Abstract:
BACKGROUND:A nationwide increase in the rate and severity of Clostridium difficile-associated disease may reflect infection with a virulent strain characterized by polymerase chain reaction as ribotype 027 (NAP1/B1). HYPOTHESIS:The high prevalence of ribotype 027 at our institution would allow investigation of the risk of mortality and admission to the intensive care unit (ICU) associated with C difficile infection. METHODS:In a retrospective cohort study, we identified 108 patients with positive enzyme-linked immunosorbant assay tests for C difficile toxins over a 6-month period and compared them to 108 patients who were suspected to have C difficile but with negative toxin assays. Proportions of all-cause mortality and ICU admission were compared using chi(2), and odds ratios (ORs) were estimated using logistic regression to adjust for potential confounders. Mean log lengths of stay were compared using t test. RESULTS:Comparing patients with C difficile to those without, mortality (20% vs 8%) and ICU admission (32% vs 17%) were significantly higher (P = .02 for both), whereas log length of stay was not (P = .29). Adjusting for potential confounders, the OR for mortality was 6.8 (95% confidence interval, 1.8-25.4; P = .01), whereas for ICU admission, the association was no longer observed (OR, 1.0; 95% confidence interval, 0.4-2.5; P = .97). CONCLUSION:C difficile infection was associated with increased all-cause mortality. An observed association with ICU admission and C difficile infection was identified through univariate analysis but was not significant in multivariate analysis. Although we did not strain-type isolates for patients infected with C difficile, the institutional prevalence of ribotype 027 C difficile infection was known to be high. These results document a strong association between ribotype 027 C difficile infection and mortality and underscore the need to identify effective C difficile preventive strategies.
journal_name
J Crit Carejournal_title
Journal of critical careauthors
Gasperino J,Garala M,Cohen HW,Kvetan V,Currie Bdoi
10.1016/j.jcrc.2009.04.002subject
Has Abstractpub_date
2010-06-01 00:00:00pages
282-6issue
2eissn
0883-9441issn
1557-8615pii
S0883-9441(09)00083-5journal_volume
25pub_type
杂志文章abstract:PURPOSE:In the vascularly isolated canine hemidiaphragm, we tested the hypothesis that alpha-adrenoreceptor stimulation may influence diaphragmatic function and O2 extraction during reductions in O2 delivery (QO2di). METHODS:The diaphragm was perfused using a constant flow pump with blood diverted from the left femora...
journal_title:Journal of critical care
pub_type: 杂志文章
doi:10.1016/s0883-9441(96)90016-7
更新日期:1996-03-01 00:00:00
abstract::This paper focuses on the use of data from an electronic medical record (EMR) within a multi-facility health care organization. It describes how health provider workflow is enhanced by extracting data from multiple sources in a near real-time fashion and presenting it to the user in ways that are unavailable in the el...
journal_title:Journal of critical care
pub_type: 杂志文章
doi:10.1016/j.jcrc.2004.09.003
更新日期:2004-12-01 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:It is unclear whether quick sequential (sepsis-related) organ failure assessment (qSOFA) also has prognostic value for organ failure in patients with a suspected infection. The aim of this study was to determine whether qSOFA has prognostic value when compared to systemic inflammatory response syndrome (SIRS) i...
journal_title:Journal of critical care
pub_type: 杂志文章
doi:10.1016/j.jcrc.2017.06.020
更新日期:2017-12-01 00:00:00
abstract:PURPOSE:Newly diagnosed swallowing dysfunction is rare, with an incidence <1% in hospitalized patients. The purpose of this study was to evaluate the incidence and clinical characteristics of dysphagia in elderly trauma patients specifically. METHODS:Patients ≥75years who had newly diagnosed swallowing dysfunction wer...
