Abstract:
OBJECTIVE:The role of systemic corticosteroids in pathophysiology and treatment of acute respiratory distress syndrome is controversial. Use of prehospital systemic corticosteroid therapy may prevent the development of acute respiratory distress syndrome and improve hospital outcomes. DESIGN:This is a preplanned retrospective subgroup analysis of the prospectively identified cohort from a trial by the U.S. Critical Illness and Injury Trials Group designed to validate the Lung Injury Prediction Score. SETTING:Twenty-two acute care hospitals. PATIENTS:: Five thousand eighty-nine patients with at least one risk factor for acute respiratory distress syndrome at the time of hospitalization. INTERVENTION:Propensity-based analysis of previously recorded data. MEASUREMENTS AND MAIN RESULTS:Three hundred sixty-four patients were on systemic corticosteroids. Prevalence of acute respiratory distress syndrome was 7.7% and 6.9% (odds ratio, 1.1 [95% CI, 0.8-1.7]; p = 0.54) for patients on systemic corticosteroid and not on systemic corticosteroids, respectively. A propensity for being on systemic corticosteroids was derived through logistic regression by using all available covariates. Subsequently, 354 patients (97%) on systemic corticosteroids were matched to 1,093 not on systemic corticosteroids by their propensity score for a total of 1,447 patients in the matched set. Adjusted risk for acute respiratory distress syndrome (odds ratio, 0.96 [95% CI, 0.54-1.38]), invasive ventilation (odds ratio, 0.84 [95% CI, 0.62-1.12]), and in-hospital mortality (odds ratio, 0.97 [95% CI, 0.63-1.49]) was then calculated from the propensity-matched sample using conditional logistic regression model. No significant associations were present. CONCLUSIONS:Prehospital use of systemic corticosteroids neither decreased the development of acute respiratory distress syndrome among patients hospitalized with at one least risk factor, nor affected the need for mechanical ventilation or hospital mortality.
journal_name
Crit Care Medjournal_title
Critical care medicineauthors
Karnatovskaia LV,Lee AS,Gajic O,Festic E,U.S. Critical Illness and Injury Trials Group: Lung Injury Prevention Study Investigators (USCIITG–LIPS).doi
10.1097/CCM.0b013e31828a1fc7subject
Has Abstractpub_date
2013-07-01 00:00:00pages
1679-85issue
7eissn
0090-3493issn
1530-0293journal_volume
41pub_type
杂志文章,多中心研究abstract:OBJECTIVE:Head-to-head comparison of the success rate of jejunal placement of a new electromagnetically visualized jejunal tube with that of the endoscopic technique in critically ill patients. DESIGN:: Prospective, randomized clinical trial. SETTING:Two intensive care units at a university hospital. PATIENTS:: A to...
journal_title:Critical care medicine
pub_type: 杂志文章,随机对照试验
doi:10.1097/CCM.0b013e3181fb7b5f
更新日期:2011-01-01 00:00:00
abstract:OBJECTIVE:To evaluate the use of enriched thioglycolate as a transport medium of protected specimen brush samples, in particular its value in direct examination of respiratory specimens and in guiding initial antibiotic prescription. DESIGN:Prospective, randomized, pilot study. SETTING:Medical-surgical teaching inten...
