Abstract:
PURPOSE:Patients with severe penetrating head injury often have a coagulopathy that is difficult to correct. In this report, we describe 3 such patients who were treated with activated factor VII (FVIIa) to stop ongoing hemorrhage that was refractory to conventional treatment. SUBJECTS AND METHODS:We treated 3 patients with severe head injury secondary to gunshot wounds to the head. All 3 patients had ongoing bleeding secondary to a severe consumptive coagulopathy that was refractory to treatment with fresh frozen plasma, platelets, and cryoprecipitate. Recombinant FVIIa was then administered to achieve hemostasis. RESULTS:Administration of FVIIa (90-120 microg/kg) was successful in rapidly achieving hemostasis and correcting abnormal laboratory parameters indicative of coagulopathy in all patients. Although all 3 patients died, control of bleeding made organ donation possible in 2 patients. CONCLUSION:In patients with a severe head injury and coagulopathy, use of FVIIa may help in correction of coagulopathy and decrease transfusion requirements. In patients where ongoing bleeding precludes the declaration of brain death, the use of this agent might help in achieving hemodynamic stability and preserve the possibility of organ donation. The ethical implications of using FVIIa in this situation are discussed.
journal_name
J Crit Carejournal_title
Journal of critical careauthors
Aiyagari V,Menendez JA,Diringer MNdoi
10.1016/j.jcrc.2005.02.004subject
Has Abstractpub_date
2005-06-01 00:00:00pages
176-9issue
2eissn
0883-9441issn
1557-8615pii
S0883-9441(05)00045-6journal_volume
20pub_type
杂志文章abstract:PURPOSE:The criteria for starting extracorporeal membrane oxygenation (ECMO) therapy in term newborn patients with hypoxemic respiratory failure consist of an oxygenation index (OI) of 25 or higher and alveolar-arterial oxygen (Aao(2)) gradient of more than 600 at sea level. In such conditions, inhaled nitric oxide (iN...
journal_title:Journal of critical care
pub_type: 杂志文章
doi:10.1016/j.jcrc.2005.05.011
更新日期:2005-09-01 00:00:00
abstract:PURPOSE:To define the incidence of healthcare-associated ventriculitis and meningitis (HAVM) in the neuro-ICU and to identify HAVM risk factors using tree-based machine learning (ML) algorithms. METHODS:An observational cohort study was conducted in Russia from 2010 to 2017, and included high-risk neuro-ICU patients. ...
journal_title:Journal of critical care
pub_type: 杂志文章
doi:10.1016/j.jcrc.2018.01.022
更新日期:2018-06-01 00:00:00
abstract:PURPOSE:To compare the quality of data recorded by a commercially available clinical information system (CIS) to other commonly used methods for obtaining large amounts of patient data. MATERIALS AND METHODS:Five sets of clinical patient data were chosen as a cross-section of all the data collected by a CIS in our int...
journal_title:Journal of critical care
pub_type: 杂志文章
doi:10.1016/j.jcrc.2004.02.003
更新日期:2004-03-01 00:00:00
abstract:PURPOSE:The purpose of this article was to determine the extent to which patients at high risk of hospital death who undergo cardiopulmonary resuscitation (CPR) have previously had their life support preferences addressed and documented. MATERIALS AND METHODS:We conducted a retrospective chart review of all patients o...
journal_title:Journal of critical care
pub_type: 杂志文章
doi:10.1016/s0883-9441(97)90026-5
更新日期:1997-12-01 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 investigate predictive powers of S100B and cell-free DNA (cfDNA) levels in patients in the intensive care unit (ICU) who have with intracranial hemorrhage (ICH) for prognosis. METHODS:Ninety-nine patients diagnosed with ICH were included in the study. The blood samples were drawn on the day of admittance to...
journal_title:Journal of critical care
pub_type: 杂志文章
doi:10.1016/j.jcrc.2013.03.005
更新日期:2013-10-01 00:00:00
abstract:PURPOSE:To identify early mortality-associated clinical risk factors preceding, during, and after cardiac surgery in children. MATERIALS AND METHODS:Of the 722 children admitted to our pediatric intensive care unit (PICU) from January 1992 to January 1997 after repair of congenital heart defects, 70 required 48 hours ...
journal_title:Journal of critical care
pub_type: 杂志文章
doi:10.1053/jcrc.2002.36760
更新日期:2002-12-01 00:00:00
abstract:PURPOSE:To evaluate whether the changes of central venous oxygen saturation (Scvo2) after fluid challenge can define fluid responsiveness in patients with septic shock. METHODS:In this prospective observational study, septic shock patients with invasive cardiac output monitoring requiring fluid challenge were included...
journal_title:Journal of critical care
pub_type: 杂志文章
doi:10.1016/j.jcrc.2016.09.030
更新日期:2017-04-01 00:00:00
abstract:PURPOSE:Enrolling traumatic brain injury (TBI) patients with an inability to provide informed consent in research is challenging. Alternatives to patient consent are not sufficiently embedded in European and national legislation, which allows procedural variation and bias. We aimed to quantify variations in informed co...