journal_title:Journal of critical care
pub_type: 杂志文章
doi:10.1016/j.jcrc.2017.07.027
更新日期:2017-12-01 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:PURPOSE:The objective of this study is to explore the attitudes, knowledge, and behavior of house staff physicians regarding the use of ultrasound guidance (UG) during central venous catheter placement (CP). MATERIALS AND METHODS:A questionnaire-based study was used to survey house staff in multiple training programs ...
journal_title:Journal of critical care
pub_type: 杂志文章
doi:10.1016/j.jcrc.2005.06.005
更新日期:2005-09-01 00:00:00
abstract:BACKGROUND:Changes in mean perfusion pressure (MPP) from premorbid resting values may contribute to the progression of septic acute kidney injury (AKI). OBJECTIVES:In patients with septic shock, we aimed to investigate the association of changes from premorbid values with AKI severity and progression. METHODS:We obta...
journal_title:Journal of critical care
pub_type: 杂志文章
doi:10.1016/j.jcrc.2015.05.003
更新日期:2015-10-01 00:00:00
abstract:PURPOSE:In mechanically ventilated patients, the endotracheal tube is an essential interface between the patient and ventilator, but inadvertently, it also facilitates the development of ventilator-associated pneumonia (VAP) by subverting pulmonary host defenses. A number of investigations suggest that bacteria coloniz...
journal_title:Journal of critical care
pub_type: 杂志文章
doi:10.1016/j.jcrc.2016.07.019
更新日期:2017-02-01 00:00:00
abstract:PURPOSE:Family needs and expectations are often unmet in the intensive care unit (ICU), leading to dissatisfaction. This study assesses cross-cultural adaptability of an instrument evaluating family satisfaction in the ICU. MATERIALS AND METHODS:A Canadian instrument on family satisfaction was adapted for German langu...
journal_title:Journal of critical care
pub_type: 杂志文章
doi:10.1016/j.jcrc.2006.12.008
更新日期:2007-09-01 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:Oxygen (O2) is the most common therapy in mechanically ventilated patients, but targets and dose are poorly understood. We aimed to describe current O2 administration and titration in such patients in an academic intensive care unit. MATERIALS AND METHODS:In consecutive ventilated (>48 hours) patients we prosp...
journal_title:Journal of critical care
pub_type: 杂志文章
doi:10.1016/j.jcrc.2013.03.010
更新日期:2013-10-01 00:00:00
abstract:INTRODUCTION:The HACOR scale is a clinical score that can predict early failure of NIV in hypoxemic acute respiratory failure (ARF) The aim of this study is to analyze the validity of the HACOR scale. METHODS:A retrospective study of a cohort of over 2749 episodes on 2711 consecutive patients requiring NIV for hypoxem...
journal_title:Journal of critical care
pub_type: 杂志文章
doi:10.1016/j.jcrc.2020.08.008
更新日期:2020-12-01 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::The use of diagnostic ultrasound by physiotherapists is not a new concept; it is frequently performed in musculoskeletal physiotherapy. Physiotherapists currently lack accurate, reliable, sensitive, and valid measurements for the assessment of the indications and effectiveness of chest physiotherapy. Thoracic ultrasou...
journal_title:Journal of critical care
pub_type: 杂志文章,评审
doi:10.1016/j.jcrc.2015.10.014
更新日期:2016-02-01 00:00:00
abstract:OBJECTIVE:The purpose of the study was to investigate the pharmacokinetics of combined intravenous (i.v.) and intracerebroventricular (i.c.v.) vancomycin for patients with intracranial infections after craniotomy and to provide the basis for establishing the intracranial local administration criterion. METHODS:Fourtee...
journal_title:Journal of critical care
pub_type: 杂志文章
doi:10.1016/j.jcrc.2014.09.020
更新日期:2015-02-01 00:00:00
abstract:PURPOSE:To determine if recruitment manoeuvres (RMs) would decrease 28-day mortality of patients with acute respiratory distress syndrome (ARDS) compared with standard care. MATERIALS AND METHODS:Relevant randomized controlled trials (RCTs) published prior to April 26, 2018 were systematically searched. The primary ou...
