Abstract:
:We evaluated prospectively the use of Gram staining of protected pulmonary specimens to allow the early diagnosis of ventilator-associated pneumonia (VAP), compared with the use of 60 bronchoscopic protected specimen brushes (PSB) and 126 blinded plugged telescopic catheters (PTC) obtained from 134 patients. Gram stains were from Cytospin slides; they were studied for the presence of microorganisms in 10 and 50 fields by two independent observers and classified according to their Gram stain morphology. Quantitative cultures were performed after serial dilution and plating on appropriate culture medium. A final diagnosis of VAP, based on a culture of > or = 10(3) c.f.u. ml-1, was established after 81 (44%) samplings. When 10 fields were analysed, a strong relationship was found between the presence of bacteria on Gram staining and the final diagnosis of VAP (for PSB and PTC respectively: sensitivity 74 and 81%, specificity 94 and 100%, positive predictive value 91 and 100%, negative predictive value 82 and 88%). The correlation was less when we compared the morphology of microorganisms observed on Gram staining with those of bacteria obtained from quantitative cultures (for PSB and PTC respectively: sensitivity 54 and 69%, specificity 86 and 89%, positive predictive value 72 and 78%, negative predictive value 74 and 84%). Increasing the number of fields read to 50 was associated with a slight decrease in specificity and positive predictive value of Gram staining, but with a small increase in its sensitivity and negative predictive value. The results obtained by the two observers were similar to each other for both numbers of fields analysed. Gram staining of protected pulmonary specimens performed on 10 fields predicted the presence of VAP and partially identified (using Gram stain morphology) the microorganisms growing at significant concentrations, and could help in the early choice of the treatment of VAP. Increasing the number of fields read or having the Gram stain analysed by two independent individuals did not improve the results.
journal_name
Br J Anaesthjournal_title
British journal of anaesthesiaauthors
Mimoz O,Karim A,Mazoit JX,Edouard A,Leprince S,Nordmann Pdoi
10.1093/bja/85.5.735subject
Has Abstractpub_date
2000-11-01 00:00:00pages
735-9issue
5eissn
0007-0912issn
1471-6771pii
S0007-0912(17)36862-9journal_volume
85pub_type
杂志文章abstract::We have studied the tone of the lower oesophageal sphincter (LOS) in 40 adults undergoing routine body surface surgery and allocated randomly to receive anaesthesia either by face mask and Guedel airway or by laryngeal mask airway. In the laryngeal mask group there was a mean (SEM) decrease in barrier pressure (LOS mi...
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/69.4.346
更新日期:1992-10-01 00:00:00
abstract::We describe the anaesthetic management of a patient who underwent transthoracic endoscopic vagotomy. One-lung ventilation was necessary to provide adequate surgical access. Potential intraoperative problems involved arterial oxygen saturation during one-lung ventilation, unequal intrathoracic pressures causing mediast...
journal_title:British journal of anaesthesia
pub_type: 杂志文章
doi:10.1093/bja/68.3.318
更新日期:1992-03-01 00:00:00
abstract::We report the anaesthetic management of a male neonate with congenital cyst adenoid malformation (CCAM) of the lung who underwent thoracotomy for resection of CCAM 24 h after birth and again at 24 days. The initial operation involved a 10-day admission to a paediatric intensive care unit (PICU) requiring ventilation, ...
journal_title:British journal of anaesthesia
pub_type: 杂志文章,评审
doi:10.1093/bja/aei171
更新日期:2005-08-01 00:00:00
abstract::Alcuronium 0.16 mg kg-1 was used to provide neuromuscular blockade in patients with chronic renal failure undergoing renal transplantation. Relaxation was found to be adequate for intubation and surgery. There were minimal alterations to cardiovascular variables. The dose required was small, and complete reversal occu...
journal_title:British journal of anaesthesia
pub_type: 杂志文章
doi:10.1093/bja/56.11.1229
更新日期:1984-11-01 00:00:00
abstract::The analgesic effects and bioavailability of a slow-release preparation of morphine (Duromorph) were studied in 12 patients with acute postoperative pain. Duromorph produced significant analgesia within 1-2 h of administration i.m., and there was a progressive decrease in the mean pain score for at least 8 h. None of ...
journal_title:British journal of anaesthesia
pub_type: 杂志文章
doi:10.1093/bja/57.10.949
更新日期:1985-10-01 00:00:00
abstract:BACKGROUND:The aim of this study was to determine the prevalence of postoperative nausea and vomiting (PONV) after fast-track cardiac anaesthesia, risk factors for PONV and its influence on the length of stay in the intensive care unit (ICU). METHODS:A prospective study was performed in the cardiothoracic ICU (CTICU) ...
journal_title:British journal of anaesthesia
pub_type: 临床试验,杂志文章
doi:10.1093/bja/aeg166
更新日期:2003-08-01 00:00:00
abstract:BACKGROUND:Isoflurane has been reported to induce caspase-3 activation, which may induce neurotoxicity and contribute to the pathogenesis of Alzheimer's disease. However, the underlying mechanism is largely unknown, especially whether or not isoflurane can induce ryanodine receptors (RyRs)-associated endoplasmic reticu...
