Abstract:
PURPOSE:Arterial blood gas measurement is frequently performed in critically ill patients to diagnose and monitor acute respiratory failure. At a given metabolic rate, carbon dioxide partial pressure (PaCO2) is entirely determined by CO2 elimination through ventilation. Transcutaneous partial pressure of carbon dioxide (PtcCO2) monitoring permits a noninvasive and continuous estimation of arterial CO2 tension (PaCO2). The accuracy of PtcCO2, however, has not been well studied. To assess the accuracy of different CO2 monitoring methods, we compared PtcCO2 and end-tidal CO2 concentration (EtCO2) to PaCO2 measurements in nonintubated intensive care unit (ICU) patients with acute respiratory failure. METHODS:During a 2-month period, we conducted a prospective observational cohort study in 25 consecutive nonintubated and spontaneously breathing patients admitted to our ICU. Arterial blood gases were measured at study inclusion, 30, 60, and 120 minutes later. At each sampling time, EtCO2 was continuously monitored using a Philips Smart Capnoline Plus, and PtcCO2 was measured using was measured using SenTec device. The aim of the study was to assess agreement between PtcCO2 and PaCO2 and between EtCO2 and PaCO2 in nonintubated ICU patients with acute respiratory failure. Bland-Altman techniques and Pearson correlation coefficients were used. The differences over time (at 30, 60, and 120 minutes) between PaCO2 and EtCO2 and between PtcCO2 and PaCO2 were evaluated using 1-way analysis of variance. RESULTS:Transcutaneous partial pressure of carbon dioxide and PaCO2 were well correlated (R = 0.97), whereas the correlation between EtCO2 and PaCO2 was poor (R = 0.62) probably due to the presence of an alveolar dead space in a few patients, most notably in the group with chronic obstructive pulmonary disease. The difference over time remained stable for both PaCO2 vs EtCO2 (analysis of variance; P = .88) and PaCO2 vs PtcCO2 (P = .93). CONCLUSION:We found large differences between EtCO2 and Paco2 in spontaneously breathing nonintubated ICU patients admitted for acute respiratory failure. Our study argues against the use of EtCO2 monitoring in such patients but raises the possibility that PtcCO2 measurement may provide reasonable estimates of PaCO2.
journal_name
J Crit Carejournal_title
Journal of critical careauthors
Lermuzeaux M,Meric H,Sauneuf B,Girard S,Normand H,Lofaso F,Terzi Ndoi
10.1016/j.jcrc.2015.09.014subject
Has Abstractpub_date
2016-02-01 00:00:00pages
150-6issue
1eissn
0883-9441issn
1557-8615pii
S0883-9441(15)00474-8journal_volume
31pub_type
杂志文章abstract:PURPOSE:The aim of this study was to determine whether the relative change in the end-expiratory lung volume (EELV) obtained by the recruitment maneuver (RM) can serve as an indicator of the change in the P/F ratio. MATERIALS AND METHODS:The effects of the intermittent stepwise increases in the RM (peak inspiratory pr...
journal_title:Journal of critical care
pub_type: 杂志文章
doi:10.1016/j.jcrc.2012.11.003
更新日期:2013-08-01 00:00:00
abstract:PURPOSE:We identified risk factors for noninvasive ventilation (NIV) failure in patients with acute cardiogenic pulmonary edema (ACPE). MATERIALS AND METHODS:We conducted an observational cohort study over a 3-year period in a 28-bed emergency intensive care unit (EICU) and prospectively included all consecutive patie...
journal_title:Journal of critical care
pub_type: 杂志文章
doi:10.1016/j.jcrc.2017.01.001
更新日期:2017-06-01 00:00:00
abstract:PURPOSE:This study aimed to systematically review studies that investigated the effects of normal saline instillation before endotracheal suctioning and to determine the views of nurses concerning this procedure. METHODS:This study was carried out in 2 stages as a systematic review and a descriptive study. In the firs...
journal_title:Journal of critical care
pub_type: 杂志文章,评审
doi:10.1016/j.jcrc.2015.02.019
更新日期:2015-08-01 00:00:00
abstract:PURPOSE:Closed endotracheal suctioning (CES) may impact ventilator-associated pneumonia (VAP) risk by reducing environmental contamination. In developing countries where resource limitations constrain the provision of optimal bed space for critically ill patients, CES assumes greater importance. MATERIALS AND METHODS:...
