Abstract:
OBJECTIVE:The evaluation of incidences and relating factors of severe persisting critical illness polyneuropathy (CIP) in survivors of multiple organ failure (MOF). DESIGN:Prospective study with an entry period of 24 months. Electrophysiological studies for the diagnosis of CIP were performed 1 or 2 days before the patients were discharged from the intensive care unit (ICU). Factors which might have been related to the development of CIP were identified by a retrospective chart analysis. SETTING:The interdisciplinary ICU of a university hospital. PATIENTS:Thirty-three patients who survived MOF. Sixteen of these critically ill patients developed severe sepsis due to nosocomial infections with gram-negative bacteria. RESULTS:In seven survivors of MOF and sepsis typical electrophysiological features of CIP, like spontaneous fibrillations and low compound muscle action potentials, were detectable at the time of discharge from the ICU. Seventeen patients with MOF following multiple trauma who developed no sepsis, and nine survivors of MOF with sepsis showed no signs of persisting CIP at the end of their ICU stay. Chart analysis revealed that eight survivors of MOF with sepsis and without the development of CIP had been treated with intravenous immunoglobulin (IVIG) with a dosage of 0.3 g/kg per day for 3 days immediately (within 24 h) after the diagnosis of sepsis. Four out of seven patients with MOF and sepsis who developed CIP were transferred to our ICU after the onset of sepsis and had not received IVIG treatment. The IVIG treatment in three patients was delayed for more than 24 h after the diagnosis of sepsis and was then omitted. Obviously not related to the development of CIP were aminoglycoside antibiotics, steroids, nutritional disturbances and episodes of hypotension or hypoxia. Neuromuscular blocking agents were not used during intensive care treatment. CONCLUSIONS:A high incidence of severe CIP persisting until the day of discharge from the ICU was related to gram-negative sepsis but not to MOF alone. Retrospective chart analysis suggested that early application of IVIG may prevent or mitigate this severe complication. However, these results have to be confirmed in a prospective, placebo-controlled study.
journal_name
Intensive Care Medjournal_title
Intensive care medicineauthors
Mohr M,Englisch L,Roth A,Burchardi H,Zielmann Sdoi
10.1007/s001340050471subject
Has Abstractpub_date
1997-11-01 00:00:00pages
1144-9issue
11eissn
0342-4642issn
1432-1238journal_volume
23pub_type
杂志文章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::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 determine the prevalence and the prognostic significance of microalbuminuria in patients after aneurysmal subarachnoid hemorrhage (SAH). DESIGN:Prospective and observational clinical study. SETTING:Multidisciplinary intensive care unit. PATIENTS:Fifty-one consecutive patients who underwent aneurysm clip...
journal_title:Intensive care medicine
pub_type: 杂志文章
doi:10.1007/s00134-007-0617-z
更新日期:2007-06-01 00:00:00
abstract::Nosocomial pneumonia continues to represent a significant cause of morbidity and mortality in hospitalized patients. Bacteria are responsible for greater than 90% of the pneumonias, the most common isolates being aerobic Gram-negative bacilli and S. aureus. Cornerstones of treatment are intravenous antibiotics and sup...
journal_title:Intensive care medicine
pub_type: 杂志文章,评审
doi:10.1007/BF01752974
更新日期:1992-01-01 00:00:00
abstract:OBJECTIVE:The study was undertaken to determine if critically ill patients under mechanical ventilation could reactivate latent cytomegalovirus (CMV) in either lung or blood. DESIGN:Prospective study in critically ill patients was performed in a multidisciplinary intensive care unit in a university hospital. PATIENTS...
journal_title:Intensive care medicine
pub_type: 杂志文章
doi:10.1007/BF01709343
更新日期:1996-11-01 00:00:00
abstract:OBJECTIVE:To assess procalcitonin (PCT) and C-reactive protein (CRP) plasma concentrations and clearance in nonseptic end-stage renal failure patients undergoing their first three hemodialysis sessions. DESIGN AND SETTING:Prospective observational consecutive clinical study at a university hospital. PATIENTS:The stud...
journal_title:Intensive care medicine
pub_type: 杂志文章
doi:10.1007/s00134-003-1664-8
更新日期:2003-04-01 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::Thirty patients with adult respiratory distress syndrome required intermittent positive pressure ventilation; 15 survived. In 25 the syndrome followed bacterial infection or multiple injuries. From the peak upper airway pressure, the oxygen gradient and the age of the patient, an index was obtained which discriminated...
