当前位置： SCI文献检索 > INTENSIVE CARE MEDICINE期刊下所有文献 > Acute hypoxemic respiratory failure in children: case mix and the utility of respiratory severity indices.

Acute hypoxemic respiratory failure in children: case mix and the utility of respiratory severity indices.

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 best early respiratory indices in those who died compared with those who survived. DESIGN:A prospective observational study of 118 consecutive AHRF admissions with data analysis incorporating all blood gases. SETTING:A pediatric intensive care unit in a national children's hospital. INTERVENTIONS:None. RESULTS:Mortality was 26/118, 22% (95 % confidence interval 18-26%). There were no significant differences in the best alveolar-arterial oxygen tension gradient (A-aDO2, torr), oxygenation index (OI), ventilation index (VI), or PaO2/FIO2 during the first 2 days of intensive care between the survivors and non-survivors. Only the mean airway pressure (MAP, cm H2O) used for supportive care was significantly different on days 0 and 1 (p < 0.05) with higher pressure being used in non-survivors. Multiple logistic regression analysis did not identify any gas exchange or ventilator parameter independently associated with mortality. Rather, all deaths were associated with coincident pathology or multi-organ system failure, or perceived treatment futility due to pre-existing diagnoses instead of unsupportable respiratory failure. When using previously published predictors of outcome (VI > 40 and OI > 40; A-aDO2 > 450 for 24 h; A-aDO2 > 470 or MAP > 23; or A-aDO2 > 420) the risk of mortality was overestimated significantly in the current population. CONCLUSION:The original hypothesis was refuted. It appears that the outcome of AHRF in present day pediatric critical care is principally related to the severity of associated pathology and now no longer solely to the severity of respiratory failure. Further studies in larger series are needed to confirm these findings.

journal_name

Intensive Care Med

journal_title

Intensive care medicine

authors

Peters MJ,Tasker RC,Kiff KM,Yates R,Hatch DJ

doi

10.1007/s001340050647

subject

Has Abstract

pub_date

1998-07-01 00:00:00

pages

699-705

issue

7

eissn

0342-4642

issn

1432-1238

journal_volume

24

pub_type

杂志文章

相关文献

INTENSIVE CARE MEDICINE文献大全
  • Intrapulmonary percussive ventilation in tracheostomized patients: a randomized controlled trial.

    abstract：OBJECTIVE:To investigate whether the addition of intrapulmonary percussive ventilation to the usual chest physiotherapy improves gas exchange and lung mechanics in tracheostomized patients. DESIGN AND SETTING:Randomized multicenter trial in two weaning centers in northern Italy. PATIENTS AND PARTICIPANTS:46 tracheost...

    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/s00134-006-0427-8

    authors： Clini EM,Antoni FD,Vitacca M,Crisafulli E,Paneroni M,Chezzi-Silva S,Moretti M,Trianni L,Fabbri LM

    更新日期：2006-12-01 00:00:00

  • A new device to remove obstruction from endotracheal tubes during mechanical ventilation in critically ill patients.

    abstract：OBJECTIVE:To evaluate the efficiency of a new device developed to remove obstructions from endotracheal tubes (ETT) in mechanically ventilated patients. DESIGN:Open study in mechanically ventilated sedated and paralyzed ICU patients. SETTING:General ICU and Laboratory of Respiratory Mechanics of the University of Rom...

    journal_title：Intensive care medicine

    pub_type： 临床试验,杂志文章

    doi：10.1007/BF01705724

    authors： Conti G,Rocco M,De Blasi RA,Lappa A,Antonelli M,Bufi M,Gasparetto A

    更新日期：1994-11-01 00:00:00

  • Pain relief with low-dose intravenous clonidine in a child with severe burns.

    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

    authors： Lyons B,Casey W,Doherty P,McHugh M,Moore KP

    更新日期：1996-03-01 00:00:00

  • Evaluation of the catheter positioning for neurally adjusted ventilatory assist.

    abstract：PURPOSE:During neurally adjusted ventilatory assist (NAVA) the ventilator is driven by the patients electrical activation of the diaphragm (EAdi), detected by a special esophageal catheter. A reliable positioning of the EAdi-catheter is mandatory to trace a representative EAdi signal. We aimed to determine whether a fo...

    journal_title：Intensive care medicine

    pub_type： 杂志文章

    doi：10.1007/s00134-009-1587-0

    authors： Barwing J,Ambold M,Linden N,Quintel M,Moerer O

    更新日期：2009-10-01 00:00:00

  • Oxidative parameters and mortality in sepsis induced by cecal ligation and perforation.

