Abstract:
OBJECTIVES:To assess trends in the use of extracorporeal membrane oxygenation for poisoning in the United States. DESIGN:Retrospective cohort study. SETTING:The National Poison Data System, the databased owned and managed by the American Association of Poison Control Centers, the organization that supports and accredits all 55 U.S. Poison Centers, 2000-2018. PATIENTS:All patients reported to National Poison Data System treated with extracorporeal membrane oxygenation. INTERVENTIONS:None. MEASUREMENTS AND MAIN RESULTS:In total, 407 patients met final inclusion criteria (332 adults, 75 children). Median age was 27 years (interquartile range, 15-39 yr); 52.5% were male. Median number of ingested substances was three (interquartile range, 2-4); 51.5% were single-substance exposures. Extracorporeal membrane oxygenation use in poisoned patients in the United States has significantly increased over time (z = 3.18; p = 0.001) in both adults (age > 12 yr) and children (age ≤ 12 yr), increasing by 9-100% per year since 2008. Increase in use occurred more commonly in adults. We found substantial geographical variation in extracorporeal membrane oxygenation use by geospatially mapping the ZIP code associated with the initial call, with large, primarily rural areas of the United States reporting no cases. Overall survival was 70% and did not vary significantly over the study period for children or adults. Patients with metabolic and hematologic poisonings were less likely to survive following extracorporeal membrane oxygenation than those with other poisonings (49% vs 72%; p = 0.004). CONCLUSIONS:The use of extracorporeal membrane oxygenation to support critically ill, poisoned patients in the United States is increasing, driven primarily by increased use in patients greater than 12 years old. We observed no trends in survival over time. Mortality was higher when extracorporeal membrane oxygenation was used for metabolic or hematologic poisonings. Large, predominantly rural regions of the United States reported no cases of extracorporeal membrane oxygenation for poisoning. Further research should focus on refining criteria for the use of extracorporeal membrane oxygenation in poisoning.
journal_name
Crit Care Medjournal_title
Critical care medicineauthors
Cole JB,Olives TD,Ulici A,Litell JM,Bangh SA,Arens AM,Puskarich MA,Prekker MEdoi
10.1097/CCM.0000000000004401subject
Has Abstractpub_date
2020-08-01 00:00:00pages
1111-1119issue
8eissn
0090-3493issn
1530-0293pii
00003246-202008000-00003journal_volume
48pub_type
杂志文章abstract:OBJECTIVE:Pathogens that cause pneumonia may be treated in a targeted fashion by antibiotics, but if this therapy fails, then treatment involves only nonspecific supportive measures, independent of the inciting infection. The purpose of this study was to determine whether host response is similar after disparate infect...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/CCM.0b013e3181b4a76b
更新日期:2010-01-01 00:00:00
abstract:OBJECTIVES:To determine the effects of sustained, 3-day endotoxin infusion on early steps of the insulin-signaling pathway in rat liver and skeletal muscle in vivo; to examine insulin signaling in well-established acute endotoxin models of insulin resistance. DESIGN:Prospective, controlled animal study. SETTING:Unive...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/00003246-200104000-00032
更新日期:2001-04-01 00:00:00
abstract:OBJECTIVE:To compare two forms of continuous renal replacement therapy, continuous venovenous hemofiltration (CVVH) vs. continuous venovenous hemodialysis (CVVHD), in terms of the removal of inflammatory mediators from the blood of patients with systemic inflammatory response syndrome and acute renal failure. DESIGN:R...
