Acidemia does not affect outcomes of patients with acute cardiogenic pulmonary edema treated with continuous positive airway pressure.

Abstract:

INTRODUCTION:A lack of data exists in the literature evaluating acidemia on admission as a favorable or negative prognostic factor in patients with acute cardiogenic pulmonary edema (ACPE) treated with non-invasive continuous positive airway pressure (CPAP). The objective of the present study was to investigate the impact of acidemia on admission on outcomes of ACPE patients treated with CPAP. METHODS:This was a retrospective, observational study of consecutive patients admitted with a diagnosis of ACPE to the Emergency Department of IRCCS Fondazione Cà Granda Ospedale Maggiore Policlinico, Milan, Italy, between January 2003 and December 2006, treated with CPAP on admission. Two groups of patients were identified: subjects with acidemia (acidotic group), and those with a normal pH on admission (controls). The primary endpoint was clinical failure, defined as switch to bi-level ventilation, switch to endotracheal intubation or inhospital mortality. RESULTS:Among the 378 patients enrolled, 290 (77%) were acidotic on admission. A total of 28 patients (9.7%) in the acidotic group and eight patients (9.1%) among controls experienced a clinical failure (odds ratio = 1.069, 95% confidence interval = 0.469 to 2.438, P = 0.875). Survival analysis indicates that, among acidotic patients, the time at which 50% of patients reached the 7.35 threshold was 173 minutes (95% confidence interval = 153 to 193). Neither acidemia (P = 0.205) nor the type of acidosis on admission (respiratory acidosis, P = 0.126; metabolic acidosis, P = 0.292; mixed acidosis, P = 0.397) affected clinical failure after adjustment for clinical and laboratory factors in a multivariable logistic regression model. CONCLUSIONS:Neither acidemia nor the type of acidosis on admission should be considered risk factors for adverse outcomes in ACPE patients treated with CPAP.

journal_name

Crit Care

authors

Aliberti S,Piffer F,Brambilla AM,Bignamini AA,Rosti VD,Maraffi T,Monzani V,Cosentini R

doi

10.1186/cc9315

subject

Has Abstract

pub_date

2010-01-01 00:00:00

pages

R196

issue

6

eissn

1364-8535

issn

1466-609X

pii

cc9315

journal_volume

14

pub_type

杂志文章
  • Preload-independent mechanisms contribute to increased stroke volume following large volume saline infusion in normal volunteers: a prospective interventional study.

    abstract:INTRODUCTION:Resuscitation with saline is a standard initial response to hypotension or shock of almost any cause. Saline resuscitation is thought to generate an increase in cardiac output through a preload-dependent (increased end-diastolic volume) augmentation of stroke volume. We sought to confirm this to be the mec...

    journal_title:Critical care (London, England)

    pub_type: 临床试验,杂志文章

    doi:10.1186/cc2844

    authors: Kumar A,Anel R,Bunnell E,Zanotti S,Habet K,Haery C,Marshall S,Cheang M,Neumann A,Ali A,Kavinsky C,Parrillo JE

    更新日期:2004-06-01 00:00:00

  • Clinical review: Vasculitis on the intensive care unit--part 1: diagnosis.

    abstract::The first part of this review addresses the diagnosis and differential diagnosis of the primary vasculitides Wegener's granulomatosis, microscopic polyangiitis, Churg-Strauss syndrome and polyarteritis nodosa. Prompt diagnosis and treatment of these conditions ensures an optimal prognosis. The development of assays fo...

    journal_title:Critical care (London, England)

    pub_type: 杂志文章,评审

    doi:10.1186/cc2936

    authors: Semple D,Keogh J,Forni L,Venn R

    更新日期:2005-02-01 00:00:00

  • Clinical use of [TIMP-2]•[IGFBP7] biomarker testing to assess risk of acute kidney injury in critical care: guidance from an expert panel.

    abstract:BACKGROUND:The first FDA-approved test to assess risk for acute kidney injury (AKI), [TIMP-2]•[IGFBP7], is clinically available in many parts of the world, including the USA and Europe. We sought to understand how the test is currently being used clinically. METHODS:We invited a group of experts knowledgeable on the u...

