Sepsis and its complications: the clinical problem.


OBJECTIVES:To review the difficulties associated with defining sepsis and its complications and to characterize the role of the proinflammatory cytokines in the development of human septic shock, adult respiratory distress syndrome, and the systemic inflammatory response syndrome. DATA SOURCES:Information presented at the 22nd Educational and Scientific Symposium of the Society of Critical Care Medicine on June 9-13, 1993 in New York City was reviewed, along with supportive documentation from the English language literature. STUDY SELECTION:Human studies that provide evidence for the definitions of sepsis and related entities. DATA EXTRACTION:This review focused on those data that described the role of selected cytokines in septic shock. DATA SYNTHESIS:Information concerning the evolution of the definition of sepsis and its sequelae was integrated with considerations used for patient identification for clinical trials involving novel septic shock therapies. CONCLUSIONS:Sepsis and its complications constitute a complex biological cascade that may be defined by specific clinical characteristics. The clinical variability in these events suggests that definitions based on clinical end points be used in combination with assessments of severity of illness to best define patient status, predict clinical course, and guide treatment decision-making.


Crit Care Med


Critical care medicine


Bone RC


Has Abstract


1994-07-01 00:00:00












  • Effects of propofol on hemodynamic and inflammatory responses to endotoxemia in rats.

    abstract:OBJECTIVE:To document the effects of propofol on the hemodynamic and inflammatory responses to endotoxemia in an animal model. DESIGN:Randomized, prospective laboratory study. SETTING:University experimental laboratory. SUBJECTS:Thirty-two male rats. INTERVENTIONS:The animals were randomly assigned to one of four g...

    journal_title:Critical care medicine

    pub_type: 杂志文章


    authors: Taniguchi T,Yamamoto K,Ohmoto N,Ohta K,Kobayashi T

    更新日期:2000-04-01 00:00:00

  • Incidence and Mortality of Acute Respiratory Distress Syndrome in Children: A Systematic Review and Meta-Analysis.

    abstract:OBJECTIVES:Our understanding of the acute respiratory distress syndrome in children is limited, and literature is dominated by investigations in adult patients. Recent preclinical studies suggest that the susceptibility to and severity of acute respiratory distress syndrome in children could differ from that in adults....

    journal_title:Critical care medicine

    pub_type: 杂志文章,meta分析,评审


    authors: Schouten LR,Veltkamp F,Bos AP,van Woensel JB,Serpa Neto A,Schultz MJ,Wösten-van Asperen RM

    更新日期:2016-04-01 00:00:00

  • A phase II randomized, controlled trial of continuous hemofiltration in sepsis.

    abstract:OBJECTIVE:To study the effect of early and continuous venovenous hemofiltration (CVVH) on the plasma concentrations of several humoral mediators of inflammation and subsequent organ dysfunction in septic patients. DESIGN:Randomized, controlled trial. SETTING:Intensive care unit of a tertiary hospital. PATIENTS:Twent...

    journal_title:Critical care medicine

    pub_type: 临床试验,杂志文章,随机对照试验


    authors: Cole L,Bellomo R,Hart G,Journois D,Davenport P,Tipping P,Ronco C

    更新日期:2002-01-01 00:00:00

  • Frequency, risk factors, and outcomes of early unplanned readmissions to PICUs.

    abstract:OBJECTIVES:To determine the rate of unplanned PICU readmissions, examine the characteristics of index admissions associated with readmission, and compare outcomes of readmissions versus index admissions. DESIGN:Retrospective cohort analysis. SETTING:Ninety North American PICUs that participated in the Virtual Pediatr...

    journal_title:Critical care medicine

    pub_type: 杂志文章


    authors: Edwards JD,Lucas AR,Stone PW,Boscardin WJ,Dudley RA

    更新日期:2013-12-01 00:00:00

  • Survey of critical care management of comatose, head-injured patients in the United States.

