Abstract：
:Appropriate antimicrobial therapy is essential to ensuring positive patient outcomes. Inappropriate or suboptimal utilization of antibiotics can lead to increased length of stay, multidrug-resistant infections, and mortality. Critically ill intensive care patients, particularly those with severe sepsis and septic shock, are at risk of antibiotic failure and secondary infections associated with incorrect antibiotic use. Through the initiation of active empiric antibiotic therapy based upon local susceptibilities, daily evaluation of signs and symptoms of infection and narrowing of antibiotic therapy when feasible, providers can streamline the treatment of common intensive care unit (ICU) infections. Optimizing antibiotic dosing through prolonged infusions can be beneficial in intensive care populations with altered pharmacokinetics. Antimicrobial stewardship teams can assist ICU providers in managing and implementing these tactics. This review will discuss the current literature on antibiotic use in the ICU applying antimicrobial stewardship strategies. Based upon the most recent evidence, ICUs would benefit from employing empiric guidelines for antibiotic use, collecting appropriate specimens and implementing molecular diagnostics, optimizing the dosing of antibiotics, and reducing the duration of total therapy. These strategies for antibiotic use have the potential to enhance patient care while preventing adverse outcomes.
journal_name
J Intensive Care Medjournal_title
Journal of intensive care medicineauthors
Campion M,Scully Gdoi
10.1177/0885066618762747subject
Has Abstractpub_date
2018-12-01 00:00:00pages
647-655issue
12eissn
0885-0666issn
1525-1489journal_volume
33pub_type
杂志文章,评审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：BACKGROUND AND OBJECTIVES:Impaired physical functioning is common and long lasting after an intensive care unit (ICU) admission. The 6-minute walk test (6MWT) is a validated and widely used test of functional capacity. This systematic review synthesizes existing data in order to: (1) evaluate 6-minute walk distance (6M...
journal_title：Journal of intensive care medicine
pub_type： 杂志文章
doi：10.1177/0885066619885838
更新日期：2019-11-05 00:00:00
abstract：:The authors retrospectively review their experience with low immunoglobulin G (IgG) levels in a pediatric ICU population over a 12-month period. The total IgG level was below the normal for age in 14 of the 20 patients. The 14 patients with a low IgG level were younger and weighed less when compared with the 6 patient...
journal_title：Journal of intensive care medicine
pub_type： 杂志文章
doi：10.1177/0885066603255905
更新日期：2003-09-01 00:00:00
abstract：:Acute brain injury (ABI) increases morbidity and mortality in patients with veno-arterial extracorporeal membrane oxygenation (VA-ECMO). Optimal neurologic monitoring methods have not been well-explicated. We studied the use of Near-infrared Spectroscopy (NIRS) to monitor cerebral regional oxygenation tissue saturatio...
journal_title：Journal of intensive care medicine
pub_type： 杂志文章
doi：10.1177/0885066620966962
更新日期：2020-10-15 00:00:00
abstract：:Transfusion-related acute lung injury (TRALI) refers to a clinical syndrome of acute lung injury that occurs in a temporal relationship with the transfusion of blood products. Because of the difficulty in making its diagnosis, TRALI is often underreported. Three not necessarily mutually exclusive hypotheses have been ...
journal_title：Journal of intensive care medicine
pub_type： 杂志文章,评审
doi：10.1177/0885066607312994
更新日期：2008-03-01 00:00:00
abstract：:The management of the critically ill patients with asthma can be rather challenging. Potentially devastating complications relating to this presentation include hypoxemia, worsening bronchospasm, pulmonary aspiration, tension pneumothorax, dynamic hyperinflation, hypotension, dysrhythmias, and seizures. In contrast to...
journal_title：Journal of intensive care medicine
pub_type： 杂志文章,评审
doi：10.1177/0885066617740079
更新日期：2018-09-01 00:00:00
abstract：:Video laryngoscopy has demonstrated utility in airway management. For the present case series, we report the use of video laryngoscopy to evaluate the airway of critically ill, mechanically ventilated patients, as a means to reduce the risk of immediate postextubation stridor by assessing the degree of laryngeal edema...
