Abstract:
OBJECTIVE:To compare urea nitrogen removal by continuous hemodiafiltration vs. functional native kidneys in critically ill, septic patients receiving > 2 g of amino acids/kg body weight per day. DESIGN:Prospective, comparative, unblinded study. SETTING:Trauma critical care units of a Level I adult trauma hospital. PATIENTS:Fifteen septic patients with multiple organ failure including renal failure who were receiving continuous hemodiafiltration; 11 septic patients with multiple organ failure without renal failure (control group). Ages of patients ranged from 18 to 60 yrs. INTERVENTIONS:Collection of effluent (dialysate + ultrafiltrate) from hemodiafilters. Collection of urine from control patients. MEASUREMENTS:Urea nitrogen and creatinine concentrations in blood, urine, and the hemodiafiltration effluent, measured every 24 hrs for 6 days. Effluent and urine volumes were measured. MAIN RESULTS:Hemodiafilters were operational for 21.8 +/- 3.0 hrs/day. Mean urea nitrogen removal in the renal failure group was 28 +/- 10 g/day. Blood urea nitrogen was stable over the 6-day study period. In control subjects, urea nitrogen removal was 27 +/- 9 g/day, which was not significantly different from the continuous hemodiafiltration group. Blood urea nitrogen concentrations in control patients increased over the 6-day study period (p < .05). Urea nitrogen removal correlated moderately well with amino acid intake in the control group (r2 = .30), but not in the continuous hemodiafiltration group (r2 = .0004). In patients receiving continuous hemodiafiltration, effluent volume was most significantly correlated with urea nitrogen removal (r2 = .69). CONCLUSIONS:The technique of continuous hemodiafiltration can remove substantial amounts of urea nitrogen, similar to that of normal native kidneys. In addition, at amino acid intake rates of > 2 g/kg body weight/day, urea nitrogen removal during continuous hemodiafiltration remains a function of effluent volume, so there is no need to restrict amino acid intake in acute renal failure patients supported with continuous hemodiafiltration.
journal_name
Crit Care Medjournal_title
Critical care medicineauthors
Frankenfield DC,Reynolds HN,Wiles CE 3rd,Badellino MM,Siegel JHdoi
10.1097/00003246-199403000-00009subject
Has Abstractpub_date
1994-03-01 00:00:00pages
407-12issue
3eissn
0090-3493issn
1530-0293journal_volume
22pub_type
杂志文章abstract:SUBJECT:After transient global cerebral ischemia, selective vulnerable brain areas show delayed neurodegeneration with characteristics of apoptosis. Recent data demonstrate potent neuroprotective effects of the application of endogenous growth hormones such as brain-derived neurotrophic factor (BDNF) after focal cerebr...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/01.ccm.0000134223.09056.fc
更新日期:2004-09-01 00:00:00
abstract:OBJECTIVE:To assess the influence of private attending physician status on the withdrawal of life-sustaining interventions among patients dying within a medical intensive care unit (ICU). DESIGN:Retrospective cohort analysis. SETTING:An academic tertiary care center. PATIENTS:One hundred fifty-nine consecutive patie...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/00003246-199606000-00016
更新日期:1996-06-01 00:00:00
abstract:OBJECTIVE:To cost adult intensive care by determining inputs to production, resource consumption per patient, and total cost per intensive care unit (ICU) stay. DESIGN:Prospective cost-accounting analysis of each patient stay in the ICU, over a 1-yr period. SETTING:An 11-bed, medical/surgical adult ICU, in a 932-bad ...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/00003246-199607000-00017
更新日期:1996-07-01 00:00:00
abstract:OBJECTIVE:Cerebral perfusion pressure<40 mm Hg following pediatric traumatic brain injury has been associated with increased mortality independent of age, and current guidelines recommend maintaining cerebral perfusion pressure between 40 mm Hg-60 mm Hg. Although adult traumatic brain injury studies have observed an in...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/CCM.0b013e31825333e6
更新日期:2012-08-01 00:00:00
abstract:OBJECTIVE:To determine the ability of somatosensory evoked potentials (SEP) compared with clinical findings to monitor and predict recovery in patients suffering from closed head injury with predominantly diffuse axonal injury (DAI). DESIGN:Prospective cohort study. SETTING:Neurologic intensive care unit (ICU) of a u...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/00003246-200103000-00005
更新日期:2001-03-01 00:00:00
abstract::Three patients under observation in ICUs developed mechanical upper airway obstruction requiring surgical intervention for airway control. One patient was treated by tracheotomy placed through a vertical midline incision and 2 patients were treated by cricothyroidotomy followed by elective tracheostomy and closure of ...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/00003246-198108000-00004
更新日期:1981-08-01 00:00:00
abstract:OBJECTIVES:To determine the reliability of volitional and nonvolitional limb muscle strength assessment in critically ill patients and to provide guidelines for the implementation of limb muscle strength assessment this population. DATA SOURCES:The following computerized bibliographic databases were searched with MeSH...
