Abstract:
:To assess the usefulness of the Gram stain in the early diagnosis of ventilator-associated pneumonia (VAP), we performed 146 protected specimen brushings (PSB) and bronchoalveolar lavages (BAL) in 118 patients suspected of having nosocomial pneumonia. Gram stain and counts of infected cells were performed in all samples from BAL fluid. A final diagnosis of pneumonia was established in 51 patients and there was no infection in 95 cases. A threshold of 2% of infected cells was used to distinguish between VAP and the group without VAP (sensitivity 86.3%, specificity 78.9%, positive predictive value 68.7% and negative predictive value 91.4%); there was good agreement with the final diagnosis (kappa statistic 0.616; concordance 81.5%). Regarding detection of bacteria using the Gram stain, we found a sensitivity of 90.2%, specificity 73.7%, positive predictive value 64.8% and negative predictive value 93.3%; there was moderate agreement with the final diagnosis (kappa statistic 0.586; concordance 79.4%). In the VAP group, we analysed the degree of qualitative agreement between Gram stain and PSB quantitative cultures: the correlation was complete in 51% (26 of 51 VAP), partial in 39.2% (20 of 51 VAP) and there was no correlation in 9.8% (five of 51 VAP). We conclude that the Gram stain is useful for rapid diagnosis of VAP but unreliable for early adaptation of empiric therapy.
journal_name
Br J Anaesthjournal_title
British journal of anaesthesiaauthors
Allaouchiche B,Jaumain H,Chassard D,Boulétreau Pdoi
10.1093/bja/83.6.845subject
Has Abstractpub_date
1999-12-01 00:00:00pages
845-9issue
6eissn
0007-0912issn
1471-6771pii
S0007-0912(17)38147-3journal_volume
83pub_type
杂志文章abstract::In nine patients, undergoing repeat operations because of severe intra-abdominal infection developing after major abdominal surgery, serum potassium concentrations were monitored during induction of anaesthesia. Four patients showed an increase of serum potassium ranging from 2.5 to 3.1 mmol/litre above baseline value...
journal_title:British journal of anaesthesia
pub_type: 杂志文章
doi:10.1093/bja/48.6.557
更新日期:1976-06-01 00:00:00
abstract::In a prospective randomized multi-centre study, the mortality following internal fixation surgery for fracture of the upper femur was investigated in 538 elderly patients allocated to receive subarachnoid blockade or general (narcotic-relaxant) anaesthesia. The 28-day mortality was 6.6% with subarachnoid, and 5.9% wit...
journal_title:British journal of anaesthesia
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1093/bja/59.9.1080
更新日期:1987-09-01 00:00:00
abstract:BACKGROUND:The objective of this study was to develop a pharmacokinetic (PK) model to characterize the influence of obesity on propofol PK parameters. METHODS:Nineteen obese ASA II patients undergoing bariatric surgery were studied. Patients received propofol 2 mg kg(-1) bolus dose followed by a 5-20-40-120 min, 10-8-...
journal_title:British journal of anaesthesia
pub_type: 杂志文章,随机对照试验
doi:10.1093/bja/aeq195
更新日期:2010-10-01 00:00:00
abstract::In a randomized study of patients undergoing Caesarean section, either enflurane (mean 0.24 MAC-h) or halothane (mean 0.23 MAC-h) and 50% nitrous oxide in oxygen were administered to women (n = 12) with severe pre-eclampsia-eclampsia and to 16 healthy pregnant patients with normal renal and hepatic function. No eviden...
journal_title:British journal of anaesthesia
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1093/bja/56.6.587
更新日期:1984-06-01 00:00:00
abstract::This article briefly reviews psychological aspects of pain, paying special attention to chronic pain. The review considers the interruptive and interference effects of pain and its impact on a person's identity. The importance of processes related to interruption, interference, and identity will vary across people and...
journal_title:British journal of anaesthesia
pub_type: 杂志文章,评审
doi:10.1093/bja/aen123
更新日期:2008-07-01 00:00:00
abstract::We studied 133 women given a combined spinal-epidural for analgesia in labour. The initial intrathecal dose contained bupivacaine 2.5 mg with fentanyl 25 micrograms. When the mothers were comfortable, they were allocated randomly to one of three groups: continuous infusion (group Cl, n = 46), midwife top-ups (group MW...
journal_title:British journal of anaesthesia
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1093/bja/82.2.233
更新日期:1999-02-01 00:00:00
abstract:BACKGROUND:Microvascular dysfunction is considered to play an important pathophysiological role in sepsis. We addressed the hypothesis that macrovascular and microvascular flow are uncoupled in early sepsis, using a rodent model with well-characterized haemodynamic and biochemical markers of severity and subsequent mor...
journal_title:British journal of anaesthesia
pub_type: 杂志文章
doi:10.1093/bja/aes093
更新日期:2012-06-01 00:00:00
abstract::We report an unusual case of acute upper airway obstruction. Inhalation of a foreign body caused choking in a 5-yr-old child, but subsequent investigations revealed a large anterior mediastinal tumour, externally compressing the trachea and the main bronchi. Such a presentation may be deceptive and is important, as ge...