    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

    authors： Ritter C,Andrades M,Frota Júnior ML,Bonatto F,Pinho RA,Polydoro M,Klamt F,Pinheiro CT,Menna-Barreto SS,Moreira JC,Dal-Pizzol F

    更新日期：2003-10-01 00:00:00

  • Current practice regarding invasive monitoring in intensive care units in Finland. A nationwide study of the uses of arterial, pulmonary artery and central venous catheters and their effect on outcome. The Finnish Intensive Care Study Group.

    abstract：:As part of a nationwide evaluation of intensive care, we examined patient- and hospital-related factors which could influence the patterns of utilization of arterial cannulae and central venous and pulmonary artery catheters. We also studied the possible impact of these interventions on the short-term outcome among 14...

    journal_title：Intensive care medicine

    pub_type： 杂志文章

    doi：10.1007/BF01713935

    authors： Saarela E,Kari A,Nikki P,Rauhala V,Iisalo E,Kaukinen L

    更新日期：1991-01-01 00:00:00

  • Age-dependent effects of gradual decreases in cerebral perfusion pressure on the neurochemical response in swine.

    abstract：OBJECTIVE:There is still a lack of knowledge on the age-dependent relation between a reduction in cerebral perfusion pressure (CPP) and compromised brain perfusion leading to excessive transmitter release and brain damage cascades. The hypothesis is that an age-dependent lower threshold of cerebral blood flow (CBF) aut...

    journal_title：Intensive care medicine

    pub_type： 杂志文章

    doi：10.1007/s00134-010-1846-0

    authors： Walter B,Aisenpreis K,Fritz HG,Soukup J,Eiselt M,Bauer R

    更新日期：2010-06-01 00:00:00

  • Organ donations and unused potential donations in traumatic brain injury, subarachnoid haemorrhage and intracerebral haemorrhage.

    abstract：OBJECTIVE:To obtain insight into the occurrence of brain death and the potential for brain dead and controlled non-heart-beating organ donors (CNHB) in patients with traumatic brain injury (TBI), subarachnoid haemorrhage (SAH) and intracerebral haemorrhage (ICH) in a large neurosurgical serving area (2.1 million inhabi...

    journal_title：Intensive care medicine

    pub_type： 杂志文章

    doi：10.1007/s00134-005-0001-9

    authors： Kompanje EJO,Bakker J,Slieker FJA,IJzermans JNM,Maas AIR

    更新日期：2006-02-01 00:00:00

  • Assessment of depth of midazolam sedation using objective parameters.

    abstract：OBJECTIVE:To determine the relationship between the clinically evaluated depth of midazolam-induced sedation and the cardiac beat-to-beat variability (RR variability) in ICU patients in the intensive care unit (ICU). DESIGN:Prospective study. SETTING:ICU of a university hospital. PATIENTS:20 consecutive patients stu...

    journal_title：Intensive care medicine

    pub_type： 杂志文章

    doi：10.1007/BF01709555

    authors： Haberthür C,Lehmann F,Ritz R

    更新日期：1996-12-01 00:00:00

  • Susceptibility to critical illness: reserve, response and therapy.

    abstract：:Risk of critical illness is determined both by genetic and environmental influences, particularly those relating to infectious and cardiovascular diseases. Physiologically-based scoring systems cannot measure prior risk because they do not quantify physiological reserve independently of the acute illness. Genetic prof...

    journal_title：Intensive care medicine

    pub_type： 杂志文章,评审

    doi：10.1007/s001340051120

    authors： Bion JF

    更新日期：2000-01-01 00:00:00

  • Safety and feasibility of a strategy of early central venous catheter insertion in a deployed UK military Ebola virus disease treatment unit.

    abstract：PURPOSE:Early central venous catheter (CVC) insertion in Ebola virus disease (EVD) is a novel approach and has not previously been described. This report delineates the safety, feasibility and clinical implications of early CVC insertion as the optimum means of vascular access in patients with EVD, in the setting of a ...

    journal_title：Intensive care medicine

    pub_type： 杂志文章

    doi：10.1007/s00134-015-3736-y

    authors： Rees PS,Lamb LE,Nicholson-Roberts TC,Ardley CN,Bailey MS,Hinsley DE,Fletcher TE,Dickson SJ

    更新日期：2015-05-01 00:00:00

  • Clinical estimation of trunk position among mechanically ventilated patients.

    abstract：OBJECTIVES:Trunk position at 45 degrees from the horizontal is associated with a decreased risk of gastroesophageal aspiration. The objectives of this study were to determine the accuracy of trunk flexion estimates compared to a reference standard measurement, and to determine agreement about trunk flexion among ICU cl...

