Abstract:
PURPOSE:Data regarding outcome of patients with chronic liver disease with severe hepatic encephalopathy in intensive care unit are currently scarce. METHODS:This study is a retrospective observational case series in a medical intensive care unit (ICU) in a university hospital from 1995 to 2005. Patients with hepatic encephalopathy (HE) (admitted with or developing) were identified. Clinical and laboratory parameters were analyzed to determinate predictors of ICU and 1-year mortality. RESULTS:Seventy-one patients were included (53 male). Median Simplified Acute Physiology Score was 56 with Child-Pugh score 11 +/- 2. Seventy-six percent of patients were admitted with coma (Glasgow Coma Scale, 7.7 +/- 4). Eighty-two percent of patients required intubation, and 28% vasopressors. Thirty-five percent died during ICU stay. At 1 year, mortality was 54%. Univariate analysis identified arterial hypotension, mechanical ventilation, vasopressors at any time, acute renal failure, Simplified Acute Physiology Score, and sepsis associated with ICU mortality. In multivariate analysis, vasopressor use or acute renal failure was the main independent predictor of ICU death and 1-year mortality. Patients free of these risk factors, even requiring intubation, were identified as isolated HE, with lower mortality rates. CONCLUSION:Predictors of outcome were similar to other groups of patients with liver disease admitted for other reasons. Intensive care unit mortality was lower than reported for other groups of patients with similar illness. Patients with severe HE admitted to ICU with no organ dysfunction other than mechanical ventilation had a better outcome and may require ICU admission.
journal_name
J Crit Carejournal_title
Journal of critical careauthors
Fichet J,Mercier E,Genée O,Garot D,Legras A,Dequin PF,Perrotin Ddoi
10.1016/j.jcrc.2009.01.008subject
Has Abstractpub_date
2009-09-01 00:00:00pages
364-70issue
3eissn
0883-9441issn
1557-8615pii
S0883-9441(09)00011-2journal_volume
24pub_type
杂志文章abstract:PURPOSE:The purpose of this study is to investigate the accuracy of currently used scoring systems in differentiating transient and persistent organ failure in patients with acute pancreatitis (AP). MATERIALS AND METHODS:In this retrospective study, 127 consecutive patients with AP and organ failure were included. Pat...
journal_title:Journal of critical care
pub_type: 杂志文章
doi:10.1016/j.jcrc.2014.01.011
更新日期:2014-08-01 00:00:00
abstract:PURPOSE:To investigate microorganisms causing central venous catheter contamination and how this contamination differs across different catheter metrics. MATERIALS AND METHODS:After obtaining IRB approval and informed consent, 830 cultures were prospectively obtained from 45 ICU patients with central venous catheter o...
journal_title:Journal of critical care
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更新日期:2017-06-01 00:00:00
abstract:PURPOSE:Utilization of renal replacement therapy (RRT) in cirrhotic patients has been controversial and is typically dependent on the status of transplantation. A better understanding of the central role for arterial vasodilatation in the pathogenesis of hepatorenal syndrome (HRS) has led to routine use of vasoconstric...
journal_title:Journal of critical care
pub_type: 杂志文章
doi:10.1016/j.jcrc.2015.05.006
更新日期:2015-10-01 00:00:00
abstract:PURPOSE:The purpose of this study is to determine if monitoring urinary bladder PCO2, PO2, and calculated intramucosal pH would be a reliable index of tissue perfusion. MATERIALS AND METHODS:This nonrandomized controlled study was conducted in a laboratory at a university medical center. Eight immature female Yorkshir...
journal_title:Journal of critical care
pub_type: 杂志文章
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更新日期:1999-06-01 00:00:00
abstract:PURPOSE:To assess the feasibility of a trial evaluating whether hyperoncotic albumin, in addition to diuretics, improves diuresis and facilitates liberation from mechanical ventilation in critically ill adults. MATERIALS AND METHODS:We randomized 46 hemodynamically stable patients with hypoalbuminemia, prescribed diur...
journal_title:Journal of critical care
pub_type: 杂志文章,随机对照试验
doi:10.1016/j.jcrc.2018.07.020
更新日期:2018-12-01 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::Advances in the management of malignancies and organ failures have led to substantial increases in survival as well as in the number of cancer patients requiring intensive care unit (ICU) admission. Although effectiveness of ICU in this group remains controversial, the heterogeneity of its population in terms of the n...
