Abstract:
OBJECTIVE:To evaluate the hospital survival in patients with severe ARDS managed with ECMO and low tidal volume ventilation as compared to patients managed with low tidal volume ventilation alone. METHODS:Electronic databases were searched for studies of at least 10 adult patients with severe ARDS comparing the use of ECMO with low tidal volume ventilation to mechanical ventilation with a low tidal volume alone. Only studies reporting hospital or ICU survival were included. All identified studies were assessed independently by two reviewers. RESULTS:Of 1782 citations, 27 studies (n=1674) met inclusion criteria. Hospital survival for ECMO patients ranged from 33.3 to 86%, while survival with conventional therapy ranged from 36.3 to 71.2%. Five studies were identified with appropriate control groups allowing comparison, but due to the high degree of variability between studies (I2=63%), their results could not be pooled. Two of these studies demonstrated a significant difference, both favouring ECMO over conventional therapy. CONCLUSION:Given the lack of studies with appropriate control groups, our confidence in a difference in outcome between the two therapies remains weak. Future studies on the use of ECMO for severe ARDS are needed to clarify the role of ECMO in this disease.
journal_name
J Crit Carejournal_title
Journal of critical careauthors
Tillmann BW,Klingel ML,Iansavichene AE,Ball IM,Nagpal ADdoi
10.1016/j.jcrc.2017.04.041subject
Has Abstractpub_date
2017-10-01 00:00:00pages
64-71eissn
0883-9441issn
1557-8615pii
S0883-9441(16)30707-9journal_volume
41pub_type
杂志文章,评审abstract:BACKGROUND:A nationwide increase in the rate and severity of Clostridium difficile-associated disease may reflect infection with a virulent strain characterized by polymerase chain reaction as ribotype 027 (NAP1/B1). HYPOTHESIS:The high prevalence of ribotype 027 at our institution would allow investigation of the ris...
journal_title:Journal of critical care
pub_type: 杂志文章
doi:10.1016/j.jcrc.2009.04.002
更新日期:2010-06-01 00:00:00
abstract::Integral to the management of the neurocritically injured patient are the prevention and treatment of hypotension, maintenance of cerebral perfusion pressure, and occasionally blood pressure augmentation. When adequate volume resuscitation fails to meet perfusion needs, vasopressors are often used to restore end-organ...
journal_title:Journal of critical care
pub_type: 杂志文章
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更新日期:2016-08-01 00:00:00
abstract:PURPOSE:To investigate the impact of delay in rapid response call (RRC) activation on Hospital mortality. MATERIALS AND METHODS:This study was conducted in a university affiliated hospital providing medical, surgical, mental health, maternity, and pediatric services. RRCs were considered delayed if RRC activation was ...
journal_title:Journal of critical care
pub_type: 杂志文章
doi:10.1016/j.jcrc.2017.05.006
更新日期:2017-10-01 00:00:00
abstract:PURPOSE:This study compared clinical outcomes associated with exposure to pulmonary artery catheters (PACs), central venous catheters (CVCs), arterial pressure waveform analysis for cardiac output (APCO), or no central monitoring (NCM) in patients with shock. MATERIALS AND METHODS:We assessed 6929 consecutive patients...
journal_title:Journal of critical care
pub_type: 杂志文章
doi:10.1016/j.jcrc.2010.07.001
更新日期:2011-04-01 00:00:00
abstract::Advances in the management of malignancies and organ failures have led to substantial increases in survival as well as in the number of cancer patients requiring intensive care unit (ICU) admission. Although effectiveness of ICU in this group remains controversial, the heterogeneity of its population in terms of the n...
journal_title:Journal of critical care
pub_type: 杂志文章,评审
doi:10.1016/j.jcrc.2014.04.007
更新日期:2014-10-01 00:00:00
abstract::Neurosurgical patients commonly require mechanical ventilation and monitoring in a neurocritical care unit. There are only few studies that specifically address the process of liberation from mechanical ventilation in this population. Patients who remain ventilator or artificial airway dependent receive a tracheostomy...
journal_title:Journal of critical care
pub_type: 杂志文章,评审
doi:10.1016/j.jcrc.2011.08.018
更新日期:2012-08-01 00:00:00
abstract:INTRODUCTION:Posttraumatic stress disorder (PTSD) in relatives of intensive care unit (ICU) patients has not been fully described. We studied potential relationships between PTSD and specific patients' conditions and relatives' psychologic characteristics. METHODS:This is a prospective study of family caregivers of IC...
journal_title:Journal of critical care
pub_type: 杂志文章
doi:10.1016/j.jcrc.2015.06.009
更新日期:2015-10-01 00:00:00
abstract:PURPOSE:The Fas ligand (FasL)/Fas system is an apoptosis induction system that plays an important role in homeostasis and biophylaxis. We measured tumor necrosis factor alpha (TNF-alpha), soluble FasL (sFasL), and soluble Fas (sFas) in patients with acute hepatic failure to determine the relation between such failure a...