    journal_title:Critical care (London, England)

    pub_type: 杂志文章

    doi:10.1186/s13054-019-2504-8

    authors: Guzzi LM,Bergler T,Binnall B,Engelman DT,Forni L,Germain MJ,Gluck E,Göcze I,Joannidis M,Koyner JL,Reddy VS,Rimmelé T,Ronco C,Textoris J,Zarbock A,Kellum JA

    更新日期:2019-06-20 00:00:00

  • Risk factors and events in the adult intensive care unit associated with pain as self-reported at the end of the intensive care unit stay.

    abstract:BACKGROUND:The short-term and long-term consequences of the most frequent painful procedures performed in the ICU are unclear. This study aimed to identify the risk factors associated with pain-related discomfort perceived by critically ill patients during the whole ICU stay as self-reported by patients at the end of t...

    journal_title:Critical care (London, England)

    pub_type: 杂志文章

    doi:10.1186/s13054-020-03396-2

    authors: Kalfon P,Boucekine M,Estagnasie P,Geantot MA,Berric A,Simon G,Floccard B,Signouret T,Fromentin M,Nyunga M,Audibert J,Ben Salah A,Mauchien B,Sossou A,Venot M,Robert R,Follin A,Renault A,Garrouste-Orgeas M,Collange O

    更新日期:2020-12-07 00:00:00

  • Clinical review: Drug metabolism and nonrenal clearance in acute kidney injury.

    abstract::Decreased renal drug clearance is an obvious consequence of acute kidney injury (AKI). However, there is growing evidence to suggest that nonrenal drug clearance is also affected. Data derived from human and animal studies suggest that hepatic drug metabolism and transporter function are components of nonrenal clearan...

    journal_title:Critical care (London, England)

    pub_type: 杂志文章,评审

    doi:10.1186/cc7093

    authors: Vilay AM,Churchwell MD,Mueller BA

    更新日期:2008-01-01 00:00:00

  • Inhaled nitric oxide and the risk of renal dysfunction in patients with acute respiratory distress syndrome: a propensity-matched cohort study.

    abstract:BACKGROUND:Inhaled nitric oxide (iNO) is a rescue therapy for severe hypoxemia in patients with acute respiratory distress syndrome (ARDS). Pooled data from clinical trials have signaled a renal safety warning for iNO therapy, but the significance of these findings in daily clinical practice is unclear. We used primary...

    journal_title:Critical care (London, England)

    pub_type: 杂志文章

    doi:10.1186/s13054-016-1566-0

    authors: Ruan SY,Wu HY,Lin HH,Wu HD,Yu CJ,Lai MS

    更新日期:2016-11-30 00:00:00

  • Clinical review: Serious adverse events associated with the use of rituximab - a critical care perspective.

    abstract::The advent of biologic agents has provided a more specific and targeted approach to the treatment of various hematological malignancies and other autoimmune disorders. Such biologic agents have been relatively well tolerated with fewer adverse events reported as compared with many other chemotherapeutic agents. Rituxi...

    journal_title:Critical care (London, England)

    pub_type: 杂志文章,评审

    doi:10.1186/cc11304

    authors: Kasi PM,Tawbi HA,Oddis CV,Kulkarni HS

    更新日期:2012-08-31 00:00:00

  • Diagnosis and management of inhalation injury: an updated review.

    abstract::In this article we review recent advances made in the pathophysiology, diagnosis, and treatment of inhalation injury. Historically, the diagnosis of inhalation injury has relied on nonspecific clinical exam findings and bronchoscopic evidence. The development of a grading system and the use of modalities such as chest...

    journal_title:Critical care (London, England)

    pub_type: 杂志文章,评审

    doi:10.1186/s13054-015-1077-4

    authors: Walker PF,Buehner MF,Wood LA,Boyer NL,Driscoll IR,Lundy JB,Cancio LC,Chung KK

    更新日期:2015-10-28 00:00:00

  • Cardiovascular response to dobutamine stress predicts outcome in severe sepsis and septic shock.

    abstract:INTRODUCTION:During septic shock, resistance to the haemodynamic effects of catecholamine vasopressors and inotropes is a well-recognised marker of mortality risk. However, the specific cardiovascular or metabolic response elements that are most closely associated with outcome have not been well defined. The objective ...