journal_title:British journal of anaesthesia
pub_type: 杂志文章
doi:10.1093/bja/aeu053
更新日期:2014-10-01 00:00:00
abstract:BACKGROUND:Postoperative delirium and cognitive decline are common in elderly surgical patients after non-cardiac surgery. Despite this prevalence and clinical importance, no specific aetiological factor has been identified for postoperative delirium and cognitive decline. In experimental setting in a rat model, nitrou...
journal_title:British journal of anaesthesia
pub_type: 杂志文章,随机对照试验
doi:10.1093/bja/ael106
更新日期:2006-06-01 00:00:00
abstract::Using respiratory inductive plethysmography, we have measured rib cage and abdominal motion during isoflurane anaesthesia in 16 healthy day-surgery patients. Anaesthesia was induced with propofol and maintained with 1 MAC isoflurane in air-oxygen via a laryngeal mask. Measurements were taken during both resting ventil...
journal_title:British journal of anaesthesia
pub_type: 杂志文章
doi:10.1093/bja/67.6.712
更新日期:1991-12-01 00:00:00
abstract:BACKGROUND:Neurological deficit after repair of a thoracic or thoracoabdominal aortic aneurysm (TAA/TAAA) remains a devastating complication. The aim of our study was to investigate the clinical value of biochemical markers [S-100B, neurone-specific enolase (NSE) and lactate dehydrogenase (LD)], evoked potentials and t...
journal_title:British journal of anaesthesia
pub_type: 杂志文章
doi:10.1093/bja/aei239
更新日期:2005-11-01 00:00:00
abstract::The case histories are reported of one patient who developed evidence of extradural infection 16 days postpartum, and another who spontaneously developed an extradural haematoma. Several points of interest and concern raised by these case histories are discussed. ...
journal_title:British journal of anaesthesia
pub_type: 杂志文章
doi:10.1093/bja/47.3.412
更新日期:1975-03-01 00:00:00
abstract::To determine the influence of renal failure on the pharmacokinetics and neuromuscular blockade of Org NC 45 (Norcuron), a new monoquaternary homologue of pancuronium, 13 patients under halothane and nitrous oxide anesthesia were studied. Org NC 45 was administered by 2-min infusion in doses of 0.28 mg kg-1 (normal ren...
journal_title:British journal of anaesthesia
pub_type: 杂志文章
doi:10.1093/bja/53.10.1049
更新日期:1981-10-01 00:00:00
abstract::Summary While complex physiological mechanisms exist to regulate and optimize tissue oxygenation under various conditions, clinical and experimental evidence indicates that anaemia, unchecked, is associated with organ injury and unfavourable outcomes. More data (especially from human studies) are needed to answer ques...
journal_title:British journal of anaesthesia
pub_type: 杂志文章,评审
doi:10.1093/bja/aer350
更新日期:2011-12-01 00:00:00
abstract::We investigated whether low-dose erythromycin (200 mg) given as an oral premedicant altered the residual gastric volume and its acidity in fasted patients at induction of anaesthesia in a single-blinded study. Sixty patients were allocated randomly to receive either an erythromycin tablet (200 mg) or nothing with 10 m...
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/85.6.861
更新日期:2000-12-01 00:00:00
abstract:BACKGROUND:In 2016, the World Health Organization (WHO) strongly recommended the use of a high fraction of inspired oxygen (FiO2) in adult patients undergoing general anaesthesia to reduce the risk of surgical site infection (SSI). Since then, further trials have been published, trials included previously have come und...
journal_title:British journal of anaesthesia
pub_type: meta分析
doi:10.1016/j.bja.2018.11.024
更新日期:2019-03-01 00:00:00
abstract::We have investigated the value of lower oesophageal contractility (LOC) in detecting awareness during anaesthesia in 20 human volunteer patients. LOC was measured either with subjects awake or after induction with propofol, during induction with propofol, and then as consciousness returned. Statistically significant c...
journal_title:British journal of anaesthesia
pub_type: 杂志文章
doi:10.1093/bja/65.3.319
更新日期:1990-09-01 00:00:00
abstract:BACKGROUND:Data on contributors to between-individual variability in overall tramadol clearance and O-demethyl tramadol (M1) formation in preterm neonates and young infants are limited. METHODS:A population pharmacokinetic analysis of tramadol and M1 was undertaken using non-linear mixed effects model. Covariate analy...
journal_title:British journal of anaesthesia
pub_type: 杂志文章
doi:10.1093/bja/aen019
更新日期:2008-04-01 00:00:00
abstract:BACKGROUND:Recent research into memory formation under sedation has generated conflicting results. We investigated explicit and implicit memory in ICU patients during moderate to deep propofol sedation following cardiac surgery. METHODS:Two different methods of memory testing were used; (1). free-association (F-A) wor...
journal_title:British journal of anaesthesia
pub_type: 杂志文章
doi:10.1093/bja/aeg274
更新日期:2003-12-01 00:00:00
abstract::The effects of age on the dose of Org NC 45 were studied in 24 healthy, anaesthetized patients using an on-demand infusion of the drug which produced a stable twitch height of 10% of its initial value. The patients were allocated as follows: group I = age less than 40 yr; group II = 40-60 yr and group III = age greate...
journal_title:British journal of anaesthesia
pub_type: 杂志文章
doi:10.1093/bja/54.6.653
更新日期:1982-06-01 00:00:00
abstract::The speeds of onset of pancuronium, atracurium and vecuronium are increased by prior administration of magnesium sulphate. A prospective, randomized, double-blind, controlled, clinical study was performed to examine the effects of prior i.v. administration of magnesium sulphate 60 mg kg-1 on the neuromuscular blocking...
