Abstract：
OBJECTIVE:To determine if autopsies performed on patients who die in the medical intensive care unit (ICU) provide clinically important new information. DESIGN:Retrospective review. SETTING:A 16-bed medical-coronary ICU. PATIENTS:Patients who underwent autopsy during a 1-yr period. INTERVENTIONS:Pre mortem diagnoses were determined from the medical record. Autopsy results were obtained from the final pathology report. A panel of three physicians with certification of added qualifications in critical care medicine reviewed the findings. MEASUREMENTS AND MAIN RESULTS:These questions were asked: a) Is the primary clinical diagnosis confirmed? b) Are the clinical and pathologic causes of death the same? c) Are new active diagnoses revealed? and d) If the new findings had been known before death, would the clinical management have differed? Forty-one autopsies (31% of deaths) were done that showed: a) the same primary clinical diagnosis and post mortem diagnosis in 34 (83%) patients; b) the same clinical and pathologic cause of death in 27 (66%) patients; c) new active diagnoses in 37 (90%) patients; and d) findings that would have changed medical ICU therapy had the findings been known in 11 (27%) patients. CONCLUSIONS:Although the primary clinical diagnosis was accurate in most cases before death, the cause of death was frequently unknown. Almost all autopsies demonstrated new diagnoses, and knowledge of these new findings would have changed medical ICU therapy in many cases. In the critical care setting, autopsies continue to provide information that could be important for education and quality patient care.
journal_name
Crit Care Medjournal_title
Critical care medicineauthors
Blosser SA,Zimmerman HE,Stauffer JLdoi
10.1097/00003246-199808000-00015subject
Has Abstractpub_date
1998-08-01 00:00:00pages
1332-6issue
8eissn
0090-3493issn
1530-0293journal_volume
26pub_type
杂志文章abstract：OBJECTIVES:To compare the incidence of withdrawal or withholding of life support (WD/WHLS), and to identify similarities and differences in the process of the withdrawal of life support (WDLS) between teaching and community hospitals' intensive care units (ICUs). DESIGN:Prospective cohort study, with some data obtaine...
journal_title：Critical care medicine
pub_type： 杂志文章
doi：10.1097/00003246-199802000-00018
更新日期：1998-02-01 00:00:00
abstract：:A safe, simple, reliable technique for sampling uncontaminated peripheral bronchial secretions in patients with endotracheal tubes has been developed. It is easily performed and requires no special training or equipment. This report summarizes the techniques's usefulness in providing diagnostic samples of peripheral a...
journal_title：Critical care medicine
pub_type： 杂志文章
doi：10.1097/00003246-197703000-00003
更新日期：1977-03-01 00:00:00
abstract：OBJECTIVE:To determine whether treatment with patient-controlled analgesia (PCA) alone or in combination with nonsteroidal anti-inflammatory drugs can prevent postoperative pulmonary complications after cardiac surgery, when compared with conventional nurse-controlled analgesia. DESIGN:Randomized controlled trial. SE...
journal_title：Critical care medicine
pub_type： 临床试验,杂志文章,随机对照试验
doi：10.1097/00003246-199910000-00025
更新日期：1999-10-01 00:00:00
abstract：OBJECTIVE:To determine the influence of a selective, sterile central nervous system surgery on immune reactivity, particularly whether a decrease of monocytic human leukocyte antigen-DR expression, indicating immunodepression, occurs after neurosurgery and if this measurement is useful for identification of patients wi...
journal_title：Critical care medicine
pub_type： 杂志文章
doi：10.1097/00003246-199512000-00006
更新日期：1995-12-01 00:00:00
abstract：OBJECTIVE:To determine the feasibility of utilizing a scintigraphic technique to differentiate patients with adult respiratory distress syndrome due to sepsis syndrome from control volunteers and patients with congestive heart failure. Gamma scintigraphy was compared with chest roentgenograms to predict mortality rate ...
