Abstract:
PURPOSE:A volume challenge is useful for determining whether cardiac output will respond to further volume loading by the Frank-Starling mechanism. To properly test this mechanism, there must be an increase in right atrial pressure (Pra) but this requires variable amounts of normal saline. The purpose of this study was to determine if 100 mL of 25% albumin would reliably provide a predictable increase in Pra and to compare this with a volume challenge with normal saline. As in a previous study, we also examined the potential for the pattern of respiratory variation of Pra to predict the response to a fluid challenge. MATERIALS AND METHODS:Twenty-eight stable patients following cardiopulmonary bypass surgery were studied in a randomized, nonblinded interventional study in an intensive care unit. All patients had pulmonary artery flotation catheter as part of their routine management and were breathing spontaneously. They were randomized to receive sufficient normal saline to increase Pra by 2 mm Hg (n = 15) or 100 mL of 25% albumin (n = 13). We also tested the ability of the respiratory variation in Pra to predict the response to a fluid challenge. They had to have an inspiratory fall in the pulmonary capillary wedge pressure of more than 2 mm Hg as an indication that they had an adequate inspiratory effort. They were classified as either having or not having an inspiratory fall in Pra. We predicted that patients without an inspiratory fall in Pra should not respond to volume loading. RESULTS:In contrast to our prediction, the increase in Pra with albumin was less than the increase with normal saline. However, the cardiac output increased more with albumin, which suggests that there was an increase in cardiac function with the hypertonic, hyperosmolar albumin solution. In the saline group, a lack of inspiratory fall in Pra successfully predicted that cardiac output would fail to increase with an increase in Pra in 8 out of 10 patients given saline, and 5 of 6 patients given albumin. CONCLUSION:A hyperoncotic albumin solution appears to have an inotropic effect in patients following cardiopulmonary bypass procedures. We also again show that the pattern of respiratory variation in right atrial pressure is a useful guide to predict response to volume loading.
journal_name
J Crit Carejournal_title
Journal of critical careauthors
Magder S,Lagonidis Ddoi
10.1016/s0883-9441(99)90030-8subject
Has Abstractpub_date
1999-12-01 00:00:00pages
164-71issue
4eissn
0883-9441issn
1557-8615pii
S0883-9441(99)90030-8journal_volume
14pub_type
临床试验,杂志文章,随机对照试验abstract:PURPOSE:To find predictors of intensive care unit (ICU) requirement within the first 48 hours in newly diagnosed sepsis patients presenting at the emergency department. MATERIALS AND METHODS:Analysis of a prospective observational cohort was performed. We recruited new sepsis patients at the emergency department, and ...
journal_title:Journal of critical care
pub_type: 杂志文章
doi:10.1016/j.jcrc.2016.01.019
更新日期:2016-06-01 00:00:00
abstract:PURPOSE:Developing countries carry the greatest burden of sepsis, yet few descriptive data exist from the Western Hemisphere. We conducted a retrospective cohort study to elucidate the presentation, treatment, and outcomes of sepsis at an urban referral hospital in Port-au-Prince, Haiti. MATERIALS AND METHODS:We studi...
journal_title:Journal of critical care
pub_type: 杂志文章
doi:10.1016/j.jcrc.2016.09.031
更新日期:2017-04-01 00:00:00
abstract:PURPOSE:The purpose of the study is to describe the role of human metapneumovirus (hMPV) infection in critical illness and acute respiratory distress syndrome (ARDS). MATERIALS AND METHODS:We collected clinical and demographic information from a retrospective chart review, comparing patients with and without an intens...
journal_title:Journal of critical care
pub_type: 杂志文章
doi:10.1016/j.jcrc.2015.09.035
更新日期:2016-02-01 00:00:00
abstract:PURPOSE:To identify elements which enable patient and family centred care (PFCC) in the intensive care unit (ICU) and priorities for PFCC research. MATERIALS AND METHODS:We engaged a panel of multidisciplinary stakeholders in a modified Delphi process. Items generated from a literature review and panelist suggestions ...
