Abstract：
BACKGROUND:The management of refractory septic shock remains a major challenge in critical care and its early indicators are not fully understood. We hypothesized that the maximum norepinephrine dosage within 24 hours of intensive care unit (ICU) admission may be a useful indicator of early mortality in patients with septic shock. METHODS:In this retrospective single-center observational study, patients with septic shock admitted to the emergency ICU of an academic medical center between April 2011 and March 2017 were included. Individuals with cardiac arrest and those with do-not-resuscitate orders before admission were excluded. We analyzed if the maximum norepinephrine dosage within 24 hours of ICU admission (MD24) was associated with 7-day mortality. RESULTS:Among 152 patients with septic shock, 20 (15%) did not survive by day 7. The receiver operating characteristic curve analysis for predicting 7-day mortality revealed a cutoff of MD24 of 0.6 μg/kg/min (sensitivity 47%, specificity 93%). In the multivariable regression analysis, a higher MD24 was significantly associated with 7-day mortality (odds ratio: 7.20; 95% confidence interval [CI]: 2.02-25.7; P = .002) but not with 30-day mortality. Using the inverse probability of treatment weighting method in a propensity scoring analysis, a higher MD24 was significantly associated with 7-day (hazard ratio [HR]: 8.9; 95% CI: 3.2-25.0; P < .001) and 30-day mortality (HR: 2.7; 95% CI: 1.2-5.8; P = .012). CONCLUSIONS:An MD24 ≥0.6 μg/kg/min was significantly associated with 7-day mortality in patients with septic shock and may therefore be a useful indicator of refractory septic shock.
journal_name
J Intensive Care Medjournal_title
Journal of intensive care medicineauthors
Kasugai D,Hirakawa A,Ozaki M,Nishida K,Ikeda T,Takahashi K,Matsui S,Uenishi Ndoi
10.1177/0885066619860736subject
Has Abstractpub_date
2020-11-01 00:00:00pages
1285-1289issue
11eissn
0885-0666issn
1525-1489journal_volume
35pub_type
杂志文章abstract：:Cardiac transplantation has now become accepted therapy for the treatment of end-stage heart disease in both children and adults, and literally thousands of patients are bearers of cardiac grafts. Because of these patients' susceptibility to infections, rejection, coronary disease, and malignancy, as well as to serio...
journal_title：Journal of intensive care medicine
pub_type： 杂志文章,评审
doi：10.1177/088506669100600201
更新日期：1991-03-01 00:00:00
abstract：:Controlled donation after circulatory determination of death (cDCDD) concerns donation after withdrawal of life-sustaining therapy (W-LST). We examine the ethical issues raised by W-LST in the cDCDD context in the light of a review of cDCDD protocols and the ethical literature. Our analysis confirms that W-LST procedu...
journal_title：Journal of intensive care medicine
pub_type： 杂志文章,评审
doi：10.1177/0885066615625628
更新日期：2017-03-01 00:00:00
abstract：OBJECTIVE:To examine racial and ethnic differences in the utilization of 3 interventions (tracheostomy placement, gastrostomy tube placement, and hospice utilization) among patients with severe acute brain injury (SABI). DESIGN:Retrospective cohort study. SETTING:Data from the National Inpatient Sample, from 2002 to ...
journal_title：Journal of intensive care medicine
pub_type： 杂志文章
doi：10.1177/0885066620945911
更新日期：2020-09-10 00:00:00
abstract：:Bronchopulmonary dysplasia is the most common morbidity among surviving premature infants. Injury to the developing lung is the result of the interaction between a susceptible host and a number of contributing factors such as mechanical ventilation and infection. The resulting persistent impairment of pulmonary functi...
journal_title：Journal of intensive care medicine
pub_type： 杂志文章,评审
doi：10.1177/0885066604273494
更新日期：2005-03-01 00:00:00
abstract：AIMS:To investigate the occurrence and etiology of fever at anytime during pediatric intensive care unit (PICU) admission, and to study its possible effects on clinical outcome in a heterogeneous population of critically ill children. METHODS:Retrospective, observational single center study, comprising 202 patients ag...
journal_title：Journal of intensive care medicine
pub_type： 杂志文章
doi：10.1177/0885066609340631
更新日期：2009-09-01 00:00:00
abstract：:Renal replacement therapy in the intensive care unit can vary from simple procedures to very complex technologies. I discuss the factors that contribute to the decisions regarding the selection of a specific therapy. These factors include immediate and intermediate therapeutic goals (e.g., solute removal, dehydratio...
