Abstract：
PURPOSE:Under-triage is a major threat when admitting patients at the Intermediate Care Unit (IMCU). This study aims to identify risk factors and predict early deterioration of IMCU admissions, to reduce the risk of under-triage. MATERIALS AND METHODS:This retrospective cohort study included all admissions to the mixed-surgical stand-alone IMCU of a tertiary referral hospital (2001-2015). Variables included were age, sex, admission indication, admitting specialty, re-admission, and nursing interventions. Early clinical deterioration was defined as ICU transfer or death ≤24 h of admission. Multinomial and logistic regression analyses were performed to identify risk factors and obtain predictions, for several frequently encountered subgroups. RESULTS:A total of 9103 admissions were included, of which 350 (3.8%) early deteriorated. Patients admitted for hemodynamic and respiratory instability had a high risk of early deterioration (OR 16.3 (CI 4.5-59.1)), probability 47.1%. Patients admitted with respiratory insufficiency and active diuresis or complicated sepsis had a high probability of early deterioration (≥29% and ≥26% respectively). The model had an optimism-corrected c-statistic of 0.79 (IQR 0.78-0.80). CONCLUSIONS:Patients with combined hemodynamic and respiratory instability should not be admitted to the IMCU. Patients with respiratory insufficiency and active diuresis, or complicated sepsis require close monitoring.
journal_name
J Crit Carejournal_title
Journal of critical careauthors
Plate JDJ,Hietbrink F,Leenen LPH,Peelen LMdoi
10.1016/j.jcrc.2018.08.012subject
Has Abstractpub_date
2018-12-01 00:00:00pages
97-103eissn
0883-9441issn
1557-8615pii
S0883-9441(18)30594-Xjournal_volume
48pub_type
杂志文章abstract：PURPOSE:The study aimed to determine whether improvements in intensive care unit (ICU) structural environment affect the incidence of ICU-acquired infections (IAIs), particularly those caused by multidrug-resistant pathogens. METHODS:The incidence of IAI and the number of infections caused by organisms during the 6 mo...
journal_title：Journal of critical care
pub_type： 杂志文章
doi：10.1016/j.jcrc.2012.12.013
更新日期：2013-08-01 00:00:00
abstract：PURPOSE:Dynamometry is an objective tool for volitional strength evaluation that may overcome the limited sensitivity of the Medical Research Council scale for manual muscle tests, particularly at grades 4 and 5. The primary aims of this study were to investigate the reliability, minimal detectable change, and time to ...
journal_title：Journal of critical care
pub_type： 杂志文章
doi：10.1016/j.jcrc.2012.03.001
更新日期：2013-02-01 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：PURPOSE:Gastric intramucosal PCO2 (PiCO2) is a marker of splanchnic dysoxia and hypoperfusion that is increasingly used in intensive care medicine. We assessed two methods, saline-balloon tonometry versus continuous capnometric recirculating gas tonometry (CRGT), for detecting changes in PiCO2 in animals subjected to v...
journal_title：Journal of critical care
pub_type： 杂志文章
doi：10.1016/s0883-9441(98)80001-4
更新日期：1998-06-01 00:00:00
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...
journal_title：Journal of critical care
pub_type： 杂志文章,评审
doi：10.1016/j.jcrc.2017.04.041
更新日期：2017-10-01 00:00:00
abstract：PURPOSE:To evaluate the associations between strained ICU capacity and patient outcomes. METHODS:Multi-center population-based cohort study of nine integrated ICUs in Alberta, Canada. Path-analysis modeling was adopted to investigate direct and indirect associations between strain (available beds ≤1; occupancy ≥95%) a...
journal_title：Journal of critical care
pub_type： 杂志文章,多中心研究
doi：10.1016/j.jcrc.2017.08.032
更新日期：2018-02-01 00:00:00
abstract：PURPOSE:Enrolling traumatic brain injury (TBI) patients with an inability to provide informed consent in research is challenging. Alternatives to patient consent are not sufficiently embedded in European and national legislation, which allows procedural variation and bias. We aimed to quantify variations in informed co...
journal_title：Journal of critical care
pub_type： 杂志文章
doi：10.1016/j.jcrc.2020.05.004
更新日期：2020-10-01 00:00:00
abstract：PURPOSE:This paper describes the methodology of a clinical trial of prone positioning in pediatric patients with acute lung injury (ALI). Nonrandomized studies suggest that prone positioning improves oxygenation in patients with ALI/acute respiratory distress syndrome without the risk of serious iatrogenic injury. It i...
journal_title：Journal of critical care
pub_type： 杂志文章,多中心研究,随机对照试验
doi：10.1016/j.jcrc.2005.12.004
更新日期：2006-03-01 00:00:00
abstract：PURPOSE:Developing countries carry the greatest burden of sepsis, yet few descriptive data exist from the Western Hemisphere. We conducted a retrospective cohort study to elucidate the presentation, treatment, and outcomes of sepsis at an urban referral hospital in Port-au-Prince, Haiti. MATERIALS AND METHODS:We studi...