journal_title:Journal of critical care
pub_type: 杂志文章
doi:10.1016/j.jcrc.2017.08.008
更新日期:2017-12-01 00:00:00
abstract::"Healthcare-associated ventriculitis and meningitis" is a potentially devastating illness following neurosurgical procedures. Multidrug resistant (MDR) and extensively drug resistant (XDR) organisms such as Acinetobacter baumannii and Klebsiella pneumoniae have increasingly been isolated in ventriculitis and meningiti...
journal_title:Journal of critical care
pub_type: 信件
doi:10.1016/j.jcrc.2018.07.025
更新日期:2018-10-01 00:00:00
abstract:PURPOSE:Medication-related problems (MRPs) frequently occur at the interfaces of care settings. We examined this further because little has been published about MRPs experienced by patients/carers after discharge from the intensive care unit (ICU). METHODS AND MATERIALS:Medication history data were collected before, d...
journal_title:Journal of critical care
pub_type: 杂志文章
doi:10.1016/j.jcrc.2012.06.002
更新日期:2013-02-01 00:00:00
abstract:PURPOSE:The study aimed to compare hemoglobin (Hb) values determined using the portable HemoCue system (HemoCue Hb 201+; HemoCue AB, Ängelholm, Sweden) with laboratory Hb level determination. MATERIALS AND METHODS:Adult patients hospitalized in our surgical intensive care unit who required an Hb level determination we...
journal_title:Journal of critical care
pub_type: 杂志文章
doi:10.1016/j.jcrc.2010.08.012
更新日期:2011-08-01 00:00:00
abstract:PURPOSE:There is a paucity of literature to support undertaking emergency laparotomy when indicated in patients supported on ECMO. Our study aims to identify the prevalence, outcomes and complications of this high risk surgery at a large ECMO centre. MATERIALS AND METHODS:A single centre, retrospective, observational ...
journal_title:Journal of critical care
pub_type: 杂志文章
doi:10.1016/j.jcrc.2019.06.021
更新日期:2019-10-01 00:00:00
abstract:INTRODUCTION:Heart rate complexity, commonly described as a "new vital sign," has shown promise in predicting injury severity, but its use in clinical practice is not yet widely adopted. We previously demonstrated the ability of this noninvasive technology to predict lifesaving interventions (LSIs) in trauma patients. ...
journal_title:Journal of critical care
pub_type: 杂志文章
doi:10.1016/j.jcrc.2015.03.018
更新日期:2015-08-01 00:00:00
abstract:PURPOSE:It is unclear whether ventilator-associated pneumonia (VAP) is actually a bilateral and multifocal process. In addition, the diagnostic role of chest x-ray is under debate. Assuming a low microbiologic concordance between the left and right lungs, the reliability of a single pulmonary sampling becomes questiona...
journal_title:Journal of critical care
pub_type: 杂志文章
doi:10.1016/j.jcrc.2016.02.016
更新日期:2016-06-01 00:00:00
abstract:PURPOSE:Increasingly, hospitals are engaging in continuous quality improvement (CQI) endeavors, aimed at optimizing patient care. Physician involvement is critical to the success of such initiatives. Little is known about any mediating factors that affect physician participation in these projects, though such knowledge...
journal_title:Journal of critical care
pub_type: 杂志文章
doi:10.1053/jcrc.2001.30165
更新日期:2001-12-01 00:00:00
abstract:BACKGROUND:Ventilator associated pneumonia (VAP) is one of the most serious nosocomial infections in Intensive Care Unit (ICU). The aim of this study was to evaluate a new approach to spare the carbapenems for the management of patients diagnosed with VAP due to Acinetobacter baumannii (A. baumannii). METHOD:This retr...
