Abstract:
OBJECTIVE:To describe a severe axonal polyneuropathy that follows acute respiratory failure and, in turn, causes continued ventilator dependence and paralysis after resolution of the primary illness. DESIGN:Retrospective chart review of three patients and prospective analysis of two patients. SETTING:Respiratory and neurologic ICUs of a general hospital. PATIENTS:Five critically ill patients after an episode of acute respiratory failure. Neuromuscular blocking drugs were used in four patients, intermittently in two patients, high doses of corticosteroids were briefly administered in four, four patients had multiple organ failure, three patients had sepsis, but weakness preceded these complications in two patients. INTERVENTIONS:None. MAIN RESULTS:All patients had moderate-to-severe limb weakness with reduced or absent reflexes. Sensation was relatively preserved and the spinal fluid protein concentrations were normal. Electrophysiologic studies showed a severe, acute axonal motor neuropathy in four patients and normal studies in the fifth that later demonstrated denervation. Sensory potentials were mildly or not affected. Two quadriparetic patients died at 2.5 months, one remained weak and ventilator dependent several months after onset, and two patients recovered to walk in 4 to 6 months. CONCLUSIONS:Severe axonal motor neuropathy after acute respiratory failure probably represents a variant of "critical illness polyneuropathy" that can be recognized from the temporal course of a conversion from primarily pulmonary to a pattern of neuromuscular ventilatory failure.
journal_name
Crit Care Medjournal_title
Critical care medicineauthors
Gorson KC,Ropper AHdoi
10.1097/00003246-199302000-00020subject
Has Abstractpub_date
1993-02-01 00:00:00pages
267-71issue
2eissn
0090-3493issn
1530-0293journal_volume
21pub_type
杂志文章abstract:OBJECTIVE:To assess protective and risk factors for mortality among pediatric patients during initial care after hematopoietic stem cell transplantation (HSCT) and to evaluate changes in hospital mortality. DESIGN:Retrospective cohort using the 1997, 2000, and 2003 Kids Inpatient Database, a probabilistic sample of ch...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/01.CCM.0B013E318161FAC1
更新日期:2008-03-01 00:00:00
abstract:OBJECTIVES:Anaphylactic shock is associated with severe hypotension. Potassium channel blockers, such as 4-aminopyridine, induce vasoconstriction. The objective of this study was to test the ability of 4-aminopyridine to restore blood pressure and increase survival in anaphylactic shock. DESIGN:Experimental study. SE...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/CCM.0000000000001822
更新日期:2016-11-01 00:00:00
abstract::The aim of this study was to assess prospectively the variations of serum phosphorus concentration (P) after onset of mechanical ventilation (MV) in patients with chronic obstructive pulmonary disease (COPD) and acute respiratory acidosis. In 14 COPD patients, we measured P, PaCO2, and pH, immediately before MV (H0), ...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/00003246-198911000-00005
更新日期:1989-11-01 00:00:00
abstract:OBJECTIVE:To determine whether low-dose dopamine administration reduces the incidence or severity of acute renal failure, need for dialysis, or mortality in patients with critical illness. DATA SOURCES AND STUDY SELECTION:We performed a MEDLINE search of literature published from 1966 to 2000 for studies addressing th...
journal_title:Critical care medicine
pub_type: 杂志文章,meta分析
doi:10.1097/00003246-200108000-00005
更新日期:2001-08-01 00:00:00
abstract:OBJECTIVE:The purpose of this study was to evaluate the effect of a neutrophil elastase inhibitor, sivelestat, on lipopolysaccharide-induced acute lung injury through analysis of hemodynamic changes in the pulmonary microcirculation. DESIGN:Randomized animal study. SETTING:Medical school laboratory. SUBJECTS:Twenty-...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/01.ccm.0000172547.54086.ad
更新日期:2005-08-01 00:00:00
abstract:OBJECTIVE:To compare the results of cardiac output measurements obtained by lithium dilution and thermodilution. DESIGN:Case series, observational study. SETTING:High-dependency postoperative unit and intensive care unit of a teaching hospital. PATIENTS:Forty patients were studied. Thirty-four patients had undergoin...
