Abstract:
OBJECTIVES:Extracorporeal membrane oxygenation is increasingly used in the management of severe acute respiratory distress syndrome. With extracorporeal membrane oxygenation, select patients with acute respiratory distress syndrome can be managed without mechanical ventilation, sedation, or neuromuscular blockade. Published experience with this approach, specifically with attention to a patient's respiratory drive following cannulation, is limited. DESIGN:We describe our experience with three consecutive patients with severe acute respiratory distress syndrome supported with right jugular-femoral configuration of venovenous extracorporeal membrane oxygenation without therapeutic anticoagulation as an alternative to lung-protective mechanical ventilation. Outcomes are reported including daily respiratory rate, vital capacities, and follow-up pulmonary function testing. RESULTS:Following cannulation, patients were extubated within 24 hours. During extracorporeal membrane oxygenation support, all patients were able to maintain a normal respiratory rate and experienced steady improvements in vital capacities. Patients received oral nutrition and ambulated daily. At follow-up, no patients required supplemental oxygen. CONCLUSIONS:Our results suggest that venovenous extracorporeal membrane oxygenation can provide a safe and effective alternative to lung-protective mechanical ventilation in carefully selected patients. This approach facilitates participation in physical therapy and avoids complications associated with mechanical ventilation.
journal_name
Crit Care Medjournal_title
Critical care medicineauthors
Kurihara C,Walter JM,Singer BD,Cajigas H,Shayan S,Al-Qamari A,DeCamp MM,Wunderink R,Budinger GRS,Bharat Adoi
10.1097/CCM.0000000000003354subject
Has Abstractpub_date
2018-11-01 00:00:00pages
e1070-e1073issue
11eissn
0090-3493issn
1530-0293journal_volume
46pub_type
杂志文章abstract:OBJECTIVES:Studies have shown contradicting results on the association of nursing workload and mortality. Most of these studies expressed workload as patients per nurse ratios; however, this does not take into account that some patients require more nursing time than others. Nursing time can be quantified by tools like...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/CCM.0000000000004005
更新日期:2020-01-01 00:00:00
abstract:OBJECTIVE:Effective therapies are needed to reverse the increased vascular permeability that characterizes acute inflammatory diseases such as acute lung injury. FTY720 is a pharmaceutical analog of the potent barrier-enhancing phospholipid, sphingosine 1-phosphate. Because both FTY720 and sphingosine 1-phosphate have ...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/CCM.0000000000000097
更新日期:2014-03-01 00:00:00
abstract:OBJECTIVE:To appraise the literature on the effect of initial renal replacement therapy (RRT) modality on clinical outcomes. DESIGN:Systematic review and meta-analysis. SETTING:Academic medical center. PATIENTS AND PARTICIPANTS:Adult critically ill patients with acute kidney injury. INTERVENTIONS:Continuous vs. int...
journal_title:Critical care medicine
pub_type: 杂志文章,meta分析,评审
doi:10.1097/01.CCM.0B013E3181611F552
更新日期:2008-02-01 00:00:00
abstract:OBJECTIVES:To assess the reversibility of acute kidney injury-induced neutrophil dysfunction and to identify involved mechanisms. DESIGN:Controlled laboratory experiment and prospective observational clinical study. SETTING:University laboratory and hospital. SUBJECTS:C57BL/6 wild-type mice. PATIENTS:Patients with ...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/CCM.0000000000001472
更新日期:2016-07-01 00:00:00
abstract:OBJECTIVE:The demand for intensive care beds far exceeds their availability in many European countries. Consequently, many critically ill patients occupy hospital beds outside intensive care units, throughout the hospital. The outcome of patients who fit intensive care unit admission criteria but are hospitalized in re...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/01.ccm.0000133021.22188.35
更新日期:2004-08-01 00:00:00
abstract:OBJECTIVES:Cardiac surgery-associated acute kidney injury occurs in up to 50% of patients and is associated with increased mortality and morbidity. This study aimed to discover if perioperative urinary alkalinization with sodium bicarbonate infusion reduces the prevalence of cardiac surgery-associated acute kidney inju...
