Abstract:
OBJECTIVE:Currently 162-325 mg aspirin is recommended for the treatment of acute coronary syndrome. We tested the effect of an additional loading dose of 250 mg aspirin at the onset of acute coronary syndrome in patients who were already on chronic therapy with 100 mg aspirin. DESIGN:This was a prospective trial in patients presenting with symptoms suggestive of acute coronary syndrome that included a randomized, double-blind, placebo-controlled trial subgroup. SETTING:An emergency department in a tertiary care center. PATIENTS:Consecutive patients with symptoms suggestive of acute coronary syndrome were enrolled, including a cohort already on chronic aspirin therapy. INTERVENTIONS:Patients received an intravenous infusion of 250 mg aspirin. MEASUREMENTS AND MAIN RESULTS:Platelet function was measured with a platelet function analyzer in 234 patients before and after aspirin infusion. Aspirin infusion prolonged collagen epinephrine closure times in almost all patients. Aspirin infusion further lowered thromboxane B(2) levels in patients with acute coronary syndrome who were on chronic aspirin therapy before admission. Concomitantly, collagen epinephrine closure times increased by 22% from 223 secs (95% confidence interval, 192-255 secs) before to 273 secs (95% confidence interval, 252-294 secs) after aspirin infusion (p < .01). Eleven patients with ST-elevation myocardial infarction on daily aspirin therapy (53%) displayed platelet hyperfunction (collagen epinephrine closure times <193 secs). Additional aspirin infusion further decreased platelet function in these patients with ST-elevation myocardial infarction (30% prolongation of collagen epinephrine closure times; p < .01), and only two patients with ST-elevation myocardial infarction still displayed platelet hyperfunction (p = .02). CONCLUSION:Aspirin loading in the emergency room further reduced thromboxane B(2) levels and further inhibited platelet function in many patients with acute coronary syndrome already on 100 mg aspirin.
journal_name
Crit Care Medjournal_title
Critical care medicineauthors
Fuchs I,Spiel AO,Frossard M,Derhaschnig U,Riedmüller E,Jilma Bdoi
10.1097/CCM.0b013e3181de8b1esubject
Has Abstractpub_date
2010-06-01 00:00:00pages
1423-9issue
6eissn
0090-3493issn
1530-0293journal_volume
38pub_type
杂志文章,随机对照试验abstract:OBJECTIVES:The aim of this study was to analyze the effect of the International Nosocomial Infection Control Consortium's multidimensional approach on the reduction of ventilator-associated pneumonia in patients hospitalized in intensive care units. DESIGN:A prospective active surveillance before-after study. The stud...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/CCM.0b013e3182657916
更新日期:2012-12-01 00:00:00
abstract:OBJECTIVE:To determine the impact of the rotation of antimicrobial agents on the rates of infection, intestinal colonization, and acquisition with antimicrobial-resistant Gram-negative bacteria. DESIGN:Pre- and postintervention design. SETTING:A 19-bed, medical intensive care unit. PATIENTS:Individuals admitted to t...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/01.ccm.0000147685.79487.28
更新日期:2004-12-01 00:00:00
abstract:OBJECTIVES:To investigate aortic functional alterations in the acute phase of aneurysmal subarachnoid hemorrhage and to evaluate the relationship between potential cardiovascular alterations and delayed cerebral infarctions or poor Glasgow Outcome Scale score at discharge from critical care unit. DESIGN:Prospective ob...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/CCM.0b013e31822e9fab
更新日期:2012-01-01 00:00:00
abstract:OBJECTIVES:To evaluate the epidemiology of hyperammonemia unrelated to liver failure in the critical care setting. DESIGN:Retrospective case series. SETTING:Critically ill patients admitted to ICUs at Mayo Clinic, Rochester, MN (medical ICU, two mixed medical-surgical ICUs, coronary care unit, or the cardiosurgical I...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/CCM.0000000000003278
更新日期:2018-09-01 00:00:00
abstract:OBJECTIVES:To evaluate the frequency of unsuspected posterior vessel wall penetration of the internal jugular vein during ultrasound-guided needle cannulation. DESIGN:Prospective, single-blinded observational study. SETTING:Urban level I emergency department with an annual census of 80,000. PATIENTS:Residents who ha...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/CCM.0b013e3181a067d4
更新日期:2009-08-01 00:00:00
abstract:OBJECTIVE:To examine the accuracy of brain multimodal monitoring-consisting of intracranial pressure, brain tissue PO2, and cerebral microdialysis--in detecting cerebral hypoperfusion in patients with severe traumatic brain injury. DESIGN:Prospective single-center study. PATIENTS:Patients with severe traumatic brain ...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/CCM.0000000000000720
更新日期:2015-02-01 00:00:00
abstract:OBJECTIVES:To determine the proportion of patients with documented bacterial aspiration pneumonia among comatose ICU patients with symptoms suggesting either bacterial aspiration pneumonia or non-bacterial aspiration pneumonitis. DESIGN:Prospective observational study. SETTING:University-affiliated 30-bed ICU. PATIE...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/CCM.0000000000002525
更新日期:2017-08-01 00:00:00
abstract:OBJECTIVE:To determine the impact of Acinetobacter baumannii (AB) acquisition in intensive care unit (ICU) patients on mortality and length of stay (LOS). DESIGN:Pairwise matched 1:1 case-control study. SETTING:Medical-surgical ICU in a tertiary health care institution. PATIENTS:During 16 months, all patients admitt...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/00003246-199909000-00015
更新日期:1999-09-01 00:00:00
abstract:OBJECTIVE:To develop definitions of infection that can be used in clinical trials in patients with sepsis. CONTEXT:Infection is a key component of the definition of sepsis, yet there is currently no agreement on the definitions that should be used to identify specific infections in patients with sepsis. Agreeing on a ...