journal_title：Journal of critical care
pub_type： 杂志文章
doi：10.1016/j.jcrc.2016.09.031
更新日期：2017-04-01 00:00:00
abstract：PURPOSE:Although 4% albumin is associated with increased mortality in patients with traumatic brain injury (TBI), evidence concerning the safety of synthetic colloids is lacking. We aimed to determine if there is an association between synthetic colloids and mortality in patients with severe TBI. MATERIALS AND METHODS...
journal_title：Journal of critical care
pub_type： 杂志文章
doi：10.1016/j.jcrc.2010.12.001
更新日期：2011-08-01 00:00:00
abstract：PURPOSE:To evaluate the relationship between phase angle (PA) and nutritional status and the prognostic significance of PA in critically ill cancer patients. METHODS:31 patients that had been admitted to the intensive care unit (ICU) of a center on oncology were evaluated. Their PA was obtained from their bioelectrica...
journal_title：Journal of critical care
pub_type： 杂志文章
doi：10.1016/j.jcrc.2018.01.006
更新日期：2018-04-01 00:00:00
abstract：:Tropical diseases are those that occur primarily or solely in the tropics, and as such include infectious diseases that are particularly prevalent in hot, humid conditions. The incidence of encephalitis in tropical countries is reported to be as high as 6.34/100,000/year. The term encephalitis implies inflammation of ...
journal_title：Journal of critical care
pub_type： 杂志文章,评审
doi：10.1016/j.jcrc.2017.11.001
更新日期：2017-12-01 00:00:00
abstract：PURPOSE:Studies have shown that lung-ultrasound may be superior to chest x-ray (CXR) in diagnosing ventilator-associated pneumonia (VAP). This study investigated whether the use of lung-ultrasound monitoring could detect VAP earlier and improve patient outcome. METHODS:This was a single-center diagnostic randomized co...
journal_title：Journal of critical care
pub_type： 杂志文章
doi：10.1016/j.jcrc.2020.03.012
更新日期：2020-08-01 00:00:00
abstract：:Recent advances in the field of molecular biology have revolutionized our understanding of the functioning of living organisms and facilitated the development of robust tools for both diagnosis and treatment of diseases. With particular reference to the field of critical care medicine, development of molecular biology...
journal_title：Journal of critical care
pub_type： 杂志文章,评审
doi：10.1016/0883-9441(95)90004-7
更新日期：1995-09-01 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:Acute kidney injury (AKI) is a common source of morbidity after trauma. We sought to determine novel risk factors for AKI, by Acute Kidney Injury Network (AKIN) criteria, in critically ill trauma patients. MATERIALS AND METHODS:A prospective cohort of 400 patients admitted to the intensive care unit of a level...
journal_title：Journal of critical care
pub_type： 杂志文章
doi：10.1016/j.jcrc.2012.02.002
更新日期：2012-10-01 00:00:00
abstract：PURPOSE:We investigated whether a critical rise of intracranial pressure (ICP) leading to a loss of cerebral perfusion pressure (CPP) could serve as a surrogate marker of brain death (BD). MATERIALS AND METHODS:We retrospectively analyzed ICP and CPP of patients in whom BD was diagnosed (n = 32, 16-79 years). Intracra...
journal_title：Journal of critical care
pub_type： 杂志文章
doi：10.1016/j.jcrc.2016.03.009
更新日期：2016-08-01 00:00:00
abstract：OBJECTIVES:To assess the effect on healthcare professional emergency response time and safety of small compared to large clog size. DESIGN:Randomized controlled trial. SETTING:The intensive care unit of a single university medical centre in The Netherlands. PARTICIPANTS:Intensive care medicine professionals. INTERV...
journal_title：Journal of critical care
pub_type： 杂志文章,随机对照试验
doi：10.1016/j.jcrc.2020.07.028
更新日期：2020-12-01 00:00:00
abstract：BACKGROUND:Extracorporeal membrane oxygenation (ECMO) is an effective support method for acute fulminant myocarditis (AFM) with cardiogenic shock. However, deciding whether to bridge to a left ventricular assist device (LVAD) or to maintain ECMO support until heart recovery is still controversial. MATERIAL AND METHODS...
journal_title：Journal of critical care
pub_type： 杂志文章
doi：10.1016/j.jcrc.2020.03.007
更新日期：2020-06-01 00:00:00
abstract：INTRODUCTION:Barotrauma and cardiovascular insufficiency are frequently encountered problems in patients with acute bronchospastic disease who require mechanical ventilation. Permissive hypercapnia is a recognized strategy for minimizing these adverse effects; however, it has potential risks. Tracheal gas insufflation ...