journal_title：Critical care medicine
pub_type： 杂志文章
doi：10.1097/00003246-199201000-00012
更新日期：1992-01-01 00:00:00
abstract：OBJECTIVE:Hypoxemic reperfusion attenuates brain injury secondary to severe cerebral ischemia, myocardial, and intestinal injury occurring in intestinal postischemic shock, and offers hemodynamic stabilization and attenuation of inflammatory response when applied in the resuscitation from hemorrhagic shock. In this stu...
journal_title：Critical care medicine
pub_type： 杂志文章
doi：10.1097/CCM.0b013e31819b81ec
更新日期：2009-03-01 00:00:00
abstract：OBJECTIVES:To determine nuclear factor kappa B (NF-kappa B) activation in mononuclear and neutrophils from critically ill patients and to compare NF-kappa B activation with circulating concentrations of interleukin (IL)-6, IL-8, and soluble intercellular adhesion molecule (sICAM)-1. DESIGN:Observational study. SETTIN...
journal_title：Critical care medicine
pub_type： 杂志文章
doi：10.1097/00003246-200004000-00022
更新日期：2000-04-01 00:00:00
abstract：OBJECTIVE:To evaluate the accuracies of the respiratory rate/tidal volume ratio (rate/volume ratio), minute volume, and negative inspired force in predicting weaning outcome in postoperative mechanically ventilated patients. DESIGN:A prospective, observational study. SETTING:Surgical intensive care unit of a 270-bed ...
journal_title：Critical care medicine
pub_type： 杂志文章
doi：10.1097/00003246-199702000-00010
更新日期：1997-02-01 00:00:00
abstract：OBJECTIVES:To test whether hospital-based physicians made different intensive care unit and life-sustaining treatment decisions for otherwise identical black and white patients with end-stage cancer and life-threatening hypoxia. DESIGN:We conducted a randomized trial of the relationship between patient race and physic...
journal_title：Critical care medicine
pub_type： 杂志文章,随机对照试验
doi：10.1097/CCM.0b013e3182186e98
更新日期：2011-07-01 00:00:00
abstract：:Paranasal sinusitis is reported as a complication of prolonged nasal intubation and the source of sepsis in adult intensive care patients. In surgical neonates with congenital malformations, prolonged intubation with a nasotracheal (NT) or NG tube is often necessary, but sinusitis with complicating sepsis is seldom re...
journal_title：Critical care medicine
pub_type： 杂志文章
doi：
更新日期：1989-09-01 00:00:00
abstract：OBJECTIVE:To test the hypothesis that therapeutic hypercapnia enhances the proinflammatory responses to endotoxemia in the lung and spleen of rats. DESIGN:Prospective randomized study. SETTINGS:Hospital research institute. SUBJECTS:Forty-eight adult male rats. INTERVENTIONS:Rats were randomly assigned for a 24-hr p...
journal_title：Critical care medicine
pub_type： 杂志文章
doi：10.1097/CCM.0b013e31820ee1f2
更新日期：2011-06-01 00:00:00
abstract：OBJECTIVE:To determine the effect of a bolus infusion of diaspirin cross-linked hemoglobin (DCLHb or hemoglobin crosfumaril) on the ileal mucosal microcirculation in septic rats. DESIGN:Prospective, randomized, single-blinded study. SETTING:University-affiliated animal research laboratory. SUBJECTS:Twenty-four male ...
journal_title：Critical care medicine
pub_type： 杂志文章
doi：10.1097/00003246-200003000-00029
更新日期：2000-03-01 00:00:00
abstract：OBJECTIVE:To determine the blood discard volume, as a multiple of deadspace, that is required for accurate arterial blood gas and electrolyte testing from arterial catheters. DESIGN:Prospective, controlled, crossover trial. SETTING:Eighteen-bed intensive care unit of a metropolitan teaching hospital. PATIENTS:A tota...