journal_title:Critical care medicine
pub_type: 临床试验,杂志文章
doi:10.1097/00003246-199711000-00015
更新日期:1997-11-01 00:00:00
abstract:OBJECTIVE:A comparison of federal Medicare databases to identify critical care medicine (CCM) use, cost discrepancies, and their possible causes. DESIGN:A 6-yr (1995-2000) retrospective analysis of Medicare hospital and CCM use and cost, comparing the Hospital Cost Report Information System (HCRIS) with Medicare Provi...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/01.CCM.0000257255.57899.5D
更新日期:2007-03-01 00:00:00
abstract::Given the limitations of high-dose diuretics and vasodilators and the increasing literature showing that inotropes, regardless of the dose used, have a detrimental effect on mortality, a variety of new agents are under investigation for the treatment of pulmonary and systemic congestion and restoration of cardiac outp...
journal_title:Critical care medicine
pub_type: 杂志文章,评审
doi:10.1097/01.CCM.0000296810.74724.8D
更新日期:2008-01-01 00:00:00
abstract:OBJECTIVE:Evaluations of plasma leptin and ghrelin levels and their relations with circulating levels of proinflammatory mediators, stress hormones, and biochemical markers of hepatorenal injury during experimental endotoxemia in dogs. SETTING:Uludag University. DESIGN:Placebo-controlled animal study. ANIMALS:Adult ...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/01.CCM.0B013E3181611F5AA
更新日期:2008-03-01 00:00:00
abstract::The applicability of continuous arteriovenous hemofiltration (CAVH) for renal replacement therapy was evaluated in three infants and two young children with catastrophic medical and surgical illnesses. In the first four patients, CAVH was used in conjunction with either peritoneal or hemodialysis. In the fifth patient...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/00003246-198612000-00014
更新日期:1986-12-01 00:00:00
abstract::Fifteen patients with septic shock and perfusion failure received a 20-min infusion of glucose-insulin-potassium (GIK, glucose 50%, 1 g/kg body weight; insulin 1.5 U/kg, potassium, 10 mMol) after volume loading and vasoactive medication had failed to eliminate hypotension and lactacidemia. Hemodynamic and oxygen measu...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/00003246-198507000-00012
更新日期:1985-07-01 00:00:00
abstract:OBJECTIVES:Guidelines recommend offering family members of critically ill patients the option to attend interdisciplinary team rounds as a way to improve communication and satisfaction. Uncertainty remains around the benefits and risks. DESIGN:We conducted an observational study to describe family participation in ICU...
journal_title:Critical care medicine
pub_type: 杂志文章,多中心研究
doi:10.1097/CCM.0000000000003193
更新日期:2018-08-01 00:00:00
abstract:OBJECTIVES:To determine if prior total body hyperthermia protected against subsequent acute ileitis induced by the cytotoxic lectin, ricin, in rats. The time course of heat shock mRNA and protein expression in the ileum was determined. The effects of heat stress on small intestinal mucosal integrity, arachidonic acid m...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/00003246-199702000-00020
更新日期:1997-02-01 00:00:00
abstract::The ICU has been considered a psychologically stressful environment. Although numerous studies have investigated this stress in ICU nurses, virtually none have examined how stressful the ICU is for physicians. This prospective study compares housestaff physicians' ratings of stress in the ICU to other medical-surgical...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/00003246-198602000-00004
更新日期:1986-02-01 00:00:00
abstract:OBJECTIVES:Regional tidal lung strain may trigger local inflammation during mechanical ventilation, particularly when additional inflammatory stimuli are present. However, it is unclear whether inflammation develops proportionally to tidal strain or only above a threshold. We aimed to 1) assess the relationship between...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/CCM.0000000000000346
更新日期:2014-07-01 00:00:00
abstract::In a series of 56 patients (24 uncomplicated postoperative and 32 septic patients), neopterin and elastase alpha 1 protease inhibitor complex (E-alpha 1 PI) plasma levels were measured daily. The clinical course of each patient was evaluated with the Multiple Organ Failure (MOF) score according to Goris. Neopterin cou...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/00003246-198903000-00004
更新日期:1989-03-01 00:00:00
abstract:OBJECTIVE:Antioxidant therapy has shown some promise in critical care medicine in which glutathione depletion and heart failure are often seen in critically ill patients. This study was designed to examine the impact of glutathione depletion and the free radical scavenger, metallothionein (MT), on cardiac function. DE...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/CCM.0b013e31817bf925
更新日期:2008-07-01 00:00:00
abstract:OBJECTIVE:To describe the philosophy and approach to patient care called evidence based medicine, and to highlight how it can enhance the practice of intensive care. DATA SOURCES:We searched MEDLINE, reference lists, and our personal files to identify relevant literature. STUDY SELECTION:Articles on intensive care pr...