journal_title:Critical care medicine
pub_type: 杂志文章,meta分析,评审
doi:10.1097/CCM.0000000000000030
更新日期:2014-03-01 00:00:00
abstract:OBJECTIVE:To evaluate whether current criteria for the diagnosis of brain death fulfill the requirement for the "irreversible cessation of all functions of the entire brain, including the brainstem." DATA SOURCES:Clinical, philosophical, legal, and public policy literature on the subject of brain death. DATA EXTRACTI...
journal_title:Critical care medicine
pub_type: 杂志文章,评审
doi:10.1097/00003246-199212000-00018
更新日期:1992-12-01 00:00:00
abstract:CONTEXT:The results of studies on noninvasive positive pressure ventilation (NPPV) for acute hypoxemic respiratory failure unrelated to cardiogenic pulmonary edema have been inconsistent. OBJECTIVE:To assess the effect of NPPV on the rate of endotracheal intubation, intensive care unit and hospital length of stay, and...
journal_title:Critical care medicine
pub_type: 杂志文章,评审
doi:10.1097/01.ccm.0000148011.51681.e2
更新日期:2004-12-01 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::The care of critically ill children has become more complex and demanding. This document establishes recommendations for developing regionalized integration of the care of these children into the emergency medical services system. These recommendations were developed by pediatricians with expertise in pediatric critic...
journal_title:Critical care medicine
pub_type: 共识发展会议,杂志文章,评审
doi:10.1097/00003246-200001000-00040
更新日期:2000-01-01 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::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:BACKGROUND:Remarkable progress has been made during the last decade in defining the molecular mechanisms that underlie septic shock. This rapidly expanding field is leading to new therapeutic opportunities in the management of severe sepsis. AIM:To provide the clinician with a timely summary of the molecular biology o...
journal_title:Critical care medicine
pub_type: 杂志文章,评审
doi:10.1097/CCM.0b013e31819267fb
更新日期:2009-01-01 00:00:00
abstract::Traumatic injuries occur in > 20 million children each year and are the leading source of death in children over the age of 1 yr. Mechanisms of injury and subsequent therapies for critically injured children are diverse. This review will focus on resources and management strategies for caring for the severely injured ...
journal_title:Critical care medicine
pub_type: 杂志文章,评审
doi:10.1097/00003246-200211001-00013
更新日期:2002-11-01 00:00:00
abstract:OBJECTIVE:There is evidence to suggest that anemia after severe traumatic brain injury (sTBI) is detrimental. However, there is a paucity of evidence supporting the use of transfusion of packed red blood cells in patients with sTBI. To understand the acute effect of packed red blood cell transfusion on cerebral oxygena...
journal_title:Critical care medicine
pub_type: 杂志文章,随机对照试验
doi:10.1097/CCM.0b013e318194ad22
更新日期:2009-03-01 00:00:00
abstract:OBJECTIVE:Addressing the quality gap in ICU-based palliative care is limited by uncertainty about acceptable models of collaborative specialist and generalist care. Therefore, we characterized the attitudes of physicians and nurses about palliative care delivery in an ICU environment. DESIGN:Mixed-methods study. SETT...
journal_title:Critical care medicine
pub_type: 杂志文章,多中心研究
doi:10.1097/CCM.0000000000002099
更新日期:2017-04-01 00:00:00
abstract:OBJECTIVE:The purpose of this study was to determine the prognostic value of sublingual PCO2 (P(SL)CO2), lactate concentration, and mixed venous oxygen saturation (S(MV)O2) in hemodynamically unstable intensive care patients and, additionally, to compare the temporal changes of these variables in response to treatment....
