Abstract:
OBJECTIVE:Intrahospital transport of critically ill patients is often necessary for optimal patient care. However, transport of intensive care unit (ICU) patients within the hospital has been associated with a high rate of potentially detrimental complications. This study was designed to determine the occurrence rate of transport-related complications and to determine if these complications have any effect on patient morbidity and mortality. DESIGN:Prospective, cohort-matched study. SETTING:A 780-bed urban, university teaching hospital. PATIENTS:Seven hundred fifty-nine surgical ICU patients. INTERVENTIONS:One hundred seventy-five patients were transported out of the surgical ICU for diagnostic testing or operative interventions deemed necessary by their surgical or critical care team. MEASUREMENTS AND MAIN RESULTS:Acute Physiology and Chronic Health Evaluation (APACHE) II and APACHE III scores were determined 24 hrs after admission. Transport patients were stratified into low-risk and high-risk transport groups. Patients were considered a high-risk transport if they required positive end-expiratory pressure of > 5 cm H2O, a continuous infusion of dobutamine, or a continuous infusion of norepinephrine. The high-risk group was further stratified into three groups based on the number of defined treatment regimens required to maintain the patient during transport. The patients were then followed during their transport for any potentially detrimental complications, such as a need for an increased dose of vasoactive medications, loss of intravenous access, a need for additional ventilatory support, or cardiopulmonary arrest. APACHE-matched control cohorts were identified as patients who did not leave the surgical ICU. The overall occurrence rate of complications was similar in the two groups (low-risk group, 6.3%; high-risk group, 5.5%). The mortality rate for all transport patients was 28.6%, which was statistically higher (p < .01) than the mortality rate for all control patients (11.4%). However, there was no mortality as a direct result of a transport. The overall mortality rate (10.9%) of the low-risk group was not significantly different from the APACHE-matched controls (6.0%). The overall mortality rate (51.4%) in the high-risk group was significantly higher (p < .01) than the APACHE-matched controls, but was not statistically higher than predicted mortality (p = .416). Both the low-risk and the high-risk groups stayed in the surgical ICU three times as long as the APACHE-matched control cohorts. CONCLUSIONS:Intrahospital transport of critically ill patients is safe and carries a low risk of detrimental complications. Although patients requiring "high-risk" interventions experienced a higher mortality rate than did APACHE-matched controls, the increase in mortality does not appear to be directly related to the intrahospital transport. Patients requiring transport out of the surgical ICU are a more critically ill group of patients. These patients require a greater length of stay in the surgical ICU and may experience an increased mortality rate by virtue of the severity of their illness.
journal_name
Crit Care Medjournal_title
Critical care medicineauthors
Szem JW,Hydo LJ,Fischer E,Kapur S,Klemperer J,Barie PSdoi
10.1097/00003246-199510000-00009subject
Has Abstractpub_date
1995-10-01 00:00:00pages
1660-6issue
10eissn
0090-3493issn
1530-0293journal_volume
23pub_type
杂志文章abstract::We studied prospectively 40 critically ill neurosurgical patients who required prolonged mechanical ventilation to determine the current incidence of stress-related gastroduodenal erosions and ulcers, and to assess endoscopically the efficacy of acid-reducing prophylactic treatment. Nineteen patients were randomized t...
journal_title:Critical care medicine
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1097/00003246-199003000-00004
更新日期:1990-03-01 00:00:00
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
doi:10.1097/00003246-199611000-00019
更新日期:1996-11-01 00:00:00
abstract:OBJECTIVE:In 2003, critical care and infectious disease experts representing 11 international organizations developed management guidelines for the use of corticosteroid therapy in patients with sepsis and septic shock that would be of practical use for the bedside clinician, under the auspices of the Surviving Sepsis ...
