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 cerebral ischemia, overcome diffusion barriers, and improve mitochondrial function. In this study, we investigated the relation between arterial oxygen levels and cerebral energy metabolism, pressure autoregulation, and clinical outcome. METHODS:This retrospective study was based on 115 patients with severe TBI treated in the neurointensive care unit, Uppsala university hospital, Sweden, 2008 to 2018. Data from cerebral microdialysis (MD), arterial blood gases, hemodynamics, and intracranial pressure were analyzed the first 10 days post-injury. The first day post-injury was studied in particular. RESULTS:Arterial oxygen levels were higher and with greater variability on the first day post-injury, whereas it was more stable the following 9 days. Normal-to-high mean pO2 was significantly associated with better pressure autoregulation/lower pressure reactivity index (P = .02) and lower cerebral MD-lactate (P = .04) on day 1. Patients with limited cerebral energy metabolic substrate supply (MD-pyruvate below 120 µM) and metabolic disturbances with MD-lactate-/pyruvate ratio (LPR) above 25 had significantly lower arterial oxygen levels than those with limited MD-pyruvate supply and normal MD-LPR (P = .001) this day. Arterial oxygenation was not associated with clinical outcome. CONCLUSIONS:Maintaining a pO2 above 12 kPa and higher may improve oxidative cerebral energy metabolism and pressure autoregulation, particularly in cases of limited energy substrate supply in the early phase of TBI. Evaluating the cerebral energy metabolic profile could yield a better patient selection for hyperoxic treatment in future trials.
journal_name
J Intensive Care Medjournal_title
Journal of intensive care medicineauthors
Wettervik TS,Engquist H,Howells T,Lenell S,Rostami E,Hillered L,Enblad P,Lewén Adoi
10.1177/0885066620944097subject
Has Abstractpub_date
2020-07-27 00:00:00pages
885066620944097eissn
0885-0666issn
1525-1489pub_type
杂志文章abstract:BACKGROUND:Circulatory shock affects every third patient in intensive care units and is associated with high mortality. Near-infrared spectroscopy (NIRS) could serve as a means for monitoring tissue perfusion in circulatory shock. PURPOSE:To assess the evidence of NIRS monitoring in circulatory shock, we conducted a s...
journal_title:Journal of intensive care medicine
pub_type: 杂志文章
doi:10.1177/0885066620907307
更新日期:2020-10-01 00:00:00
abstract::Venous thromboembolism (VTE) is a major health concern associated with significant morbidity and mortality. Critically ill patients are at an increased risk of VTE compared to general medical patients due to unique risk factors: prolonged immobilization, invasive lines and devices, certain medications, and acquired th...
journal_title:Journal of intensive care medicine
pub_type: 杂志文章,评审
doi:10.1177/0885066618796486
更新日期:2019-11-01 00:00:00
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::Cardiomyopathy secondary to toxic shock syndrome (TSS) is an uncommon but potentially life-threatening problem. We report the case of a 51-year-old male who presented with profound cardiogenic shock and multiorgan failure that could not be managed by conventional therapy with intravenous fluids, vasopressors and inotr...
journal_title:Journal of intensive care medicine
pub_type: 杂志文章
doi:10.1177/0885066613517069
更新日期:2015-02-01 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:OBJECTIVES:We report the case of a 28-year-old patient with systemic lupus erythematosus (SLE) with rapid onset of dyspnea and hemoptysis found to have diffuse alveolar hemorrhage (DAH) with refractory hypoxemia successfully treated with venovenous extracorporeal membrane oxygenation (ECMO). The discussion includes cli...
journal_title:Journal of intensive care medicine
pub_type: 杂志文章,评审
doi:10.1177/0885066612464335
更新日期:2014-03-01 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
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::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::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: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 whole-brain criterion of death provides that a person who has irreversibly lost all clinical functions of the brain is dead. Bedside brain death (BD) tests permit physicians to determine BD by showing that the whole-brain criterion of death has been fulfilled. In a nonsystematic literature review, we identified an...