journal_title:Journal of critical care
pub_type: 杂志文章
doi:10.1053/jcrc.2001.25470
更新日期:2001-06-01 00:00:00
abstract:BACKGROUND:It is known that acute respiratory distress syndrome and acute lung injury are independent risk factors for developing acute kidney injury (AKI) through complex pathophysiologic mechanisms. Our specific aim is to evaluate the risk factors for AKI postburn injury and whether inhalation thermal injury is an in...
journal_title:Journal of critical care
pub_type: 杂志文章
doi:10.1016/j.jcrc.2016.10.008
更新日期:2017-04-01 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::Complex microbial communities within the human body, constituting the microbiome, have a broad impact on human health and disease. A growing body of research now examines the role of the microbiome in patients with critical illness, such as sepsis and acute respiratory failure. In this article, we provide an introduct...
journal_title:Journal of critical care
pub_type: 杂志文章,评审
doi:10.1016/j.jcrc.2016.09.029
更新日期:2017-04-01 00:00:00
abstract:PURPOSE:Few guidelines exist regarding the selection of a particular type or size of tracheostomy tube. Although nonstandard tubes can be placed over the percutaneous kit dilator, clinicians often place standard tracheostomy tubes and change to nonstandard tubes only after problems arise. This practice risks early trac...
journal_title:Journal of critical care
pub_type: 杂志文章
doi:10.1016/j.jcrc.2016.05.025
更新日期:2017-02-01 00:00:00
abstract:PURPOSE:With increasing emphasis on high-quality care, we designed this study to evaluate the relationship between Magnet® recognition and patient outcomes in pediatric critical care. MATERIALS AND METHODS:Post hoc analysis of data from an existing administrative national database. We used inverse probability of treat...
journal_title:Journal of critical care
pub_type: 杂志文章
doi:10.1016/j.jcrc.2017.09.004
更新日期:2018-02-01 00:00:00
abstract:PURPOSE:Utilization of renal replacement therapy (RRT) in cirrhotic patients has been controversial and is typically dependent on the status of transplantation. A better understanding of the central role for arterial vasodilatation in the pathogenesis of hepatorenal syndrome (HRS) has led to routine use of vasoconstric...
journal_title:Journal of critical care
pub_type: 杂志文章
doi:10.1016/j.jcrc.2015.05.006
更新日期:2015-10-01 00:00:00
abstract:PURPOSE:To investigate microorganisms causing central venous catheter contamination and how this contamination differs across different catheter metrics. MATERIALS AND METHODS:After obtaining IRB approval and informed consent, 830 cultures were prospectively obtained from 45 ICU patients with central venous catheter o...
journal_title:Journal of critical care
pub_type: 杂志文章
doi:10.1016/j.jcrc.2017.02.035
更新日期:2017-06-01 00:00:00
abstract:PURPOSE:The aim of this study was to assess the pharmacokinetics of individualized amikacin single-dosage regimens targeting low peak serum concentrations in a population of intensive care unit (ICU) patients, and to describe the outcomes associated with this dosing strategy. MATERIALS AND METHODS:In this prospective,...
journal_title:Journal of critical care
pub_type: 临床试验,杂志文章
doi:10.1053/jcrc.2003.50003
更新日期:2003-06-01 00:00:00
abstract:PURPOSE:The aim of this study was to determine the incidence of pressure ulcers (PUs) in ventilated patients in all intensive care units (ICUs) in Granada (Spain) and identify risk factors for their development. MATERIALS AND METHODS:A prospective cohort study in 9 medical-surgical ICUs was conducted. Two hundred nine...
journal_title:Journal of critical care
pub_type: 杂志文章
doi:10.1016/j.jcrc.2009.09.002
更新日期:2010-09-01 00:00:00
abstract::This paper focuses on the use of data from an electronic medical record (EMR) within a multi-facility health care organization. It describes how health provider workflow is enhanced by extracting data from multiple sources in a near real-time fashion and presenting it to the user in ways that are unavailable in the el...
journal_title:Journal of critical care
pub_type: 杂志文章
doi:10.1016/j.jcrc.2004.09.003
更新日期:2004-12-01 00:00:00
abstract:PURPOSE:To find predictors of intensive care unit (ICU) requirement within the first 48 hours in newly diagnosed sepsis patients presenting at the emergency department. MATERIALS AND METHODS:Analysis of a prospective observational cohort was performed. We recruited new sepsis patients at the emergency department, and ...