journal_title:British journal of anaesthesia
pub_type: 杂志文章
doi:10.1093/bja/67.5.632
更新日期:1991-11-01 00:00:00
abstract::We have recently reported that continuous administration of butorphanol into the brachial plexus neurovascular sheath provided superior analgesia compared with that obtained with continuous i.v. administration. Furthermore, we found that analgesia was most pronounced when a mixture of mepivacaine and butorphanol was g...
journal_title:British journal of anaesthesia
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1093/bja/78.1.83
更新日期:1997-01-01 00:00:00
abstract::Experiments were performed on 14 anaesthetized, artifically ventilated dogs, in which efferent activity in the phrenic nerve was recorded and blood-gas tensions, arterial pH and core temperature were controlled. Doses of midazolam between 0.2 mg kg-1 and 2 mg kg-1 abolished phrenic nerve activity for periods between 3...
journal_title:British journal of anaesthesia
pub_type: 杂志文章
doi:10.1093/bja/56.10.1161
更新日期:1984-10-01 00:00:00
abstract:BACKGROUND:Intraoperative fluid therapy regimens using oesophageal Doppler monitoring (ODM) to optimize stroke volume (SV) (goal-directed fluid therapy, GDT) have been associated with a reduction in length of stay (LOS) and complication rates after major surgery. We hypothesized that intraoperative GDT would reduce the...
journal_title:British journal of anaesthesia
pub_type: 杂志文章,随机对照试验
doi:10.1093/bja/aer273
更新日期:2012-01-01 00:00:00
abstract:BACKGROUND:The analgesic efficacy of continuous transversus abdominis plane (TAP) blocks in comparison with that of single-injection TAP blocks is not clear. This randomized, triple-blind, placebo-controlled trial investigated the benefits of adding continuous TAP blocks to single-injection TAP blocks after a laparotom...
journal_title:British journal of anaesthesia
pub_type: 杂志文章
doi:10.1093/bja/aew339
更新日期:2016-12-01 00:00:00
abstract::The effects of doxacurium chloride, a new long-acting non-depolarizing neuromuscular blocking drug, on cardiac performance were studied in 45 patients undergoing high-dose fentanyl-diazepam-oxygen anaesthesia for cardiac surgery. Data were collected at baseline (10 min after tracheal intubation), and at 2, 5 and 10 mi...
journal_title:British journal of anaesthesia
pub_type: 杂志文章
doi:10.1093/bja/63.6.675
更新日期:1989-12-01 00:00:00
abstract::We have investigated the effect of dopamine and dopexamine on the isolated perfused rat kidney. After an equilibration period of 20 min and two control periods of 10 min, dopexamine 1.0, 2.5 or 4.0 micrograms kg-1 min-1 or dopamine 2.0 micrograms kg-1 min-1 were perfused for a further 40 min in random order. Renal blo...
journal_title:British journal of anaesthesia
pub_type: 杂志文章
doi:10.1093/bja/83.6.898
更新日期:1999-12-01 00:00:00
abstract::The retention of nitrous oxide in samples of nitrous oxide in air held in disposable plastic syringes, glass syringes and custom-made nylon film bags was studied by means of gas chromatography at intervals of 90 min, 24, 48 and 120 h after filling the containers. After 24 h the nylon bags retained a mean concentration...
journal_title:British journal of anaesthesia
pub_type: 杂志文章
doi:10.1093/bja/50.11.1109
更新日期:1978-11-01 00:00:00
abstract:BACKGROUND:Signalling of several G-protein-coupled receptors of the Gq/11 family is time-dependently inhibited by local anaesthetics (LAs). Since LA-induced modulation of muscarinic m1 and m3 receptor function may explain their beneficial effects in clinical practice, such as decreased postoperative cognitive dysfuncti...
journal_title:British journal of anaesthesia
pub_type: 杂志文章
doi:10.1093/bja/aet299
更新日期:2014-02-01 00:00:00
abstract:BACKGROUND:Moderate to deep sedation has been recommended during endoscopic submucosal dissection (ESD). However, it is often accompanied by adverse events such as respiratory depression or aspiration pneumonia. This study investigated the respiratory complications and ESD outcomes of two sedation protocols: moderate s...
journal_title:British journal of anaesthesia
pub_type: 杂志文章
doi:10.1093/bja/aeu555
更新日期:2015-07-01 00:00:00
abstract::In a controlled, randomized study, we evaluated duration of neuromuscular block in 80 patients undergoing routine abdominal surgery. Forty patients were aged 18-50 yr (control group) and 40 patients were more than 65 yr (elderly group). All patients had normal plasma creatinine concentrations. After induction of anaes...
journal_title:British journal of anaesthesia
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1093/bja/74.6.709
更新日期:1995-06-01 00:00:00
abstract::Cis AB blood group is a rare variant of the AB blood group resulting from inheritance of both A and B genes on one chromosome. It may lead to misclassification in ABO grouping and clinical misdiagnosis as a result of its divergence from the laws of Landsteiner and Mendel. We encountered a case of cis AB blood group, a...
