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 (iNO) may improve oxygenation and reduce the need for ECMO therapy. We studied early changes in OI and Aao(2) gradients in response to iNO treatment that may indicate a need to continue iNO treatment or the necessity to start an ECMO therapy. MATERIALS AND METHODS:In this prospective study, we used 34 outborn neonatal patients that were referred to our pediatric critical care unit in a children's hospital for ECMO therapy with diagnosis of hypoxemic respiratory failure. In all patients, iNO therapy, starting at 80 ppm, was instituted either during transport or on arrival to hospital. Response to iNO was assessed after 1 hour, at which time, iNO concentration was reduced to 40 ppm, provided there was more than 20% improvement in either or both oxygenation indices. Patients who did not respond positively to continuous iNO therapy and met ECMO criteria were given ECMO therapy. RESULTS:Inhaled nitric oxide therapy alone was successful in 10 (29%) of 34 patients. Eighteen patients (53%) required ECMO therapy within the first 10 hours of iNO treatment (early ECMO therapy), whereas 6 other neonates (18%) became eligible for ECMO therapy after prolonged (2-4 days) iNO treatment (late ECMO therapy). No mortality occurred with any treatment. Within 4 hours after iNO therapy, patients who required early ECMO therapy had significantly higher OI and Aao(2) gradients than patients who were treated with iNO therapy alone (P<.01, analysis of variance followed by Tukey-Kramer multiple comparison test). Six of 34 patients (18%), categorized as late ECMO therapy, on the average, had initially higher levels of OI and mean airway pressure than neonates in iNO treatment and early ECMO therapy. CONCLUSION:Persisting levels of OI of more than 20 or Aao(2) gradients of more than 600 after 4 hours of iNO therapy could be indicative of an immediate need for ECMO therapy.
journal_name
J Crit Carejournal_title
Journal of critical careauthors
Fakioglu H,Totapally BR,Torbati D,Raszynski A,Sussmane JB,Wolfsdorf Jdoi
10.1016/j.jcrc.2005.05.011subject
Has Abstractpub_date
2005-09-01 00:00:00pages
288-93issue
3eissn
0883-9441issn
1557-8615pii
S0883-9441(05)00059-6journal_volume
20pub_type
杂志文章abstract:PURPOSE:Genetic deletions decreasing serum alpha-Klotho (alpha-KL) have been associated with rapid aging, multi-organ failure and increased mortality in experimental sepsis. We hypothesized that lower alpha-KL obtained at the onset of septic shock correlates with higher mortality. MATERIALS AND METHODS:Prospective coh...
journal_title:Journal of critical care
pub_type: 杂志文章
doi:10.1016/j.jcrc.2017.11.023
更新日期:2018-04-01 00:00:00
abstract::Septic shock remains one of the major causes of morbidity and mortality in the critically ill. Despite early goal therapy and administration of cathecholaminergic agents, up to 30% of patients succumb to the disease. In this manuscript, we first summarize the standard of care of patients with septic shock and current ...
journal_title:Journal of critical care
pub_type: 杂志文章,评审
doi:10.1016/j.jcrc.2017.03.008
更新日期:2017-08-01 00:00:00
abstract:PURPOSE:Early mobility (EM) is being used in adult ICUs in an effort to treat and prevent intensive care unit acquired weakness (ICU-AW) and Post-Intensive Care Syndrome (PICS). Data supports children suffer from ICU-AW and PICS as well. Our objective was to create and implement an EM protocol for pediatric patients re...
journal_title:Journal of critical care
pub_type: 杂志文章
doi:10.1016/j.jcrc.2017.08.004
更新日期:2017-10-01 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:INTRODUCTION:In the absence of a reference standard, a probabilistic approach to the diagnosis of ventilator-associated pneumonia (VAP) has been proposed; and clinician judgment augmented by microbiological tests is used to guide therapy for patients having a clinical suspicion of VAP (CSVAP). However, the correlation ...