journal_title:Journal of critical care
pub_type: 杂志文章
doi:10.1016/j.jcrc.2016.01.019
更新日期:2016-06-01 00:00:00
abstract::The science of safety is well established in such disciplines as the automotive and aviation industry. In this brief history of safety science as it pertains to patient care, we review remote and recent publications that have guided the maturation of this field that has particular relevance to the complex structure of...
journal_title:Journal of critical care
pub_type: 历史文章,杂志文章
doi:10.1016/j.jcrc.2005.02.003
更新日期:2005-03-01 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:BACKGROUNDS:Using biomarkers to predict mortality in patient with severe sepsis or septic shock is of importance, as these patients frequently have high mortality and unsatisfied outcome. N-terminal pro-brain natriuretic peptide (NT-proBNP) and cardiac troponin I (cTnI) play extremely important roles in prognostic valu...
journal_title:Journal of critical care
pub_type: 杂志文章
doi:10.1016/j.jcrc.2014.12.008
更新日期:2015-06-01 00:00:00
abstract:PURPOSE:Cervical spine (CS) injury in blunt trauma is a prevalent and devastating complication. Clearing CS injuries in obtunded patients is fraught with challenges, and no single imaging modality or algorithm is both safe and effective. Increased time in c-spine precautions is associated with greater patient morbidity...
journal_title:Journal of critical care
pub_type: 杂志文章,评审
doi:10.1016/j.jcrc.2013.10.022
更新日期:2014-04-01 00:00:00
abstract:OBJECTIVE:To determine whether the systolic fraction (SF) of the pulmonary venous flow (PVF), measured by transesophageal echocardiography (TEE) could be used to estimate the pulmonary artery occlusion pressure (PAOP). DESIGN:Prospective clinical investigation. PATIENTS:Nineteen intubated patients with ARDS. INTERVE...
journal_title:Journal of critical care
pub_type: 临床试验,杂志文章
doi:10.1016/j.jcrc.2004.07.009
更新日期:2004-09-01 00:00:00
abstract:PURPOSE:Rescue organ offers may help to overcome the organ shortage. However, because of initial poor liver function, the recipient may develop a severe lung injury with the requirement for higher positive end-expiratory pressure (PEEP) levels to achieve adequate oxygenation. Positive end-expiratory pressure has been a...
journal_title:Journal of critical care
pub_type: 杂志文章
doi:10.1016/j.jcrc.2009.11.002
更新日期:2010-09-01 00:00:00
abstract:OBJECTIVE:The purpose of the study was to investigate the pharmacokinetics of combined intravenous (i.v.) and intracerebroventricular (i.c.v.) vancomycin for patients with intracranial infections after craniotomy and to provide the basis for establishing the intracranial local administration criterion. METHODS:Fourtee...
journal_title:Journal of critical care
pub_type: 杂志文章
doi:10.1016/j.jcrc.2014.09.020
更新日期:2015-02-01 00:00:00
abstract:PURPOSE:To assess the safety of medical-ward bedside percutaneous dilatational tracheostomy (GWB-PDT). MATERIALS AND METHODS:A retrospective study of all patients who underwent elective GWB-PDT between 2009 and 2015. A joint otolaryngology-ICU team performed all GWB-PDTs. The patients were followed until decannulation...
journal_title:Journal of critical care
pub_type: 杂志文章
doi:10.1016/j.jcrc.2018.06.020
更新日期:2018-10-01 00:00:00
abstract:PURPOSE:Interhospital critical care transfers are common, yet few studies address the underlying reasons for transfers. We examined clinician and patient/surrogate perceptions about interhospital transfers and assessed their agreement on these transfers. MATERIALS AND METHODS:This is a mixed-mode survey of 3 major sta...
journal_title:Journal of critical care
pub_type: 杂志文章
doi:10.1016/j.jcrc.2012.07.027
更新日期:2013-04-01 00:00:00
abstract:PURPOSE:To define the incidence of healthcare-associated ventriculitis and meningitis (HAVM) in the neuro-ICU and to identify HAVM risk factors using tree-based machine learning (ML) algorithms. METHODS:An observational cohort study was conducted in Russia from 2010 to 2017, and included high-risk neuro-ICU patients. ...
journal_title:Journal of critical care
pub_type: 杂志文章
doi:10.1016/j.jcrc.2018.01.022
更新日期:2018-06-01 00:00:00
abstract:BACKGROUND:Metabolic acidosis is highly prevalent in critically ill patients with acute renal failure. Little is known about the mechanisms by which renal replacement therapy intervenes in such cases. The objective of this study is to analyze the role of hemodialysis in acidosis correction in intensive care unit patien...
journal_title:Journal of critical care
pub_type: 杂志文章
doi:10.1016/j.jcrc.2006.03.011
更新日期:2006-12-01 00:00:00