journal_title:Critical care medicine
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1097/00003246-199812000-00027
更新日期:1998-12-01 00:00:00
abstract:OBJECTIVES:In this study, we evaluated the inflammatory response in patients with severe acute respiratory infection due to the Middle East respiratory syndrome and non-Middle East respiratory syndrome and assessed the presence of distinct inflammatory subphenotypes using latent class analysis. DESIGN:Prospective coho...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/CCM.0000000000004724
更新日期:2021-02-01 00:00:00
abstract::We developed a method to measure accurately pressures at the airway opening (Pao) and in the trachea (Ptr) in neonates during high frequency oscillatory ventilation (HFOV) from 15-30 Hz. All component parts of the pressure-measuring system were tested as a unit against a reference transducer in a closed chamber in whi...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/00003246-198401000-00011
更新日期:1984-01-01 00:00:00
abstract:OBJECTIVES:To test the hypothesis that after cecal ligation and puncture in the rat, there is increased expression of the tumor necrosis factor (TNF)/interleukin-1-dependent, acute-phase reactant alpha 1-acid glycoprotein in the liver, and that this change correlates temporally with increased abundance of TNF-alpha in ...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/00003246-199612000-00004
更新日期:1996-12-01 00:00:00
abstract:OBJECTIVE:To determine the incidence and risk factors of chronic critical illness after severe blunt trauma. DESIGN:Prospective observational cohort study (NCT01810328). SETTING:Two level-one trauma centers in the United States. PATIENTS:One hundred thirty-five adult blunt trauma patients with hemorrhagic shock who ...
journal_title:Critical care medicine
pub_type: 杂志文章,多中心研究
doi:10.1097/CCM.0000000000002697
更新日期:2017-12-01 00:00:00
abstract::Hemodynamic, respiratory, and cerebral variables during 2 h of standard external CPR were studied in 5 dogs. In an additional 12 dogs, possible augmentation of these variables by Military Anti-Shock Trousers (MAST) was evaluated. In 9 dogs, external and internal cardiac massage were compared. During ventricular fibril...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/00003246-198003000-00012
更新日期:1980-03-01 00:00:00
abstract::Colloid osmotic pressure (COP) was measured simultaneously with cardiorespiratory measurements in 103 surgical patients suspected of having circulatory problems. In a small subset of 28 patients, measurements were taken before, during, and after surgical operations. Similarly, data sets were taken before, during, and ...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/00003246-198303000-00010
更新日期:1983-03-01 00:00:00
abstract:OBJECTIVES:Despite the universal proliferation of emergency medical services programs throughout the United States since 1970, only a few have ever documented a valid lifesaving effect, particularly in large, urban centers. The purpose of this study was to demonstrate the effect of specialized physician supervision on ...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/00003246-199309000-00009
更新日期:1993-09-01 00:00:00
abstract:OBJECTIVE:To examine the effect of glycosylated recombinant human tumor necrosis factor binding protein-1 (r-hTNF binding protein-1), the extracellular domain of the tumor necrosis factor receptor p55 produced in mammalian cells, in a rabbit model of circulatory shock due to Escherichia coli. DESIGN:Prospective, rando...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/00003246-199506000-00014
更新日期:1995-06-01 00:00:00
abstract:OBJECTIVE:To assess the effect of a helium-oxygen mixture on intubation rate and clinical outcomes during noninvasive ventilation in acute exacerbation of chronic obstructive pulmonary disease. DESIGN:Multicenter, prospective, randomized, controlled trial. SETTING:Seven intensive care units. PATIENTS:A total of 204 ...
journal_title:Critical care medicine
pub_type: 杂志文章,多中心研究,随机对照试验
doi:10.1097/CCM.0b013e3181b78abe
更新日期:2010-01-01 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:Perfluorocarbon liquid ventilation has been shown to enhance pulmonary mechanics and gas exchange in the setting of respiratory failure. To optimize the total liquid ventilation process, we developed a volume-limited, time-cycled liquid ventilatory support, consisting of an electrically actuated, microprocess...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/00003246-200005000-00038
更新日期:2000-05-01 00:00:00
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
doi:10.1097/CCM.0b013e318232d8c4
更新日期:2012-02-01 00:00:00
abstract::High-frequency jet ventilation using a jet injector located at the right mainstem bronchus was superimposed on standard mechanical ventilation to ventilate the injured lung of a patient with unilateral massive atelectasis secondary to pulmonary hemorrhage. This technique of differential ventilation markedly improved a...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/00003246-198409000-00039
更新日期:1984-09-01 00:00:00
abstract:BACKGROUND:The randomized two-way factorial Dressing Study (1,636 patients, 28,931 catheter days) showed that a chlorhexidine-impregnated sponge decreased the incidence of major catheter-related infections from 1.4‰ to 0.6‰ catheter days, and that scheduled dressing changes every 7 days was not inferior to scheduled ch...