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/79.1.122
更新日期:1997-07-01 00:00:00
abstract::We have studied haemodynamic responses to 0, 0.25, 0.5, 0.75 and 1 MAC isoflurane administration in 10 patients during a zero-order propofol infusion and normocapnia. Isoflurane reduced mean arterial pressure (MAP), systemic vascular resistance and left ventricular stroke work in a dose-dependent manner (29%, 38% and ...
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/69.1.36
更新日期:1992-07-01 00:00:00
abstract:BACKGROUND:The memory effect of dexmedetomidine has not been prospectively evaluated in children. We evaluated the feasibility of measuring memory and sedation responses in children during dexmedetomidine sedation for non-painful radiological imaging studies. Secondarily, we quantified changes in memory in relation to ...
journal_title:British journal of anaesthesia
pub_type: 杂志文章
doi:10.1093/bja/aew421
更新日期:2017-02-01 00:00:00
abstract:BACKGROUND:The debate on lung-protective ventilation strategies for surgical patients is ongoing. Evidence suggests that the use of low tidal volume VT improves clinical outcomes. However, the optimal levels of PEEP and recruitment manoeuvre (RM) strategies incorporated into low VT ventilation remain unclear. METHODS:...
journal_title:British journal of anaesthesia
pub_type: 杂志文章,meta分析
doi:10.1016/j.bja.2019.10.024
更新日期:2020-03-01 00:00:00
abstract::A 72-yr-old patient was to undergo a left lumbar plexus block by the posterior approach to achieve postoperative analgesia after hip replacement. The block failed after three unsuccessful attempts to identify nerve structures and a fascia iliaca compartment block was performed. Postoperatively the patient received eno...
journal_title:British journal of anaesthesia
pub_type: 杂志文章
doi:10.1093/bja/aeh242
更新日期:2004-10-01 00:00:00
abstract::We have studied 14 female patients undergoing elective laparoscopy under general anaesthesia with peritoneal insufflation of carbon dioxide in order to examine changes in physiological deadspace (VDphys), arterial to end-tidal carbon dioxide partial pressure difference (PaCO2-PE' CO2) and PaCO2. VCO2 increased after i...
journal_title:British journal of anaesthesia
pub_type: 杂志文章
doi:10.1093/bja/68.2.211
更新日期:1992-02-01 00:00:00
abstract::Atropine and glycopyrronium are frequently used for premedication to reduce oral and respiratory secretions and prevent bradycardia. Glycopyrronium is said to have similar antisialagogue effects, but is less likely to cause significant tachycardia than atropine. Different antimuscarinic receptor selectivity patterns c...
journal_title:British journal of anaesthesia
pub_type: 杂志文章
doi:10.1093/bja/74.5.549
更新日期:1995-05-01 00:00:00
abstract:BACKGROUND:Desflurane at more than 1 minimum alveolar concentration (MAC) has been shown to prolong the QT interval, but it is unclear whether this is the case at lower concentrations. The aim of this study was to determine whether desflurane concentrations of <1 MAC affect tracheal intubation-induced prolongation of t...
journal_title:British journal of anaesthesia
pub_type: 杂志文章,随机对照试验
doi:10.1093/bja/aep355
更新日期:2010-02-01 00:00:00
abstract::We have compared bupivacaine 5 mg ml-1, either isobaric in saline 0.9% or hyperbaric in 8% glucose, for spinal anaesthesia in 100 children, aged 2-115 months, in a double-blind, randomized, parallel group, prospective study. Children were premedicated with diazepam 0.5 mg kg-1 orally. Seventy-two children were sedated...
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/81.4.502
更新日期:1998-10-01 00:00:00
abstract::The respiratory effects of a new strong analgesic, meptazinol, were compared with a placebo and with equianalgesic doses of morphine and pentazocine in a double-blind crossover trial in seven healthy volunteers. No significant change in the ventilatory response to rebreathing carbon dioxide was observed after meptazin...
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/51.6.497
更新日期:1979-06-01 00:00:00
abstract::The effect of the combination of opiates and hypnotics on bispectral index (BIS) is unclear. This double-blind placebo-controlled trial investigated the effect on BIS and sedation of different infusion doses of remifentanil combined with a steady infusion of propofol. Forty patients initially received a target-control...
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/oxfordjournals.bja.a013474
更新日期:2000-04-01 00:00:00