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 community teaching hospital. PATIENTS:One hundred eighty-three postoperative, mechanically ventilated patients. INTERVENTIONS:None. MEASUREMENTS AND MAIN RESULTS:The spontaneous minute volume, unassisted respiratory rate/tidal volume ratio, and negative inspired force were measured just before weaning. The rate/volume ratio was remeasured after 30 to 60 mins of weaning. Weaning was conducted by the patients' primary physicians. Weaning success was defined as unassisted breathing for >24 hrs. Predictive characteristics were computed using threshold values of 100 breaths/min/L, 10 L/min, and -20 cm H2O for the rate/volume ratios, minute volume, and negative inspired force, respectively. Receiver operating characteristic curves were also constructed to assess each parameter. Sensitivities for the initial rate/volume ratio, rate/volume ratio after 30 mins, minute volume, and negative inspired force were 0.97, 0.96, 0.76, and 0.96, respectively. Specificities were 0.33, 0.31, 0.40, and 0.07, respectively. Areas (+/- SD) for receiver operating characteristic curves were 0.76 +/- 0.08, 0.75 +/- 0.06, 0.54 +/- 0.08, and 0.62 +/- 0.07, respectively. The rate/volume ratio after 30 mins correlated with the initial rate/volume ratio; the rate/volume ratio after 30 mins did not add significant, additional predictive information. CONCLUSIONS:The rate/volume ratio measured at the beginning and after 30 mins of weaning is more highly predictive of weaning outcome than the negative inspired force and minute volume. The principal weakness of the rate/volume ratio is false-positive results.
journal_name
Crit Care Medjournal_title
Critical care medicineauthors
Jacob B,Chatila W,Manthous CAdoi
10.1097/00003246-199702000-00010subject
Has Abstractpub_date
1997-02-01 00:00:00pages
253-7issue
2eissn
0090-3493issn
1530-0293journal_volume
25pub_type
杂志文章abstract:OBJECTIVE:To evaluate the role of amino acid profiles in septic encephalopathy. DESIGN:Retrospective analysis. SETTING:Medical wards and medical ICU of a university hospital. PATIENTS:Patients with infections and normal mental status were compared with patients with septic shock and altered sensorium. INTERVENTIONS...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/00003246-199106000-00004
更新日期:1991-06-01 00:00:00
abstract:OBJECTIVE:To review recent advances in the use of transforming growth factor (TGF)-beta in acute lung injury and to apply this knowledge to understanding the pathophysiology of this syndrome. DATA SOURCES AND STUDY SELECTION:Published research and review articles in the English language related to the role of TGF-beta...
journal_title:Critical care medicine
pub_type: 杂志文章,评审
doi:10.1097/01.CCM.0000057901.92381.75
更新日期:2003-04-01 00:00:00
abstract:OBJECTIVES:Despite the common occurrence of brain injury in patients undergoing extracorporeal membrane oxygenation, it is unclear which cannulation method carries a higher risk of brain injury. We compared the prevalence of brain injury between patients undergoing venoarterial and venovenous extracorporeal membrane ox...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/CCM.0000000000004618
更新日期:2020-12-01 00:00:00
abstract:OBJECTIVE:Sepsis-induced multi-organ failure continues to have a high mortality. The liver is an organ central to the disease pathogenesis. The objective of this study was to identify the liver proteins that change in abundance with sepsis and subsequently identify new drug targets. DESIGN:Proteomic discovery study an...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/01.ccm.0000281858.44387.a2
更新日期:2007-10-01 00:00:00
abstract:OBJECTIVE:Trauma induces a state of immunosuppression, which is responsible for the development of nosocomial infections. Hydrocortisone reduces the rate of pneumonia in patients with trauma. Because alterations of dendritic cells and natural killer cells play a central role in trauma-induced immunosuppression, we inve...
journal_title:Critical care medicine
pub_type: 杂志文章,多中心研究,随机对照试验
doi:10.1097/CCM.0000000000000658
更新日期:2014-12-01 00:00:00
abstract::An 8-yr-old child suffered traumatic bilateral pneumothoraces and a ruptured right main bronchus. Surgical repair of the bronchus was postponed for 18 h after a definite diagnosis was established due to severe hypoxemia and hypercarbia. Only left endobronchial high-frequency ventilation with muscle relaxation correcte...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/00003246-198712000-00019
更新日期:1987-12-01 00:00:00
abstract:OBJECTIVE:During cardiopulmonary bypass, inflammation and immunosuppression is present. We measured circulating mediators and monocyte-based functions and tested the hypothesis that these variables are influenced by methylprednisolone (MP) or tirilazad mesylate (TM) treatment. DESIGN:Randomized, controlled, double-bli...
