Abstract:
:In a prospective 30-month study of nosocomial infections in a pediatric ICU (PICU), the incidence, sites, and causes of infection were determined. Factors associated with increased risk of infection were investigated. In 1,388 patients who remained in the PICU for a minimum of 72 h, 116 infections occurred (6.1 infections/100 admissions). Primary bacteremias comprised 38% of PICU infections and lower respiratory infections comprised 15%. The remaining infections were divided equally among GI, skin, eye, upper respiratory, postoperative wounds, and other sites. Coagulase-negative staphylococci, Pseudomonas aeruginosa, and Staphylococcus aureus were the most prevalent pathogens. Surgical patients had similar rates of infection to medical patients. Patients in the first 2 yr of life, particularly those between 7 and 30 days of age, had the highest rate of infection. Onset of infection was more common after the first week in the PICU with 11% of patients staying 14 to 20 days, 27% of patients staying 21 to 27 days, 48% of patients staying 28 to 34 days, and 52% of patients staying more than 35 days before the onset of infection. The risk of nosocomial infection increases with arterial and central line use, prolonged intubation, ventilation, intracranial pressure monitoring, and paralysis.
journal_name
Crit Care Medjournal_title
Critical care medicineauthors
Milliken J,Tait GA,Ford-Jones EL,Mindorff CM,Gold R,Mullins Gdoi
10.1097/00003246-198803000-00005subject
Has Abstractpub_date
1988-03-01 00:00:00pages
233-7issue
3eissn
0090-3493issn
1530-0293journal_volume
16pub_type
杂志文章,评审abstract:OBJECTIVE:Heatstroke requires active body cooling and organ failure supportive care. Although heat waves are expected to recur over the next decades, little is known about the risk factors for mortality in heatstroke patients. We examined the prognosis and risk factors for hospital mortality in patients with heatstroke...
journal_title:Critical care medicine
pub_type: 评论,杂志文章,多中心研究
doi:10.1097/01.CCM.0000206469.33615.02
更新日期:2006-04-01 00:00:00
abstract:OBJECTIVE:To study the epidemiology, style of management, and outcome of intensive care patients with acute renal failure requiring replacement therapy in Australia. DESIGN:Prospective epidemiologic study. SETTING:Australian adult intensive care units providing acute renal replacement therapy. PATIENTS:Adult intensi...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/00003246-200110000-00010
更新日期:2001-10-01 00:00:00
abstract:OBJECTIVES:Previous workers have demonstrated that controlled mechanical ventilation results in diaphragm inactivity and elicits a rapid development of diaphragm weakness as a result of both contractile dysfunction and fiber atrophy. Limited data exist regarding the impact of pressure support ventilation, a commonly us...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/CCM.0b013e31823c8cc9
更新日期:2012-04-01 00:00:00
abstract:OBJECTIVES:Lung CT is the reference imaging technique for acute respiratory distress syndrome, but requires transportation outside the intensive care and x-ray exposure. Lung ultrasound is a promising, inexpensive, radiation-free, tool for bedside imaging. Aim of the present study was to compare the global and regional...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/CCM.0000000000003971
更新日期:2019-11-01 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::To determine the influence of arachidonic acid metabolites on acute lung injury induced by glass bead embolism, two groups of animals were studied before and after the pulmonary artery pressure was doubled by glass bead embolism. One group represented an untreated time control (n = 6) while the second group (n = 6) wa...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/00003246-198809000-00007
更新日期:1988-09-01 00:00:00
abstract:OBJECTIVE:To describe the experience of pediatric intensive care hospitalization from the perspective of a parents of children with severe, antecedent disability. DESIGN:Qualitative analysis of data obtained through semistructured interviews. SETTING:Pediatric intensive care unit (PICU) in a children's hospital. SUB...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/CCM.0b013e3181a00578
更新日期:2009-06-01 00:00:00
abstract::Mucus plugging of a large airway resulted in the formation of a check-valve mechanism and pulmonary hyperinflation, rather than atelectasis. Fiberoptic bronchoscopy was both diagnostic and curative. The physician should be aware that mucus plugging may have unusual presentations and may mimic other clinical entities. ...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/00003246-198609000-00015
更新日期:1986-09-01 00:00:00
abstract:OBJECTIVE:We sought to investigate if the chloride content of fluids used in resuscitation was associated with short- and long-term outcomes. DESIGN:We identified patients who received large-volume fluid resuscitation, defined as greater than 60 mL/kg over a 24-hour period. Chloride load was determined for each patien...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/CCM.0000000000002063
更新日期:2017-02-01 00:00:00