    abstract:OBJECTIVE:This survey was designed to study current practices in the monitoring and treatment of patients with severe head injury in the United States. DATA SOURCES:The collected data represent answers to telephone interviews of nurse managers, clinical specialists, and staff nurses specializing in neurotrauma care at...

    journal_title:Critical care medicine

    pub_type: 杂志文章,多中心研究


    authors: Ghajar J,Hariri RJ,Narayan RK,Iacono LA,Firlik K,Patterson RH

    更新日期:1995-03-01 00:00:00

  • Antibiotic-Associated Apoptotic Enterocolitis in the Absence of a Defined Pathogen: The Role of Intestinal Microbiota Depletion.

    abstract:OBJECTIVE:Antibiotic therapy is a major risk factor for the development of diarrhea and colitis with varying severity. Often the origin of antibiotic-associated gastrointestinal deterioration remains elusive and no specific infectious agents could be discerned. PATIENTS:We represent three cases of intractable high-vol...

    journal_title:Critical care medicine

    pub_type: 杂志文章


    authors: Wurm P,Spindelboeck W,Krause R,Plank J,Fuchs G,Bashir M,Petritsch W,Halwachs B,Langner C,Högenauer C,Gorkiewicz G

    更新日期:2017-06-01 00:00:00

  • Ventilator-Associated Events: Prevalence, Outcome, and Relationship With Ventilator-Associated Pneumonia.

    abstract:OBJECTIVES:Centers for Disease Control and Prevention built up new surveillance paradigms for the patients on mechanical ventilation and the ventilator-associated events, comprising ventilator-associated conditions and infection-related ventilator-associated complications. We assess 1) the current epidemiology of venti...

    journal_title:Critical care medicine

    pub_type: 杂志文章,多中心研究


    authors: Bouadma L,Sonneville R,Garrouste-Orgeas M,Darmon M,Souweine B,Voiriot G,Kallel H,Schwebel C,Goldgran-Toledano D,Dumenil AS,Argaud L,Ruckly S,Jamali S,Planquette B,Adrie C,Lucet JC,Azoulay E,Timsit JF,OUTCOMEREA Study

    更新日期:2015-09-01 00:00:00

  • Granulocyte colony-stimulating factor improves survival rate and reduces concentrations of bacteria, endotoxin, tumor necrosis factor, and endothelin-1 in fulminant intra-abdominal sepsis in rats.

    abstract:OBJECTIVE:To study the therapeutic effect of granulocyte colony-stimulating factor (G-CSF) on the mortality rate and host defense pattern in fulminant intra-abdominal sepsis. DESIGN:Prospective, randomized, controlled trial. SETTING:Research laboratory in a university hospital. SUBJECTS:Adult male Wistar rats. INTE...

    journal_title:Critical care medicine

    pub_type: 杂志文章


    authors: Lundblad R,Nesland JM,Giercksky KE

    更新日期:1996-05-01 00:00:00

  • Mean airway pressure: physiologic determinants and clinical importance--Part 1: Physiologic determinants and measurements.

    abstract:PURPOSES:To discuss the theoretical relationship of mean alveolar pressure to its most easily measured analog, the mean airway pressure, and to describe the key determinants, measurement considerations, and clinical implications of this index. DATA SOURCES:Relevant articles from the medical and physiologic literature,...

    journal_title:Critical care medicine

    pub_type: 杂志文章


    authors: Marini JJ,Ravenscraft SA

    更新日期:1992-10-01 00:00:00

  • Management of upper airway obstruction in the intensive care unit.