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.2007.12.007
更新日期:2008-03-01 00:00:00
abstract:PURPOSE:We sought to delineate highly visible publications related to sepsis. Within these subsets, elements of altmetrics performance, including mentions on Twitter, and the correlation between altmetrics and conventional citation counts were ascertained. MATERIALS AND METHODS:Three subsets of sepsis publications fro...
journal_title:Journal of critical care
pub_type: 杂志文章
doi:10.1016/j.jcrc.2018.09.033
更新日期:2018-12-01 00:00:00
abstract:BACKGROUND AND PURPOSE:Delirium is thought to be associated with systemic inflammatory response. However, its association with the most widely used inflammatory biomarker C-reactive protein (CRP) has not been well established. We aimed to examine whether CRP on intensive care unit (ICU) entry was associated with subseq...
journal_title:Journal of critical care
pub_type: 杂志文章
doi:10.1016/j.jcrc.2013.09.002
更新日期:2014-02-01 00:00:00
abstract:PURPOSE:Sepsis damages the endothelial glycocalyx, contributing to fluid extravasation, organ injury, and death. Our goal was to determine if syndecan-1 level is associated with the risk of intubation and modifying effect of intravenous fluids (IVFs) in these patients. METHODS:Syndecan-1 was measured at enrollment in ...
journal_title:Journal of critical care
pub_type: 杂志文章
doi:10.1016/j.jcrc.2016.06.027
更新日期:2016-12-01 00:00:00
abstract:PURPOSE:We determined the prevalence of risk factors for the development of acute respiratory distress syndrome (ARDS), outcomes of critical illness, and the impact of highly active antiretroviral therapy in HIV-1-infected patients. We hypothesized that in an urban county hospital, HIV-1-infected patients with ARDS wou...
journal_title:Journal of critical care
pub_type: 杂志文章
doi:10.1016/j.jcrc.2014.10.020
更新日期:2015-02-01 00:00:00
abstract::Sepsis and SIRS is the outward manifestation of a generalized uncontrolled inflammatory response, which, if sustained, induces widespread endothelial damage and MODS. Immunomodulating therapies, at present, have proven ineffective in reducing morbidity and mortality, presumably because of the heterogeneous nature of s...
journal_title:Journal of critical care
pub_type: 杂志文章,评审
doi:10.1016/s0883-9441(96)90024-6
更新日期:1996-06-01 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:BACKGROUND:Severe vasodilatation is commonly seen upon weaning from cardiopulmonary bypass (CPB). We examined the effects of vasopressin (arginine vasopressin [AVP]) on acute kidney injury (AKI) in postoperative period. METHODS:The records of 483 patients undergoing coronary bypass surgery on CPB from 2004 to 2008 wer...
journal_title:Journal of critical care
pub_type: 杂志文章
doi:10.1016/j.jcrc.2015.06.013
更新日期:2015-10-01 00:00:00
abstract:PURPOSE:The purpose was to determine prognosis of patients presenting extreme acidosis (pH <7) on admission to the intensive care unit (ICU) and to identify mortality risk factors. MATERIALS AND METHODS:We retrospectively analyzed all patients who presented with extreme acidosis within 24 hours of admission to a polyv...
journal_title:Journal of critical care
pub_type: 杂志文章
doi:10.1016/j.jcrc.2015.09.025
更新日期:2016-02-01 00:00:00
abstract:OBJECTIVE:Sodium retention occurs commonly in cardiac and liver disease, requiring the administration of diuretics to restore fluid balance. Whether obesity is associated with sodium retention has not been fully evaluated. METHODS:In a large single-center cohort of critically ill patients, we evaluated whether admissi...
journal_title:Journal of critical care
pub_type: 杂志文章
doi:10.1016/j.jcrc.2015.01.023
更新日期:2015-06-01 00:00:00
abstract:INTRODUCTION:Given the complexity of biological systems, understanding their dynamic behaviors, such as the Acute Inflammatory Response (AIR), requires a formal synthetic process. Dynamic Mathematical Modeling (DMM) represents a suite of methods intended for inclusion within the required synthetic framework. The DMM, h...
journal_title:Journal of critical care
pub_type: 杂志文章
doi:10.1016/j.jcrc.2006.12.001
更新日期:2007-03-01 00:00:00
abstract::Cell-free circulating DNA (cf-DNA) can be detected by various of laboratory techniques. We described a branched DNA-based Alu assay for measuring cf-DNA in septic patients. Compared to healthy controls and systemic inflammatory response syndrome (SIRS) patients, serum cf-DNA levels were significantly higher in septic ...
journal_title:Journal of critical care
pub_type: 杂志文章
doi:10.1016/j.jcrc.2015.10.013
更新日期:2016-02-01 00:00:00
abstract:PURPOSE:The purpose of this narrative review is to provide practical and useful guidance for clinicians considering the use of intravenous ketamine for its analgosedative properties in adult, critically ill patients. METHODS:MEDLINE was searched from inception until January 2016. Articles related to the pharmacologica...