journal_title：Critical care medicine
pub_type： 临床试验,杂志文章
doi：10.1097/01.CCM.0000063448.98777.EF
更新日期：2003-06-01 00:00:00
abstract：OBJECTIVE:To test whether spectral indices derived from the electroencephalogram (EEG), and especially the bispectral index (BIS), can be used as measures of neurologic status in unsedated, critically ill patients. DESIGN:Prospective, observational study. SETTING:Medical intensive care unit (ICU) of a university-affi...
journal_title：Critical care medicine
pub_type： 杂志文章
doi：10.1097/00003246-200110000-00024
更新日期：2001-10-01 00:00:00
abstract：:This review focuses on the effects of restoring hormonal levels and/or influence on muscle protein metabolism in the stressed state. We have highlighted our clinical experience in the administration of anabolic and anticatabolic agents in stressed clinical populations, primarily adult and pediatric burn injury, as wel...
journal_title：Critical care medicine
pub_type： 杂志文章,评审
doi：10.1097/01.CCM.0000278529.44899.57
更新日期：2007-09-01 00:00:00
abstract：OBJECTIVE:To evaluate the frequency and clinical correlates of ultrafilterable hypomagnesemia in neonates admitted to the neonatal intensive care unit (ICU). DESIGN:Prospective, observational study. SETTING:Massachusetts General Hospital and Mount Auburn Hospital. PATIENTS:A total of 117 patients (84 neonatal ICU pa...
journal_title：Critical care medicine
pub_type： 杂志文章
doi：10.1097/00003246-199405000-00017
更新日期：1994-05-01 00:00:00
abstract：OBJECTIVE:Sepsis and acute lung injury continue to be major causes of morbidity and mortality worldwide despite advances in our understanding of pathophysiology and the discovery of new management strategies. Recent investigations show that stem cells may be beneficial as prognostic biomarkers and novel therapeutic str...
journal_title：Critical care medicine
pub_type： 杂志文章,评审
doi：10.1097/CCM.0b013e3181f96f5f
更新日期：2010-12-01 00:00:00
abstract：OBJECTIVE:To evaluate the early myocardial biochemical inflammatory response with the microdialysis technique during porcine endotoxemia and to simultaneously monitor systemic hemodynamics. DESIGN:Prospective, randomized, placebo-controlled trial with parallel groups. SETTING:Animal research laboratory at the Univers...
journal_title：Critical care medicine
pub_type： 杂志文章
doi：10.1097/01.CCM.0000075740.61294.a6
更新日期：2003-06-01 00:00:00
abstract：OBJECTIVE:To determine whether mechanical ventilation using high tidal volume is associated with nonpulmonary organ dysfunction that can be attenuated by dexamethasone. DESIGN:Prospective randomized animal intervention study. SETTING:Animal care facility in a university hospital. SUBJECTS:Sedated and tracheostomized...
journal_title：Critical care medicine
pub_type： 杂志文章
doi：10.1097/01.CCM.0000205663.92384.E7
更新日期：2006-04-01 00:00:00
abstract：OBJECTIVES:Ethicists advise that life-sustaining treatment decisions should be made in keeping with patient preferences. Until recently, there has been little systematic study of the impact of patient preferences on the use of various life-sustaining treatments or the consequent cost of hospital care. This prospective ...
journal_title：Critical care medicine
pub_type： 杂志文章
doi：10.1097/00003246-199611000-00009
更新日期：1996-11-01 00:00:00
abstract：OBJECTIVE:To compare and evaluate the potential benefit of two different anticoagulation regimens during endotoxemia in an ovine model. DESIGN:Animal prospective randomized and controlled study following preliminary dose-range study conforming with the Guide for the Care and Use of Laboratory Animals as promulgated by...
journal_title：Critical care medicine
pub_type： 杂志文章
doi：10.1097/00003246-200212000-00013
更新日期：2002-12-01 00:00:00
abstract：OBJECTIVES:To compare the frequency and preventability of adverse drug events and potential adverse drug events in intensive care units (ICUs) and non-ICUs. To evaluate systems factors involving the individual caregivers, care unit teams, and patients involved in each adverse drug event by comparing ICUs with non-ICUs ...