journal_title:Intensive care medicine
pub_type: 杂志文章
doi:10.1007/BF00254517
更新日期:1986-01-01 00:00:00
abstract:OBJECTIVE:To evaluate the impact of two different comorbidity measures on the 6-month mortality of severely ill cancer patients. DESIGN AND SETTING:Prospective cohort study in a ten-bed oncological medical-surgical intensive care unit (ICU). PATIENTS:A total of 772 consecutive patients were included over a 45-month p...
journal_title:Intensive care medicine
pub_type: 杂志文章
doi:10.1007/s00134-005-2554-z
更新日期:2005-03-01 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:To compare the concentration conformity of infusion solutions manually prepared on intensive care units (ICU) with solutions from pharmacy-based, automated production. METHODS:A prospective observational study conducted in a university hospital in Germany. Drug concentrations of 100 standardised infusion solut...
journal_title:Intensive care medicine
pub_type: 杂志文章
doi:10.1007/s00134-011-2230-4
更新日期:2011-08-01 00:00:00
abstract:OBJECTIVES:Critically ill patients often develop anaemia which can be related to a number of factors. However, the exact causes of anaemia in many patients remain unexplained. We hypothesized that the relationship between erythropoietin (EPO) and haematocrit may be altered in critically ill patients. DESIGN:Serum conc...
journal_title:Intensive care medicine
pub_type: 杂志文章,多中心研究
doi:10.1007/s001340050310
更新日期:1997-02-01 00:00:00
abstract:OBJECTIVE:To characterize hemodynamic changes during experimental aspiration pneumonitis, paying special attention to echocardiographic assessment. DESIGN AND SETTING:Animal study in a university-based research laboratory. SUBJECTS:Fourteen mechanically ventilated New Zealand white rabbits INTERVENTIONS:We instilled...
journal_title:Intensive care medicine
pub_type: 杂志文章
doi:10.1007/s00134-006-0457-2
更新日期:2007-02-01 00:00:00
abstract:PURPOSE:To study the incidence and clinical characteristics of delayed cerebral thrombosis in bacterial meningitis patients. METHODS:We assessed the incidence and clinical characteristics of delayed cerebral thrombosis in adults with cerebrospinal fluid (CSF) culture-proven community-acquired bacterial meningitis incl...
journal_title:Intensive care medicine
pub_type: 杂志文章
doi:10.1007/s00134-012-2792-9
更新日期:2013-05-01 00:00:00
abstract:PURPOSE:To determine the incidence of and risk factors for adverse cardiac events during catecholamine vasopressor therapy in surgical intensive care unit patients with cardiovascular failure. METHODS:The occurrence of any of seven predefined adverse cardiac events (prolonged elevated heart rate, tachyarrhythmia, myoc...
journal_title:Intensive care medicine
pub_type: 杂志文章
doi:10.1007/s00134-012-2531-2
更新日期:2012-06-01 00:00:00
abstract:OBJECTIVE:We propose that higher airway occlusion pressure (P0.1) responses to hypercapnic challenge (HC) indicate less severe injury. The study aim was to determine whether P0.1 responses to HC were associated with successful weaning after prolonged mechanical ventilation (PMV) in patients with brainstem lesions and t...
journal_title:Intensive care medicine
pub_type: 杂志文章
doi:10.1007/s00134-008-1197-2
更新日期:2009-01-01 00:00:00
abstract::Optimal fluid management is one of the main challenges in the care of the critically ill. However, the physiological parameters that are commonly monitored and used to guide fluid management are often inadequate and even misleading. From 1987 to 1989 we published four experimental studies which described a method for ...
journal_title:Intensive care medicine
pub_type: 杂志文章,评审
doi:10.1007/s00134-014-3285-9
更新日期:2014-06-01 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:OBJECTIVE:To evaluate the efficacy of minitracheotomy (MT) insertion for intratracheal oxygen insufflation (ITO2) on arterial blood gases and survival in patients with respiratory failure from chronic lung disease. DESIGN:Open, prospective clinical study. SETTING:A 12-bed medical intensive care unit in a non-universi...