journal_title:Journal of critical care
pub_type: 杂志文章,随机对照试验
doi:10.1016/j.jcrc.2010.10.002
更新日期:2011-10-01 00:00:00
abstract:PURPOSE:Bacterial ventriculitis (BV) may develop in patients requiring external ventricular drains (EVDs). The purpose of this study was to determine predictors of EVD-associated BV onset. MATERIALS AND METHODS:A retrospective review of Duke University Hospital patients with EVD device placement between January 2005 a...
journal_title:Journal of critical care
pub_type: 杂志文章
doi:10.1016/j.jcrc.2013.08.012
更新日期:2014-02-01 00:00:00
abstract:PURPOSE:Although 4% albumin is associated with increased mortality in patients with traumatic brain injury (TBI), evidence concerning the safety of synthetic colloids is lacking. We aimed to determine if there is an association between synthetic colloids and mortality in patients with severe TBI. MATERIALS AND METHODS...
journal_title:Journal of critical care
pub_type: 杂志文章
doi:10.1016/j.jcrc.2010.12.001
更新日期:2011-08-01 00:00:00
abstract:PURPOSE:Pediatric venous thromboembolism (VTE) is becoming an increasingly recognized morbidity associated with critical illness. The objective of this survey is to identify the patient factors and radiological features that pediatric intensivists consider more or less likely to make a venous thrombosis (VTE) clinicall...
journal_title:Journal of critical care
pub_type: 杂志文章
doi:10.1016/j.jcrc.2005.09.012
更新日期:2005-12-01 00:00:00
abstract:PURPOSE:To explore the effect of emotion priming and physician communication behaviors on optimism bias. MATERIALS AND METHODS:We conducted a 5 × 2 between-subject randomized factorial experiment using a Web-based interactive video designed to simulate a family meeting for a critically ill spouse/parent. Eligibility i...
journal_title:Journal of critical care
pub_type: 杂志文章,随机对照试验
doi:10.1016/j.jcrc.2015.11.015
更新日期:2016-04-01 00:00:00
abstract:PURPOSE:The purpose of the study is to describe early predictors and to develop a prediction tool that accurately identifies the need for mechanical ventilation (MV) in pneumonia patients with hypoxemic acute respiratory failure (ARF) treated with high-flow nasal cannula (HFNC). MATERIALS AND METHODS:This is a 4-year ...
journal_title:Journal of critical care
pub_type: 杂志文章
doi:10.1016/j.jcrc.2016.05.022
更新日期:2016-10-01 00:00:00
abstract:PURPOSE:Current guidelines for traumatic brain injury (TBI) recommend antiepileptic drugs (AEDs) for 7 days after injury to decrease posttraumatic seizure risk. Phenytoin decreases seizure risk 73% vs placebo during this time. Levetiracetam (LEV) is an alternative; however, no published data validate comparable efficac...
journal_title:Journal of critical care
pub_type: 杂志文章
doi:10.1016/j.jcrc.2012.11.020
更新日期:2013-10-01 00:00:00
abstract:PURPOSE:The purpose of study was to evaluate the clinical results of early stabilization of spine fractures in polytrauma patients. MATERIALS AND METHODS:Between August 2003, and May 2012, 166 polytrauma patients with thoracolumbar spine fractures were included. Patients were divided into 2 groups according to injury-...
journal_title:Journal of critical care
pub_type: 杂志文章
doi:10.1016/j.jcrc.2014.03.003
更新日期:2014-08-01 00:00:00
abstract:PURPOSE:Early mobility (EM) is being used in adult ICUs in an effort to treat and prevent intensive care unit acquired weakness (ICU-AW) and Post-Intensive Care Syndrome (PICS). Data supports children suffer from ICU-AW and PICS as well. Our objective was to create and implement an EM protocol for pediatric patients re...
journal_title:Journal of critical care
pub_type: 杂志文章
doi:10.1016/j.jcrc.2017.08.004
更新日期:2017-10-01 00:00:00
abstract:PURPOSE:Partial pressure of carbon dioxide (PCO2), strong ion difference (SID), and total amount of weak acids independently regulate pH. When blood passes through an extracorporeal membrane lung, PCO2 decreases. Furthermore, changes in electrolytes, potentially affecting SID, were reported. We analyzed these phenomena...