    journal_title:Critical care (London, England)

    pub_type: 杂志文章

    doi:10.1186/cc6814

    authors: Kumar A,Schupp E,Bunnell E,Ali A,Milcarek B,Parrillo JE

    更新日期:2008-01-01 00:00:00

  • Prediction of mortality in adult patients with severe acute lung failure receiving veno-venous extracorporeal membrane oxygenation: a prospective observational study.

    abstract:INTRODUCTION:Veno-venous extracorporeal membrane oxygenation (vvECMO) can be a life-saving therapy in patients with severe acute lung failure refractory to conventional therapy. Nevertheless, vvECMO is a procedure associated with high costs and resource utilization. The aim of this study was to assess published models ...

    journal_title:Critical care (London, England)

    pub_type: 杂志文章

    doi:10.1186/cc13824

    authors: Enger T,Philipp A,Videm V,Lubnow M,Wahba A,Fischer M,Schmid C,Bein T,Müller T

    更新日期:2014-04-09 00:00:00

  • Open lung biopsy in early-stage acute respiratory distress syndrome.

    abstract:INTRODUCTION:Acute respiratory distress syndrome (ARDS) has heterogeneous etiologies, rapid progressive change and a high mortality rate. To improve the outcome of ARDS, accurate diagnosis is essential to the application of effective early treatment. The present study investigated the clinical effects and safety of ope...

    journal_title:Critical care (London, England)

    pub_type: 杂志文章

    doi:10.1186/cc4981

    authors: Kao KC,Tsai YH,Wu YK,Chen NH,Hsieh MJ,Huang SF,Huang CC

    更新日期:2006-01-01 00:00:00

  • Pentobarbital versus thiopental in the treatment of refractory intracranial hypertension in patients with traumatic brain injury: a randomized controlled trial.

    abstract:INTRODUCTION:Experimental research has demonstrated that the level of neuroprotection conferred by the various barbiturates is not equal. Until now no controlled studies have been conducted to compare their effectiveness, even though the Brain Trauma Foundation Guidelines recommend that such studies be undertaken. The ...

    journal_title:Critical care (London, England)

    pub_type: 杂志文章,随机对照试验

    doi:10.1186/cc6999

    authors: Pérez-Bárcena J,Llompart-Pou JA,Homar J,Abadal JM,Raurich JM,Frontera G,Brell M,Ibáñez J,Ibáñez J

    更新日期:2008-01-01 00:00:00

  • Development of antibiotic treatment algorithms based on local ecology and respiratory surveillance cultures to restrict the use of broad-spectrum antimicrobial drugs in the treatment of hospital-acquired pneumonia in the intensive care unit: a retrospecti

    abstract:INTRODUCTION:Timely administration of appropriate antibiotic therapy has been shown to improve outcome in hospital-acquired pneumonia (HAP). Empirical treatment guidelines tailored to local ecology have been advocated in antibiotic stewardship programs. We compared a local ecology based algorithm (LEBA) to a surveillan...

    journal_title:Critical care (London, England)

    pub_type: 杂志文章

    doi:10.1186/cc13990

    authors: De Bus L,Saerens L,Gadeyne B,Boelens J,Claeys G,De Waele JJ,Benoit DD,Decruyenaere J,Depuydt PO

    更新日期:2014-07-15 00:00:00

  • Recently published papers: from superbugs to superbowl.

    abstract::Several papers are discussed including the CARP (Coronary Artery Revascularisation Prophylaxis) trial, examining the role, if any, of preoperative coronary revascularisation and a study examining the heart rate in the intensive care unit (ICU) population. We also take a look at infections in the ICU with particular re...

    journal_title:Critical care (London, England)

    pub_type: 杂志文章

    doi:10.1186/cc3505

    authors: Tomlinson LA,Forni LG

    更新日期:2005-04-01 00:00:00

  • The subxiphoid view cannot replace the apical view for transthoracic echocardiographic assessment of hemodynamic status.

    abstract:INTRODUCTION:This prospective study aimed to assess whether use of the subxiphoid acoustic window in transthoracic echocardiography (TTE) can be an accurate alternative in the absence of an apical view to assess hemodynamic parameters. METHODS:This prospective study took place in a teaching hospital medical ICU. Over ...

    journal_title:Critical care (London, England)

    pub_type: 杂志文章

    doi:10.1186/cc12869

    authors: Maizel J,Salhi A,Tribouilloy C,Massy ZA,Choukroun G,Slama M

    更新日期:2013-09-03 00:00:00

  • A systematic review of randomized controlled trials exploring the effect of immunomodulative interventions on infection, organ failure, and mortality in trauma patients.

