Abstract:
PURPOSE:Nearly all sepsis trials report no statistically significant difference in mortality. The attributable fraction of deaths due to sepsis (AFsepsis) may be an important, yet overlooked consideration. We derived AFsepsis and explored the effect of incorporating AFsepsis into sample size calculations. MATERIALS AND METHODS:We derived AFsepsis with a matched cohort study using consecutive admissions to adult general intensive care units (ICUs) in England (n = 614,509). Cases were ICU patients with sepsis and the two controls were ICU-non-sepsis controls, matched for propensity to have sepsis and age-sex-matched general population. The primary exposure was sepsis. The primary outcome was hospital mortality. We generated sample size graphs, by varying control group mortality (10%-60%), relative risk reduction (0-1), for 80% power and 5% alpha. We then compared AFsepsis derived sample sizes with sample size calculations from published sepsis trials. RESULTS:AFsepsis was 15% (95% CI: 14%-16%) compared with propensity matched ICU-non-sepsis controls and 93% (95% CI: 92%-93%) compared with age-sex-matched general population controls. When comparing AFsepsis derived sample sizes with sample size calculations from 18 trials meeting our selection criteria, these calculations assumed very high AFsepsis and/or very effective treatments. CONCLUSIONS:Estimating trial specific AFsepsis to inform sample size calculations could be an additional step in sepsis trial design.
journal_name
J Crit Carejournal_title
Journal of critical careauthors
Shankar-Hari M,Harrison DA,Rowan KM,Rubenfeld GDdoi
10.1016/j.jcrc.2018.01.018subject
Has Abstractpub_date
2018-06-01 00:00:00pages
33-39eissn
0883-9441issn
1557-8615pii
S0883-9441(17)31892-0journal_volume
45pub_type
杂志文章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:The specific norepinephrine dose at which epinephrine should be added in septic shock is unclear. This study sought to determine the norepinephrine-equivalent dose at epinephrine initiation that correlated with hemodynamic stability. METHODS:Septic shock patients receiving both norepinephrine and epinephrine w...
journal_title:Journal of critical care
pub_type: 杂志文章
doi:10.1016/j.jcrc.2019.05.024
更新日期:2019-10-01 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:HYPOTHESIS:As vasopressin is a small peptide, its sieving coefficient (SC) and clearance (CL) during continuous renal replacement therapy may be intermediate to those for urea and β2 microglobulin (commonly used markers for small- and middle-molecular weight solutes, respectively). METHODS:A prospective, minimal-risk ...
journal_title:Journal of critical care
pub_type: 杂志文章
doi:10.1016/j.jcrc.2010.03.005
更新日期:2010-12-01 00:00:00
abstract::Invasive pulmonary aspergillosis (IPA) is an emerging and life-threatening infectious disease in patients admitted to the intensive care unit (ICU). Most diagnostic studies are conducted in hematological patients and results cannot readily be transferred to ICU patients lacking classical host factors. In a multicenter...
journal_title:Journal of critical care
pub_type: 杂志文章,多中心研究
doi:10.1016/j.jcrc.2018.07.001
更新日期:2018-10-01 00:00:00
abstract:PURPOSE:Acute kidney injury (AKI) is prevalent in critically ill patients and associated with poor outcomes. Current AKI diagnostics- changes to serum creatinine (SCr) and urine output- are imprecise. Integration of injury biomarkers with SCr may improve diagnostic precision. METHODS:We performed a secondary analysis ...
journal_title:Journal of critical care
pub_type: 杂志文章
doi:10.1016/j.jcrc.2019.05.017
更新日期:2019-10-01 00:00:00
abstract:PURPOSE:Analgesia and sedation protocols (ASPs) reduce duration of mechanical ventilation (MV) in the medical intensive care unit (ICU), but data in the surgical ICU (SICU) are limited. The objective of this study was to determine the impact of a nursing-driven ASP with criteria for infusion initiation in the SICU. MA...
journal_title:Journal of critical care
pub_type: 杂志文章
doi:10.1016/j.jcrc.2018.11.029
更新日期:2019-04-01 00:00:00
abstract:PURPOSE:Early mobilization in intensive care unit (ICU) is safe, feasible, and beneficial. However, mobilization frequently does not occur in practice. The study objective was to elicit attitudinal, normative, and control beliefs (barriers and enablers) toward the mobilization of ventilated patients, to inform developm...
journal_title:Journal of critical care
pub_type: 杂志文章
doi:10.1016/j.jcrc.2015.08.010
更新日期:2015-12-01 00:00:00
abstract:PURPOSE:Genetic deletions decreasing serum alpha-Klotho (alpha-KL) have been associated with rapid aging, multi-organ failure and increased mortality in experimental sepsis. We hypothesized that lower alpha-KL obtained at the onset of septic shock correlates with higher mortality. MATERIALS AND METHODS:Prospective coh...