journal_title:Journal of critical care
pub_type: 杂志文章
doi:10.1016/j.jcrc.2014.09.013
更新日期:2015-02-01 00:00:00
abstract:PURPOSE:To investigate predictive powers of S100B and cell-free DNA (cfDNA) levels in patients in the intensive care unit (ICU) who have with intracranial hemorrhage (ICH) for prognosis. METHODS:Ninety-nine patients diagnosed with ICH were included in the study. The blood samples were drawn on the day of admittance to...
journal_title:Journal of critical care
pub_type: 杂志文章
doi:10.1016/j.jcrc.2013.03.005
更新日期:2013-10-01 00:00:00
abstract:PURPOSE:The prevalence and clinical significance of lactic acidosis in diabetic ketoacidosis (DKA) are understudied. The objective of this study was to determine the prevalence of lactic acidosis in DKA and its association with intensive care unit (ICU) length of stay (LOS) and mortality. METHODS:Retrospective, observ...
journal_title:Journal of critical care
pub_type: 杂志文章
doi:10.1016/j.jcrc.2011.07.071
更新日期:2012-04-01 00:00:00
abstract:PURPOSE:The purpose of this study is to identify and evaluate to what extent the literature on team coordination during cardiopulmonary resuscitation (CPR) empirically confirms its positive effect on clinically relevant medical outcome. MATERIAL AND METHODS:A systematic literature search in PubMed, MEDLINE, PsycINFO a...
journal_title:Journal of critical care
pub_type: 杂志文章,评审
doi:10.1016/j.jcrc.2013.01.005
更新日期:2013-08-01 00:00:00
abstract:PURPOSE:We sought to investigate the relationship between high CVP, AKI, and mortality in patients undergoing cardiac surgery with cardiopulmonary bypass. MATERIALS:All patients aged 18 years or older who underwent cardiac surgery with CPB were prospectively reviewed. Patients were excluded when renal artery were invo...
journal_title:Journal of critical care
pub_type: 杂志文章
doi:10.1016/j.jcrc.2018.08.034
更新日期:2018-12-01 00:00:00
abstract:PURPOSE:Little is known about the relationship between anxiety and pain in intensive care unit (ICU) patients despite its importance. The aims of the present study are to examine the correlation between pain and anxiety during ICU care and to investigate its effects on the dose of opioids and anxiolytics administered. ...
journal_title:Journal of critical care
pub_type: 杂志文章
doi:10.1016/j.jcrc.2015.05.025
更新日期:2015-10-01 00:00:00
abstract:PURPOSE:The mortality rate of severe acute pancreatitis (AP) is 20-30% even after admission to intensive care unit (ICU). Thus we aimed to develop a laboratory-based nomogram to identify AP patients at high risk for mortality. MATERIALS AND METHODS:The primary and validation cohorts were extracted from the Medical Inf...
journal_title:Journal of critical care
pub_type: 杂志文章
doi:10.1016/j.jcrc.2018.10.030
更新日期:2019-04-01 00:00:00
abstract:PURPOSE:Hyperosmolar therapies aim at controlling increased intracranial pressure (ICP) in patients with traumatic brain injury (TBI). The aim of this study was to evaluate the effect of 7.5% hypertonic saline (HTS) on ICP and cerebral perfusion pressure (CPP) in children with severe TBI. MATERIALS AND METHODS:Medical...
journal_title:Journal of critical care
pub_type: 杂志文章
doi:10.1016/j.jcrc.2016.10.014
更新日期:2017-04-01 00:00:00
abstract:PURPOSE:Evaluation of the effects of nimodipine administration during and after cardiopulmonary resuscitation (CPR) on oxygen delivery and consumption was the aim of this study. METHODS:A randomized double-blind study in 32 anesthetized domestic pigs was performed. After 5 minutes of ventricular fibrillation (VF) and ...
