Abstract:
:The ideal diagnostic approach for ventilator-associated pneumonia currently is based on invasive procedures to obtain respiratory tract cultures. Given the lack of consensus and relatively poor acceptance of full bronchoscopic bronchoalveolar lavage (BAL) and protected specimen brush (PSB), less invasive procedures have been developed. We review the nonbronchoscopic procedures (nonbronchoscopic bronchoalveolar lavage, including mini-BAL, blinded protected specimen, and blinded bronchial sampling) and endotracheal aspiration. We provide a critique of the methods used, the types of catheters inserted, and the sample collection methods. Most studies were flawed in that antibiotic use before initiation of the procedure was not controlled. The variability of both the methods and the criteria for the gold standard in the numerous investigations show that these procedures are neither standardized nor proven to be accurate and often did not improve management. Pending future studies, use of endotracheal aspirates without the use of quantitation seems to be a reasonable approach for clinicians who are not committed to an invasive procedure.
journal_name
J Intensive Care Medjournal_title
Journal of intensive care medicineauthors
Fujitani S,Yu VLdoi
10.1177/0885066605283094subject
Has Abstractpub_date
2006-01-01 00:00:00pages
17-21issue
1eissn
0885-0666issn
1525-1489pii
21/1/17journal_volume
21pub_type
杂志文章,评审abstract:INTRODUCTION:Red cell distribution width (RDW) is reflective of systemic inflammation. The objective of this study was to investigate the association between RDW (on day 1 of development of septic shock) and mortality. METHODS:A total of 279 patients with septic shock were included. We categorized the patients into qu...
journal_title:Journal of intensive care medicine
pub_type: 杂志文章
doi:10.1177/0885066612452838
更新日期:2013-09-01 00:00:00
abstract::Hyponatremia is one of the newer and emerging risk factors for an adverse prognosis in chronic heart failure. Why decreased serum sodium is associated with worse prognosis remains unclear. It may reflect worsening heart failure and the deleterious effects of activation of neurohormones. The mechanism of hyponatremia i...
journal_title:Journal of intensive care medicine
pub_type: 杂志文章,评审
doi:10.1177/0885066609344941
更新日期:2009-11-01 00:00:00
abstract:OBJECTIVE:To evaluate the effect of high-flow nasal cannula oxygen (HFNO) therapy on hospital length of stay (LOS) and postoperative pulmonary complications (PPCs) in adult postoperative patients. DATA SOURCES:PubMed, Embase, the Cochrane Library, Web of Science of Studies, China National Knowledge Index, and Wan Fang...
journal_title:Journal of intensive care medicine
pub_type: 杂志文章
doi:10.1177/0885066618817718
更新日期:2020-10-01 00:00:00
abstract:PURPOSE:Methods to optimize positive end-expiratory pressure (PEEP) in acute respiratory distress syndrome (ARDS) remain controversial despite decades of research. The pressure-volume curve (PVC), a graphical ventilator relationship, has been proposed for prescription of PEEP in ARDS. Whether the use of PVC's improves ...
journal_title:Journal of intensive care medicine
pub_type: 杂志文章,评审
doi:10.1177/0885066613488747
更新日期:2014-11-01 00:00:00
abstract::Respiratory complications before and after liver transplant are common, diverse, and potentially have a negative impact on patient outcomes. In this review, we discuss the most frequent respiratory conditions that patients may develop in the perioperative period. Their prevention and/or treatment may help to maximize ...
journal_title:Journal of intensive care medicine
pub_type: 杂志文章,评审
doi:10.1177/0885066618781526
更新日期:2019-05-01 00:00:00
abstract::Cirrhotic patients admitted to the medical intensive care unit (ICU) are associated with high mortality rates. The prognosis of critically ill cirrhotic patients is determined by the extent of hepatic and extrahepatic organ dysfunction. This study was conducted to assess and compare the accuracy of the Child-Pugh clas...
journal_title:Journal of intensive care medicine
pub_type: 杂志文章
doi:10.1177/0885066603261991
更新日期:2004-03-01 00:00:00
abstract::The aim of the study was to describe our experience with bi-level positive airway pressure (BiPAP) ventilation in oncology children with acute respiratory failure, hospitalized in a single tertiary pediatric tertiary center. This was a retrospective cohort study of all pediatric oncology patients in our center admitte...
journal_title:Journal of intensive care medicine
pub_type: 杂志文章
doi:10.1177/0885066609344956
更新日期:2009-11-01 00:00:00
abstract::Intraoperative neuromonitoring was introduced in the second half of the 20th century with the goal of preventing patient morbidity for patients undergoing complex operations of the central and peripheral nervous system. Since its early use for scoliosis surgery, the growth and utilization of IOM techniques expanded dr...