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/01.CCM.0000054862.74829.EA
更新日期:2003-03-01 00:00:00
abstract:OBJECTIVE:To evaluate the use of the selective alpha 1-adrenergic receptor agonist phenylephrine in the hemodynamic support of patients with septic shock. DESIGN:Retrospective analysis of clinical use of phenylephrine. SETTING:Surgical ICU in a university hospital. PATIENTS:Thirteen patients with septic shock (diagn...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/00003246-199111000-00016
更新日期:1991-11-01 00:00:00
abstract:OBJECTIVE:During pressure support ventilation, ventilator inspiration ends when inspiratory flow drops to a given percentage of the peak inspiratory flow cycling-off criteria. This study evaluated the effect of two different cycling-off criteria on breathing pattern, respiratory effort, and gas exchange in patients wit...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/01.CCM.0000287594.80110.34
更新日期:2007-11-01 00:00:00
abstract:OBJECTIVES:Prone-position ventilation (PPV) induces acute improvement in oxygenation in many patients with acute respiratory distress syndrome (ARDS), with some maintaining their oxygenation even after they were returned to the supine position, but it is unclear what clinical factors determine the sustained oxygenation...
journal_title:Critical care medicine
pub_type: 临床试验,杂志文章
doi:10.1097/00003246-200207000-00008
更新日期:2002-07-01 00:00:00
abstract:OBJECTIVES:To compare sleep, work hours, and behavioral alertness in faculty and fellows during a randomized trial of nighttime in-hospital intensivist staffing compared with a standard daytime intensivist model. DESIGN:Prospective observational study. SETTING:Medical ICU of a tertiary care academic medical center du...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/CCM.0000000000003773
更新日期:2019-07-01 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
abstract::To determine whether end-tidal carbon dioxide tension (PETCO2) accurately reflects PaCO2 during high-frequency jet ventilation (HFJV), 43 studies were performed on eight mongrel dogs with normal lungs. During HFJV, minute volume was modified to obtain a range of PaCO2 values from 15.5 to 74.5 torr. When PETCO2 was mea...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/00003246-198610000-00014
更新日期:1986-10-01 00:00:00
abstract:OBJECTIVE:To determine the association of pulmonary artery catheter (PAC) use with in-hospital mortality. DESIGN:Prospective, observational study. SETTING:The medical intensive care units (MICU) of two teaching hospitals. METHODS:The study included 751 adults who were admitted to the MICU, excluding those who stayed...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/00003246-200106000-00010
更新日期:2001-06-01 00:00:00
abstract:OBJECTIVE:To review the history and development of critical care nurses, the supply and demand issues related to critical care nursing, critical care nursing's contribution to patient outcomes, and recommendations to ensure a steady and strong workforce. DATA SOURCE AND SELECTION:Information presented in this article ...
journal_title:Critical care medicine
pub_type: 杂志文章,评审
doi:10.1097/01.CCM.0000203087.42439.53
更新日期:2006-03-01 00:00:00
abstract:OBJECTIVES:Critical care ultrasonography has become established within ICUs as a diagnostic tool and to guide management strategies and practical procedures. Following an international consensus statement in 2011, various national professional societies and organizations have sought to develop and deliver training prog...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/CCM.0000000000003626
更新日期:2019-03-01 00:00:00
abstract:OBJECTIVES:The primary objective of this study was to identify which patient demographic, patient health, and hospital characteristics were associated with in-hospital mortality. A secondary objective was to determine the relative influence of these characteristics on mortality. DESIGN AND SETTING:Public-use data for ...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/CCM.0b013e31825bc92f
更新日期:2012-11-01 00:00:00
abstract:OBJECTIVE:To explore the feedback regulation of glucocorticoids on corticotropin secretion in patients with septic and nonseptic circulatory shock. DESIGN:Prospective study. SETTING:An intensive care unit of a general hospital. PATIENTS:Two groups of patients with septic shock (n = 11) or nonseptic shock (n = 7). A ...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/00003246-199303000-00018
更新日期:1993-03-01 00:00:00
abstract:BACKGROUND AND METHODS:This study was designed to test whether dopexamine, a dopaminergic and beta 2-adrenergic agonist, would a) increase systemic oxygen delivery (DO2) in endotoxic dogs, and b) interfere with the ability of resting skeletal muscle to extract oxygen. There were three treatment groups (n = 6 in each gr...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/00003246-199102000-00015
更新日期:1991-02-01 00:00:00