Abstract:
INTRODUCTION:Emergence of multidrug-resistant (MDR) gram-negative (GN) pathogens and lack of novel antibiotics have increased the use of colistin, despite unknown optimal dosing. This study aimed to evaluate the safety and efficacy of a colistin loading dose, high-dose (LDHD) maintenance regimen in patients with MDR-GN pneumonia. METHODS:A retrospective cohort analysis was performed comparing critically ill patients with MDR-GN pneumonia pre- and postimplementation of a colistin LDHD guideline with a primary outcome of clinical cure. Safety was assessed using incidence of acute kidney injury (AKI) based on RIFLE (risk, injury, failure, loss, end-stage renal disease) criteria. RESULTS:Seventy-two patients met the inclusion criteria (42 preimplementation and 30 postimplementation). Clinical cure was achieved in 23 (55%) patients in the preimplementation group and 20 (67%) patients in the postimplementation group ( P = .31). AKI occurred in 50% of the patients during the preimplementation period and 58% during the postimplementation period ( P = .59) with no difference in initiation rates of renal replacement therapy. CONCLUSION:The increased clinical cure rate after implementation of the colistin LDHD guideline did not reach statistical significance. The LDHD guideline, however, was not associated with an increased incidence of AKI, despite higher intravenous colistin doses. Opportunity exists to optimize colistin dosage while balancing toxicity, but larger studies are warranted.
journal_name
J Intensive Care Medjournal_title
Journal of intensive care medicineauthors
Elefritz JL,Bauer KA,Jones C,Mangino JE,Porter K,Murphy CVdoi
10.1177/0885066616646551subject
Has Abstractpub_date
2017-09-01 00:00:00pages
487-493issue
8eissn
0885-0666issn
1525-1489pii
0885066616646551journal_volume
32pub_type
杂志文章abstract::This was a retrospective observational study in a pediatric intensive care unit, in which 19 patients received levosimendan. There were no adverse events attributable to levosimendan and no instances where the clinical condition worsened after administration. Arterial lactate levels decreased significantly following l...
journal_title:Journal of intensive care medicine
pub_type: 杂志文章
doi:10.1177/0885066606287039
更新日期:2006-05-01 00:00:00
abstract::Acute adrenocortical insufficiency is a critical care emergency characterized by hemodynamic instability, lethargy, and cardiovascular collapse. Acute adrenal insufficiency has many etiologies, from rapid withdrawal of exogenous glucocorticoids to adrenocortical destruction to poor adrenal reserve after administration...
journal_title:Journal of intensive care medicine
pub_type: 杂志文章,评审
doi:10.1177/0885066606298140
更新日期:2007-03-01 00:00:00
abstract::Cardiac transplantation has now become accepted therapy for the treatment of end-stage heart disease in both children and adults, and literally thousands of patients are bearers of cardiac grafts. Because of these patients' susceptibility to infections, rejection, coronary disease, and malignancy, as well as to serio...
journal_title:Journal of intensive care medicine
pub_type: 杂志文章,评审
doi:10.1177/088506669100600201
更新日期:1991-03-01 00:00:00
abstract:OBJECTIVE:When patients deteriorate after decannulation from extracorporeal membrane oxygenation (ECMO), a second run of extracorporeal support may be considered. However, repeat cannulation can be difficult and poor outcomes associated with multiple ECMO runs are a concern. The aim of this study was to evaluate outcom...
journal_title:Journal of intensive care medicine
pub_type: 杂志文章
doi:10.1177/0885066620981903
更新日期:2020-12-22 00:00:00
abstract:PURPOSE:The aim of this study was to check if serum lactate was independently associated with mortality among critically ill patients. MATERIALS AND METHODS:This was a single-center, retrospective cohort study. All adult patients (>18 years of age) who had at least 1 measurement of lactate within 24 hours of admission...
journal_title:Journal of intensive care medicine
pub_type: 杂志文章
doi:10.1177/0885066619854355
更新日期:2020-11-01 00:00:00
abstract::Objectives: Standard management strategies for lowering intracranial pressure (ICP) in traumatic brain injury has been well-studied, but the use of lesser known interventions for ICP in subarachnoid hemorrhage (SAH) remains elusive. Searches were performed in PubMed and EBSCO Host to identify best available evidence f...
journal_title:Journal of intensive care medicine
pub_type: 杂志文章,评审
doi:10.1177/0885066618813073
更新日期:2020-03-01 00:00:00
abstract::Hypercalcemia may be seen in a variety of clinical settings and often requires intensive management when serum calcium levels are dramatically elevated. All of the many etiologies of mild hypercalcemia can lead to severe hypercalcemia. Knowledge of the physiologic mechanisms involved in maintaining normocalcemia and b...
journal_title:Journal of intensive care medicine
pub_type: 杂志文章,评审
doi:10.1177/0885066613507530
更新日期:2015-07-01 00:00:00
abstract:OBJECTIVES:We report the case of a 28-year-old patient with systemic lupus erythematosus (SLE) with rapid onset of dyspnea and hemoptysis found to have diffuse alveolar hemorrhage (DAH) with refractory hypoxemia successfully treated with venovenous extracorporeal membrane oxygenation (ECMO). The discussion includes cli...