    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


    authors: Schecter WP,Wilson RS

    更新日期:1981-08-01 00:00:00

  • A quantitative assessment of how Canadian intensivists believe they utilize oxygen in the intensive care unit.

    abstract:OBJECTIVES:To investigate attitudes and practices regarding oxygen therapy in intensive care units (ICUs) and to devise quantitative descriptive indices. SETTING:Canadian university-affiliated adult ICUs. PARTICIPANTS:Fifty-two medical directors of ICUs in 48 institutions. INTERVENTION:Structured postal questionnair...

    journal_title:Critical care medicine

    pub_type: 杂志文章


    authors: Mao C,Wong DT,Slutsky AS,Kavanagh BP

    更新日期:1999-12-01 00:00:00

  • Cytochrome P450 3A4 activity after surgical stress.

    abstract:OBJECTIVE:To evaluate the relationship between the acute inflammatory response after surgical trauma and changes in hepatic cytochrome P450 3A4 activity, compare changes in cytochrome P450 3A4 activity after procedures with varying degrees of surgical stress, and to explore the time course of any potential drug-cytokin...

    journal_title:Critical care medicine

    pub_type: 杂志文章


    authors: Haas CE,Kaufman DC,Jones CE,Burstein AH,Reiss W

    更新日期:2003-05-01 00:00:00

  • Long-term mortality and quality of life after prolonged mechanical ventilation.

    abstract:OBJECTIVE:To describe and identify factors associated with mortality rate and quality of life 1 yr after prolonged mechanical ventilation. DESIGN:Prospective, observational cohort study with patient recruitment over 26 months and follow-up for 1 yr. SETTING:Intensive care units at a tertiary care university hospital....

    journal_title:Critical care medicine

    pub_type: 杂志文章


    authors: Chelluri L,Im KA,Belle SH,Schulz R,Rotondi AJ,Donahoe MP,Sirio CA,Mendelsohn AB,Pinsky MR

    更新日期:2004-01-01 00:00:00

  • Bulk diffusion apnea test in the diagnosis of brain death.

    abstract:OBJECTIVE:To assess the efficacy of bulk diffusion in maintaining oxygenation during apnea testing for brain death. DESIGN:Case series. SETTING:ICU in a primary care hospital. PATIENTS:Twenty-four consecutive patients with suspected brain death. Most patients suffered cerebral trauma from vehicular accidents. INTER...

    journal_title:Critical care medicine

    pub_type: 杂志文章


    authors: al Jumah M,McLean DR,al Rajeh S,Crow N

    更新日期:1992-11-01 00:00:00

  • Mild hypothermic cardiopulmonary resuscitation improves outcome after prolonged cardiac arrest in dogs.

    abstract:BACKGROUND AND METHODS:This study was designed to explore the effect of mild cerebral and systemic hypothermia (34 degrees C) on outcome after prolonged cardiac arrest in dogs. After ventricular fibrillation with no flow of 10 min, and standard external CPR with epinephrine (low flow) from ventricular fibrillation time...

    journal_title:Critical care medicine

    pub_type: 杂志文章


    authors: Sterz F,Safar P,Tisherman S,Radovsky A,Kuboyama K,Oku K

    更新日期:1991-03-01 00:00:00

  • Aminophylline versus doxapram in weaning premature infants from mechanical ventilation: preliminary report.

    abstract::A small, double-blind crossover study compared the efficacy of aminophylline and doxapram in ventilator weaning of eight premature infants recovering from respiratory distress syndrome (RDS). Although neither drug was significantly better than the other, four infants were weaned from mechanical ventilation after drug ...

    journal_title:Critical care medicine

    pub_type: 临床试验,杂志文章


    authors: Eyal FG,Sagi EF,Alpan G,Glick B,Arad I

    更新日期:1985-02-01 00:00:00

  • Long-Term Mental Health Problems After Delirium in the ICU.

    abstract:OBJECTIVES:To determine whether delirium during ICU stay is associated with long-term mental health problems defined as symptoms of anxiety, depression, and posttraumatic stress disorder. DESIGN:Prospective cohort study. SETTING:Survey study, 1 year after discharge from a medical-surgical ICU in the Netherlands. PAT...