journal_title：Journal of intensive care medicine
pub_type： 杂志文章,评审
doi：10.1177/088506669200700604
更新日期：1992-11-01 00:00:00
abstract：PURPOSE:Methods to optimize positive end-expiratory pressure (PEEP) in acute respiratory distress syndrome (ARDS) remain controversial despite decades of research. The pressure-volume curve (PVC), a graphical ventilator relationship, has been proposed for prescription of PEEP in ARDS. Whether the use of PVC's improves ...
journal_title：Journal of intensive care medicine
pub_type： 杂志文章,评审
doi：10.1177/0885066613488747
更新日期：2014-11-01 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：:The treatment of sepsis is an ongoing challenge for clinicians; despite the wide choice of effective antibiotics to treat infection, sepsis remains the leading cause of morbidity and mortality for patients admitted to an intensive care unit. Dysregulation of the immune response is now recognized to be a key factor in ...
journal_title：Journal of intensive care medicine
pub_type： 杂志文章,评审
doi：10.1177/0885066611425759
更新日期：2013-09-01 00:00:00
abstract：PURPOSE:Bloodstream infections (BSIs) caused by Acinetobacter species have been extensively reported, however, which majorly focused on respiratory tract infections. The risk of mortality and the effect of early catheter removal on survival in catheter-related BSIs (CRBSIs) caused by Acinetobacter spp. remain unclear. ...
journal_title：Journal of intensive care medicine
pub_type： 杂志文章,多中心研究
doi：10.1177/0885066616677710
更新日期：2018-06-01 00:00:00
abstract：:Combined poisoning with calcium-channel blockers and beta-blockers is usually associated with severe heart failure. This report shows the effectiveness of emergency extracorporeal life support in treating life-threatening simultaneous propranolol and verapamil intoxication. A 15-year-old girl presented in cardiogenic ...
journal_title：Journal of intensive care medicine
pub_type： 杂志文章
doi：10.1177/0885066607307528
更新日期：2007-11-01 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：:Hospital-acquired infections (HAIs) are common in intensive care unit (ICU) patients and are associated with increased morbidity and mortality. There has been an increasing effort to prevent HAIs, and infection control practices are paramount in avoiding these complications. In the last several years, numerous develop...
journal_title：Journal of intensive care medicine
pub_type： 杂志文章,评审
doi：10.1177/0885066613485215
更新日期：2014-11-01 00:00:00
abstract：PURPOSE:To evaluate the effects of midodrine in addition to intravenous vasopressor therapy on outcomes in adults recovering from shock. MATERIALS AND METHODS:PubMed, Scopus, Clinicaltrials.gov, and published abstracts were searched from inception to November 2018 for studies comparing outcomes in shock after midodrin...
journal_title：Journal of intensive care medicine
pub_type： 杂志文章
doi：10.1177/0885066619843279
更新日期：2020-11-01 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：:Brain blood flow tests with diffusible radiopharmaceuticals are often done as an ancillary test in brain death (BD). We report a case of an infant with absent brain blood flow on an anterior planar image despite persistent breathing and extensor posturing. We reviewed the literature from 1980 to 2008 using MEDLINE and...
journal_title：Journal of intensive care medicine
pub_type： 杂志文章,评审
doi：10.1177/0885066609355388
更新日期：2010-01-01 00:00:00
abstract：:Relocation of large numbers of critically ill patients between hospitals is sometimes necessary and the risks associated with relocation may be high. In the setting of adherence to an interhospital intensive care unit (ICU) relocation protocol, we aimed to determine whether the interhospital relocation of all ICU pati...
journal_title：Journal of intensive care medicine
pub_type： 杂志文章
doi：10.1177/0885066617726754
更新日期：2019-11-01 00:00:00
abstract：BACKGROUND:In the setting of the COVID pandemic, many patients falling ill with acute respiratory distress syndrome eventually require prone positioning for gas exchange. Traditionally, central venous catheters are inserted with patient in the supine or Trendelenburg position. However, when a patient cannot tolerate su...
journal_title：Journal of intensive care medicine
pub_type： 杂志文章
doi：10.1177/0885066620959649
更新日期：2020-09-16 00:00:00
abstract：INTRODUCTION:The use of transesophageal echocardiography (TEE) by intensivist physicians (IPs) and emergency physicians (EPs) in critically ill patients is increasing in the intensive care unit, emergency department, and prehospital environments. Coagulopathy and thrombocytopenia are common in critically ill patients. ...