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.0b013e31828a3f99
更新日期:2013-07-01 00:00:00
abstract:OBJECTIVE:The receptor for advanced glycation end products mediates a variety of inflammatory responses. Soluble receptor for advanced glycation end products has been suggested to function as a decoy abrogating cellular activation. High-mobility group box 1 is a high-affinity binding ligand for the receptor for advance...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/CCM.0b013e3181de18bc
更新日期:2010-06-01 00:00:00
abstract::The venous-arterial PCO2 gradient may increase in certain low-flow states, such as CPR and canine endotoxemia. To determine whether venous hypercarbia also occurs in hemorrhagic shock, we studied 12 anesthetized, mechanically ventilated dogs. We performed laparotomies on the animals, inserting catheters into their ren...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/00003246-198705000-00013
更新日期:1987-05-01 00:00:00
abstract::To correlate radiant warmer bed power output with state of hydration in the critically ill infant, warmer power input was measured by a wattmeter and recorded by an on-line computer every 5 sec for 2 periods of 8-24 h each in 11 newborns with respiratory distress syndrome (mean birth weight 1.42 kg, mean gestational a...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/00003246-198210000-00012
更新日期:1982-10-01 00:00:00
abstract:OBJECTIVE:Monitoring of ventilation performance during cardiopulmonary resuscitation would be desirable to improve the quality of cardiopulmonary resuscitation. To investigate the potential for measuring ventilation rate and inspiration time, we calculated the correlation in waveform between transthoracic impedance mea...
journal_title:Critical care medicine
pub_type: 评论,杂志文章
doi:10.1097/01.CCM.0000235666.40378.60
更新日期:2006-09-01 00:00:00
abstract:OBJECTIVES:Clinical providers have access to a number of pharmacologic agents during in-hospital cardiac arrest. Few studies have explored medication administration patterns during in-hospital cardiac arrest. Herein, we examine trends in use of pharmacologic interventions during in-hospital cardiac arrest both over tim...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/CCM.0000000000003506
更新日期:2019-02-01 00:00:00
abstract:OBJECTIVES:Hyperammonemia is a key contributing factor for cerebral edema in acute liver failure. Continuous renal replacement therapy may help reduce ammonia levels. However, the optimal timing, mode, intensity, and duration of continuous renal replacement therapy in this setting are unknown. We aimed to study continu...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/CCM.0000000000004153
更新日期:2020-02-01 00:00:00
abstract:OBJECTIVE:Procalcitonin has been advocated as a specific biomarker for bacterial infection. We performed this study to determine whether accuracy of procalcitonin for diagnosis of postoperative bacterial infection is affected by renal function after aortic surgery. DESIGN:Single-center prospective study. SETTING:Univ...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/CCM.0b013e3181692966
更新日期:2008-04-01 00:00:00
abstract:OBJECTIVES:Extracellular mitochondrial DNA and N-formyl peptides released following tissue damage may contribute to systemic inflammation through stimulation of the innate immune system. In this review, we evaluate existing in vivo human data regarding a role for mitochondrial DNA and N-formyl peptides in producing sys...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/CCM.0000000000003381
更新日期:2018-12-01 00:00:00
abstract:OBJECTIVE:This study aims to explore the relationship between team-leadership skills and quality of cardiopulmonary resuscitation in an adult cardiac-arrest simulation. Factors affecting team-leadership skills were also assessed. DESIGN:Forty advanced life-support providers leading a cardiac arrest team in a standardi...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/CCM.0b013e3182591fda
更新日期:2012-09-01 00:00:00
abstract:OBJECTIVES:Interventions that reduce the generation or the effects of reactive oxygen species exert controversial effects in animal models of lung injury, and these could be secondary to the pro-oxidant effects of antioxidants generally by their interaction with iron. We here describe the effects of N-acetylcysteine, d...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/01.ccm.0000199069.19193.89
更新日期:2006-02-01 00:00:00
abstract:OBJECTIVE:To investigate the interrelationship between cardiac surgery, age, circulating concentrations of the vitamin D hormone 1,25-dihydroxyvitamin D, and clinical outcome. DESIGN:Prospective, monocentric, two-arm parallel study. SETTING:Tertiary Heart and Diabetes Center in the Federal State of North Rhine-Westph...
journal_title:Critical care medicine
pub_type: 临床试验,杂志文章
doi:10.1097/CCM.0b013e31824e8c42
更新日期:2012-07-01 00:00:00
abstract:OBJECTIVES:In this systematic review and meta-analysis, we assessed whether a high CO2 gap predicts mortality in adult critically ill patients with circulatory shock. DATA SOURCES:A systematic search of MEDLINE and EMBASE electronic databases from inception to October 2019. STUDY SELECTION:Studies from adult (age ≥ 1...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/CCM.0000000000004578
更新日期:2020-12-01 00:00:00
abstract:OBJECTIVE:The Sequential Organ Failure Assessment (SOFA) score was developed to quantify the severity of patients' illness, based on the degree of organ dysfunction. This study aimed to evaluate the accuracy and the reliability of SOFA scoring. DESIGN:Prospective study. SETTING:Adult intensive care unit (ICU) in a te...