    journal_title:Critical care medicine

    pub_type: 杂志文章


    authors: Wolters AE,Peelen LM,Welling MC,Kok L,de Lange DW,Cremer OL,van Dijk D,Slooter AJ,Veldhuijzen DS

    更新日期:2016-10-01 00:00:00

  • Outcomes and complications of intracranial pressure monitoring in acute liver failure: a retrospective cohort study.

    abstract:OBJECTIVE:To determine if intracranial pressure monitor placement in patients with acute liver failure is associated with significant clinical outcomes. DESIGN:Retrospective multicenter cohort study. SETTING:Academic liver transplant centers comprising the U.S. Acute Liver Failure Study Group. PATIENTS:Adult critica...

    journal_title:Critical care medicine

    pub_type: 杂志文章,多中心研究


    authors: Karvellas CJ,Fix OK,Battenhouse H,Durkalski V,Sanders C,Lee WM,U S Acute Liver Failure Study Group.

    更新日期:2014-05-01 00:00:00

  • Hypocalcemia during porcine endotoxemic shock: effects of calcium administration.

    abstract:OBJECTIVE:To evaluate the pathophysiology involved in hypocalcemia in septic shock and to investigate the value of calcium administration. DESIGN:Prospective, randomized placebo-controlled trial with parallel groups. SETTING:Animal research laboratory at the University Hospital of Uppsala. SUBJECTS:Twenty-four pigs ...

    journal_title:Critical care medicine

    pub_type: 杂志文章


    authors: Carlstedt F,Eriksson M,Kiiski R,Larsson A,Lind L

    更新日期:2000-08-01 00:00:00

  • Neglect of quality-of-life considerations in intensive care unit family meetings for long-stay intensive care unit patients.

    abstract:OBJECTIVE:To examine the frequency with which quality of life and treatment limitation were discussed in formal family meetings for long-stay intensive care unit patients with high risk for mortality and morbidity. DESIGN:Descriptive observational study. SETTING:Five intensive care units. PATIENTS:One hundred sixtee...

    journal_title:Critical care medicine

    pub_type: 杂志文章


    authors: Douglas SL,Daly BJ,Lipson AR

    更新日期:2012-02-01 00:00:00

  • Cigarette Smoke Exposure and the Acute Respiratory Distress Syndrome.

    abstract:OBJECTIVE:The association between cigarette smoke exposure and the acute respiratory distress syndrome in patients with the most common acute respiratory distress syndrome risk factors of sepsis, pneumonia, and aspiration has not been well studied. The goal of this study was to test the association between biomarker-co...

    journal_title:Critical care medicine

    pub_type: 杂志文章


    authors: Calfee CS,Matthay MA,Kangelaris KN,Siew ED,Janz DR,Bernard GR,May AK,Jacob P,Havel C,Benowitz NL,Ware LB

    更新日期:2015-09-01 00:00:00

  • Detection of pulmonary aspiration of gastric contents in an animal model by assay of peptic activity in bronchoalveolar fluid.

    abstract:OBJECTIVE:To determine whether peptic activity in bronchoalveolar fluid, due to the presence of the gastric proteolytic enzyme pepsin, could serve as a biochemical marker for pulmonary aspiration of gastric contents. DESIGN:Prospective, experimental trial. SETTING:A university animal research laboratory. SUBJECTS:Th...

    journal_title:Critical care medicine

    pub_type: 杂志文章


    authors: Badellino MM,Buckman RF Jr,Malaspina PJ,Eynon CA,O'Brien GM,Kueppers F

    更新日期:1996-11-01 00:00:00

  • Frequency of technical problems encountered in the measurement of pulmonary artery wedge pressure.

    abstract::A total of 2711 pulmonary artery wedge pressure (WP) measurement attempts were made prospectively from WP recordings in 44 (30 men) critically ill patients, using 77 flow-directed catheters. Of these, 322 (12%) failed to yield a WP measurement, and 521 (18%) were associated with technical problems. One half of these t...