journal_title:Intensive care medicine
pub_type: 临床试验,杂志文章
doi:10.1007/BF01709545
更新日期:1996-12-01 00:00:00
abstract::An 18-month-old male infant presented with hypoglycemic coma and clinical signs of bronchopneumonia. He was suspected of suffering from septic shock. The patient progressed to irreversible multiple organ failure before the diagnosis of adrenal crisis was established. Plasma levels of ACTH and cortisol remained undetec...
journal_title:Intensive care medicine
pub_type: 杂志文章
doi:10.1007/s001340050021
更新日期:2000-01-01 00:00:00
abstract:OBJECTIVE:We examined whether early diffusion-weighted magnetic resonance imaging (DW-MRI) abnormalities of the brain and variation of apparent diffusion coefficient (ADC) values can provide prognostic information on clinical outcome in children following cardiac arrest (CA). DESIGN:Retrospective study. SETTING:A 12-...
journal_title:Intensive care medicine
pub_type: 杂志文章
doi:10.1007/s00134-013-2930-z
更新日期:2013-07-01 00:00:00
abstract:BACKGROUND:In critical illness, serum total cortisol (TC) may not adequately reflect adrenal function because of reduced cortisol-binding globulin (CBG). AIM:To evaluate adrenal function of critically ill children, using free cortisol index (FCI), calculated free cortisol (cFC), and TC levels. METHODS:Thirty-two crit...
journal_title:Intensive care medicine
pub_type: 杂志文章
doi:10.1007/s00134-009-1480-x
更新日期:2009-07-01 00:00:00
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:...
journal_title:Intensive care medicine
pub_type: 杂志文章
doi:10.1007/BF01709514
更新日期:1996-08-01 00:00:00
abstract:INTRODUCTION:Approximately 20 years have passed since we reported our results of histologically proven cytomegalovirus (CMV) pneumonia in non-immunocompromised ICU patients. Even if there are more recent reports suggesting that CMV may worsen the outcomes for ICU patients, there is no definite answer to this question: ...
journal_title:Intensive care medicine
pub_type: 杂志文章
doi:10.1007/s00134-015-4066-9
更新日期:2016-01-01 00:00:00
abstract::During a 3-year period, a clinical diagnosis of invasive candidosis was made in 8 out of 2054 consecutive surgical intensive care unit (ICU) patients. These patients were retrospectively matched with 16 control patients who underwent similar surgical procedures and had a similar clinical course except for negative Can...
journal_title:Intensive care medicine
pub_type: 杂志文章
doi:10.1007/s001340100891
更新日期:2001-05-01 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:To present the efficacy and tolerability of a new oral dosage form of the calcium antagonist nitrendipine compared to nifedipine capsules in patients with hypertensive emergency. DESIGN:Multicenter randomized double blind clinical study. SETTING:23 study centres (hospitals) in Germany. PATIENTS:161 patient...
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/BF01708963
更新日期:1994-01-01 00:00:00
abstract:PURPOSE:Neurologic and endothelial injury biomarkers are associated with prolonged delirium during critical illness and may reflect injury pathways that lead to poor long-term outcomes. We hypothesized that blood-brain barrier (BBB), neuronal, and endothelial injury biomarkers measured during critical illness are assoc...
journal_title:Intensive care medicine
pub_type: 杂志文章
doi:10.1007/s00134-018-5120-1
更新日期:2018-03-01 00:00:00
abstract:OBJECTIVE:To demonstrate bleeding complications encountered in patients after cardiac surgery on continuous venovenous haemofiltration (CVVH) treated with continuous versus intermittent r-hirudin for heparin-induced thrombocytopenia (HIT) type II. DESIGN:Case description. SETTING:Cardiothoracic intensive care unit at...
journal_title:Intensive care medicine
pub_type: 杂志文章
doi:10.1007/s001340051064
更新日期:1999-11-01 00:00:00
abstract:OBJECTIVE:Inhalation of high concentrations of nitric oxide (NO) has been shown to improve gas exchange and to reduce pulmonary vascular resistance in individuals with ischemia-reperfusion injury following orthotopic lung transplantation. We assessed the cardiopulmonary effects of low doses of NO in early allograft dys...
journal_title:Intensive care medicine
pub_type: 临床试验,杂志文章
doi:10.1007/s001340050741
更新日期:1998-11-01 00:00:00