journal_title:Journal of intensive care medicine
pub_type: 杂志文章
doi:10.1177/0885066618784268
更新日期:2020-08-01 00:00:00
abstract:BACKGROUND::Patients with septic shock by multidrug resistant (MDR) microorganism maybe considered a specific population of critical patients at very high risk of death in whom the effects of standard sepsis treatment has never been assessed. The objective of this retrospective analysis was to evaluate the risk factors...
journal_title:Journal of intensive care medicine
pub_type: 杂志文章
doi:10.1177/0885066616688165
更新日期:2019-01-01 00:00:00
abstract:BACKGROUND:Diagnosing acute kidney injury (AKI) stage 3 in critically ill patients may help physicians in making treatment decisions. This diagnosis relies chiefly on urinary output and serum creatinine, which may be of limited value. This study aimed to explore the diagnostic performance of renal resistive index (RRI)...
journal_title:Journal of intensive care medicine
pub_type: 杂志文章
doi:10.1177/0885066619887333
更新日期:2021-01-01 00:00:00
abstract::Pulmonary embolus (PE) is estimated to cause 200 000 to 300 000 deaths annually. Many deaths occur in hemodynamically unstable patients and the estimated mortality for inpatients with hemodynamic instability is between 15% and 25%. The diagnosis of PE in the critically ill is often challenging because the presentation...
journal_title:Journal of intensive care medicine
pub_type: 杂志文章,评审
doi:10.1177/0885066610392658
更新日期:2011-09-01 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:OBJECTIVE:The process of controlled donation after circulatory death (cDCD) is strongly connected with the process of withdrawal of life-sustaining therapy. In addition to impacting cDCD success, actions comprising withdrawal of life-sustaining therapy have implications for quality of palliative care. We examined pilot...
journal_title:Journal of intensive care medicine
pub_type: 杂志文章
doi:10.1177/0885066615571529
更新日期:2016-05-01 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::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
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: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::Bladder pressure measurement through a foley catheter is the current standard in monitoring for intraabdominal hypertension (IAH) and abdominal compartment syndrome (ACS). Accurate pressure transduction requires a continuous fluid column with a small volume of transducing medium at the tip of the catheter. Infusing ex...
journal_title:Journal of intensive care medicine
pub_type: 杂志文章
doi:10.1177/0885066609335730
更新日期:2009-07-01 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::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::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::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:PURPOSE:Reintubation following unplanned extubation (UE) is often required and associated with increased morbidity; however, knowledge of risk factors leading to reintubation and subsequent outcomes in children is still lacking. We sought to determine the incidence, risk factors, and outcomes related to reintubation af...
journal_title:Journal of intensive care medicine
pub_type: 杂志文章
doi:10.1177/0885066616675130
更新日期:2018-08-01 00:00:00
abstract:OBJECTIVE:When patients deteriorate after decannulation from extracorporeal membrane oxygenation (ECMO), a second run of extracorporeal support may be considered. However, repeat cannulation can be difficult and poor outcomes associated with multiple ECMO runs are a concern. The aim of this study was to evaluate outcom...
journal_title:Journal of intensive care medicine
pub_type: 杂志文章
doi:10.1177/0885066620981903
更新日期:2020-12-22 00:00:00
abstract:BACKGROUND:Poor communication among health-care providers is cited as the most common cause of sentinel events involving patients. Patient care in the critical care setting is incredibly complex. A consistent care plan is necessary between day/night shift teams and among bedside intensive care unit (ICU) nurses, consul...
journal_title:Journal of intensive care medicine
pub_type: 杂志文章
doi:10.1177/0885066616653947
更新日期:2017-09-01 00:00:00
abstract:BACKGROUND:Consensus guidelines support the use of low-molecular-weight heparin for venous thromboembolism (VTE) prophylaxis in high-risk trauma patients but do not recommend a specific regimen. The current study compared the effectiveness and safety of enoxaparin 40 mg once-daily versus enoxaparin 30 mg twice-daily fo...
journal_title:Journal of intensive care medicine
pub_type: 杂志文章
doi:10.1177/0885066610384462
更新日期:2011-03-01 00:00:00