journal_title：Journal of intensive care medicine
pub_type： 杂志文章
doi：10.1177/0885066612437528
更新日期：2013-01-01 00:00:00
abstract：:Thrombolytic therapy has been established as a safe and effective therapeutic strategy in acute myocardial infarction (MI). Its efficacy is improved with early administration, although modest benefits can be demonstrated for up to 12 hours. Tissue plasminogen activator (TPA) appears to offer benefits over streptokinas...
journal_title：Journal of intensive care medicine
pub_type： 杂志文章,评审
doi：10.1177/088506669501000202
更新日期：1995-03-01 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
abstract：:Extracorporeal membrane oxygenation (ECMO) comprises a commonly used method of extracorporeal life support. It has proven efficacy and is an accepted modality of care for isolated respiratory or cardiopulmonary failure in neonatal and pediatric populations. In adults, there are conflicting studies regarding its benefi...
journal_title：Journal of intensive care medicine
pub_type： 杂志文章,评审
doi：10.1177/0885066610384061
更新日期：2011-01-01 00:00:00
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...
journal_title：Journal of intensive care medicine
pub_type： 杂志文章
doi：10.1177/0885066616646551
更新日期：2017-09-01 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：BACKGROUND:At this time, there are no studies evaluating the risk of delirium or coma with the use of ketamine in mechanically ventilated adult patients, compared to conventional therapies such as propofol or dexmedetomidine. OBJECTIVE:The objective of this study was to evaluate the number of days alive without deliri...
journal_title：Journal of intensive care medicine
pub_type： 杂志文章
doi：10.1177/0885066618767619
更新日期：2020-06-01 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：:The ideal diagnostic approach for ventilator-associated pneumonia currently is based on invasive procedures to obtain respiratory tract cultures. Given the lack of consensus and relatively poor acceptance of full bronchoscopic bronchoalveolar lavage (BAL) and protected specimen brush (PSB), less invasive procedures ha...
journal_title：Journal of intensive care medicine
pub_type： 杂志文章,评审
doi：10.1177/0885066605283094
更新日期：2006-01-01 00:00:00
abstract：OBJECTIVE:To evaluate the effect of high-flow nasal cannula oxygen (HFNO) therapy on hospital length of stay (LOS) and postoperative pulmonary complications (PPCs) in adult postoperative patients. DATA SOURCES:PubMed, Embase, the Cochrane Library, Web of Science of Studies, China National Knowledge Index, and Wan Fang...
journal_title：Journal of intensive care medicine
pub_type： 杂志文章
doi：10.1177/0885066618817718
更新日期：2020-10-01 00:00:00
abstract：:Substantial progress has been made to create innovative technology that can monitor the different physiological characteristics that precede the onset of secondary brain injury, with the ultimate goal of intervening prior to the onset of irreversible neurological damage. One of the goals of neurocritical care is to re...
journal_title：Journal of intensive care medicine
pub_type： 杂志文章,评审
doi：10.1177/0885066618788022
更新日期：2019-06-01 00:00:00
abstract：BACKGROUND:Ischemic and hypoxic secondary brain insults are common and detrimental in traumatic brain injury (TBI). Treatment aims to maintain an adequate cerebral blood flow with sufficient arterial oxygen content. It has been suggested that arterial hyperoxia may be beneficial to the injured brain to compensate for c...
journal_title：Journal of intensive care medicine
pub_type： 杂志文章
doi：10.1177/0885066620944097
更新日期：2020-07-27 00:00:00
abstract：:Acute diverticulitis is a frequent and important diagnosis in gastrointestinal disease, most commonly involving the colon. It is estimated that approximately 15% to 30% of patients with diverticulosis develop symptomatic diverticulitis at some point in the natural history of the condition, often requiring medical and/...
journal_title：Journal of intensive care medicine
pub_type： 杂志文章,评审
doi：10.1177/0885066604265260
更新日期：2004-07-01 00:00:00
abstract：PURPOSE:We evaluated the effects of after-hours/nighttime patient transfers out of the ICU on patient outcomes, by performing a systematic review and meta-analysis (PROSPERO CRD 42017074082). DATA SOURCES:MEDLINE, PubMed, EMBASE, Google Scholar, CINAHL, and the Cochrane Library from 1987-November 2019. Conference abst...