journal_title:Critical care medicine
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1097/00003246-200111000-00015
更新日期:2001-11-01 00:00:00
abstract:OBJECTIVES:The aim of this study was to highlight the link between induced hypothermia and increased survival duration as observed in the septic model developed by the laboratory. To reach this objective, survival duration and blood oxygen transport capacity were measured at two temperatures-38 °C (induced normothermia...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/CCM.0b013e3182373134
更新日期:2012-03-01 00:00:00
abstract::The authors have examined cardiopulmonary resuscitation (CPR) skills retention in a police force initially trained to instructor level performance skills as defined by the 1977 American Heart Association Instructor Manual. In 1977, the entire Winnipeg Police Force received a basic 8-h course of CPR training with recor...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/00003246-198011000-00011
更新日期:1980-11-01 00:00:00
abstract::In the pathogenesis of sepsis, inflammation and coagulation play a pivotal role. Increasing evidence points to an extensive cross-talk between these two systems, whereby inflammation leads to activation of coagulation, and coagulation also considerably affects inflammatory activity. Molecular pathways that contribute ...
journal_title:Critical care medicine
pub_type: 杂志文章,评审
doi:10.1097/CCM.0b013e3181c98d21
更新日期:2010-02-01 00:00:00
abstract:OBJECTIVE:To test whether intensive care unit (ICU) nasal screening for methicillin-resistant Staphylococcus aureus (MRSA) predicts the presence or absence of MRSA infections requiring antimicrobial treatment. DESIGN:A prospective cohort study. SETTING:Medical ICU at Barnes-Jewish Hospital, a 1252-bed urban teaching ...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/CCM.0b013e3181eeda3f
更新日期:2010-10-01 00:00:00
abstract:OBJECTIVES:Mechanical ventilation can cause ventilator-induced brain injury via afferent vagal signaling and hippocampal neurotransmitter imbalances. The triggering mechanisms for vagal signaling during mechanical ventilation are unknown. The objective of this study was to assess whether pulmonary transient receptor po...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/CCM.0000000000003977
更新日期:2019-11-01 00:00:00
abstract::The authors evaluated the effectiveness of 6% hydroxyethyl starch (hetastarch) solution for treatment of hypovolemia in 46 critically ill patients. Thirty-two of the patients were studied retrospectively and in 14 patients, cardiopulmonary variables were prospectively measured. A total of 29 patients were in shock sec...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/00003246-198112000-00006
更新日期:1981-12-01 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:OBJECTIVE:Transarterial chemoembolization is a widely used therapy for the treatment of hepatocellular carcinoma. A rare adverse event is acute respiratory distress syndrome from pulmonary embolization of Lipiodol, an iodinated oil commonly used during the procedure. The objective of this report is to describe an atypi...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/CCM.0000000000000307
更新日期:2014-06-01 00:00:00
abstract::Cardiac arrest is most commonly encountered as the end result of severe derangements in metabolic homeostasis. These derangements may include toxic, ischemic, or electrophysiological causes of circulatory and/or respiratory arrests. Occasionally, mechanical obstruction or impediment to circulation may cause cardiac ar...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/00003246-198203000-00013
更新日期:1982-03-01 00:00:00
abstract:OBJECTIVE:Sympathetic vasoconstriction regulates peripheral circulation and controls blood pressure, but sepsis is associated with hypotension. We evaluated whether apparent loss of sympathetic vasoconstrictor responsiveness relates to distended smooth muscles or to endotoxemia and/or hypoxia. DESIGN:Prospective descr...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/CCM.0000000000001486
更新日期:2016-04-01 00:00:00
abstract:OBJECTIVE:To determine whether the energy expenditure of mechanically ventilated multiple trauma patients correlates with the severity of injury and illness indices before important systemic infection has complicated the clinical course, and to compare the energy expenditure with the energy expenditure expected from th...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/00003246-199912000-00013
更新日期:1999-12-01 00:00:00
abstract:OBJECTIVE:To assess the mortality rate and complications in a population of surgical patients with severe adult respiratory distress syndrome (ARDS) treated with positive end-expiratory pressure (PEEP) of > 15 cm H2O in an attempt to reduce intrapulmonary shunt to approximately 0.20 and reduce FIO2 to < 0.50. DESIGN:R...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/00003246-199509000-00008
更新日期:1995-09-01 00:00:00
abstract::The current investigation describes the morphological and pathophysiological effects of stroma-free hemoglobin solution (SFH) on the liver and kidney. One h after a 75% blood volume exchange in animals receiving 7% SFH, hepatic morphology was normal. Animals whose blood was similarly exchanged with 7% albumin demonstr...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/00003246-198204000-00011
更新日期:1982-04-01 00:00:00
abstract::Balloon flotation catheterization of the central circulation provides data which may be most meaningful and important to the management of critically ill patients. It allows the measurements of the filling pressures of the right and left ventricle as well as the cardiac output. These data combined with information con...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/00003246-197505000-00001
更新日期:1975-05-01 00:00:00
abstract:OBJECTIVE:To develop clinical practice guidelines for the use of restraining therapies to maintain physical and psychological safety of adult and pediatric patients in the intensive care unit. PARTICIPANTS:A multidisciplinary, multispecialty task force of experts in critical care practice was convened from the members...