journal_title:Critical care medicine
pub_type: 杂志文章,随机对照试验
doi:10.1097/CCM.0b013e31822f0604
更新日期:2012-01-01 00:00:00
abstract::One hundred patients were ventilated with high-frequency jet ventilation (HFJV) during the initial 24-h postoperative period in the surgical and neurosurgical ICUs. Eighty-three were successfully weaned, 2 could not be ventilated adequately with HFJV, and 15 with criteria of acute respiratory failure received HFJV for...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/00003246-198409000-00022
更新日期:1984-09-01 00:00:00
abstract:BACKGROUND:Increased intracranial pressure (ICP) worsens the outcome of acute liver failure (ALF). This study investigates the underlying pathophysiological mechanisms and evaluates the therapeutic effect of albumin dialysis in ALF with use of the Molecular Adsorbents Recirculating System without hemofiltration/dialysi...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/01.ccm.0000196203.39832.3c
更新日期:2006-01-01 00:00:00
abstract::The hemodynamic response to a dopamine HCl infusion (10 microgram/kg per min) was measured in 25 adult patients with severe sepsis: there were 6 patients with circulatory hyperdynamic states, 9 patients with myocardial failure, and 10 with hypovolemia. Each patient also had acute respiratory failure. Changes of intrap...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/00003246-197906000-00004
更新日期:1979-06-01 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...
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pub_type: 杂志文章
doi:10.1097/00003246-200110000-00010
更新日期:2001-10-01 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:To examine the value of laser bronchoscopy in patients with inoperable carcinoma of the lung who required ventilatory assistance for acute respiratory failure. DESIGN:Retrospective review of the medical records of all patients undergoing laser bronchoscopy. SETTING:The Lahey Clinic Medical Center, a tertiar...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/00003246-199303000-00016
更新日期:1993-03-01 00:00:00
abstract::The resolution time of pneumothorax in neonates requiring tube thoracotomy is not known. We found that 28%, 50%, and 83% of 54 pneumothoraces in 40 neonates resolved within 24, 96, and 168 h of tube thoracotomy, respectively. Pneumothoraces that persisted beyond 168 h were in infants requiring ventilatory assistance. ...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/00003246-198505000-00010
更新日期:1985-05-01 00:00:00
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journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/CCM.0000000000001200
更新日期:2015-10-01 00:00:00
abstract::Vecuronium's short half-life and minimal cardiopulmonary side-effects make it a suitable drug for continuous infusion. Vecuronium is used frequently in critically ill patients to increase their total compliance and to minimize the adverse effects of mechanical ventilation. This crossover, prospective study evaluates t...
journal_title:Critical care medicine
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1097/00003246-198910000-00004
更新日期:1989-10-01 00:00:00
abstract::Trauma is the leading cause of both morbidity and mortality in the pediatric population, and traumatic injury causes > 50% of all childhood deaths. Significant mortality rates have been reported for children with traumatic brain injury. Although children have better survival rates as compared with adults with traumati...
journal_title:Critical care medicine
pub_type: 杂志文章,评审
doi:10.1097/00003246-200211001-00003
更新日期:2002-11-01 00:00:00
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journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/CCM.0000000000000312
更新日期:2014-06-01 00:00:00
abstract:OBJECTIVE:In the pathogenesis of disseminated intravascular coagulation, dysfunctional natural anticoagulant pathways appear to play a pivotal role. In this article, we will address the mechanisms that contribute to this defect in the regulation of coagulation activation. Furthermore, we will explore the experimental a...
journal_title:Critical care medicine
pub_type: 杂志文章,评审
doi:10.1097/00003246-200107001-00028
更新日期:2001-07-01 00:00:00
abstract:OBJECTIVES:To create a novel tool to predict favorable neurologic outcomes during ICU stay among children with critical illness. DESIGN:Logistic regression models using adaptive lasso methodology were used to identify independent factors associated with favorable neurologic outcomes. A mixed effects logistic regressio...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/CCM.0000000000002753
更新日期:2018-01-01 00:00:00