abstract::Arterial oxygen saturation, determined noninvasively by pulse oximetry in 32 pediatric patients with cyanotic congenital heart disease (CHD), was compared with oxygen saturation measured by a cooximeter in simultaneously obtained arterial blood samples. The patients were studied in the cardiac catheterization laborato...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/00003246-198711000-00015
更新日期:1987-11-01 00:00:00
abstract:OBJECTIVE:To investigate the effect of norepinephrine on static (right atrial pressure, pulmonary artery occlusion pressure ) and dynamic (pulse pressure variation and arterial systolic pressure variation) preload indicators in experimental hemorrhagic shock. DESIGN:Prospective controlled experimental study. SETTING:...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/01.ccm.0000182801.48137.13
更新日期:2005-10-01 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:OBJECTIVE:To determine if there is a difference in nosocomial pneumonia frequency rate in mechanically ventilated trauma patients treated with sucralfate vs. ranitidine for stress ulcer prophylaxis. DESIGN:Prospective, randomized trial. SETTING:A 640-bed urban teaching hospital and trauma center. PATIENTS:Ninety-two...
journal_title:Critical care medicine
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1097/00003246-199312000-00012
更新日期:1993-12-01 00:00:00
abstract:OBJECTIVES:To determine the proportion of patients with documented bacterial aspiration pneumonia among comatose ICU patients with symptoms suggesting either bacterial aspiration pneumonia or non-bacterial aspiration pneumonitis. DESIGN:Prospective observational study. SETTING:University-affiliated 30-bed ICU. PATIE...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/CCM.0000000000002525
更新日期:2017-08-01 00:00:00
abstract:OBJECTIVE:Antimicrobial effects of nitric oxide (NO) have been demonstrated in vitro against a variety of infectious pathogens, yet in vivo evidence of a potential therapeutic role for exogenous NO as an antimicrobial agent is limited. Thus, we assessed the effects of inhaled NO on pulmonary infection, leukocyte infilt...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/00003246-200007000-00035
更新日期:2000-07-01 00:00:00
abstract:OBJECTIVE:When treating patients with cardiac arrest with mild therapeutic hypothermia, a reliable and easy-to-use temperature probe is desirable. This study was conducted to investigate the accuracy and safety of tracheal temperature as a measurement of body temperature. DESIGN:Observational cohort study. SETTING:Em...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/CCM.0b013e3181e47a20
更新日期:2010-07-01 00:00:00
abstract:OBJECTIVE:To evaluate partial occlusion in patients with pulmonary hypertension with regard to a) the degree to which it leads to overestimation of pulmonary artery occlusion pressure (Ppao) and b) identification of factors that could enhance its recognition. DESIGN:Observational descriptive study. SETTING:Medical in...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/00003246-200301000-00015
更新日期:2003-01-01 00:00:00
abstract::Flow rates and pressure recording accuracy were compared for Argyle 14-, 16-, and 18-ga double-lumen and Edwards 7-Fr triple-lumen CVP catheters. Physiologic saline solution was pressure-infused into dogs through one lumen and CVP was measured via the other lumen. CVP accuracy was unaltered by simultaneous rapid infus...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/00003246-198507000-00017
更新日期:1985-07-01 00:00:00
abstract:OBJECTIVES:Streptococcus pneumoniae is the most common causative pathogen in community-acquired pneumonia. In patients, thrombocytopenia is correlated with an adverse outcome of pneumonia. Platelets can modulate the host response to infection in several ways, that is, by facilitating clot formation, production of antim...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/CCM.0000000000000853
更新日期:2015-03-01 00:00:00
abstract:OBJECTIVES:To study the relation between nitrite, nitrate, nitrotyrosine, and nitrosothiols as NO indices in human septic shock. DESIGN:A prospective clinical study. SETTING:Intensive care units in a university hospital and a central county hospital. PATIENTS:Sixteen patients admitted for septic shock. Nine healthy ...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/00003246-200008000-00017
更新日期:2000-08-01 00:00:00
abstract::The effects of hypertonic mannitol on postischemic cerebral circulation were studied in 20 dogs. Mannitol, 2 g/kg iv, was infused into ten dogs during a 2-h period starting 1.5 h after 6 min of complete cerebral ischemia. One hour postischemia, regional cerebral blood flow (rCBF) was 36% in the control group (ten dogs...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/00003246-198607000-00010
更新日期:1986-07-01 00:00:00
abstract:OBJECTIVES:To understand when the use of high-frequency ventilation would be advantageous, we formulated the problem of achieving adequate alveolar ventilation at minimal pressure cost by dividing it into two simpler problems: a) the pressure cost per unit of convective oscillatory flow; and b) the convective flow cost...