journal_title:Journal of critical care
pub_type: 杂志文章
doi:10.1016/j.jcrc.2020.05.004
更新日期:2020-10-01 00:00:00
abstract:BACKGROUND:As an emerging "new vital sign," heart rate complexity (by sample entropy [SampEn]) has been shown to be a useful trauma triage tool by predicting occult physiologic compromise and need for life-saving interventions. Sample entropy may be confounded by anesthesia possibly limiting its value intraoperatively....
journal_title:Journal of critical care
pub_type: 杂志文章
doi:10.1016/j.jcrc.2014.08.008
更新日期:2015-02-01 00:00:00
abstract:PURPOSE:The response to inhaled nitric oxide (iNO) is inconsistent in patients with acute respiratory distress syndrome (ARDS). We sought to determine whether the response to iNO, defined as 20% Pao(2)/Fio(2) increase from baseline, depends on the level of cardiac natriuretic peptides. MATERIALS AND METHODS:This is a ...
journal_title:Journal of critical care
pub_type: 杂志文章
doi:10.1016/j.jcrc.2008.10.014
更新日期:2010-03-01 00:00:00
abstract:PURPOSE:Gastric intramucosal PCO2 (PiCO2) is a marker of splanchnic dysoxia and hypoperfusion that is increasingly used in intensive care medicine. We assessed two methods, saline-balloon tonometry versus continuous capnometric recirculating gas tonometry (CRGT), for detecting changes in PiCO2 in animals subjected to v...
journal_title:Journal of critical care
pub_type: 杂志文章
doi:10.1016/s0883-9441(98)80001-4
更新日期:1998-06-01 00:00:00
abstract:BACKGROUND:It is known that acute respiratory distress syndrome and acute lung injury are independent risk factors for developing acute kidney injury (AKI) through complex pathophysiologic mechanisms. Our specific aim is to evaluate the risk factors for AKI postburn injury and whether inhalation thermal injury is an in...
journal_title:Journal of critical care
pub_type: 杂志文章
doi:10.1016/j.jcrc.2016.10.008
更新日期:2017-04-01 00:00:00
abstract:PURPOSE:This study investigated the feasibility of high-flow nasal cannula (HFNC) oxygen therapy for acute respiratory failure in adult patients with hematologic malignancies. MATERIALS AND METHODS:We identified 45 acute respiratory failure patients with hematologic malignancies who received HFNC therapy between March...
journal_title:Journal of critical care
pub_type: 杂志文章
doi:10.1016/j.jcrc.2015.03.014
更新日期:2015-08-01 00:00:00
abstract:BACKGROUND:Metabolic acidosis is highly prevalent in critically ill patients with acute renal failure. Little is known about the mechanisms by which renal replacement therapy intervenes in such cases. The objective of this study is to analyze the role of hemodialysis in acidosis correction in intensive care unit patien...
journal_title:Journal of critical care
pub_type: 杂志文章
doi:10.1016/j.jcrc.2006.03.011
更新日期:2006-12-01 00:00:00
abstract:PURPOSE:This study compared clinical outcomes associated with exposure to pulmonary artery catheters (PACs), central venous catheters (CVCs), arterial pressure waveform analysis for cardiac output (APCO), or no central monitoring (NCM) in patients with shock. MATERIALS AND METHODS:We assessed 6929 consecutive patients...
journal_title:Journal of critical care
pub_type: 杂志文章
doi:10.1016/j.jcrc.2010.07.001
更新日期:2011-04-01 00:00:00
abstract:PURPOSE:The purpose of this study is to determine if temperature extremes are associated with reduced heart rate variability (HRV) and "cardiac uncoupling." MATERIALS AND METHODS:This was a retrospective, observational cohort study performed on 278 trauma intensive care unit admissions that had continuous HR, cardiac ...
journal_title:Journal of critical care
pub_type: 杂志文章
doi:10.1016/j.jcrc.2010.11.008
更新日期:2011-10-01 00:00:00
abstract:PURPOSE:Cervical spine (CS) injury in blunt trauma is a prevalent and devastating complication. Clearing CS injuries in obtunded patients is fraught with challenges, and no single imaging modality or algorithm is both safe and effective. Increased time in c-spine precautions is associated with greater patient morbidity...
journal_title:Journal of critical care
pub_type: 杂志文章,评审
doi:10.1016/j.jcrc.2013.10.022
更新日期:2014-04-01 00:00:00
abstract::Critical care physicians may hear a surrogate decision-maker ask, "What would you do if she was your mother?" or "What if your father was this sick?" These kinds of questions ask more of the critical care physician than the surrogate might realize. There are deep-seated ethical, professional, and personal complexities...