    abstract:INTRODUCTION:Following trauma, patients may suffer an overwhelming pro-inflammatory response and immune paralysis resulting in infection and multiple organ failure (MOF). Various potentially immunomodulative interventions have been tested. The objective of this study is to systematically review the randomized controlle...

    journal_title:Critical care (London, England)

    pub_type: 杂志文章,评审

    doi:10.1186/cc9218

    authors: Spruijt NE,Visser T,Leenen LP

    更新日期:2010-01-01 00:00:00

  • Clinical review: Intra-abdominal hypertension: does it influence the physiology of prone ventilation?

    abstract::Prone ventilation (PV) is a ventilatory strategy that frequently improves oxygenation and lung mechanics in critical illness, yet does not consistently improve survival. While the exact physiologic mechanisms related to these benefits remain unproven, one major theoretical mechanism relates to reducing the abdominal e...

    journal_title:Critical care (London, England)

    pub_type: 杂志文章,评审

    doi:10.1186/cc9099

    authors: Kirkpatrick AW,Pelosi P,De Waele JJ,Malbrain ML,Ball CG,Meade MO,Stelfox HT,Laupland KB

    更新日期:2010-01-01 00:00:00

  • Immune derangement occurs in patients with H7N9 avian influenza.

    abstract:INTRODUCTION:Currently, little is known about the immunological characteristics of patients with avian influenza A (H7N9) virus infection. METHODS:The numbers and percentages of peripheral blood immune cells were measured in 27 patients with laboratory-confirmed H7N9 virus infection and 30 healthy controls (HCs). The ...

    journal_title:Critical care (London, England)

    pub_type: 杂志文章

    doi:10.1186/cc13788

    authors: Wu W,Shi Y,Gao H,Liang W,Sheng J,Li L

    更新日期:2014-03-24 00:00:00

  • Efficacy and safety of a low-flow veno-venous carbon dioxide removal device: results of an experimental study in adult sheep.

    abstract:INTRODUCTION:Extracorporeal lung assist, an extreme resource in patients with acute respiratory failure (ARF), is expanding its indications since knowledge about ventilator-induced lung injury has increased and protective ventilation has become the standard in ARF. METHODS:A prospective study on seven adult sheep was ...

    journal_title:Critical care (London, England)

    pub_type: 杂志文章

    doi:10.1186/cc5082

    authors: Livigni S,Maio M,Ferretti E,Longobardo A,Potenza R,Rivalta L,Selvaggi P,Vergano M,Bertolini G

    更新日期:2006-01-01 00:00:00

  • Body cell mass evaluation in critically ill patients: killing two birds with one stone.

    abstract::Body cell mass (BCM) is the metabolically active cell mass involved in O₂ consumption, CO₂ production and energy expenditure. BCM measurement has been suggested as a tool for the evaluation of nutritional status. Since BCM is closely related to energy expenditure, it could also represent a good reference value for the...

    journal_title:Critical care (London, England)

    pub_type: 评论,杂志文章

    doi:10.1186/cc13852

    authors: Fiaccadori E,Morabito S,Cabassi A,Regolisti G

    更新日期:2014-05-01 00:00:00

  • Association of inflammatory biomarkers with subsequent clinical course in suspected late onset sepsis in preterm neonates.

    abstract:BACKGROUND:Sepsis is a major health issue in preterm infants. Biomarkers are used to diagnose and monitor patients with sepsis, but C-reactive protein (CRP) is proven not predictive at onset of late onset neonatal sepsis (LONS) diagnosis. The aim of this study was to evaluate the association of interleukin-6(IL-6), pro...

    journal_title:Critical care (London, England)

    pub_type: 杂志文章

    doi:10.1186/s13054-020-03423-2

    authors: Kurul Ş,Simons SHP,Ramakers CRB,De Rijke YB,Kornelisse RF,Reiss IKM,Taal HR

    更新日期:2021-01-06 00:00:00

  • An updated study-level meta-analysis of randomised controlled trials on proning in ARDS and acute lung injury.

    abstract:INTRODUCTION:In patients with acute lung injury (ALI) and/or acute respiratory distress syndrome (ARDS), recent randomised controlled trials (RCTs) showed a consistent trend of mortality reduction with prone ventilation. We updated a meta-analysis on this topic. METHODS:RCTs that compared ventilation of adult patients...