journal_title:Journal of intensive care medicine
pub_type: 杂志文章,评审
doi:10.1177/0885066612464335
更新日期:2014-03-01 00:00:00
abstract:INTRODUCTION:Red cell distribution width (RDW) is reflective of systemic inflammation. The objective of this study was to investigate the association between RDW (on day 1 of development of septic shock) and mortality. METHODS:A total of 279 patients with septic shock were included. We categorized the patients into qu...
journal_title:Journal of intensive care medicine
pub_type: 杂志文章
doi:10.1177/0885066612452838
更新日期:2013-09-01 00:00:00
abstract::A review of adults with septic arthritis was undertaken to evaluate outcome of treatment and intensive care requirements in a community-based teaching hospital. During an 80-month period (1986-1992), 38 cases of septic arthritis were identified. Underlying joint disease was present in 84% of patients. Mean age was 68 ...
journal_title:Journal of intensive care medicine
pub_type: 杂志文章
doi:10.1177/088506669501000507
更新日期:1995-09-01 00:00:00
abstract::Diabetes mellitus (DM) represents an enormous health care concern for the United States and other countries. According to the American Diabetes Association in 2007, there were more than 23 million Americans living with diabetes. This is a 13.5% increase from 2005, likely representing increases in Type II DM (DMII). Di...
journal_title:Journal of intensive care medicine
pub_type: 杂志文章,评审
doi:10.1177/0885066610396813
更新日期:2012-07-01 00:00:00
abstract:BACKGROUND:Morbidity associated with stress ulcer-related bleeding, the cost of medications, and the possible complications associated with stress ulcer prophylaxis are important considerations when prescribing prophylaxis. We prospectively studied the prescription patterns for stress ulcer prophylaxis in patients admi...
journal_title:Journal of intensive care medicine
pub_type: 杂志文章,多中心研究
doi:10.1177/0885066612453542
更新日期:2014-03-01 00:00:00
abstract::Neurologic complications of cancer are common and are frequently life-threatening events. Certain neurologic emergencies occur more frequently in the cancer population, specifically elevated intracranial pressure, epidural cord compression, status epilepticus, ischemic and hemorrhagic stroke, central nervous system in...
journal_title:Journal of intensive care medicine
pub_type: 杂志文章,评审
doi:10.1177/0885066615619582
更新日期:2017-02-01 00:00:00
abstract:OBJECTIVE:To describe intubation practices and duration of mechanical ventilation in children with status asthmaticus admitted from emergency departments (ERs) to pediatric intensive care units (PICUs). DESIGN:Retrospective cohort study using the Virtual PICU Performance System database (VPS, LLC) of children with sta...
journal_title:Journal of intensive care medicine
pub_type: 杂志文章,评审
doi:10.1177/0885066613476446
更新日期:2014-05-01 00:00:00
abstract:PURPOSE:We previously developed a bedside model (I-TRACH), which used commonly obtained data at the time of intubation to predict the duration of mechanical ventilation (MV). We now sought to validate this in a prospective trial. METHODS:A prospective, observational study of 225 consecutive adult medical intensive car...
journal_title:Journal of intensive care medicine
pub_type: 杂志文章
doi:10.1177/0885066616679974
更新日期:2018-10-01 00:00:00
abstract::Left ventricular assist devices (LVADs) and total artificial hearts (TAHs) are surgically implanted as permanent treatment of unrecoverable heart failure. Both LVADs and TAHs are durable mechanical circulatory support (MCS) devices that can prolong patient survival but also alter end-of-life trajectory. The permissibi...
journal_title:Journal of intensive care medicine
pub_type: 杂志文章,评审
doi:10.1177/0885066611432415
更新日期:2014-01-01 00:00:00
abstract::Decision-making for the hospitalized dying and critically ill is often characterized by an understanding of autonomy that leads to clinical care and outcomes that are antithetical to patients' preferences around suffering and quality of life. A better understanding of autonomy will facilitate the ultimate goal of a pa...
journal_title:Journal of intensive care medicine
pub_type: 杂志文章
doi:10.1177/0885066619870458
更新日期:2020-11-01 00:00:00
abstract::Primary and acquired abdominal pathology accounts for a significant proportion of sepsis and SIRS in the ICU population. Abdominal processes often present a difficult diagnostic dilemma in the truly critically ill patient who, due to hemodynamic instability or severe acute respiratory distress syndrome (ARDS) requirin...
journal_title:Journal of intensive care medicine
pub_type: 杂志文章
doi:10.1177/0885066613492102
更新日期:2015-07-01 00:00:00
abstract::The purpose of this study was to analyze the relationship of intrahospital transport patterns with patient throughput and outcomes in an oncological intensive care unit. We retrospectively reviewed all patients admitted to a closed medical-surgical intensive care unit at a cancer center between January 1, 2004 and Dec...
