensive care medicine
pub_type: 杂志文章,meta分析,评审
doi:10.1007/s00134-015-3845-7
更新日期:2015-08-01 00:00:00
abstract:OBJECTIVE:To analyze the effects of polymyxin B-immobilized fiber (PMX-F) on bone resorption in septic patients. DESIGN AND SETTING:Observational prospective study in intensive care units of a general hospital. PATIENTS AND PARTICIPANTS:25 patients with severe sepsis and 20 healthy controls. MEASUREMENTS AND RESULTS...
journal_title:Intensive care medicine
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1007/s00134-004-2357-7
更新日期:2004-09-01 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::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:To evaluate a least squares fitting technique for the purpose of measuring total respiratory compliance (Crs) and resistance (Rrs) in patients submitted to partial ventilatory support, without the need for esophageal pressure measurement. DESIGN:Prospective, randomized study. SETTING:A general ICU of a Univ...
journal_title:Intensive care medicine
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1007/BF01707409
更新日期:1995-05-01 00:00:00
abstract::The pharmacokinetics of theophylline and ethylenediamine were examined in 6 patients with septicaemia and multiorgan failure (MOF). The patients received a bolus injection of 4 mg/kg aminophylline. Aminophylline is the ethylenediamine salt of theophylline. The clearance of theophylline was reduced in all our patients ...
journal_title:Intensive care medicine
pub_type: 杂志文章
doi:10.1007/BF01690768
更新日期:1991-01-01 00:00:00
abstract:OBJECTIVE:To investigate the accuracy of lung ultrasonography (LUS) in the quantification of lung water in critically ill patients by using quantitative computed tomography (CT) as the gold standard for the determination of lung weight. METHODS:Twenty consecutive patients admitted to an intensive care unit who underwe...
journal_title:Intensive care medicine
pub_type: 杂志文章
doi:10.1007/s00134-012-2694-x
更新日期:2013-01-01 00:00:00
abstract:PURPOSE:Meconium aspiration syndrome (MAS) is a life-threatening neonatal lung injury, whose pathophysiology has been mainly studied in animal models. In such models, pancreatic secretory phospholipase A2 (sPLA2-IB) and proinflammatory cytokines present in meconium challenge the lungs, catabolising surfactant and harmi...
journal_title:Intensive care medicine
pub_type: 杂志文章
doi:10.1007/s00134-011-2243-z
更新日期:2011-07-01 00:00:00
abstract:OBJECTIVE:To evaluate the extent to which respiratory changes in inferior vena cava (IVC) diameter can be used to predict fluid responsiveness. DESIGN:Prospective clinical study. SETTING:Hospital intensive care unit. PATIENTS:Twenty-three patients with acute circulatory failure related to sepsis and mechanically ven...
journal_title:Intensive care medicine
pub_type: 临床试验,杂志文章
doi:10.1007/s00134-004-2259-8
更新日期:2004-09-01 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:Patients undergoing cardiac surgery often require transfusions of red blood cells, plasma and platelets. These components differ widely in both indications for use and composition. However, from a statistical point of view there is a significant colinearity between the components. This study explores the relati...
journal_title:Intensive care medicine
pub_type: 杂志文章
doi:10.1007/s00134-012-2723-9
更新日期:2013-03-01 00:00:00
abstract:PURPOSE:To assess the utility of two in situ techniques, differential time to positivity (DTP) and semiquantitative superficial cultures (SQSC) for diagnosing catheter-related bloodstream infection (CR-BSI) in critically ill adults. METHODS:This was a prospective cohort study in patients with suspected CR-BSI arising ...
journal_title:Intensive care medicine
pub_type: 杂志文章
doi:10.1007/s00134-012-2689-7
更新日期:2013-01-01 00:00:00
abstract:PURPOSE:The effect of advanced age per se versus severity of chronic and acute diseases on the short- and long-term survival of older patients admitted to the intensive care unit (ICU) remains unclear. METHODS:Intensive care unit admissions to the surgical ICU and medical ICU of patients older than 65 years were analy...
journal_title:Intensive care medicine
pub_type: 杂志文章
doi:10.1007/s00134-012-2629-6
更新日期:2012-10-01 00:00:00
abstract:OBJECTIVE:To assess acute cardiorespiratory effects of recruitment manoeuvres in experimental acute lung injury. DESIGN:Experimental study in animal models of acute lung injury. SETTING:Experimental laboratory at a University Medical Centre. ANIMALS:Ten pigs with bronchoalveolar lavage and eight pigs with endotoxin-...
journal_title:Intensive care medicine
pub_type: 杂志文章
doi:10.1007/s00134-004-2496-x
更新日期:2005-01-01 00:00:00
abstract:PURPOSE:Relatives of intensive care unit (ICU) patients suffer emotional distress that impairs their ability to acquire the information they need from the staff. We sought to evaluate whether providing relatives with a list of important questions was associated with better comprehension on day 5. METHODS:Randomized, p...
journal_title:Intensive care medicine
pub_type: 杂志文章,随机对照试验
doi:10.1007/s00134-018-5423-2
更新日期:2018-11-01 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:OBJECTIVE:Based on limited data, Candida sp. isolates from bronchoalveolar lavage (BAL) cultures in immunocompetent patients are thought to be contaminants rather than pathogens. The objective of this study was to determine the clinical significance of Candida sp. isolated from BAL cultures in critically ill trauma pat...
journal_title:Intensive care medicine
pub_type: 杂志文章
doi:10.1007/s00134-005-0065-6
更新日期:2006-04-01 00:00:00