journal_title:Journal of intensive care medicine
pub_type: 杂志文章
doi:10.1177/0885066620962453
更新日期:2020-09-28 00:00:00
abstract:BACKGROUND:The management of refractory septic shock remains a major challenge in critical care and its early indicators are not fully understood. We hypothesized that the maximum norepinephrine dosage within 24 hours of intensive care unit (ICU) admission may be a useful indicator of early mortality in patients with s...
journal_title:Journal of intensive care medicine
pub_type: 杂志文章
doi:10.1177/0885066619860736
更新日期:2020-11-01 00:00:00
abstract:BACKGROUND:Circulatory shock affects every third patient in intensive care units and is associated with high mortality. Near-infrared spectroscopy (NIRS) could serve as a means for monitoring tissue perfusion in circulatory shock. PURPOSE:To assess the evidence of NIRS monitoring in circulatory shock, we conducted a s...
journal_title:Journal of intensive care medicine
pub_type: 杂志文章
doi:10.1177/0885066620907307
更新日期:2020-10-01 00:00:00
abstract::The rapid spread of the severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) has led to a global pandemic. The 2019 coronavirus disease (COVID-19) presents with a spectrum of symptoms ranging from mild to critical illness requiring intensive care unit (ICU) admission. Acute respiratory distress syndrome is a m...
journal_title:Journal of intensive care medicine
pub_type: 杂志文章
doi:10.1177/0885066620951426
更新日期:2021-02-01 00:00:00
abstract:PURPOSE:We previously developed a bedside model (I-TRACH), which used commonly obtained data at the time of intubation to predict the duration of mechanical ventilation (MV). We now sought to validate this in a prospective trial. METHODS:A prospective, observational study of 225 consecutive adult medical intensive car...
journal_title:Journal of intensive care medicine
pub_type: 杂志文章
doi:10.1177/0885066616679974
更新日期:2018-10-01 00:00:00
abstract::Transfusion-related acute lung injury (TRALI) refers to a clinical syndrome of acute lung injury that occurs in a temporal relationship with the transfusion of blood products. Because of the difficulty in making its diagnosis, TRALI is often underreported. Three not necessarily mutually exclusive hypotheses have been ...
journal_title:Journal of intensive care medicine
pub_type: 杂志文章,评审
doi:10.1177/0885066607312994
更新日期:2008-03-01 00:00:00
abstract:BACKGROUND:Sepsis and sepsis-associated encephalopathy (SAE) are common intensive care unit (ICU) diseases; the morbidity and mortality are high. The present study analyzed the sensitivity of different diagnostic criteria of sepsis 1.0 and 3.0, epidemiological characteristics of sepsis and SAE, and explored its risk fa...
journal_title:Journal of intensive care medicine
pub_type: 杂志文章
doi:10.1177/0885066617719750
更新日期:2019-11-01 00:00:00
abstract::Acute brain injury (ABI) increases morbidity and mortality in patients with veno-arterial extracorporeal membrane oxygenation (VA-ECMO). Optimal neurologic monitoring methods have not been well-explicated. We studied the use of Near-infrared Spectroscopy (NIRS) to monitor cerebral regional oxygenation tissue saturatio...
journal_title:Journal of intensive care medicine
pub_type: 杂志文章
doi:10.1177/0885066620966962
更新日期:2020-10-15 00:00:00
abstract::Acute adrenocortical insufficiency is a critical care emergency characterized by hemodynamic instability, lethargy, and cardiovascular collapse. Acute adrenal insufficiency has many etiologies, from rapid withdrawal of exogenous glucocorticoids to adrenocortical destruction to poor adrenal reserve after administration...
journal_title:Journal of intensive care medicine
pub_type: 杂志文章,评审
doi:10.1177/0885066606298140
更新日期:2007-03-01 00:00:00
abstract:BACKGROUND:Agitation is common in the intensive care unit (ICU). Although antipsychotics are frequently used as first-line therapy, chlorpromazine has fallen out of favor due to risk of cardiovascular complications and severe hypotension. Although chlorpromazine is used anecdotally, there is a lack of data regarding it...
journal_title:Journal of intensive care medicine
pub_type: 杂志文章
doi:10.1177/0885066618818787
更新日期:2020-10-01 00:00:00
abstract:BACKGROUND:In the setting of the COVID pandemic, many patients falling ill with acute respiratory distress syndrome eventually require prone positioning for gas exchange. Traditionally, central venous catheters are inserted with patient in the supine or Trendelenburg position. However, when a patient cannot tolerate su...
journal_title:Journal of intensive care medicine
pub_type: 杂志文章
doi:10.1177/0885066620959649
更新日期:2020-09-16 00:00:00
abstract::Although the number of available donor hearts severely limits the epidemiologic impact of heart transplantation on patients with heart failure, patients with end-stage heart failure unresponsive to medical management currently have no other viable alternatives. Destination therapy with a ventricular assist device is t...