journal_title：Critical care medicine
pub_type： 杂志文章
doi：10.1097/00003246-199708000-00014
更新日期：1997-08-01 00:00:00
abstract：OBJECTIVES:To track compliance by an interprofessional team with the Awakening and Breathing Coordination, Choice of drugs, Delirium monitoring and management, Early mobility, and Family engagement (ABCDEF) bundle in implementing the Pain, Agitation, and Delirium guidelines. The aim was to study the association between...
journal_title：Critical care medicine
pub_type： 杂志文章,多中心研究
doi：10.1097/CCM.0000000000002149
更新日期：2017-02-01 00:00:00
abstract：:Among Gram-positive pathogens, Staphylococcus aureus is the leading cause of death from nosocomial pneumonia. The bacterium developed progressive resistance to beta-lactams, and methicillin-resistant strains emerged in the 1980s. In consequence, vancomycin has become the drug of choice for treatment of this infection ...
journal_title：Critical care medicine
pub_type： 杂志文章,评审
doi：10.1097/00003246-200104001-00005
更新日期：2001-04-01 00:00:00
abstract：OBJECTIVE:To describe a case of intentional ingestion of hand sanitizer in our hospital and to review published cases and those reported to the American Association of Poison Control Centers' National Poison Data System. DESIGN:A case report, a literature review of published cases, and a query of the National Poison D...
journal_title：Critical care medicine
pub_type： 杂志文章,评审
doi：10.1097/CCM.0b013e31822f09c0
更新日期：2012-01-01 00:00:00
abstract：OBJECTIVE:To determine the impact of Acinetobacter baumannii (AB) acquisition in intensive care unit (ICU) patients on mortality and length of stay (LOS). DESIGN:Pairwise matched 1:1 case-control study. SETTING:Medical-surgical ICU in a tertiary health care institution. PATIENTS:During 16 months, all patients admitt...
journal_title：Critical care medicine
pub_type： 杂志文章
doi：10.1097/00003246-199909000-00015
更新日期：1999-09-01 00:00:00
abstract：OBJECTIVES:To describe the physiologic mechanisms of ventilator-induced lung injury and to define the major ventilator and host-dependent risk factors that contribute to such injury. DATA SOURCE:Basic science and clinical studies related to ventilator-induced barotrauma and lung pathophysiology. STUDY SELECTION:Empha...
journal_title：Critical care medicine
pub_type： 杂志文章,评审
doi：10.1097/00003246-199301000-00024
更新日期：1993-01-01 00:00:00
abstract：OBJECTIVE:The objectives of this study were to evaluate safety (primary) and clinical efficacy (secondary) of the humanized monoclonal anti-L-selectin antibody aselizumab in severely injured patients. DESIGN:Prospective phase II, parallel group, double-blind, randomized, placebo-controlled clinical trial. SETTING:Fou...
journal_title：Critical care medicine
pub_type： 临床试验,杂志文章,多中心研究,随机对照试验
doi：10.1097/01.ccm.0000142396.59236.f3
更新日期：2004-10-01 00:00:00
abstract：:Healthcare systems spend considerable resources collecting and processing blood cultures for the detection of blood stream pathogens. The process is initiated with the collection of blood cultures that depend upon proper skin disinfection, collection of an adequate number of specimens and volume of blood, and prompt p...
journal_title：Critical care medicine
pub_type： 杂志文章,评审
doi：10.1097/CCM.0b013e318270e771
更新日期：2012-12-01 00:00:00
abstract：OBJECTIVE:Cytomegalovirus reactivation may complicate critical illness in latent carriers of the virus, even in patients who were previously immunocompetent. Patients with acute respiratory distress syndrome are considered to be prone for reactivation. Prophylactic antiviral therapy in immunocompetent cytomegalovirus s...
journal_title：Critical care medicine
pub_type： 杂志文章
doi：10.1097/CCM.0000000000000712
更新日期：2015-02-01 00:00:00