journal_title:Journal of critical care
pub_type: 杂志文章,评审
doi:10.1016/j.jcrc.2014.04.007
更新日期:2014-10-01 00:00:00
abstract:PURPOSE:We wanted to identify modifiable risk factors for intensive care unit (ICU)-acquired hypernatremia. MATERIALS AND METHODS:We retrospectively studied sodium and fluid loads and balances up to 7 days prior to the development of hypernatremia (first serum sodium concentration, [Na+], >150 mmol/L; H) vs control (m...
journal_title:Journal of critical care
pub_type: 杂志文章
doi:10.1016/j.jcrc.2014.01.025
更新日期:2014-06-01 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:INTRODUCTION:Ventilator-associated pneumonia (VAP) is difficult to diagnose. Recent data suggest quantitative endotracheal aspirate (ETA) may be noninferior diagnostically to quantitative bronchoalveolar lavage (BAL). We hypothesized this would be the case. METHODS:Blind quantitative ETA and BAL were performed on 150 ...
journal_title:Journal of critical care
pub_type: 杂志文章
doi:10.1016/j.jcrc.2008.06.012
更新日期:2009-09-01 00:00:00
abstract:PURPOSE:Endothelial glycocalyx (EG) shedding may promote organ failure in sepsis. This study describes temporal changes in EG biomarkers from Emergency Department (ED) arrival, and associations with clinical characteristics. MATERIALS AND METHODS:This prospective observational study included 23 patients with simple in...
journal_title:Journal of critical care
pub_type: 杂志文章
doi:10.1016/j.jcrc.2017.07.001
更新日期:2017-12-01 00:00:00
abstract:PURPOSE:Few guidelines exist regarding the selection of a particular type or size of tracheostomy tube. Although nonstandard tubes can be placed over the percutaneous kit dilator, clinicians often place standard tracheostomy tubes and change to nonstandard tubes only after problems arise. This practice risks early trac...
journal_title:Journal of critical care
pub_type: 杂志文章
doi:10.1016/j.jcrc.2016.05.025
更新日期:2017-02-01 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:PURPOSE:To investigate the effect of increasing spinal cord perfusion pressure (SCPP) on sensory evoked potentials (SEPs) and injury site metabolism in patients with severe traumatic spinal cord injury TSCI. MATERIALS AND METHODS:In 12 TSCI patients we placed a pressure probe, a microdialysis catheter and a strip elec...
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pub_type: 杂志文章
doi:10.1016/j.jcrc.2019.12.019
更新日期:2020-04-01 00:00:00
abstract:PURPOSE:Decisions to withdraw life-sustaining therapy (WDLS) are relatively common in intensive care units across Canada. As part of preliminary work to develop guidelines for WDLS, we performed a narrative review of the literature to identify published studies of WDLS. MATERIALS AND METHODS:A search of MEDLINE and EM...
journal_title:Journal of critical care
pub_type: 杂志文章,评审
doi:10.1016/j.jcrc.2016.04.006
更新日期:2016-10-01 00:00:00
abstract:PURPOSE:Endotracheal suctioning causes significant lung derecruitment. Closed suction (CS) minimizes lung volume loss during suction, and therefore, volumes are presumed to recover more quickly postsuctioning. Conflicting evidence exists regarding this. We examined the effects of open suction (OS) and CS on lung volume...
journal_title:Journal of critical care
pub_type: 杂志文章,随机对照试验
doi:10.1016/j.jcrc.2012.08.019
更新日期:2012-12-01 00:00:00
abstract:PURPOSE:The ability of the global end-diastolic volume index (GEDVI) and respiratory variations in left ventricular outflow tract velocity (ΔVTI(LVOT)) for prediction of fluid responsiveness is still under debate. The aim of the present study was to challenge the predictive power of GEDVI and ΔVTI(LVOT) compared with p...
journal_title:Journal of critical care
pub_type: 杂志文章
doi:10.1016/j.jcrc.2011.07.073
更新日期:2012-06-01 00:00:00
abstract:BACKGROUND:Resident physicians' beliefs about cardiopulmonary resuscitation (CPR) may impact their communication with patients about end-of-life care. We sought to understand how these perceptions and experiences have changed in the past decade because both medical education and American society have focused more on th...
journal_title:Journal of critical care
pub_type: 杂志文章
doi:10.1016/j.jcrc.2007.12.012
更新日期:2009-03-01 00:00:00
abstract:PURPOSE:Prolonged exposure to normobaric hyperoxia (NH) is associated with blood leukocyte activation and sequestration in the lung. Whether NH-induced leukocyte activation and sequestration can affect extrapulmonary organs or blood cellular profile has not been systematically investigated. We studied simultaneous chan...