    journal_title：Intensive care medicine

    pub_type： 杂志文章

    doi：10.1007/s00134-002-1225-6

    authors： McMullin JP,Cook DJ,Meade MO,Weaver BR,Letelier LM,Kahmamoui K,Higgins DA,Guyatt GH

    更新日期：2002-03-01 00:00:00

  • An unusual case of non-traumatic pneumococcal mediastinal abscess.

    abstract：:A 16-month old baby developed severe respiratory failure because of acute laryngitis and required mechanical ventilation. Intubation was complicated by aspiration and development of chemical pneumonia. Following 4 days of treatment the child was successfully extubated. Thirty six hours after extubation the patient aga...

    journal_title：Intensive care medicine

    pub_type： 杂志文章

    doi：10.1007/BF00256065

    authors： Lotan C,Boneh A,Tamir I,Goitein KJ

    更新日期：1985-01-01 00:00:00

  • Intensive care management of children following heart and heart-lung transplantation.

    abstract：:We report the intensive care management of 23 children (age 3-15 years) following orthotopic heart (HT) and combined heart and lung transplantation (HLT) performed at our 2 institutes between February 1985 and August 1989. Cyclosporin A, azathioprine and steroids were given as routine immunosuppression, whilst anti-th...

    journal_title：Intensive care medicine

    pub_type： 杂志文章

    doi：10.1007/BF01711219

    authors： Whitehead B,James I,Helms P,Scott JP,Smyth R,Higenbottam TW,McGoldrick J,English TA,Wallwork J,Elliott M

    更新日期：1990-01-01 00:00:00

  • Thiamine status after major trauma.

    abstract：:A prospective study of thiamine status in patients with severe injuries (injury severity scores greater than 12) showed that they all developed signs of severe thiamine deficiency on the basis of transketolase activity, the standard biochemical test for thiamine deficiency. This occurred within the first week after th...

    journal_title：Intensive care medicine

    pub_type： 杂志文章

    doi：10.1007/BF00256767

    authors： McConachie I,Haskew A

    更新日期：1988-01-01 00:00:00

  • Autoregulation of ventilation with neurally adjusted ventilatory assist on extracorporeal lung support.

    abstract：PURPOSE:Extracorporeal membrane oxygenation (ECMO) can support oxygenation and carbon dioxide elimination in severe lung failure. Usually it is accompanied by controlled mechanical ventilation. Neurally adjusted ventilatory assist (NAVA) is a new mode of ventilation triggered by the diaphragmatic electrical activity an...

    journal_title：Intensive care medicine

    pub_type： 杂志文章

    doi：10.1007/s00134-010-1982-6

    authors： Karagiannidis C,Lubnow M,Philipp A,Riegger GA,Schmid C,Pfeifer M,Mueller T

    更新日期：2010-12-01 00:00:00

  • End-of-life decision making in the intensive care unit.

    abstract：:Physicians are increasingly involved in how their critically ill patients die [72]. The more this happens, the more physicians will have to understand not only how their own backgrounds and biases influence their medical management, but also the cultural and religious backgrounds of the patient and surrogate [72, 73]....

    journal_title：Intensive care medicine

    pub_type： 杂志文章,评审

    doi：10.1007/s001340000641

    authors： Nyman DJ,Sprung CL

    更新日期：2000-10-01 00:00:00

  • Inhaled nitric oxide (NO) for the treatment of early allograft failure after lung transplantation. Munich Lung Transplant Group.

    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

    authors： Kemming GI,Merkel MJ,Schallerer A,Habler OP,Kleen MS,Haller M,Briegel J,Vogelmeier C,Fürst H,Reichart B,Zwissler B

    更新日期：1998-11-01 00:00:00

  • Emergency endovascular treatment of a life-threatening hemorrhage from traumatic rupture of the left extracranial vertebral artery.

    abstract：:Hemorrhagic complications from transection of cervical arteries in blunt traumas are rare. We report a case of potentially fatal hemorrhage from rupture of the left vertebral artery in a closed trauma, successfully treated by endovascular injection of glue. Endovascular embolization may be considered as an alternative...

    journal_title：Intensive care medicine

    pub_type： 杂志文章

    doi：10.1007/s001340051033

    authors： Simionato F,Righi C,Silvani P,Torri G,Scotti G

    更新日期：1999-10-01 00:00:00

  • Increased long-term mortality with plasma transfusion after coronary artery bypass surgery.