journal_title:Critical care medicine
pub_type: 杂志文章,评审
doi:10.1097/01.ccm.0000142983.15421.11
更新日期:2004-11-01 00:00:00
abstract::Critical decreases in oxygen delivery (DO2) and mixed venous oxygen saturation (SvO2) are associated with anaerobic metabolism and, therefore, lactic acidosis. We studied 50 consecutive patients with sepsis and 50 consecutive patients with acute myocardial infarction (AMI) in whom the arterial blood lactate was greate...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/00003246-198807000-00001
更新日期:1988-07-01 00:00:00
abstract:OBJECTIVES:Cognitive deficits after traumatic brain injury are a leading cause of disability worldwide, yet no effective pharmacologic treatments exist to improve cognition. Traumatic brain injury increases proinflammatory cytokines, which trigger excess function of α5 subunit-containing γ-aminobutyric acid type A rece...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/CCM.0000000000004161
更新日期:2020-04-01 00:00:00
abstract:OBJECTIVE:We tested whether mild hypothermia impacts on circulatory and respiratory dysfunction during experimental endotoxemia. DESIGN:Randomized controlled prospective experimental study. SETTING:Large animal facility, Medical University of Graz, Austria. SUBJECTS:Thirteen anesthetized and mechanically ventilated ...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/CCM.0b013e31829791da
更新日期:2013-12-01 00:00:00
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
doi:10.1097/CCM.0000000000001630
更新日期:2016-06-01 00:00:00
abstract:INTRODUCTION:Ventilator settings for patients with severe acute respiratory distress syndrome supported by venovenous extracorporeal membrane oxygenation are currently set arbitrarily. The impact on serum and pulmonary biotrauma markers of the transition to ultra-protective ventilation settings following extracorporeal...
journal_title:Critical care medicine
pub_type: 杂志文章,随机对照试验
doi:10.1097/CCM.0000000000003894
更新日期:2019-11-01 00:00:00
abstract:BACKGROUND:Acute lung injury (ALI) and its more severe form, acute respiratory distress syndrome (ARDS), are devastating disorders of overwhelming pulmonary inflammation and hypoxemia, resulting in high morbidity and mortality. AIM:To provide the clinician with a summary of the literature on the epidemiology, diagnosi...
journal_title:Critical care medicine
pub_type: 杂志文章,评审
doi:10.1097/CCM.0b013e3181aee5dd
更新日期:2009-08-01 00:00:00
abstract:OBJECTIVES:To confirm early, marked decrease in plasma selenium concentrations in patients admitted to a surgical and medical intensive care unit (ICU), and to study this decrease according to the presence or absence of systemic inflammatory response syndrome (SIRS), sepsis, or direct ischemia-reperfusion. DESIGN:Pros...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/00003246-199809000-00021
更新日期:1998-09-01 00:00:00
abstract:BACKGROUND:Millions of patients are discharged from intensive care units annually. These intensive care survivors and their families frequently report a wide range of impairments in their health status which may last for months and years after hospital discharge. OBJECTIVES:To report on a 2-day Society of Critical Car...
journal_title:Critical care medicine
pub_type: 杂志文章,评审
doi:10.1097/CCM.0b013e318232da75
更新日期:2012-02-01 00:00:00
abstract:OBJECTIVE:To determine whether polymorphisms of the surfactant protein B gene may be associated with increased mortality in patients with the acute respiratory distress syndrome. DESIGN:A prospective cohort study. SETTING:Four adult intensive care units at a tertiary academic medical center. PATIENTS:Two hundred fou...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/CCM.0b013e318183f608
更新日期:2008-09-01 00:00:00
abstract:OBJECTIVE:To define the occurrence rate of acute respiratory distress syndrome (ARDS) using established criteria in a well-defined general patient population, to study the clinical course of ARDS when patients were ventilated using a "lung-protective" strategy, and to define the total costs of care. DESIGN:A 3-yr (199...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/00003246-199911000-00008
更新日期:1999-11-01 00:00:00
abstract:OBJECTIVE:Cardiac surgery is frequently followed by postoperative delirium, which is associated with increased 1-year mortality, late cognitive deficits, and higher costs. Currently, there are no recommendations for pharmacologic prevention of postoperative delirium. Impaired cholinergic transmission is believed to pla...