journal_title:Journal of critical care
pub_type: 杂志文章
doi:10.1016/j.jcrc.2017.04.002
更新日期:2017-10-01 00:00:00
abstract:INTRODUCTION:The objective of the study to is to determine the characteristics associated with endotracheal intubation in septic shock patients. METHODS:This is a post hoc analysis of the database of the SEPSISPAM study, including patients with septic shock. RESULTS:Among the 776 patients, 633 (82%) were intubated wi...
journal_title:Journal of critical care
pub_type: 杂志文章,多中心研究,随机对照试验
doi:10.1016/j.jcrc.2015.08.018
更新日期:2015-12-01 00:00:00
abstract:PURPOSE:Dynamometry is an objective tool for volitional strength evaluation that may overcome the limited sensitivity of the Medical Research Council scale for manual muscle tests, particularly at grades 4 and 5. The primary aims of this study were to investigate the reliability, minimal detectable change, and time to ...
journal_title:Journal of critical care
pub_type: 杂志文章
doi:10.1016/j.jcrc.2012.03.001
更新日期:2013-02-01 00:00:00
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journal_title:Journal of critical care
pub_type: 杂志文章
doi:10.1016/j.jcrc.2013.03.010
更新日期:2013-10-01 00:00:00
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journal_title:Journal of critical care
pub_type: 杂志文章
doi:10.1016/j.jcrc.2018.06.020
更新日期:2018-10-01 00:00:00
abstract:PURPOSE:ECMO use has increased lately. However, differences between adult ECMO and non-ECMO patients admitted to the ICU remain unstudied. In terms of volume-outcome relationship, the impact of ECMO volume on survival has not been validated in a real world cohort. MATERIALS AND METHODS:Retrospective analysis of data f...
journal_title:Journal of critical care
pub_type: 杂志文章
doi:10.1016/j.jcrc.2018.09.035
更新日期:2019-02-01 00:00:00
abstract:PURPOSE:To assess health-related quality of life (HRQOL) following rehabilitation of amputees suffering symmetric peripheral gangrene (SPG) after septic shock. MATERIAL AND METHODS:A retrospective cohort study was conducted in nine French specialized rehabilitation centers. Thirty-two ICU adult patients hospitalized b...
journal_title:Journal of critical care
pub_type: 杂志文章,多中心研究
doi:10.1016/j.jcrc.2019.06.027
更新日期:2019-10-01 00:00:00
abstract::The Institute of Medicine's (IOMs) report, "To Err is Human," recently addressed patient safety in the United States, alerting the nation to the need for improved systems of health care. Seven main findings were addressed in this report, we focus on 3: (1) patient safety is a nationwide problem, (2) health care worker...
journal_title:Journal of critical care
pub_type: 杂志文章
doi:10.1053/jcrc.2002.34363
更新日期:2002-06-01 00:00:00
abstract:PURPOSE:To describe pre-ICU frailty in critically ill patients using the Clinical Frailty Scale (CFS). METHODS:We included patients ≥18years admitted to 2 ICUs in Hamilton, Canada. The ICU Research Coordinator (RC) generated 3 CFS scores using: 1) chart review, 2) family interview, 3) patient interview. Subsequently, ...
journal_title:Journal of critical care
pub_type: 杂志文章,多中心研究
doi:10.1016/j.jcrc.2018.02.004
更新日期:2018-06-01 00:00:00
abstract:BACKGROUND:Studies investigating the metabolic effects of citrate-based substitution fluids are lacking. This study aims to compare the effect of citrate- vs bicarbonate-based substitution fluid used during continuous venovenous hemofiltration (CVVH) for acute kidney injury on acid-base balance and electrolytes in crit...
journal_title:Journal of critical care
pub_type: 临床试验,杂志文章
doi:10.1016/j.jcrc.2009.02.013
更新日期:2010-03-01 00:00:00
abstract::Hypernatremia is common in intensive care units. It has detrimental effects on various physiologic functions and was shown to be an independent risk factor for increased mortality in critically ill patients. Mechanisms of hypernatremia include sodium gain and/or loss of free water and can be discriminated by clinical ...