journal_title:British journal of anaesthesia
pub_type: 杂志文章
doi:10.1093/bja/83.3.491
更新日期:1999-09-01 00:00:00
abstract::Seven patients are described in whom a prophylactic blood patch was instituted within 15 min of accidental dural puncture. Five of the patients received extradural anaesthesia before the blood patch, and one after the blood patch had been performed. In three of these patients further "top-up" doses of local anaestheti...
journal_title:British journal of anaesthesia
pub_type: 杂志文章
doi:10.1093/bja/57.5.538
更新日期:1985-05-01 00:00:00
abstract:BACKGROUND:Cardiac surgery with cardiopulmonary bypass (CPB) is commonly perceived as a risk factor for decline in renal function, especially in patients with preoperative renal dysfunction. There are few data on the effects of CPB on renal function in patients with mild preoperative renal dysfunction. The purpose of t...
journal_title:British journal of anaesthesia
pub_type: 杂志文章,多中心研究
doi:10.1093/bja/aen081
更新日期:2008-06-01 00:00:00
abstract::An extradural catheter was inserted at the third lumbar interspace for relief of pain during labour in a 21-year-old gravid patient. Attempts to withdraw the catheter met with resistance and produced severe pain in the distribution of the second left lumbar nerve. Radiography revealed an acutely angled loop of the cat...
journal_title:British journal of anaesthesia
pub_type: 杂志文章
doi:10.1093/bja/55.5.473
更新日期:1983-05-01 00:00:00
abstract::The coherent frequency (CF) of the auditory evoked response (AER) is derived using auditory clicks presented at frequencies in the range 5-47 Hz. CF and psychological performance were measured while seven subjects breathed isoflurane in doses increasing from 0% to 0.2%, 0.4% and 0.8% end-tidal concentration and then d...
journal_title:British journal of anaesthesia
pub_type: 杂志文章
doi:10.1093/bja/71.5.633
更新日期:1993-11-01 00:00:00
abstract::A 55-yr-old man received a left supraclavicular brachial plexus block with 0.42% bupivacaine; he had profound motor and sensory block 26 h after injection; complete recovery occurred at 40 h. ...
journal_title:British journal of anaesthesia
pub_type: 杂志文章
doi:10.1093/bja/63.5.604
更新日期:1989-11-01 00:00:00
abstract:BACKGROUND:The aim of this study was to evaluate the efficacy of palonosetron, the latest 5-HT3 receptor antagonist, for the prevention of postoperative nausea and vomiting (PONV) during the first 72 h after operation. METHODS:In this randomized, double-blinded, placebo-controlled study, 204 healthy inpatients who wer...
journal_title:British journal of anaesthesia
pub_type: 杂志文章,随机对照试验
doi:10.1093/bja/aet340
更新日期:2014-03-01 00:00:00
abstract:BACKGROUND:Transitions into and out of the anaesthetised state exhibit resistance to state transitions known as neural inertia. As a consequence, emergence from anaesthesia occurs at a consistently lower anaesthetic concentration than induction. Motivated by stochastic switching between discrete activity patterns obser...
journal_title:British journal of anaesthesia
pub_type: 杂志文章
doi:10.1016/j.bja.2018.02.035
更新日期:2018-07-01 00:00:00
abstract::In 15 patients (ASA I-II) undergoing intraabdominal gynaecological surgery, muscle paralysis for tracheal intubation and surgery was achieved by a combined bolus and demand infusion of vecuronium. The initial loading dose of 67 micrograms kg-1 and the rate of subsequent infusion were determined by evaluation of the ta...
journal_title:British journal of anaesthesia
pub_type: 杂志文章
doi:10.1093/bja/61.4.479
更新日期:1988-10-01 00:00:00
abstract::Cumulation and interaction of neuromuscular blocking effects of neomycin and tubocurarine were determined on responses of the tibialis anterior muscle of the anaesthetized cat to indirect stimulation. Neuromuscular block produced by neomycin was cumulative despite rapid and apparent full recovery of twitch tension and...
journal_title:British journal of anaesthesia
pub_type: 杂志文章
doi:10.1093/bja/53.6.571
更新日期:1981-06-01 00:00:00
abstract::A patient with a foreign body penetrating the neck and chest was found to have physical signs which were consistent with serious tracheal injury and included a large movement of air through the lower part of the neck. The subsequent management of the patient and the difficult problem of securing an airway are describe...
journal_title:British journal of anaesthesia
pub_type: 杂志文章
doi:10.1093/bja/66.6.724
更新日期:1991-06-01 00:00:00
abstract:BACKGROUND:Early tracheostomy may decrease the duration of mechanical ventilation, sedation exposure, and intensive care stay, possibly resulting in improved clinical outcomes, but the evidence is conflicting. METHODS:Systematic review and meta-analysis of randomized trials in patients allocated to tracheostomy within...
journal_title:British journal of anaesthesia
pub_type: 杂志文章,meta分析,评审
doi:10.1093/bja/aeu440
更新日期:2015-03-01 00:00:00