journal_title:Critical care medicine
pub_type: 杂志文章,随机对照试验
doi:10.1097/CCM.0b013e31819da780
更新日期:2009-05-01 00:00:00
abstract::Bacterial translocation and ileal and cecal injury have been shown to occur 24 h after limited periods of hemorrhagic shock. The present studies were performed to determine the temporal sequence of mucosal injury, permeability, and bacterial translocation after hemorrhagic shock. The results indicated that bacterial t...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/00003246-199005000-00014
更新日期:1990-05-01 00:00:00
abstract::Previous studies have confirmed the improved tolerance of a peptide enteral compared to standard enteral alimentation in hypoalbuminemic, critically ill patients. Animal studies, including hypoproteinemic, volume-expanded rats, demonstrated that the protein hydrolysate of a peptide enteral formula was responsible for ...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/00003246-198907000-00012
更新日期:1989-07-01 00:00:00
abstract:OBJECTIVES:Case fatality in pregnancy-associated severe sepsis or septic shock appears reduced compared with nonpregnant women with severe sepsis or septic shock. It remains unclear if this difference is due to pregnancy or better baseline health status, among others. Our study compared adverse outcomes of pregnancy-as...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/CCM.0000000000003348
更新日期:2018-11-01 00:00:00
abstract:OBJECTIVES:To assess whether sepsis-associated coagulopathy predicts hospital mortality. DESIGN:Retrospective cohort study. SETTING:One-thousand three-hundred beds urban academic medical center. PATIENTS:Six-thousand one-hundred forty-eight consecutive patients hospitalized between January 1, 2010, and December 31, ...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/CCM.0000000000002997
更新日期:2018-05-01 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:OBJECTIVES:Acute hemolysis is associated with organ damage, inflammation, and impaired vascular function. Stimulation of the cholecystokinin-1 receptor-dependent vagal anti-inflammatory reflex with lipid-rich enteral nutrition was demonstrated to prevent tissue damage and attenuate inflammation. This study investigates...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/CCM.0b013e31828e9262
更新日期:2013-11-01 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:OBJECTIVE:To discuss the potential therapeutic value of intraluminal oxygenation of the gut in critical illness. DATA SOURCES:Relevant articles published in the English language literature. STUDY SELECTION:No special study has been carried out for the present presentation. DATA EXTRACTION:Information from the litera...
journal_title:Critical care medicine
pub_type: 杂志文章,评审
doi:10.1097/00003246-199302001-00012
更新日期:1993-02-01 00:00:00
abstract:OBJECTIVE:To assess the number of adult critical care beds in Asian countries and regions in relation to population size. DESIGN:Cross-sectional observational study. SETTING:Twenty-three Asian countries and regions, covering 92.1% of the continent's population. PARTICIPANTS:Ten low-income and lower-middle-income eco...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/CCM.0000000000004222
更新日期:2020-05-01 00:00:00
abstract:OBJECTIVES:Monocytes and macrophages produce interleukin-1β by inflammasome activation which involves adenosine triphosphate release, pannexin-1 channels, and P2X7 receptors. However, interleukin-1β can also be produced in an inflammasome-independent fashion. Here we studied if this mechanism also involves adenosine tr...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/CCM.0000000000003446
更新日期:2018-12-01 00:00:00
abstract:OBJECTIVE:Hematopoietic stem cell transplant (HSCT) recipients admitted to the intensive care unit (ICU) have high mortality. The prognostic importance of peripheral blood stem cell source in critically ill HSCT recipients and the performance of Acute Physiology and Chronic Health Evaluation (APACHE) III have not been ...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/01.CCM.0000065761.51367.2D
更新日期:2003-06-01 00:00:00
abstract:OBJECTIVE:Despite concern over the appropriateness and quality of care provided in an intensive care unit (ICU) at the end of life, the number of Americans who receive ICU care at the end of life is unknown. We sought to describe the use of ICU care at the end of life in the United States using hospital discharge data ...
journal_title:Critical care medicine
pub_type: 杂志文章,多中心研究
doi:10.1097/01.ccm.0000114816.62331.08
更新日期:2004-03-01 00:00:00
abstract:BACKGROUND:Increased cardiac index, oxygen delivery (DO2), and oxygen consumption (VO2) patterns were shown to characterize the physiologic status of surviving high-risk surgical patients, and indicate increased metabolic needs; relatively normal DO2 and VO2 values were found to characterize the sequential pattern of n...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/00003246-199105000-00014
更新日期:1991-05-01 00:00:00
abstract:OBJECTIVE:To determine if inhibition of nitric oxide synthase with NG-nitro-L-arginine-methyl-ester (L-NAME) potentiates endotoxin-induced cardiopulmonary dysfunction and release of cyclooxygenase products in a porcine model of endotoxemia. DESIGN:Prospective, multiple group, controlled experimental study. SETTING:Ph...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/00003246-199706000-00024
更新日期:1997-06-01 00:00:00
abstract::PEEP is the most important therapeutic intervention in the management of acute respiratory failure. Transitory PEEP disconnection to perform clinically relevant maneuvers is often necessary, but its effect upon PaO2 and physiological shunt in patients requiring high-level PEEP is not clear from the literature. Nine ad...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/00003246-197902000-00003
更新日期:1979-02-01 00:00:00
abstract::Cerebral arteriovenous differences in oxygen content [C(a-v)O2] and glucose content [C(a-v)gluc] were used to predict outcome in 20 patients who remained comatose after resuscitation for cardiopulmonary arrest. Cerebral prognosis was good when C(a-v)O2 values were greater than 1.8 mMol/L and the oxygen glucose index (...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/00003246-198410000-00013
更新日期:1984-10-01 00:00:00