journal_title:Critical care medicine
pub_type: 杂志文章,评审
doi:10.1097/00003246-199602000-00025
更新日期:1996-02-01 00:00:00
abstract:OBJECTIVE:To review the anti-inflammatory and anti-apoptotic properties of drotrecogin alfa (activated) (recombinant human activated protein C), emphasizing its modulatory effects on endothelial nuclear factor-kappaB. We propose a broad anti-inflammatory effect of drotrecogin alfa (activated), acting on both endotheliu...
journal_title:Critical care medicine
pub_type: 杂志文章,评审
doi:10.1097/00003246-200205001-00019
更新日期:2002-05-01 00:00:00
abstract:OBJECTIVES:Sepsis-associated changes of the arachidonic acid metabolism and the utility of arachidonic acid metabolites for the diagnosis of sepsis have been poorly investigated so far. Therefore, the primary objective of our study was to screen for differentially regulated arachidonic acid metabolites in septic patien...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/CCM.0b013e3182416f05
更新日期:2012-05-01 00:00:00
abstract::Factors responsible for determining the position of the oxyhemoglobin equilibrium curve during the neonatal period are briefly reviewed and the clinical implications of these changes are examined. Two clinical trials employing exchange transfusions as an adjunct to conventional therapy of the severe respiratory distre...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/00003246-197909000-00013
更新日期:1979-09-01 00:00:00
abstract::Disseminated intravascular coagulation (DIC) is an acquired syndrome characterized by intravascular fibrin formation occurring in the course of a variety of severe diseases. In gram-negative sepsis, endotoxin is the bacterial component eliciting a cascade of tissue factor dependent hypercoagulable reactions mediated b...
journal_title:Critical care medicine
pub_type: 杂志文章,评审
doi:10.1097/00003246-200009001-00003
更新日期:2000-09-01 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::This study evaluates the recall of 100 patients after ICU admission. There was a wide spectrum of race, religion, occupation, and educational levels. The more common diagnoses included asthma, pneumonia, trauma, and adult respiratory distress syndrome. The average Acute Physiology and Chronic Health Evaluation (APACHE...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/00003246-199009000-00012
更新日期:1990-09-01 00:00:00
abstract::Standard techniques for measuring pulmonary resistance (RP) to gas flow in newborn infants yield results that are widely dispersed and difficult to interpret. The purpose of this study is to describe and evaluate a new improved method for determining RP which utilizes a sinusoidal pressure wave generator. Measurements...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/00003246-198307000-00015
更新日期:1983-07-01 00:00:00
abstract:OBJECTIVE:To explore ethnic differences in do-not-resuscitate orders after intracerebral hemorrhage. DESIGN:Population-based surveillance. SETTING:Corpus Christi, Texas. PATIENTS:All cases of intracerebral hemorrhage in the community of Corpus Christi, TX were ascertained as part of the Brain Attack Surveillance in ...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/CCM.0b013e3181a56755
更新日期:2009-10-01 00:00:00
abstract:OBJECTIVES:To assess whether, in patients under mechanical ventilation, fluid responsiveness is predicted by the effects of short respiratory holds on cardiac index estimated by esophageal Doppler. DESIGN:Prospective, monocentric study. SETTING:Medical ICU. PATIENTS:Twenty-eight adult patients with acute circulatory...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/CCM.0000000000003522
更新日期:2019-02-01 00:00:00
abstract::Critical care clinicians no longer consider family members as visitors in the intensive care unit. Family-centered care has emerged from the results of qualitative and quantitative studies evaluating the specific needs of families of patients dying in the intensive care unit. In addition, interventional studies have e...
journal_title:Critical care medicine
pub_type: 杂志文章,评审
doi:10.1097/01.CCM.0000237049.44246.8C
更新日期:2006-11-01 00:00:00
abstract::We report a case of an amniotic fluid embolism (AFE) causing a cardiorespiratory arrest associated temporally with ingestion of castor oil in a full-term normal pregnancy. Risk factors usually associated with AFE were not found in this patient. ...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/00003246-198806000-00016
更新日期:1988-06-01 00:00:00
abstract:OBJECTIVES:To evaluate the methodological quality and thematic completeness of existing clinical practice guidelines, addressing early mobilization of adults in the ICU. DATA SOURCES:Systematic review of Medline, Embase, CINAHL, Cochrane, and grey literature from January 2008 to February 2020. STUDY SELECTION:Two rev...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/CCM.0000000000004574
更新日期:2020-11-01 00:00:00