journal_title：Journal of critical care
pub_type： 杂志文章
doi：10.1016/s0883-9441(97)90021-6
更新日期：1997-03-01 00:00:00
abstract：PURPOSE:The purpose of this article was to determine the outcome, clinical and prognostic features, and microbiology of a large group of patients with community-acquired pneumonia (CAP) presenting in septic shock. MATERIALS AND METHODS:The placebo limb of the Norasept II database was examined. Data were collected on p...
journal_title：Journal of critical care
pub_type： 杂志文章
doi：10.1053/jcrc.2000.16460
更新日期：2000-09-01 00:00:00
abstract：BACKGROUND:The optimal mode of ventilation in acute respiratory distress syndrome (ARDS) remains uncertain. Airway pressure release ventilation (APRV) is a recognized treatment for mechanically-ventilated patients with severe hypoxaemia. However, contemporary data on its role as a rescue modality in ARDS is lacking. Th...
journal_title：Journal of critical care
pub_type： 杂志文章
doi：10.1016/j.jcrc.2016.03.002
更新日期：2016-08-01 00:00:00
abstract：PURPOSE:To identify elements which enable patient and family centred care (PFCC) in the intensive care unit (ICU) and priorities for PFCC research. MATERIALS AND METHODS:We engaged a panel of multidisciplinary stakeholders in a modified Delphi process. Items generated from a literature review and panelist suggestions ...
journal_title：Journal of critical care
pub_type： 杂志文章
doi：10.1016/j.jcrc.2017.08.008
更新日期：2017-12-01 00:00:00
abstract：PURPOSE:The purpose of this study is to examine the impact of hypernatremia acquired after intensive care unit (ICU) admission on mortality and length of stay (LOS). MATERIALS AND METHODS:Data for this observational study were collected from patients admitted between January 1, 2008, and September 30, 2010 to 344 ICUs...
journal_title：Journal of critical care
pub_type： 杂志文章
doi：10.1016/j.jcrc.2012.11.013
更新日期：2013-08-01 00:00:00
abstract：PURPOSE:We aimed to evaluate a dosing algorithm for continuous vancomycin administration in intensive care unit patients. MATERIALS AND METHODS:This observational study was conducted in a medical intensive care unit (German university hospital; June 2012-February 2013). Following a loading dose of 20 mg per kg actual ...
journal_title：Journal of critical care
pub_type： 杂志文章
doi：10.1016/j.jcrc.2013.12.007
更新日期：2014-06-01 00:00:00
abstract：PURPOSE:To investigate the predictive value of left ventricular-arterial coupling (VAC) for clinical prognosis of elderly patients with septic shock. MATERIALS AND METHODS:This was a single-center prospective cohort study of 63 elderly patients with septic shock treated between August 2014 and January 2016 at the 30-b...
journal_title：Journal of critical care
pub_type： 杂志文章
doi：10.1016/j.jcrc.2017.08.017
更新日期：2017-12-01 00:00:00
abstract：PURPOSE:Liquid perfluorochemicals reduce the production of reaction oxygen species by alveolar macrophages. We sought to determine whether the use of liquid perfluorochemicals in vivo during liquid ventilation would attenuate oxidative damage to the lung. MATERIALS AND METHODS:Healthy infant piglets (n = 16) were inst...
journal_title：Journal of critical care
pub_type： 杂志文章
doi：10.1016/s0883-9441(99)90004-7
更新日期：1999-03-01 00:00:00
abstract：PURPOSE:It is unclear whether ventilator-associated pneumonia (VAP) is actually a bilateral and multifocal process. In addition, the diagnostic role of chest x-ray is under debate. Assuming a low microbiologic concordance between the left and right lungs, the reliability of a single pulmonary sampling becomes questiona...
journal_title：Journal of critical care
pub_type： 杂志文章
doi：10.1016/j.jcrc.2016.02.016
更新日期：2016-06-01 00:00:00
abstract：INTRODUCTION:Patients with septic shock often receive intravenous vasopressor infusions, with little evidence available to guide their titration. We surveyed Canadian intensivists to document self-reported vasopressor titration strategies for patients with septic shock. METHODS:We identified Canadian intensivists cari...
journal_title：Journal of critical care
pub_type： 杂志文章
doi：10.1016/j.jcrc.2011.01.005
更新日期：2011-10-01 00:00:00
abstract：PURPOSE:The purpose was to investigate the value of procalcitonin (PCT) kinetics in predicting the appropriateness of empirical antimicrobial treatment in critically ill patients. MATERIALS AND METHODS:This prospective observational study recruited patients in whom empirical antimicrobial therapy was started for suspe...
journal_title：Journal of critical care
pub_type： 杂志文章
doi：10.1016/j.jcrc.2016.04.007
更新日期：2016-08-01 00:00:00