journal_title:Journal of critical care
pub_type: 杂志文章
doi:10.1016/j.jcrc.2018.10.031
更新日期:2019-02-01 00:00:00
abstract:PURPOSE:To describe the prevalence of hypocapnia and hypercapnia during the earliest period of mechanical ventilation, and determine the association between PaCO2 and mortality. MATERIALS AND METHODS:A cohort study using an emergency department registry of mechanically ventilated patients. PaCO2 was categorized: hypoc...
journal_title:Journal of critical care
pub_type: 杂志文章
doi:10.1016/j.jcrc.2017.04.033
更新日期:2017-10-01 00:00:00
abstract:PURPOSE:We investigated whether a critical rise of intracranial pressure (ICP) leading to a loss of cerebral perfusion pressure (CPP) could serve as a surrogate marker of brain death (BD). MATERIALS AND METHODS:We retrospectively analyzed ICP and CPP of patients in whom BD was diagnosed (n = 32, 16-79 years). Intracra...
journal_title:Journal of critical care
pub_type: 杂志文章
doi:10.1016/j.jcrc.2016.03.009
更新日期:2016-08-01 00:00:00
abstract:INTRODUCTION:Posttraumatic stress disorder (PTSD) in relatives of intensive care unit (ICU) patients has not been fully described. We studied potential relationships between PTSD and specific patients' conditions and relatives' psychologic characteristics. METHODS:This is a prospective study of family caregivers of IC...
journal_title:Journal of critical care
pub_type: 杂志文章
doi:10.1016/j.jcrc.2015.06.009
更新日期:2015-10-01 00:00:00
abstract:PURPOSE:Frailty in critical illness is common and associated with poor outcomes, however little is known about contributing factors. We compared the Clinical Frailty Scale (CFS) with a multi-dimensional validated tool, the Edmonton Frail Scale (EFS), and investigated which health domains are affected by frailty in ICU....
journal_title:Journal of critical care
pub_type: 杂志文章
doi:10.1016/j.jcrc.2019.04.032
更新日期:2019-08-01 00:00:00
abstract:PURPOSE:Sepsis is a lethal outcome of the inflammation and coagulation process. Human interleukin (IL)-6 and tumor necrosis factor (TNF) α are well-known inflammation factors closely associated with sepsis. In the present study, we aim to investigate the association of promoter-region polymorphisms IL-6 (-174G/C) rs180...
journal_title:Journal of critical care
pub_type: 杂志文章
doi:10.1016/j.jcrc.2015.04.123
更新日期:2015-10-01 00:00:00
abstract:PURPOSE:Nebulized heparin may reduce fibrin cast formation and reduce the degree of airway obstruction in burn inhalation injury. METHODS:Twenty-nine patients admitted to burn intensive care unit (ICU) within 24 hours of burn inhalation injury were included in this prospective double-blinded randomized study. Group H5...
journal_title:Journal of critical care
pub_type: 杂志文章,随机对照试验
doi:10.1016/j.jcrc.2013.06.017
更新日期:2014-02-01 00:00:00
abstract:PURPOSE:Diaries summarizing intensive care are routine practice in some countries, although evidence to support diary use is limited. The purpose of this study was to identify whether distress post-intensive care influences patients' and relatives' choice as to whether they would like to receive a diary and what inform...
journal_title:Journal of critical care
pub_type: 杂志文章
doi:10.1016/j.jcrc.2016.12.003
更新日期:2017-04-01 00:00:00
abstract:PURPOSE:To evaluate the relationship between phase angle (PA) and nutritional status and the prognostic significance of PA in critically ill cancer patients. METHODS:31 patients that had been admitted to the intensive care unit (ICU) of a center on oncology were evaluated. Their PA was obtained from their bioelectrica...
journal_title:Journal of critical care
pub_type: 杂志文章
doi:10.1016/j.jcrc.2018.01.006
更新日期:2018-04-01 00:00:00
abstract:PURPOSE:The aim of the present study was to explain why extravascular lung water index (EVLWI) is higher and why global end-diastolic blood volume index (GEDVI) is lower in young children when measured with the PiCCO system (Pulsion, Munich, Germany). MATERIALS AND METHODS:We pooled available data from literature from...
journal_title:Journal of critical care
pub_type: 杂志文章
doi:10.1016/j.jcrc.2010.10.014
更新日期:2011-08-01 00:00:00
abstract:PURPOSE:Newly updated guidelines suggest brain computed tomography for out-of-hospital cardiac arrest survivors to identify a neurologic cardiac arrest cause. We hypothesized that the "pseudo-subarachnoid hemorrhage" (p-SAH) sign in cardiac arrest survivors is associated with poor outcome. MATERIALS AND METHODS:We ret...
journal_title:Journal of critical care
pub_type: 杂志文章
doi:10.1016/j.jcrc.2017.02.021
更新日期:2017-08-01 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