journal_title:Critical care medicine
pub_type: 共识发展会议,杂志文章,评审
doi:10.1097/01.ccm.0000168253.91200.83
更新日期:2005-07-01 00:00:00
abstract::Bacterial translocation and ileal and cecal injury have been shown to occur 24 h after limited periods of hemorrhagic shock. The present studies were performed to determine the temporal sequence of mucosal injury, permeability, and bacterial translocation after hemorrhagic shock. The results indicated that bacterial t...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/00003246-199005000-00014
更新日期:1990-05-01 00:00:00
abstract:OBJECTIVES:To determine the accuracy of intramucosal pH (pHi) calculated using arterial bicarbonate instead of mucosal capillary bicarbonate in the Henderson-Hasselbalch equation. DESIGN:Simulation of progressive ischemia in mucosal capillary blood. SETTING:University research laboratory. SUBJECTS:Normal human blood...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/00003246-199911000-00028
更新日期:1999-11-01 00:00:00
abstract:OBJECTIVES:Low tidal volume (= tidal volume ≤ 6 mL/kg, predicted body weight) ventilation using volume control benefits patients with acute respiratory distress syndrome. Airway pressure release ventilation is an alternative to low tidal volume-volume control ventilation, but the release breaths generated are variable ...
journal_title:Critical care medicine
pub_type: 杂志文章,多中心研究,随机对照试验
doi:10.1097/CCM.0000000000003437
更新日期:2018-12-01 00:00:00
abstract:OBJECTIVE:To describe a case of intentional ingestion of hand sanitizer in our hospital and to review published cases and those reported to the American Association of Poison Control Centers' National Poison Data System. DESIGN:A case report, a literature review of published cases, and a query of the National Poison D...
journal_title:Critical care medicine
pub_type: 杂志文章,评审
doi:10.1097/CCM.0b013e31822f09c0
更新日期:2012-01-01 00:00:00
abstract:OBJECTIVE:Treatment options to ameliorate brain damage following cardiopulmonary resuscitation from cardiac arrest are limited. DESIGN:In a porcine model, we evaluated the effects of xenon treatment on neuropathologic and functional outcomes after cardiopulmonary resuscitation. SETTING:Prospective, randomized laborat...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/CCM.0b013e3181802874
更新日期:2008-08-01 00:00:00
abstract:OBJECTIVE:To characterize the endothelium-dependent and endothelium-independent components of abnormal pulmonary vascular tone in canine oleic acid lung injury. DESIGN:Prospective, interventional study. SETTING:University laboratory. SUBJECTS:Twenty anesthetized mongrel dogs. INTERVENTIONS:Right heart catheterizati...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/00003246-200207000-00028
更新日期:2002-07-01 00:00:00
abstract:OBJECTIVES:There is substantial variation in use of life sustaining technologies in patients near the end of life but little is known about variation in physicians' initial ICU admission and intubation decision making processes. Our objective is to describe variation in hospital-based physicians' communication behavior...
journal_title:Critical care medicine
pub_type: 杂志文章,多中心研究
doi:10.1097/CCM.0b013e318287f0dd
更新日期:2013-06-01 00:00:00
abstract:OBJECTIVES:We reviewed randomized trials of adult ICU patients of interventions hypothesized to reduce delirium burden to determine whether interventions that are more effective at reducing delirium duration are associated with a reduction in short-term mortality. DATA SOURCES:We searched CINHAHL, EMBASE, MEDLINE, and...
journal_title:Critical care medicine
pub_type: 杂志文章,meta分析,评审
doi:10.1097/CCM.0000000000000224
更新日期:2014-06-01 00:00:00
abstract::Reimbursement policies are a critical step in the incorporation of new technologies and therapies into the clinical armamentarium. Reimbursement is an umbrella concept describing the process to manage and pay for healthcare services, including benefit coverage, coding, and payment processes. The technologies and servi...