journal_title:Critical care medicine
pub_type: 杂志文章,评审
doi:10.1097/00003246-199422091-00004
更新日期:1994-09-01 00:00:00
abstract:OBJECTIVE:To determine the frequency and effects of weaning-related myocardial ischemia on weaning outcomes in patients with coronary artery disease. DESIGN:Prospective cohort study. SETTING:Medical and cardiac intensive care units of a 300-bed teaching community hospital. MEASUREMENTS AND MAIN RESULTS:Three-lead ST...
journal_title:Critical care medicine
pub_type: 临床试验,杂志文章
doi:10.1097/00003246-199910000-00005
更新日期:1999-10-01 00:00:00
abstract:OBJECTIVES:To evaluate the frequency of unsuspected posterior vessel wall penetration of the internal jugular vein during ultrasound-guided needle cannulation. DESIGN:Prospective, single-blinded observational study. SETTING:Urban level I emergency department with an annual census of 80,000. PATIENTS:Residents who ha...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/CCM.0b013e3181a067d4
更新日期:2009-08-01 00:00:00
abstract::Clonidine may be a source of serious toxicity when ingested by toddlers. We describe 11 cases of clonidine ingestion by toddlers (mean dose 0.15 mg/kg; range 0.01 to 0.57). The source of the clonidine was a grand-parent in six of 11 cases. Symptoms included altered level of consciousness (n = 11), miosis (n = 5), brad...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/00003246-199010000-00014
更新日期:1990-10-01 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::Perfluorocarbon (PFC) emulsions are promising oxygen-carrying blood supplements for the treatment of shock and in organ preservation for transplantation. We used the isolated, blood-perfused, canine right lower lung lobe (RLL) to determine the effect of a PFC emulsion, Oxypherol (FC-43), upon lung fluid balance and he...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/00003246-198512000-00006
更新日期:1985-12-01 00:00:00
abstract:OBJECTIVES:The role of nitric oxide in mediating the early phase of hypotension and cardiovascular hyporeactivity in sepsis, and the cellular sources of inducible nitric oxide synthase expression under in vivo conditions, remain unclear. The objective of this study was to elucidate the time course and cellular location...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/00003246-199703000-00022
更新日期:1997-03-01 00:00:00
abstract:OBJECTIVE:To examine the effects of hypertonic (7.5%) saline-6% dextran 70 (HSD) and isotonic (0.9%) saline-6% dextran 70 (ISD) on cardiovascular function and intestinal perfusion in experimental endotoxin shock. DESIGN:Experimental, randomized, unblinded, interventional study. SETTING:University experimental animal ...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/00003246-200008000-00027
更新日期:2000-08-01 00:00:00
abstract:OBJECTIVE:To study the impact of a clinical pharmacist in a pediatric intensive care unit. The goals of the study were to determine the type and quantity of patient care interventions recommended by a clinical pharmacist and to specifically examine cost savings (or loss) that resulted from clinical pharmacist recommend...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/00003246-200204000-00035
更新日期:2002-04-01 00:00:00