journal_title:Journal of intensive care medicine
pub_type: 杂志文章,评审
doi:10.1177/0885066603259012
更新日期:2004-01-01 00:00:00
abstract::A review of adults with septic arthritis was undertaken to evaluate outcome of treatment and intensive care requirements in a community-based teaching hospital. During an 80-month period (1986-1992), 38 cases of septic arthritis were identified. Underlying joint disease was present in 84% of patients. Mean age was 68 ...
journal_title:Journal of intensive care medicine
pub_type: 杂志文章
doi:10.1177/088506669501000507
更新日期:1995-09-01 00:00:00
abstract::We describe the case of a patient with hemolysis-associated Clostridium perfringens septicemia and review all similar cases published in the literature since 1990, with specific focus on the relationship between treatment strategy and survival. We searched PubMed for all published cases of C. perfringens-associated he...
journal_title:Journal of intensive care medicine
pub_type: 杂志文章
doi:10.1177/0885066613498043
更新日期:2014-11-01 00:00:00
abstract::Renal replacement therapy in the intensive care unit can vary from simple procedures to very complex technologies. I discuss the factors that contribute to the decisions regarding the selection of a specific therapy. These factors include immediate and intermediate therapeutic goals (e.g., solute removal, dehydratio...
journal_title:Journal of intensive care medicine
pub_type: 杂志文章,评审
doi:10.1177/088506669200700604
更新日期:1992-11-01 00:00:00
abstract::Hyponatremia is the most frequently occurring electrolyte abnormality and can lead to life-threatening complications. This disorder may be present on admission to the intensive care setting or develop during hospitalization as a result of treatment or multiple comorbidities. Patients with acute hyponatremia or symptom...
journal_title:Journal of intensive care medicine
pub_type: 杂志文章,评审
doi:10.1177/0885066614566794
更新日期:2016-05-01 00:00:00
abstract::Cardiac transplantation has now become accepted therapy for the treatment of end-stage heart disease in both children and adults, and literally thousands of patients are bearers of cardiac grafts. Because of these patients' susceptibility to infections, rejection, coronary disease, and malignancy, as well as to serio...
journal_title:Journal of intensive care medicine
pub_type: 杂志文章,评审
doi:10.1177/088506669100600201
更新日期:1991-03-01 00:00:00
abstract::Brain blood flow tests with diffusible radiopharmaceuticals are often done as an ancillary test in brain death (BD). We report a case of an infant with absent brain blood flow on an anterior planar image despite persistent breathing and extensor posturing. We reviewed the literature from 1980 to 2008 using MEDLINE and...
journal_title:Journal of intensive care medicine
pub_type: 杂志文章,评审
doi:10.1177/0885066609355388
更新日期:2010-01-01 00:00:00
abstract:BACKGROUND:Morbidity associated with stress ulcer-related bleeding, the cost of medications, and the possible complications associated with stress ulcer prophylaxis are important considerations when prescribing prophylaxis. We prospectively studied the prescription patterns for stress ulcer prophylaxis in patients admi...
journal_title:Journal of intensive care medicine
pub_type: 杂志文章,多中心研究
doi:10.1177/0885066612453542
更新日期:2014-03-01 00:00:00
abstract::The objective of this article was to review the effects of acute intracranial lesions on myocardial function. The authors reviewed scientific and clinical literature retrieved from a computerized MEDLINE search from January 1965 through January 2002. Pertinent literature was referenced, including clinical and laborato...
journal_title:Journal of intensive care medicine
pub_type: 杂志文章,评审
doi:10.1177/0885066603251202
更新日期:2003-05-01 00:00:00
abstract:INTRODUCTION:The invasive nature and potential complications associated with pulmonary artery (PA) catheters (PACs) have prompted the pursuit of less invasive monitoring options. Before implementing new hemodynamic monitoring technologies, it is important to determine the interchangeability of these modalities. This st...
journal_title:Journal of intensive care medicine
pub_type: 杂志文章
doi:10.1177/0885066614530085
更新日期:2016-02-01 00:00:00
abstract:BACKGROUND:Insulin receptors (IRs) in the brain have unique molecular features and a characteristic pattern of distribution. Their possible functions extend beyond glucose utilization. In this systematic review, we explore the interactions between insulin and the brain and its implications for anesthesiologists, critic...
journal_title:Journal of intensive care medicine
pub_type: 杂志文章,评审
doi:10.1177/0885066615594341
更新日期:2017-01-01 00:00:00
abstract::Fever after cardiac surgery in children may be due to bacterial infection or noninfectious origin like systemic inflammatory response syndrome (SIRS) secondary to bypass procedure. A marker to distinguish bacterial from nonbacterial fever in these conditions is clinically important. The purpose of our study was to eva...
journal_title:Journal of intensive care medicine
pub_type: 杂志文章
doi:10.1177/0885066610396642
更新日期:2012-05-01 00:00:00