journal_title:Critical care medicine
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1097/01.ccm.0000178178.02574.ab
更新日期:2005-09-01 00:00:00
abstract:RATIONALE:Life and death triage decisions are made daily by intensive care unit physicians. Admission to an intensive care unit is denied when intensive care unit resources are constrained, especially for the elderly. OBJECTIVE:To determine the effect of intensive care unit triage decisions on mortality and intensive ...
journal_title:Critical care medicine
pub_type: 杂志文章,多中心研究
doi:10.1097/CCM.0b013e318232d6b0
更新日期:2012-01-01 00:00:00
abstract:OBJECTIVE:Acute aneurysmal subarachnoid hemorrhage (SAH) is a complex multifaceted disorder that plays out over days to weeks. Many patients with SAH are seriously ill and require a prolonged intensive care unit stay. Cardiopulmonary complications are common. The management of patients with SAH focuses on the anticipat...
journal_title:Critical care medicine
pub_type: 杂志文章,评审
doi:10.1097/CCM.0b013e318195865a
更新日期:2009-02-01 00:00:00
abstract::The intensive care unit (ICU) represents a hospital setting in which death and discussion about end-of-life care are common, yet these conversations are often difficult. Such difficulties arise, in part, because a family may be facing an unexpected poor prognosis associated with an acute illness or exacerbation and, i...
journal_title:Critical care medicine
pub_type: 杂志文章,评审
doi:10.1097/00003246-200102001-00006
更新日期:2001-02-01 00:00:00
abstract::The hemodynamic effects of digitalis were examined in ten patients with acute cardiac failure. Administration of 10 micrograms/kg of digoxin iv resulted in significant increases in cardiac index, stroke volume index, and left ventricular stroke work index within one hour in five patients with acute myocardial infarcti...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/00003246-198711000-00002
更新日期:1987-11-01 00:00:00
abstract::Capnography is a valuable tool in the management of cardiac arrest, since end-tidal CO2 (PetCO2) correlates well with cardiac output and there are no other suitable noninvasive ways to measure this important variable during resuscitation. Animal studies also suggest that PetCO2 correlates well with the likelihood of r...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/00003246-199004000-00002
更新日期:1990-04-01 00:00:00
abstract:OBJECTIVE:The aim of the present study was to characterize pulmonary surfactant properties in children undergoing cardiovascular surgery with cardiopulmonary bypass. DESIGN:Prospective clinical trial. SETTING:University hospital pediatric intensive care unit. PATIENTS:Fifty pediatric patients with congenital cardiac...
journal_title:Critical care medicine
pub_type: 临床试验,杂志文章
doi:10.1097/00003246-200301000-00045
更新日期:2003-01-01 00:00:00
abstract:OBJECTIVE:In patients undergoing surgical repair of aortic dissection, false lumen perfusion during cardiopulmonary bypass may produce central nervous system damage, myocardial ischemia, aortic rupture, and death. We describe a method to detect false lumen perfusion at the beginning of retrograde aortic perfusion that ...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/00003246-200006000-00026
更新日期:2000-06-01 00:00:00
abstract:OBJECTIVES:The absence of N20 somatosensory evoked potential after cardiac arrest is related to poor outcome. However, discrimination between the low-amplitude and the absence of N20 is challenging. P25 and P30 are short-latency positive peaks with latencies between 25 and 30 ms following N20 (P25/30). P25/30 is eviden...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/CCM.0000000000003083
更新日期:2018-06-01 00:00:00
abstract:OBJECTIVES:Cardiac arrest etiology may be an important source of between-patient heterogeneity, but the impact of etiology on organ injury is unknown. We tested the hypothesis that asphyxial cardiac arrest results in greater neurologic injury than cardiac etiology cardiac arrest (ventricular fibrillation cardiac arrest...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/CCM.0000000000003070
更新日期:2018-06-01 00:00:00
abstract:OBJECTIVE:To evaluate the hypothesis that splanchnic ischemia and mucosal hypoxia are responsible for lipopolysaccharide-induced intramucosal acidosis in pigs. DESIGN:Prospective, randomized, unblinded study. SETTING:Surgical research laboratory at a large, university-affiliated medical center. SUBJECTS:Anesthetized...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/00003246-199507000-00011
更新日期:1995-07-01 00:00:00
abstract:OBJECTIVES:The results from the recent Targeted Temperature Management trial raised the question whether cooling or merely the avoidance of fever mediates better neurologic outcome in resuscitated patients. As temperature per se is a major determinant of cardiac function, we characterized the effects of hyperthermia (4...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/CCM.0000000000001358
更新日期:2016-03-01 00:00:00