journal_title:Journal of critical care
pub_type: 杂志文章
doi:10.1016/j.jcrc.2017.11.023
更新日期:2018-04-01 00:00:00
abstract:PURPOSE:The purpose of this study is to assess lipid metabolism at the tissue level in critically ill subjects. MATERIALS AND METHODS:We studied 182 patients with systemic inflammatory response syndrome/severe sepsis or shock during the acute (day 1) and subacute phase of critical illness (day 6). All subjects had a t...
journal_title:Journal of critical care
pub_type: 杂志文章
doi:10.1016/j.jcrc.2014.06.003
更新日期:2014-12-01 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::Quantitative lung computed tomographic (CT) analysis yields objective data regarding lung aeration but is currently not used in clinical routine primarily because of the labor-intensive process of manual CT segmentation. Automatic lung segmentation could help to shorten processing times significantly. In this study, w...
journal_title:Journal of critical care
pub_type: 杂志文章
doi:10.1016/j.jcrc.2016.11.001
更新日期:2017-12-01 00:00:00
abstract:PURPOSE:The goal of this study was to describe long-term survival and health-related quality of life (HRQoL), measured by EQ-6D, in a general intensive care unit (ICU) population. MATERIALS AND METHODS:We included 5934 consecutive adult patients admitted to a mixed-population ICU. There were no exclusion criteria. One...
journal_title:Journal of critical care
pub_type: 杂志文章
doi:10.1016/j.jcrc.2014.09.009
更新日期:2015-02-01 00:00:00
abstract:PURPOSE:The present study tested the hypothesis that scorpion sting induces left ventricular (LV) hypokinesia and myocardial ischemia shortly after injection due to reduction of coronary blood flow (CBF) and increased oxygen demand. METHODS:In 5 mechanically ventilated, open-chest dogs, we measured LV function followi...
journal_title:Journal of critical care
pub_type: 杂志文章
doi:10.1016/0883-9441(94)90024-8
更新日期:1994-06-01 00:00:00
abstract:PURPOSE:There is a paucity of literature to support undertaking emergency laparotomy when indicated in patients supported on ECMO. Our study aims to identify the prevalence, outcomes and complications of this high risk surgery at a large ECMO centre. MATERIALS AND METHODS:A single centre, retrospective, observational ...
journal_title:Journal of critical care
pub_type: 杂志文章
doi:10.1016/j.jcrc.2019.06.021
更新日期:2019-10-01 00:00:00
abstract:PURPOSE:To evaluate the efficacy and safety of mild induced hypothermia for intracranial hypertension in patients with traumatic brain injury after decompressive craniectomy. METHODS:A total of 60 adults with intracranial pressure (ICP) of more than 20 mm Hg after decompressive craniectomy were randomly assigned to st...
journal_title:Journal of critical care
pub_type: 杂志文章,随机对照试验
doi:10.1016/j.jcrc.2016.12.012
更新日期:2017-06-01 00:00:00
abstract:OBJECTIVE:To develop and internally validate a prediction rule for the presence of candidemia in patients with severe sepsis and septic shock (candidemia rule) that will fill the gap left by previous rules. To compare the accuracy of the available Candida prediction models. DESIGN:Retrospective cohort study. SETTING:...
journal_title:Journal of critical care
pub_type: 杂志文章
doi:10.1016/j.jcrc.2015.03.010
更新日期:2015-08-01 00:00:00
abstract:PURPOSE:Urinary excretion of chloride corrects metabolic acidosis, but this may be hampered in patients with impaired renal function. We explored the effects of renal function on acid-base characteristics and urinary strong ion excretion using the Stewart approach in critically ill patients with metabolic acidosis. MA...
journal_title:Journal of critical care
pub_type: 杂志文章
doi:10.1016/j.jcrc.2011.05.028
更新日期:2012-06-01 00:00:00
abstract::Critical care physicians may hear a surrogate decision-maker ask, "What would you do if she was your mother?" or "What if your father was this sick?" These kinds of questions ask more of the critical care physician than the surrogate might realize. There are deep-seated ethical, professional, and personal complexities...
journal_title:Journal of critical care
pub_type: 杂志文章
doi:10.1016/j.jcrc.2018.10.031
更新日期:2019-02-01 00:00:00
abstract:PURPOSE:Sepsis is a lethal outcome of the inflammation and coagulation process. Human interleukin (IL)-6 and tumor necrosis factor (TNF) α are well-known inflammation factors closely associated with sepsis. In the present study, we aim to investigate the association of promoter-region polymorphisms IL-6 (-174G/C) rs180...