journal_title:Journal of critical care
pub_type: 杂志文章,评审
doi:10.1016/j.jcrc.2016.05.016
更新日期:2016-10-01 00:00:00
abstract:INTRODUCTION:The Competency Based Training in Intensive Care Education (CoBaTrICE) programme developed common standards of ICM training by describing competencies of an intensivist. Entrustable Professional Activities (EPAs) of Intensive Care Medicine (ICM) (EPAsICM) are presented as a new workplace-based assessment to...
journal_title:Journal of critical care
pub_type: 杂志文章
doi:10.1016/j.jcrc.2019.09.012
更新日期:2019-12-01 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::Integral to the management of the neurocritically injured patient are the prevention and treatment of hypotension, maintenance of cerebral perfusion pressure, and occasionally blood pressure augmentation. When adequate volume resuscitation fails to meet perfusion needs, vasopressors are often used to restore end-organ...
journal_title:Journal of critical care
pub_type: 杂志文章
doi:10.1016/j.jcrc.2016.04.004
更新日期:2016-08-01 00:00:00
abstract:PURPOSE:We wanted to identify the importance of the duration of invasive ventilation and of renal replacement therapy for short-term prognosis of surgical patients treated in an intensive care unit (ICU). METHODS:We analyzed adult patients (n = 1462) who had an ICU length of stay of more than 4 days and who were follo...
journal_title:Journal of critical care
pub_type: 杂志文章
doi:10.1016/j.jcrc.2011.05.017
更新日期:2012-02-01 00:00:00
abstract:PURPOSE:Acute Respiratory Distress Syndrome is a major complication of leptospirosis, leading to the majority of fatalities. METHODS:Retrospective, descriptive and single-center cohort study. The primary outcome was the Standardized Mortality Ratio (SMR) for ARDS in leptospirosis based on the quartiles of the SAPS2 sc...
journal_title:Journal of critical care
pub_type: 杂志文章
doi:10.1016/j.jcrc.2019.02.018
更新日期:2019-06-01 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:Liquid perfluorochemicals reduce the production of reaction oxygen species by alveolar macrophages. We sought to determine whether the use of liquid perfluorochemicals in vivo during liquid ventilation would attenuate oxidative damage to the lung. MATERIALS AND METHODS:Healthy infant piglets (n = 16) were inst...
journal_title:Journal of critical care
pub_type: 杂志文章
doi:10.1016/s0883-9441(99)90004-7
更新日期:1999-03-01 00:00:00
abstract:PURPOSE:The aim of this study was to evaluate the causes, incidence, and impact on outcome of admission hyperlactatemia in patients admitted to a general medical intensive care unit (ICU). METHODS:A retrospective cohort study was done in an 8-bed general ICU of tertiary care hospital over 15 months. Data regarding pat...
journal_title:Journal of critical care
pub_type: 杂志文章
doi:10.1016/j.jcrc.2010.11.009
更新日期:2011-06-01 00:00:00
abstract:PURPOSE:We investigated the reproducibility of passive leg raise (PLR) and fluid bolus (BOLUS) using the Non-Invasive Cardiac Output Monitor (NICOM; Cheetah Medical, Tel Aviv, Israel) for assessment of fluid responsiveness (FR) in spontaneously breathing emergency department (ED) patients. METHODS:Prospective, observa...
journal_title:Journal of critical care
pub_type: 杂志文章
doi:10.1016/j.jcrc.2014.07.031
更新日期:2015-02-01 00:00:00
abstract:PURPOSE:This study measured the quality of data extracted from a clinical information system widely used for critical care quality improvement and research. MATERIALS AND METHODS:We abstracted data from 30 fields in a random sample of 207 patients admitted to nine adult, medical-surgical intensive care units. We asses...
journal_title:Journal of critical care
pub_type: 杂志文章
doi:10.1016/j.jcrc.2018.07.021
更新日期:2018-10-01 00:00:00
abstract:PURPOSE:To determine the incidence of postintubation hypotension (PIH) and associated outcomes in critically ill patients requiring endotracheal intubation. MATERIALS AND METHODS:Medical records were reviewed for 479 consecutive critically ill adult patients who required intubation by an intensive care unit (ICU) serv...
journal_title:Journal of critical care
pub_type: 杂志文章,多中心研究
doi:10.1016/j.jcrc.2015.06.007
更新日期:2015-10-01 00:00:00
abstract::Complex microbial communities within the human body, constituting the microbiome, have a broad impact on human health and disease. A growing body of research now examines the role of the microbiome in patients with critical illness, such as sepsis and acute respiratory failure. In this article, we provide an introduct...
journal_title:Journal of critical care
pub_type: 杂志文章,评审
doi:10.1016/j.jcrc.2016.09.029
更新日期:2017-04-01 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