journal_title:Critical care medicine
pub_type: 杂志文章,评审
doi:10.1097/CCM.0b013e3181aa6288
更新日期:2009-07-01 00:00:00
abstract::Quality improvement (QI) activities have been done as long as medicine has been practiced and are integral to safety and efficacy of patient care. The 20th century witnessed sophisticated advances of QI methods, with concurrent advances in research ethics. The suggestion that some interventional QI activities resemble...
journal_title:Critical care medicine
pub_type: 杂志文章,评审
doi:10.1097/01.CCM.0000054902.85329.50
更新日期:2003-03-01 00:00:00
abstract:OBJECTIVE:To evaluate the effects of monoclonal antibody to tumor necrosis factor (TNF)-alpha on the hemodynamic alterations and survival rate in rats subjected to intestinal ischemia/reperfusion. DESIGN:Prospective, randomized study. SETTING:Animal laboratory of an institute for research in traumatology. SUBJECTS:M...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/00003246-199609000-00020
更新日期:1996-09-01 00:00:00
abstract::Healthcare systems spend considerable resources collecting and processing blood cultures for the detection of blood stream pathogens. The process is initiated with the collection of blood cultures that depend upon proper skin disinfection, collection of an adequate number of specimens and volume of blood, and prompt p...
journal_title:Critical care medicine
pub_type: 杂志文章,评审
doi:10.1097/CCM.0b013e318270e771
更新日期:2012-12-01 00:00:00
abstract:BACKGROUND:The early detection of bacterial meningitis is crucial for successful outcome. Heparin-binding protein, a potent inducer of increased vascular permeability, is released from activated neutrophils in severe sepsis. OBJECTIVE:In this study we investigated whether heparin-binding protein levels in cerebrospina...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/CCM.0b013e318206c396
更新日期:2011-04-01 00:00:00
abstract::Twenty-one patients who underwent cardiopulmonary bypass for myocardial revascularization received postoperatively controlled mechanical ventilation (CMV) or intermittent mandatory ventilation (IMV), with or without positive end-expiratory pressure (PEEP). Functional residual capacity (FRC), right-to-left intrapulmona...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/00003246-197611000-00002
更新日期:1976-11-01 00:00:00
abstract::Accurate assessment and rapid decision-making are essential to save lives and improve performance in critical care medicine. Real-time point-of-care ultrasound has become an invaluable adjunct to the clinical evaluation of critically ill and injured patients both for pre- and in-hospital situations. However, a high le...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/01.CCM.0000260680.16213.26
更新日期:2007-05-01 00:00:00
abstract::Hemodynamic, respiratory, and cerebral variables during 2 h of standard external CPR were studied in 5 dogs. In an additional 12 dogs, possible augmentation of these variables by Military Anti-Shock Trousers (MAST) was evaluated. In 9 dogs, external and internal cardiac massage were compared. During ventricular fibril...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/00003246-198003000-00012
更新日期:1980-03-01 00:00:00
abstract::The EEGs of 40 infants paralyzed with D-tubocurarine or pancuronium during the neonatal period were reviewed retrospectively. The 23 infants who survived were re-examined at 1-3 yr of age. Sixteen infants had normal or mildly abnormal EEGs in the neonatal period; 3 died of nonneurologic causes; the remainder were norm...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/00003246-198312000-00004
更新日期:1983-12-01 00:00:00
abstract::To determine whether end-tidal carbon dioxide tension (PETCO2) accurately reflects PaCO2 during high-frequency jet ventilation (HFJV), 43 studies were performed on eight mongrel dogs with normal lungs. During HFJV, minute volume was modified to obtain a range of PaCO2 values from 15.5 to 74.5 torr. When PETCO2 was mea...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/00003246-198610000-00014
更新日期:1986-10-01 00:00:00
abstract::In order to determine and analyze the complication rate of the insertion and maintenance of the balloon-tipped, flow-directed pulmonary artery catheter (PAC), the authors prospectively studied the use of 320 catheters in 219 critically ill patients. Mean patient age was 53 +/- 1 years, and 36% had a history of cardiov...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/00003246-198104000-00006
更新日期:1981-04-01 00:00:00
abstract:OBJECTIVE:We hypothesized that the extent of injury and release of xanthine oxidase, an oxidant generator, into the circulation would be less in normal-flow hypoxia-reoxygenation than in equal duration no-flow ischemia-reperfusion. DESIGN:Randomized study. SETTING:University-based animal research facility. SUBJECTS:...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/00003246-199806000-00034
更新日期:1998-06-01 00:00:00
abstract::The disciplines of critical care and palliative care may initially seem to be polar opposites, yet they share fundamental features. Both focus on the sickest patients in the healthcare system. Each discipline's primary goal-extending life for critical care and comfort and quality of life for palliative care-represents...
journal_title:Critical care medicine
pub_type: 杂志文章,评审
doi:10.1097/01.CCM.0000237347.94229.23
更新日期:2006-11-01 00:00:00