journal_title:Journal of critical care
pub_type: 杂志文章
doi:10.1016/j.jcrc.2015.04.123
更新日期:2015-10-01 00:00:00
abstract:PURPOSE:A volume challenge is useful for determining whether cardiac output will respond to further volume loading by the Frank-Starling mechanism. To properly test this mechanism, there must be an increase in right atrial pressure (Pra) but this requires variable amounts of normal saline. The purpose of this study was...
journal_title:Journal of critical care
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1016/s0883-9441(99)90030-8
更新日期:1999-12-01 00:00:00
abstract::The use of diagnostic ultrasound by physiotherapists is not a new concept; it is frequently performed in musculoskeletal physiotherapy. Physiotherapists currently lack accurate, reliable, sensitive, and valid measurements for the assessment of the indications and effectiveness of chest physiotherapy. Thoracic ultrasou...
journal_title:Journal of critical care
pub_type: 杂志文章,评审
doi:10.1016/j.jcrc.2015.10.014
更新日期:2016-02-01 00:00:00
abstract:PURPOSE:The aim of the study was to assess agreement among 4 intensivists in diagnosing myocardial infarction (MI) in critically ill patients based on screening electrocardiograms (ECGs) and cardiac troponin (cTn) levels. METHODS:Consecutive patients admitted to a medical-surgical intensive care unit (ICU) underwent s...
journal_title:Journal of critical care
pub_type: 杂志文章
doi:10.1016/j.jcrc.2008.08.012
更新日期:2009-09-01 00:00:00
abstract:PURPOSE:To assess health-related quality of life (HRQOL) following rehabilitation of amputees suffering symmetric peripheral gangrene (SPG) after septic shock. MATERIAL AND METHODS:A retrospective cohort study was conducted in nine French specialized rehabilitation centers. Thirty-two ICU adult patients hospitalized b...
journal_title:Journal of critical care
pub_type: 杂志文章,多中心研究
doi:10.1016/j.jcrc.2019.06.027
更新日期:2019-10-01 00:00:00
abstract:PURPOSE:To validate a brief index of patient and family experiences of respect in the intensive care unit. MATERIAL AND METHODS:A survey including the 10-item ICU-RESPECT scale was administered to patients and family members in one ICU at a large west coast academic medical center. Confirmatory psychometric analyses w...
journal_title:Journal of critical care
pub_type: 杂志文章
doi:10.1016/j.jcrc.2018.03.026
更新日期:2018-08-01 00:00:00
abstract:PURPOSE:Severe sepsis is a time-dependent disease, and implementation of early treatment has been associated with mortality rate reduction. However, the literature is controversial regarding cost-effectiveness analysis of this intervention. The aim was to assess the cost-effectiveness of a managed protocol for the trea...
journal_title:Journal of critical care
pub_type: 杂志文章
doi:10.1016/j.jcrc.2014.03.008
更新日期:2014-08-01 00:00:00
abstract:PURPOSE:Prolonged exposure to normobaric hyperoxia (NH) is associated with blood leukocyte activation and sequestration in the lung. Whether NH-induced leukocyte activation and sequestration can affect extrapulmonary organs or blood cellular profile has not been systematically investigated. We studied simultaneous chan...
journal_title:Journal of critical care
pub_type: 杂志文章
doi:10.1016/j.jcrc.2005.09.057
更新日期:2006-03-01 00:00:00
abstract:OBJECTIVE:To prospectively evaluate the association between fluid overload (FO) and clinical outcomes, mortality, mechanical ventilation (MV), and duration and length of stay in a pediatric intensive care unit (PICU). METHODS:Over a 12-month period, patients who were on MV for >24h or vasoactive support were prospecti...
journal_title:Journal of critical care
pub_type: 杂志文章
doi:10.1016/j.jcrc.2017.02.023
更新日期:2017-06-01 00:00:00
abstract:PURPOSE:Diaries summarizing intensive care are routine practice in some countries, although evidence to support diary use is limited. The purpose of this study was to identify whether distress post-intensive care influences patients' and relatives' choice as to whether they would like to receive a diary and what inform...
journal_title:Journal of critical care
pub_type: 杂志文章
doi:10.1016/j.jcrc.2016.12.003
更新日期:2017-04-01 00:00:00
abstract:PURPOSE:Echocardiography is increasingly being taught to intensive care unit residents. Current training methods require teachers to closely supervise trainees individually, and are time-intensive. To reduce the time burden, dyad training (training in pairs) under simulation conditions has been shown to be non-inferior...
journal_title:Journal of critical care
pub_type: 杂志文章
doi:10.1016/j.jcrc.2018.10.009
更新日期:2019-02-01 00:00:00