journal_title:Journal of critical care
pub_type: 杂志文章,meta分析
doi:10.1016/j.jcrc.2018.10.033
更新日期:2019-04-01 00:00:00
abstract:PURPOSE:To assess health-related quality of life (HRQOL) following rehabilitation of amputees suffering symmetric peripheral gangrene (SPG) after septic shock. MATERIAL AND METHODS:A retrospective cohort study was conducted in nine French specialized rehabilitation centers. Thirty-two ICU adult patients hospitalized b...
journal_title:Journal of critical care
pub_type: 杂志文章,多中心研究
doi:10.1016/j.jcrc.2019.06.027
更新日期:2019-10-01 00:00:00
abstract:PURPOSE:To examine relationships between self-report and performance-based measures of physical function in ICU patients randomized to standardized rehabilitation therapy (SRT) or usual care (UC). METHODS:Physical function was assessed in 257 ICU patients using self-report (physical functioning scale of the SF-36 (SF-...
journal_title:Journal of critical care
pub_type: 杂志文章
doi:10.1016/j.jcrc.2019.01.020
更新日期:2019-06-01 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::The Institute of Medicine's (IOMs) report, "To Err is Human," recently addressed patient safety in the United States, alerting the nation to the need for improved systems of health care. Seven main findings were addressed in this report, we focus on 3: (1) patient safety is a nationwide problem, (2) health care worker...
journal_title:Journal of critical care
pub_type: 杂志文章
doi:10.1053/jcrc.2002.34363
更新日期:2002-06-01 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:The mortality rate of severe acute pancreatitis (AP) is 20-30% even after admission to intensive care unit (ICU). Thus we aimed to develop a laboratory-based nomogram to identify AP patients at high risk for mortality. MATERIALS AND METHODS:The primary and validation cohorts were extracted from the Medical Inf...
journal_title:Journal of critical care
pub_type: 杂志文章
doi:10.1016/j.jcrc.2018.10.030
更新日期:2019-04-01 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: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::National clinical quality registries (CQRs) are effective tools for improving the outcomes of patients admitted to the intensive care unit (ICU), and are increasingly important as healthcare needs evolve. A high-quality ICU CQR is built from a foundation of common requirements and challenges. First, performance indica...
journal_title:Journal of critical care
pub_type: 杂志文章,评审
doi:10.1016/j.jcrc.2020.08.012
更新日期:2020-12-01 00:00:00
abstract:BACKGROUND:Continuous renal replacement therapy (CRRT) is an important tool in the care of critically ill patients. However, the impact of a specific CRRT machine type on the successful delivery of CRRT is unclear. The purpose of this study was to evaluate the effectiveness of CRRT delivery with an intensive care unit ...
journal_title:Journal of critical care
pub_type: 杂志文章
doi:10.1016/j.jcrc.2013.11.012
更新日期:2014-04-01 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:To identify elements which enable patient and family centred care (PFCC) in the intensive care unit (ICU) and priorities for PFCC research. MATERIALS AND METHODS:We engaged a panel of multidisciplinary stakeholders in a modified Delphi process. Items generated from a literature review and panelist suggestions ...
journal_title:Journal of critical care
pub_type: 杂志文章
doi:10.1016/j.jcrc.2017.08.008
更新日期:2017-12-01 00:00:00
abstract:OBJECTIVE:Pneumothorax is present as a frequent complication in acute respiratory distress syndrome (ARDS). Persistent air leak (PAL) prolongs pneumothorax in 2% of cases of ARDS, increasing the rate of mortality by 26%. Pleurodesis using autologous blood (PAB) is an effective method in cases of oncological pulmonary s...
journal_title:Journal of critical care
pub_type: 杂志文章
doi:10.1016/j.jcrc.2005.10.003
更新日期:2006-06-01 00:00:00