journal_title:Critical care medicine
pub_type: 杂志文章,评审
doi:10.1097/01.CCM.0000095463.72353.AD
更新日期:2003-11-01 00:00:00
abstract:OBJECTIVE:To assess the value of soluble triggering receptor expressed on myeloid cells-1 as a biomarker of infection in patients with neutropenic fever comparing with procalcitonin and C-reactive protein. DESIGN:Prospective, comparative, single-center study. SETTING:Hematology ward at a university hospital. SUBJECT...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/CCM.0b013e31820a92dc
更新日期:2011-05-01 00:00:00
abstract:BACKGROUND:Subcutaneously administered low-molecular-weight heparins are widely used for prevention of venous thromboembolism. The appropriateness of the subcutaneous route in critically ill patients has never been established. OBJECTIVE:To determine anti-Xa activities in critically ill patients and in noncritically i...
journal_title:Critical care medicine
pub_type: 临床试验,杂志文章
doi:10.1097/01.CCM.0000059725.60509.A0
更新日期:2003-05-01 00:00:00
abstract::Varying concentrations of lipopolysaccharide (LPS) and mannan suspensions were mixed with either saline or plasma from normal volunteers, heated to 100 degrees C for 10 min, and then subjected to the limulus amebocyte lysate test (LAL). A positive LAL in saline required minimum LPS and mannan concentrations of 10(-11)...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/00003246-198512000-00016
更新日期:1985-12-01 00:00:00
abstract:OBJECTIVES:Evaluate clinicians' sentiments about participating in cardiac arrest resuscitations and identify factors associated with confidence in resuscitation of cardiac arrest. DESIGN:Electronic survey. SETTING:Twenty-one hospitals in Utah and Idaho. SUBJECTS:All attending physicians, residents, and nurses in a m...
journal_title:Critical care medicine
pub_type: 杂志文章,多中心研究
doi:10.1097/CCM.0000000000003612
更新日期:2019-03-01 00:00:00
abstract:OBJECTIVES:Swallowing disorders may be associated with adverse clinical outcomes in patients following invasive mechanical ventilation. We investigated the incidence of dysphagia, its time course, and association with clinically relevant outcomes in extubated critically ill patients. DESIGN:Prospective observational t...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/CCM.0000000000002765
更新日期:2017-12-01 00:00:00
abstract:OBJECTIVE:In patients undergoing surgical repair of aortic dissection, false lumen perfusion during cardiopulmonary bypass may produce central nervous system damage, myocardial ischemia, aortic rupture, and death. We describe a method to detect false lumen perfusion at the beginning of retrograde aortic perfusion that ...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/00003246-200006000-00026
更新日期:2000-06-01 00:00:00
abstract::This report is intended to familiarize the reader with the current legislation concerning state definitions of death, the pertinent judicial decisions concerning termination of life support and the current status of medical/ethical committees. However, it is of paramount importance to all health care personnel to beco...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:
更新日期:1982-01-01 00:00:00
abstract:OBJECTIVE:In critically ill patients, hepatic dysfunction is regarded as a late organ failure associated with poor prognosis. We investigated the incidence and prognostic implications of early hepatic dysfunction (serum bilirubin >2 mg/dL within 48 hrs of admission). DESIGN:Prospective, multicenter cohort study. SETT...
journal_title:Critical care medicine
pub_type: 杂志文章,多中心研究
doi:10.1097/01.CCM.0000259462.97164.A0
更新日期:2007-04-01 00:00:00