journal_title:Journal of critical care
pub_type: 杂志文章,评审
doi:10.1016/j.jcrc.2012.05.001
更新日期:2013-04-01 00:00:00
abstract:OBJECTIVE:The objective of this study is to evaluate the benefits of adjuvant treatment with crude rhubarb in patients with systemic inflammation reaction syndrome/sepsis by conducting a meta-analysis. METHODS:We conducted a systematic literature search of medical electronic databases (up to October 2013). Only random...
journal_title:Journal of critical care
pub_type: 杂志文章,meta分析
doi:10.1016/j.jcrc.2014.11.008
更新日期:2015-04-01 00:00:00
abstract:PURPOSE:To evaluate the role of plasma disappearance rate of indocyanine green (PDR-ICG) as an outcome prediction tool in cardiac surgery. PATIENTS AND METHODS:One hundred ninety patients undergoing coronary artery bypass grafting, valve surgery or combined procedures were enrolled. PDR-ICG measurements along with sta...
journal_title:Journal of critical care
pub_type: 杂志文章
doi:10.1016/j.jcrc.2013.10.023
更新日期:2014-04-01 00:00:00
abstract:PURPOSE:Acute kidney injury (AKI) is a common occurrence after lung transplantation (LTx). Whether transient AKI or early recovery is associated with improved outcome is uncertain. Our aim was to describe the incidence, factors, and outcomes associated with transient AKI after LTx. MATERIALS AND METHODS:We performed a...
journal_title:Journal of critical care
pub_type: 杂志文章
doi:10.1016/j.jcrc.2014.07.024
更新日期:2014-12-01 00:00:00
abstract:PURPOSE:Hyperglycemia and hypoglycemia are frequently encountered in critically ill patients and associated with adverse outcomes. We configured a smart glycemia alert (S-GLY alert) with our Intensive Care Information System to decrease the number of hyperglycemic values and increase the proportion of time within the g...
journal_title:Journal of critical care
pub_type: 杂志文章
doi:10.1016/j.jcrc.2014.07.030
更新日期:2015-02-01 00:00:00
abstract:BACKGROUND:The objectives of this study were to compare patients' energy expenditure (EE) during pressure support (PS) and T-tube (TT) weaning from mechanical ventilation (MV) through indirect calorimetry (IC) and to crosscheck these findings with the results calculated using Harris-Benedict (HB) equation. METHODS:Thi...
journal_title:Journal of critical care
pub_type: 杂志文章,随机对照试验
doi:10.1016/j.jcrc.2010.05.032
更新日期:2011-02-01 00:00:00
abstract:PURPOSE:Endothelial glycocalyx (EG) shedding may promote organ failure in sepsis. This study describes temporal changes in EG biomarkers from Emergency Department (ED) arrival, and associations with clinical characteristics. MATERIALS AND METHODS:This prospective observational study included 23 patients with simple in...
journal_title:Journal of critical care
pub_type: 杂志文章
doi:10.1016/j.jcrc.2017.07.001
更新日期:2017-12-01 00:00:00
abstract:PURPOSE:To evaluate the impact of slow-tempo music listening periods in mechanically ventilated intensive care unit patients. METHODS:A randomized crossover study was performed in a 16-bed, adult critical care unit at a tertiary care hospital. Still-sedated patients, mandating at least 3 more days of mechanical ventil...
journal_title:Journal of critical care
pub_type: 杂志文章,随机对照试验
doi:10.1016/j.jcrc.2013.01.007
更新日期:2013-08-01 00:00:00
abstract:PURPOSE:Platelets play a key role in the genesis of thrombosis. Plateletcrit (PCT) provides complete information on total platelet mass. The relationship between PCT values and long-term outcomes in patients with ST-segment elevation myocardial infarction (STEMI) who undergo primary angioplasty is not known. We sought ...
journal_title:Journal of critical care
pub_type: 杂志文章
doi:10.1016/j.jcrc.2014.07.001
更新日期:2014-12-01 00:00:00