    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

    authors： Bjursten H,Dardashti A,Ederoth P,Brondén B,Algotsson L

    更新日期：2013-03-01 00:00:00

  • Severe acute pancreatitis: treatment with somatostatin.

    abstract：OBJECTIVE:To investigate the efficacy of somatostatin for the treatment of severe acute pancreatitis. DESIGN:Prospective, randomized and unblinded study. SETTING:A general intensive care unit (ICU) in a university hospital. PATIENTS:50 patients with severe acute pancreatitis. INTERVENTIONS:All patients received the...

    journal_title：Intensive care medicine

    pub_type： 临床试验,杂志文章,随机对照试验

    doi：10.1007/s001340050512

    authors： Planas M,Pérez A,Iglesia R,Porta I,Masclans JR,Bermejo B

    更新日期：1998-01-01 00:00:00

  • Acute hemodynamic changes during lung recruitment in lavage and endotoxin-induced ALI.

    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

    authors： Odenstedt H,Aneman A,Kárason S,Stenqvist O,Lundin S

    更新日期：2005-01-01 00:00:00

  • Extracorporeal carbon dioxide removal in patients with chronic obstructive pulmonary disease: a systematic review.

    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

    authors： Sklar MC,Beloncle F,Katsios CM,Brochard L,Friedrich JO

    更新日期：2015-10-01 00:00:00

  • Respiratory changes in inferior vena cava diameter are helpful in predicting fluid responsiveness in ventilated septic patients.

    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

    authors： Barbier C,Loubières Y,Schmit C,Hayon J,Ricôme JL,Jardin F,Vieillard-Baron A

    更新日期：2004-09-01 00:00:00

  • Does continuous heparinization influence platelet function in the intensive care patient?

    abstract：OBJECTIVE:To study the influence of continuous administration of heparin on platelet function in intensive care patients. DESIGN:Prospective, serial investigation. SETTING:Clinical investigation on a surgical and neurosurgical intensive care unit in a university hospital. PATIENTS:The study included 45 patients: 15 ...

    journal_title：Intensive care medicine

    pub_type： 杂志文章

    doi：10.1007/s001340050374

    authors： Boldt J,Müller M,Rothe A,Lenzen P,Hempelmann G

    更新日期：1997-05-01 00:00:00

  • Multiple organ failure after mitral valve repair with intravascular hemolysis and its recovery due to mitral valve replacement.

    abstract：:We present a patient with evidence of severe intravascular hemolysis after mitral valve repair, an established method for the surgical treatment of mitral valve disease to avoid prosthesis related complications. The coincidence of this uncommon complication with hemodynamic instability due to pre-existing myocardial d...

    journal_title：Intensive care medicine

    pub_type： 杂志文章

    doi：10.1007/BF01694714

    authors： Seyr M,Hasibeder W,Furtwaegler W,Antretter H,Mutz NJ

    更新日期：1993-01-01 00:00:00

  • Chronic antiplatelet therapy is not associated with alterations in the presentation, outcome, or host response biomarkers during sepsis: a propensity-matched analysis.

    abstract：PURPOSE:Sepsis is a major health burden worldwide. Preclinical investigations in animals and retrospective studies in patients have suggested that inhibition of platelets may improve the outcome of sepsis. In this study we investigated whether chronic antiplatelet therapy impacts on the presentation and outcome of seps...

    journal_title：Intensive care medicine

    pub_type： 杂志文章

    doi：10.1007/s00134-015-4171-9

    authors： Wiewel MA,de Stoppelaar SF,van Vught LA,Frencken JF,Hoogendijk AJ,Klein Klouwenberg PMC,Horn J,Bonten MJ,Zwinderman AH,Cremer OL,Schultz MJ,van der Poll T,MARS Consortium.

    更新日期：2016-03-01 00:00:00

  • Safety and efficacy of colistin compared with imipenem in the treatment of ventilator-associated pneumonia: a matched case-control study.

    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

    authors： Kallel H,Hergafi L,Bahloul M,Hakim A,Dammak H,Chelly H,Hamida CB,Chaari A,Rekik N,Bouaziz M

    更新日期：2007-07-01 00:00:00

  • Prevalence, risk factors and prevention of pressure ulcers in Dutch intensive care units. Results of a cross-sectional survey.

    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

    authors： Bours GJ,De Laat E,Halfens RJ,Lubbers M

    更新日期：2001-10-01 00:00:00

  • Muscle perfusion and oxygen consumption by near-infrared spectroscopy in septic-shock and non-septic-shock patients.

    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

    authors： Girardis M,Rinaldi L,Busani S,Flore I,Mauro S,Pasetto A

    更新日期：2003-07-01 00:00:00