journal_title：Journal of intensive care medicine
pub_type： 杂志文章
doi：10.1177/0885066619887693
更新日期：2021-01-01 00:00:00
abstract：BACKGROUND:Sepsis and sepsis-associated encephalopathy (SAE) are common intensive care unit (ICU) diseases; the morbidity and mortality are high. The present study analyzed the sensitivity of different diagnostic criteria of sepsis 1.0 and 3.0, epidemiological characteristics of sepsis and SAE, and explored its risk fa...
journal_title：Journal of intensive care medicine
pub_type： 杂志文章
doi：10.1177/0885066617719750
更新日期：2019-11-01 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：:Neurogenic stunned myocardium (NSM) is a triad of transient left ventricular dysfunction, electrocardiogram changes, and elevation in cardiac enzymes, often mimicking a myocardial infarction. It has been described following acute brain injury. The purported mechanism is catecholamine excess resulting in cardiac dysfun...
journal_title：Journal of intensive care medicine
pub_type： 杂志文章,评审
doi：10.1177/0885066613511054
更新日期：2015-09-01 00:00:00
abstract：INTRODUCTION:Red cell distribution width (RDW) is reflective of systemic inflammation. The objective of this study was to investigate the association between RDW (on day 1 of development of septic shock) and mortality. METHODS:A total of 279 patients with septic shock were included. We categorized the patients into qu...
journal_title：Journal of intensive care medicine
pub_type： 杂志文章
doi：10.1177/0885066612452838
更新日期：2013-09-01 00:00:00
abstract：BACKGROUND:Pharmacogenomic (PGx) testing has the potential to provide information on specific drug-metabolizing enzymes that may lead to an absence, reduction, or increase in medication effect in patients. There is a paucity of prospective studies examining PGx testing in the intensive care unit (ICU) setting. RESEARC...
journal_title：Journal of intensive care medicine
pub_type： 杂志文章
doi：10.1177/0885066620946303
更新日期：2020-07-31 00:00:00
abstract：OBJECTIVE:Fluid responsiveness is the ability to increase the cardiac output in response to a fluid challenge. Only about 50% of patients receiving fluid resuscitation for acute circulatory failure increase their stroke volume, but the other 50% may worsen their outcome. Therefore, predicting fluid responsiveness is ne...
journal_title：Journal of intensive care medicine
pub_type： 杂志文章,meta分析
doi：10.1177/0885066617752308
更新日期：2020-04-01 00:00:00
abstract：BACKGROUND:Admission to an intensive care unit (ICU) specialized for brain and spine injury patients is associated with improved outcome. We investigated the effects of the first dedicated, combined neurological and neurosurgical ICU (NeuroICU) in Korea on patient outcomes. METHODS:The first dedicated NeuroICU in Kore...
journal_title：Journal of intensive care medicine
pub_type： 杂志文章
doi：10.1177/0885066617706675
更新日期：2019-02-01 00:00:00
abstract：:Echodynamics refers to the use of echocardiography as hemodynamic tool mostly in intensive and acute care settings. It implies a smooth drift from the classic cardiology use to a more critical care adjusted use. A more personalized approach is advocated in critical care, and echo is one way to reach such goal. Correct...
journal_title：Journal of intensive care medicine
pub_type： 杂志文章,评审
doi：10.1177/0885066617734151
更新日期：2018-08-01 00:00:00
abstract：:This was a retrospective observational study in a pediatric intensive care unit, in which 19 patients received levosimendan. There were no adverse events attributable to levosimendan and no instances where the clinical condition worsened after administration. Arterial lactate levels decreased significantly following l...
journal_title：Journal of intensive care medicine
pub_type： 杂志文章
doi：10.1177/0885066606287039
更新日期：2006-05-01 00:00:00
abstract：INTRODUCTION:Percutaneous dilational tracheostomy (PDT) is a common and increasingly used procedure in the intensive care unit (ICU). It is usually performed with bronchoscopy guidance. Ultrasound has emerged as a useful tool in order to assist PDT, potentially improving its success rate and reducing procedural-related...
journal_title：Journal of intensive care medicine
pub_type： 杂志文章,meta分析
doi：10.1177/0885066618755334
更新日期：2020-05-01 00:00:00
abstract：:Respiratory complications before and after liver transplant are common, diverse, and potentially have a negative impact on patient outcomes. In this review, we discuss the most frequent respiratory conditions that patients may develop in the perioperative period. Their prevention and/or treatment may help to maximize ...
journal_title：Journal of intensive care medicine
pub_type： 杂志文章,评审
doi：10.1177/0885066618781526
更新日期：2019-05-01 00:00:00