journal_title:Critical care medicine
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1097/00003246-200202000-00008
更新日期:2002-02-01 00:00:00
abstract:OBJECTIVES:The American College of Critical Care Medicine provided 2002 and 2007 guidelines for hemodynamic support of newborn and pediatric septic shock. Provide the 2014 update of the 2007 American College of Critical Care Medicine "Clinical Guidelines for Hemodynamic Support of Neonates and Children with Septic Shoc...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/CCM.0000000000002425
更新日期:2017-06-01 00:00:00
abstract::Pulmonary mechanics were studied in ten anemic preterm infants using an esophageal balloon and mask, before and after transfusion with 10 ml/kg of packed RBC. Their mean birth weight was 1212 +/- 323 g and gestational age was 29.27 +/- 2.4 wk. Transfusions were carried out at a mean postnatal age of 41.9 +/- 21.8 days...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/00003246-199012000-00010
更新日期:1990-12-01 00:00:00
abstract::The hemodynamic response to a dopamine HCl infusion (10 microgram/kg per min) was measured in 25 adult patients with severe sepsis: there were 6 patients with circulatory hyperdynamic states, 9 patients with myocardial failure, and 10 with hypovolemia. Each patient also had acute respiratory failure. Changes of intrap...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/00003246-197906000-00004
更新日期:1979-06-01 00:00:00
abstract:OBJECTIVE:Although hepatic cytochrome P-450 protein concentrations are altered following endotoxin shock, changes in P-450 isoforms in sepsis have not been fully investigated. The aim of this study was to determine whether the major P-450 isoform in rat liver (i.e., CYP1A2) is down-regulated during the progression of s...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/01.CCM.0000109453.57709.E2
更新日期:2004-02-01 00:00:00
abstract::The relationship between oxygen uptake (Vo2) and delivery (Do2) was examined in 64 patients immediately after cardiopulmonary bypass. In 44 patients with lactate levels below 2.5 mmol/L, Vo2 decreased proportionally when Do2 decreased below 300 ml/min X m2. At a Do2 over this level, Vo2 plateaued at 105 +/- 13 (SD) ml...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/00003246-198703000-00002
更新日期:1987-03-01 00:00:00
abstract:OBJECTIVES:Vascular beds vary in their responses to atrial natriuretic peptide and sodium nitroprusside. Both of these agents dilate blood vessels by increasing intracellular guanosine 3',5'-cyclic monophosphate (cyclic-GMP) but activate different enzymes in the vascular smooth muscle cell. We aimed to determine if the...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/00003246-199409000-00017
更新日期:1994-09-01 00:00:00
abstract:OBJECTIVES:The contribution of individual immune response to Staphylococcus aureus bacteremia on outcome has not been well studied. The objective was to relate the host cytokine response to outcome of Staphylococcus aureus bacteremia. DESIGN:Prospective observational study. SETTING:Three U.S. university-affiliated me...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/CCM.0000000000001465
更新日期:2016-04-01 00:00:00
abstract::Although recent clinical reports have noted hypokalemia after resuscitation from cardiac arrest, extensive animal work indicates that potassium is released from cells during ischemia. This study was undertaken to define the changes that occur in serum potassium ion during cardiac arrest and resuscitation in a canine m...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/00003246-198604000-00012
更新日期:1986-04-01 00:00:00
abstract::Over a 2-year period, 14 viable ventilator-dependent patients were transferred from the Medical Intensive Care Unit (MICU) to a general ward floor for nutritional support after failing to wean from mechanical ventilation (MV) while in the MICU. These patients were retrospectively grouped based on their ultimate abilit...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/00003246-198205000-00001
更新日期:1982-05-01 00:00:00
abstract:OBJECTIVES:To evaluate the effect of a part-time rapid response system on the occurrence rate of cardiopulmonary arrest by comparing the times of rapid response system operation versus nonoperation. DESIGN:Retrospective cohort study. SETTING:A 1,360-bed tertiary care hospital. PATIENTS:Adult patients admitted to the...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/CCM.0000000000002314
更新日期:2017-06-01 00:00:00
abstract:OBJECTIVE:The Cardiac Arrhythmia Suppression Trial II showed that moricizine acutely increases the occurrence of sudden cardiac death. Thus the objective of this investigation was to evaluate the antifibrillatory properties of moricizine (a new antiarrhythmic agent) alone and in combination with lidocaine (an establish...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/00003246-199310000-00029
更新日期:1993-10-01 00:00:00
abstract:OBJECTIVE:The first 70 years of critical care can be considered a period of "industrial revolution-like" advancement in terms of progressing the understanding and care of critical illness. Unfortunately, like the industrial revolution's impact on the environment, advancing ICU care of increasingly elderly, immunosuppre...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/CCM.0000000000004783
更新日期:2021-02-01 00:00:00
abstract:OBJECTIVE:To study the pharmacokinetics of dopamine in hemodynamically stable adult patients. DESIGN:Prospective clinical study. SETTING:University hospital intensive care unit. PATIENTS:Fourteen patients (aged 43 to 73 yrs) recovering from esophageal surgery. INTERVENTION:Dopamine was infused and blood samples wer...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/00003246-199311000-00013
更新日期:1993-11-01 00:00:00
abstract:OBJECTIVES:Recently, recombinant angiotensin-converting enzyme 2 was shown to protect mice from acute lung injury, an effect attributed to reduced bioavailability of angiotensin II. Since angiotensin-converting enzyme 2 metabolizes angiotensin II to angiotensin-(1-7), we hypothesized that this effect is alternatively m...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/CCM.0b013e31828a6688
更新日期:2013-11-01 00:00:00
abstract:OBJECTIVE:To discuss the potential therapeutic value of intraluminal oxygenation of the gut in critical illness. DATA SOURCES:Relevant articles published in the English language literature. STUDY SELECTION:No special study has been carried out for the present presentation. DATA EXTRACTION:Information from the litera...