journal_title：Journal of intensive care medicine
pub_type： 杂志文章
doi：10.1177/0885066620984410
更新日期：2020-12-28 00:00:00
abstract：PURPOSE:Timely recognition of critical illness is associated with improved outcomes, but is dependent on accurate triage, which is affected by system factors such as workload and staffing. We sought to first study the effect of delayed recognition on patient outcomes after controlling for system factors and then to ide...
journal_title：Journal of intensive care medicine
pub_type： 杂志文章
doi：10.1177/0885066620967901
更新日期：2020-10-29 00:00:00
abstract：:Longitudinal clivus fractures are rare in children, with only 5 cases published in the English literature to date. Clivus fractures, particularly longitudinal type, are associated with high mortality and morbidity. We report a case of longitudinal clivus fracture in a teenager with survival and complete neurological r...
journal_title：Journal of intensive care medicine
pub_type： 杂志文章
doi：10.1177/0885066614555481
更新日期：2015-10-01 00:00:00
abstract：:A 70-year-old woman was admitted to the intensive care unit with refractory nonconvulsive status epilepticus. Extensive evaluation including neuroimaging and cerebrospinal fluid examination was unrevealing. Brain biopsy revealed spongiosis, and prion disease was confirmed by immunostaining, providing the diagnosis of ...
journal_title：Journal of intensive care medicine
pub_type： 杂志文章
doi：10.1177/0885066604269771
更新日期：2004-11-01 00:00:00
abstract：BACKGROUND:Changes in white blood cell (WBC) counts and/or temperature could have important implications in patients on ventilators, but the frequency of these events is uncertain. METHODS:We reviewed the medical records from 281 ventilation episodes in our medical intensive care unit to determine patient characterist...
journal_title：Journal of intensive care medicine
pub_type： 杂志文章
doi：10.1177/0885066615605036
更新日期：2017-05-01 00:00:00
abstract：INTRODUCTION:The Surviving Sepsis Campaign guidelines recommend early goal-directed therapy (EGDT) for the resuscitation of patients with sepsis; however, the recent evidences quickly evolve and convey conflicting results. We performed a meta-analysis to evaluate the effect of EGDT on mortality in adults with severe se...
journal_title：Journal of intensive care medicine
pub_type： 杂志文章,meta分析
doi：10.1177/0885066616671710
更新日期：2018-05-01 00:00:00
abstract：:Early predictors of prognosis in comatose patients post cardiac arrest help inform decisions surrounding continuation or withdrawal of treatment and provide a framework on which to better inform relatives of the likely outcome. Markers defined prior to the widespread use of therapeutic hypothermia post arrest may no l...
journal_title：Journal of intensive care medicine
pub_type： 杂志文章,评审
doi：10.1177/0885066613511045
更新日期：2018-04-01 00:00:00
abstract：INTRODUCTION:The invasive nature and potential complications associated with pulmonary artery (PA) catheters (PACs) have prompted the pursuit of less invasive monitoring options. Before implementing new hemodynamic monitoring technologies, it is important to determine the interchangeability of these modalities. This st...
journal_title：Journal of intensive care medicine
pub_type： 杂志文章
doi：10.1177/0885066614530085
更新日期：2016-02-01 00:00:00
abstract：RATIONALE:The feasibility and clinical outcomes of conservative fluid management after sepsis resuscitation remain unknown. OBJECTIVES:To evaluate the effect of a conservative fluid management protocol on fluid balance and intensive care unit (ICU)-free days among patients with sepsis. METHODS:In a single-center phas...
journal_title：Journal of intensive care medicine
pub_type： 杂志文章
doi：10.1177/0885066618823183
更新日期：2020-12-01 00:00:00
abstract：:The objective of this retrospective study was to determine the optimal initial antibiotic regimen for hospital-acquired pneumonia using the frequency and sensitivity of Gram negative microorganisms found in sputum cultures. An antibiogram was constructed and compared with the hospital intensive care unit (ICU) antibio...
journal_title：Journal of intensive care medicine
pub_type： 杂志文章
doi：10.1177/0885066605278650
更新日期：2005-09-01 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