journal_title:Journal of critical care
pub_type: 杂志文章
doi:10.1016/j.jcrc.2005.09.057
更新日期:2006-03-01 00:00:00
abstract::While the risk of death after nonthermal trauma and sepsis may be higher for men, sex differences in outcome after burns are inconsistently reported. The Burns Evaluation And Mortality Study examined the outcomes of all patients admitted after thermal injury to the intensive care unit (ICU) at 8 of 9 burn referral cen...
journal_title:Journal of critical care
pub_type: 杂志文章
doi:10.1016/j.jcrc.2014.03.021
更新日期:2014-08-01 00:00:00
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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:To compare the rate of therapeutic failure in critically ill patients treated by third-generation cephalosporins (3GCs) or piperacillin-tazobactam (PTZ) for wild-type AmpC-producing Enterobacterales pulmonary infections. METHODS:Over a 4-year period, all adult patients treated for a wild-type AmpC-producing En...
journal_title:Journal of critical care
pub_type: 杂志文章
doi:10.1016/j.jcrc.2019.11.005
更新日期:2020-04-01 00:00:00
abstract:PURPOSE:The purpose of the study is to describe early predictors and to develop a prediction tool that accurately identifies the need for mechanical ventilation (MV) in pneumonia patients with hypoxemic acute respiratory failure (ARF) treated with high-flow nasal cannula (HFNC). MATERIALS AND METHODS:This is a 4-year ...
journal_title:Journal of critical care
pub_type: 杂志文章
doi:10.1016/j.jcrc.2016.05.022
更新日期:2016-10-01 00:00:00
abstract:PURPOSE:Studies have shown that lung-ultrasound may be superior to chest x-ray (CXR) in diagnosing ventilator-associated pneumonia (VAP). This study investigated whether the use of lung-ultrasound monitoring could detect VAP earlier and improve patient outcome. METHODS:This was a single-center diagnostic randomized co...
journal_title:Journal of critical care
pub_type: 杂志文章
doi:10.1016/j.jcrc.2020.03.012
更新日期:2020-08-01 00:00:00
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journal_title:Journal of critical care
pub_type: 杂志文章,随机对照试验
doi:10.1016/j.jcrc.2018.03.031
更新日期:2018-08-01 00:00:00
abstract:PURPOSE:The study aimed to determine whether improvements in intensive care unit (ICU) structural environment affect the incidence of ICU-acquired infections (IAIs), particularly those caused by multidrug-resistant pathogens. METHODS:The incidence of IAI and the number of infections caused by organisms during the 6 mo...
journal_title:Journal of critical care
pub_type: 杂志文章
doi:10.1016/j.jcrc.2012.12.013
更新日期:2013-08-01 00:00:00
abstract::Hypernatremia is common in intensive care units. It has detrimental effects on various physiologic functions and was shown to be an independent risk factor for increased mortality in critically ill patients. Mechanisms of hypernatremia include sodium gain and/or loss of free water and can be discriminated by clinical ...
journal_title:Journal of critical care
pub_type: 杂志文章,评审
doi:10.1016/j.jcrc.2012.05.001
更新日期:2013-04-01 00:00:00
abstract:OBJECTIVE:To develop and internally validate a prediction rule for the presence of candidemia in patients with severe sepsis and septic shock (candidemia rule) that will fill the gap left by previous rules. To compare the accuracy of the available Candida prediction models. DESIGN:Retrospective cohort study. SETTING:...
journal_title:Journal of critical care
pub_type: 杂志文章
doi:10.1016/j.jcrc.2015.03.010
更新日期:2015-08-01 00:00:00
abstract::Hemoglobin-based oxygen carriers (HBOCs) are used in extreme circumstances to increase hemoglobin concentration and improve oxygen delivery when allogenic red blood cell transfusions are contraindicated or not immediately available. However, HBOC-induced severe pulmonary and systemic vasoconstriction due to peripheral...
journal_title:Journal of critical care
pub_type: 杂志文章
doi:10.1016/j.jcrc.2018.04.008
更新日期:2019-06-01 00:00:00
abstract:PURPOSE:To assess the risk factors for invasive Candida infection (ICI) caused by fluconazole-resistant (Flu-R) Candida species in intensive care unit (ICU) patients. MATERIALS AND METHODS:Data from China Survey of Candidiasis study were analyzed. Patients with proven ICI were classified into fluconazole-sensitive (Fl...
journal_title:Journal of critical care
pub_type: 杂志文章
doi:10.1016/j.jcrc.2015.04.002
更新日期:2015-08-01 00:00:00