journal_title:Critical care medicine
pub_type: 杂志文章,评审
doi:10.1097/00003246-199302001-00012
更新日期:1993-02-01 00:00:00
abstract::Intermittent Mandatory Ventilation (IMV) provides an alternative method of support to assisted and controlled mechanical ventilation in neonates with acute respiratory failure. Specific advantages include the use of only the level of mechanical support which is required on an individual basis. Because intrapleural pre...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/00003246-197701000-00004
更新日期:1977-01-01 00:00:00
abstract:OBJECTIVE:Mannitol is widely used in hospitals worldwide to treat patients with high intracranial pressure and/or cerebral edema. One of the mechanisms by which mannitol is thought to affect intracranial pressure is by increasing the patient's serum osmolarity, but not the osmolarity in the brain or cerebrospinal fluid...
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pub_type: 临床试验,杂志文章
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更新日期:2003-02-01 00:00:00
abstract:OBJECTIVE:To describe the experience of pediatric intensive care hospitalization from the perspective of a parents of children with severe, antecedent disability. DESIGN:Qualitative analysis of data obtained through semistructured interviews. SETTING:Pediatric intensive care unit (PICU) in a children's hospital. SUB...
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pub_type: 杂志文章
doi:10.1097/CCM.0b013e3181a00578
更新日期:2009-06-01 00:00:00
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journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/00003246-198505000-00010
更新日期:1985-05-01 00:00:00
abstract::The Hemoccult slide test is used frequently to test for the presence of occult blood in samples of gastric juice obtained from critically ill patients. The purpose of this study was to investigate the accuracy of this test to determine the presence of blood in human gastric juice at various pH values. Gastric aspirate...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/00003246-198210000-00016
更新日期:1982-10-01 00:00:00
abstract:OBJECTIVE:The genetic background of hypertensive crisis is unknown. We examined the association of polymorphisms in genes involved in the renin-angiotensin-aldosterone-system with hypertensive crisis. DESIGN:Population-based case-control study. SETTING:Emergency department at a tertiary care university hospital. PAT...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/00003246-200210000-00010
更新日期:2002-10-01 00:00:00
abstract:OBJECTIVES:Over-utilization of tests, treatments, and procedures is common for hospitalized patients in ICU settings. American Board of Internal Medicine Foundation's Choosing Wisely campaign tasked professional societies to identify sources of overuse in specialty care practice. The purpose of this study was to assess...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/CCM.0000000000003496
更新日期:2019-03-01 00:00:00
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journal_title:Critical care medicine
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1097/00003246-199904000-00023
更新日期:1999-04-01 00:00:00
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journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/00003246-199203000-00016
更新日期:1992-03-01 00:00:00
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journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/00003246-199912000-00013
更新日期:1999-12-01 00:00:00
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journal_title:Critical care medicine
pub_type: 杂志文章,评审
doi:10.1097/01.ccm.0000115623.52021.c0
更新日期:2004-04-01 00:00:00
abstract:OBJECTIVE:To determine the relationship between sublingual and intestinal mucosal microcirculatory perfusion. DESIGN:Observational, experimental study. SETTING:University-affiliated large animal laboratory. SUBJECTS:Ten fasted, anesthetized, mechanically ventilated, male pigs randomized to a sham group (n = 3) or to...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/CCM.0b013e3181b029c1
更新日期:2009-11-01 00:00:00
abstract:BACKGROUND:Prevalence and causes of sex-based differences in morbidity and mortality secondary to cardiovascular disease remain controversial. Cardiac troponin I (cTnI) is a sensitive and specific marker for myocardial injury. Serial cTnI measurements have been used to identify perioperative myocardial cell injury. OB...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/01.CCM.0000055442.84685.4D
更新日期:2003-03-01 00:00:00