journal_title:Journal of critical care
pub_type: 杂志文章
doi:10.1016/0883-9441(94)90029-9
更新日期:1994-03-01 00:00:00
abstract:PURPOSE:To compare the application of three standardized definitions of acute kidney injury (AKI), using corrected serum creatinine values, in children immediately after liver transplantation. METHODS:Retrospective search of a tertiary pediatric hospital database yielded 77 patients (age < 18 years) who underwent live...
journal_title:Journal of critical care
pub_type: 杂志文章
doi:10.1016/j.jcrc.2019.01.010
更新日期:2019-04-01 00:00:00
abstract:PURPOSE:1) To determine the clinical expression and consequences of autonomic dysregulation in patients with diffuse axonal injury (DAI), and 2) to study the use of the "paroxysmal sympathetic hyperactivity assessment measure" (PSH-AM). METHODS:Patients clinically diagnosed with autonomic dysregulation were selected f...
journal_title:Journal of critical care
pub_type: 杂志文章,评审
doi:10.1016/j.jcrc.2018.10.018
更新日期:2019-02-01 00:00:00
abstract:PURPOSE:The prognostic value of hyperlactatemia in septic shock is unquestionable. However, as current definitions do not include hyperlactatemia as a mandatory criterion, some hypotensive patients may be diagnosed as having septic shock despite exhibiting normolactatemia. The significance of persistent sepsis-induced ...
journal_title:Journal of critical care
pub_type: 杂志文章
doi:10.1016/j.jcrc.2010.09.007
更新日期:2011-08-01 00:00:00
abstract:OBJECTIVE:To evaluate the effectiveness of steroids therapy on postextubation stridor (PES) depending on the clinical response, the ultrasound guided laryngeal air column width difference (LACWD) and the cuff leak volume (CLV). DESIGN:Prospective, observer-blinded study. SETTING:Carried out in intensive care unit in ...
journal_title:Journal of critical care
pub_type: 杂志文章
doi:10.1016/j.jcrc.2016.07.007
更新日期:2016-12-01 00:00:00
abstract:PURPOSE:Survivors of critical illness are frequently unable to return to their premorbid level of psychocognitive functioning following discharge. Therefore, we aimed to evaluate the burden of psychological trauma experienced by patients in the intensive care unit (ICU) as perceived by clinicians to assess factors that...
journal_title:Journal of critical care
pub_type: 杂志文章
doi:10.1016/j.jcrc.2016.09.008
更新日期:2017-02-01 00:00:00
abstract:INTRODUCTION:Ventilator-associated pneumonia (VAP) is difficult to diagnose. Recent data suggest quantitative endotracheal aspirate (ETA) may be noninferior diagnostically to quantitative bronchoalveolar lavage (BAL). We hypothesized this would be the case. METHODS:Blind quantitative ETA and BAL were performed on 150 ...
journal_title:Journal of critical care
pub_type: 杂志文章
doi:10.1016/j.jcrc.2008.06.012
更新日期:2009-09-01 00:00:00
abstract:PURPOSE:The aims of the study were to assess opinions of caregivers, families, and patients about involvement of families in the care of intensive care unit (ICU) patients; to evaluate the prevalence of symptoms of anxiety and depression in family members; and to measure family satisfaction with care. MATERIALS AND ME...
journal_title:Journal of critical care
pub_type: 杂志文章
doi:10.1016/j.jcrc.2010.03.001
更新日期:2010-12-01 00:00:00
abstract:PURPOSE:The response to inhaled nitric oxide (iNO) is inconsistent in patients with acute respiratory distress syndrome (ARDS). We sought to determine whether the response to iNO, defined as 20% Pao(2)/Fio(2) increase from baseline, depends on the level of cardiac natriuretic peptides. MATERIALS AND METHODS:This is a ...
journal_title:Journal of critical care
pub_type: 杂志文章
doi:10.1016/j.jcrc.2008.10.014
更新日期:2010-03-01 00:00:00
abstract:PURPOSE:Optimal red blood cell (RBC) transfusion thresholds in acute brain injury (ABI) are poorly defined. MATERIALS AND METHODS:We conducted a retrospective cohort study of adult patients with ABI and moderate anemia (Hb 7-10 g/dL) in a neurological intensive care unit (ICU) at an academic medical center between 200...
journal_title:Journal of critical care
pub_type: 杂志文章
doi:10.1016/j.jcrc.2018.11.006
更新日期:2019-04-01 00:00:00