    journal_title:Critical care medicine

    pub_type: 杂志文章


    authors: Morris AH,Chapman RH,Gardner RM

    更新日期:1984-03-01 00:00:00

  • Thrombocytopenia in patients in the medical intensive care unit: bleeding prevalence, transfusion requirements, and outcome.

    abstract:OBJECTIVE:To determine prevalence, risk factors, and outcome of thrombocytopenia in medical intensive care patients. DESIGN:Prospective observational study. SETTING:The 12-bed medical intensive care unit of a university hospital. PATIENTS:All consecutively admitted patients with normal platelet count at admission an...

    journal_title:Critical care medicine

    pub_type: 杂志文章


    authors: Strauss R,Wehler M,Mehler K,Kreutzer D,Koebnick C,Hahn EG

    更新日期:2002-08-01 00:00:00

  • Complexity modeling: identify instability early.

    abstract::Biological systems are innately complex, display nonlinear behavior, and respond to both disease and its treatment in similar complex ways. Complex systems display self-organization and predictive behavior along a range of possible states, often referred to as chaotic behavior, and can be both characterized and quanti...

    journal_title:Critical care medicine

    pub_type: 杂志文章


    authors: Pinsky MR

    更新日期:2010-10-01 00:00:00

  • Intermittent mandatory ventilation in the neonate.

    abstract::Intermittent Mandatory Ventilation (IMV) provides an alternative method of support to assisted and controlled mechanical ventilation in neonates with acute respiratory failure. Specific advantages include the use of only the level of mechanical support which is required on an individual basis. Because intrapleural pre...

    journal_title:Critical care medicine

    pub_type: 杂志文章


    authors: Kirby RR

    更新日期:1977-01-01 00:00:00

  • Hydroxyethyl starch for resuscitation of patients with hypovolemia and shock.

    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


    authors: Puri VK,Paidipaty B,White L

    更新日期:1981-12-01 00:00:00

  • Prediction of Large Vessel Occlusions in Acute Stroke: National Institute of Health Stroke Scale Is Hard to Beat.

    abstract:OBJECTIVES:Endovascular treatment for acute ischemic stroke with a large vessel occlusion was recently shown to be effective. We aimed to develop a score capable of predicting large vessel occlusion eligible for endovascular treatment in the early hospital management. DESIGN:Retrospective, cohort study. SETTING:Two t...

    journal_title:Critical care medicine

    pub_type: 杂志文章


    authors: Vanacker P,Heldner MR,Amiguet M,Faouzi M,Cras P,Ntaios G,Arnold M,Mattle HP,Gralla J,Fischer U,Michel P

    更新日期:2016-06-01 00:00:00

  • Intravenous amiodarone in the treatment of refractory arrhythmias.

    abstract::Oral amiodarone's slow absorption handicaps rapid treatment of life-threatening arrhythmias. We used iv amiodarone to treat ten patients with hemodynamically significant atrial arrhythmias and life-threatening ventricular arrhythmias refractory to all conventional medical treatment. Arrhythmias were controlled in nine...

    journal_title:Critical care medicine

    pub_type: 杂志文章


    authors: Alves LE,Rose EP,Cahill TB Jr

    更新日期:1985-09-01 00:00:00

  • Impaired adenosine-5'-triphosphate release from red blood cells promotes their adhesion to endothelial cells: a mechanism of hypoxemia after transfusion.

    abstract:OBJECTIVE:Transfusion of red blood cells has been linked to disappointing clinical outcomes in the critically ill, but specific mechanisms of organ dysfunction after transfusion remain poorly understood. We tested the hypothesis that red blood cell storage impairs the ability of red blood cells to release adenosine-5'-...

    journal_title:Critical care medicine

    pub_type: 杂志文章


    authors: Zhu H,Zennadi R,Xu BX,Eu JP,Torok JA,Telen MJ,McMahon TJ

    更新日期:2011-11-01 00:00:00