journal_title:Journal of intensive care medicine
pub_type: 杂志文章
doi:10.1177/0885066608329946
更新日期:2009-03-01 00:00:00
abstract::Combined poisoning with calcium-channel blockers and beta-blockers is usually associated with severe heart failure. This report shows the effectiveness of emergency extracorporeal life support in treating life-threatening simultaneous propranolol and verapamil intoxication. A 15-year-old girl presented in cardiogenic ...
journal_title:Journal of intensive care medicine
pub_type: 杂志文章
doi:10.1177/0885066607307528
更新日期:2007-11-01 00:00:00
abstract:BACKGROUND:SARS-CoV2 can cause pulmonary failure requiring prolonged invasive mechanical ventilation (MV). Lung protective ventilation strategies are recommended in order to minimize ventilator induced lung injury. Whether patients with COVID-19 have the same risk for complications including barotrauma is still unknown...
journal_title:Journal of intensive care medicine
pub_type: 杂志文章
doi:10.1177/0885066620954364
更新日期:2020-09-22 00:00:00
abstract::We report the success rate and complications of peripherally inserted central catheters (PICCs) in patients hospitalized in an intensive care unit (ICU). We performed a cohort study in the ICU of a large tertiary care, university-affiliated community hospital. All ICU patients for whom their attending physicians reque...
journal_title:Journal of intensive care medicine
pub_type: 临床试验,杂志文章
doi:10.1177/088506669601100107
更新日期:1996-01-01 00:00:00
abstract:BACKGROUND:Insulin receptors (IRs) in the brain have unique molecular features and a characteristic pattern of distribution. Their possible functions extend beyond glucose utilization. In this systematic review, we explore the interactions between insulin and the brain and its implications for anesthesiologists, critic...
journal_title:Journal of intensive care medicine
pub_type: 杂志文章,评审
doi:10.1177/0885066615594341
更新日期:2017-01-01 00:00:00
abstract::Patients admitted to the cardiac intensive care unit (CICU) are often in shock and require hemodynamic support. Identifying and addressing the pathophysiology mechanisms operating in an individual patient is crucial to achieving a successful outcome, while initiating circulatory support therapy to restore adequate tis...
journal_title:Journal of intensive care medicine
pub_type: 杂志文章
doi:10.1177/0885066620917630
更新日期:2020-04-13 00:00:00
abstract:PURPOSE:The strategy used to improve effective checklist use in intensive care unit (ICU) setting is essential for checklist success. This study aimed to test the hypothesis that an electronic checklist could reduce ICU provider workload, errors, and time to checklist completion, as compared to a paper checklist. METH...
journal_title:Journal of intensive care medicine
pub_type: 杂志文章
doi:10.1177/0885066614558015
更新日期:2016-03-01 00:00:00
abstract:INTRODUCTION:Visualization of B-lines via lung ultrasound provides a non-invasive estimation of pulmonary hydration. Extravascular lung water index (EVLWI) and pulmonary vascular permeability index (PVPI) assessed by transpulmonary thermodilution (TPTD) represent the most validated parameters of lung water and alveoloc...
journal_title:Journal of intensive care medicine
pub_type: 杂志文章
doi:10.1177/0885066620967655
更新日期:2020-11-05 00:00:00
abstract:OBJECTIVE::To analyze the management and outcome of patients with refractory respiratory failure complicating severe Legionella pneumonia rescued with extracorporeal membrane oxygenation (ECMO) in our Center. DESIGN AND SETTING::Observational study of patients with refractory respiratory failure treated with ECMO in H...
journal_title:Journal of intensive care medicine
pub_type: 杂志文章
doi:10.1177/0885066617700121
更新日期:2019-04-01 00:00:00
abstract:BACKGROUND:Circulatory shock affects every third patient in intensive care units and is associated with high mortality. Near-infrared spectroscopy (NIRS) could serve as a means for monitoring tissue perfusion in circulatory shock. PURPOSE:To assess the evidence of NIRS monitoring in circulatory shock, we conducted a s...
journal_title:Journal of intensive care medicine
pub_type: 杂志文章
doi:10.1177/0885066620907307
更新日期:2020-10-01 00:00:00
abstract::Pulmonary embolus (PE) is estimated to cause 200 000 to 300 000 deaths annually. Many deaths occur in hemodynamically unstable patients and the estimated mortality for inpatients with hemodynamic instability is between 15% and 25%. The diagnosis of PE in the critically ill is often challenging because the presentation...
journal_title:Journal of intensive care medicine
pub_type: 杂志文章,评审
doi:10.1177/0885066610392658
更新日期:2011-09-01 00:00:00
abstract:UNLABELLED:While clinicians' management of severe sepsis and septic shock has been positively influenced by a number of clinical research studies in the last decade, challenges remain regarding early hemodynamic optimization as envisioned in the Surviving Sepsis Campaign's (SSC) resuscitation bundle (RB). We examined t...
journal_title:Journal of intensive care medicine
pub_type: 杂志文章
doi:10.1177/0885066610392499
更新日期:2011-09-01 00:00:00