    journal_title:Critical care (London, England)

    pub_type: 杂志文章,meta分析

    doi:10.1186/cc9403

    authors: Abroug F,Ouanes-Besbes L,Dachraoui F,Ouanes I,Brochard L

    更新日期:2011-01-01 00:00:00

  • Antibiotic therapeutic drug monitoring in intensive care patients treated with different modalities of extracorporeal membrane oxygenation (ECMO) and renal replacement therapy: a prospective, observational single-center study.

    abstract:BACKGROUND:Effective antimicrobial treatment is key to reduce mortality associated with bacterial sepsis in patients on intensive care units (ICUs). Dose adjustments are often necessary to account for pathophysiological changes or renal replacement therapy. Extracorporeal membrane oxygenation (ECMO) is increasingly bei...

    journal_title:Critical care (London, England)

    pub_type: 杂志文章

    doi:10.1186/s13054-020-03397-1

    authors: Kühn D,Metz C,Seiler F,Wehrfritz H,Roth S,Alqudrah M,Becker A,Bracht H,Wagenpfeil S,Hoffmann M,Bals R,Hübner U,Geisel J,Lepper PM,Becker SL

    更新日期:2020-11-25 00:00:00

  • Bench-to-bedside review: fulfilling promises of the Human Genome Project.

    abstract::Since most common diseases have been shown to be influenced by inherited variations in our genes, completion of the Human Genome Project and mapping of the human genome single-nucleotide polymorphisms will have a tremendous impact on our approach to medicine. New developments in genotyping techniques and bioinformatic...

    journal_title:Critical care (London, England)

    pub_type: 杂志文章,评审

    doi:10.1186/cc1491

    authors: Chiche JD,Cariou A,Mira JP

    更新日期:2002-06-01 00:00:00

  • Brain dysfunction in sepsis: what can we learn from cerebral perfusion studies?

    abstract::Investigations on the relationship between sepsis, brain dysfunction, and cerebral perfusion are methodologically very difficult to perform. It is important to interpret the results of such studies in view of our limited ability to diagnose and quantify brain dysfunction and to consider our limited understanding of th...

    journal_title:Critical care (London, England)

    pub_type: 评论,社论

    doi:10.1186/cc6217

    authors: Steiner LA

    更新日期:2008-01-01 00:00:00

  • Novel insights in ICU-acquired respiratory muscle dysfunction: implications for clinical care.

    abstract::This article is one of ten reviews selected from the Annual Update in Intensive Care and Emergency medicine 2017. Other selected articles can be found online at http://ccforum.com/series/annualupdate2017 . Further information about the Annual Update in Intensive Care and Emergency Medicine is available from http://www...

    journal_title:Critical care (London, England)

    pub_type: 杂志文章,评审

    doi:10.1186/s13054-017-1642-0

    authors: Jonkman AH,Jansen D,Heunks LM

    更新日期:2017-03-21 00:00:00

  • Identification and characterisation of the high-risk surgical population in the United Kingdom.

    abstract:INTRODUCTION:Little is known about mortality rates following general surgical procedures in the United Kingdom. Deaths are most common in the 'high-risk' surgical population consisting mainly of older patients, with coexisting medical disease, who undergo major surgery. Only limited data are presently available to desc...

    journal_title:Critical care (London, England)

    pub_type: 杂志文章

    doi:10.1186/cc4928

    authors: Pearse RM,Harrison DA,James P,Watson D,Hinds C,Rhodes A,Grounds RM,Bennett ED

    更新日期:2006-01-01 00:00:00

  • Leukodepleted versus nonleukodepleted red blood cell transfusion in septic patients: a microcirculatory vision.

    abstract::Storage time and residual leukocytes in red blood cell (RBC) units may be deleterious by increasing the accumulation of leukocyte-derived cytokines and by raising the adhesion of RBCs to endothelium. Leukodepleted RBC transfusion may reduce the incidence of infection and organ dysfunction. However, the influence of le...

    journal_title:Critical care (London, England)

    pub_type: 评论,杂志文章

    doi:10.1186/cc13811

    authors: Tanaka S,Harrois A,Duranteau J

    更新日期:2014-04-01 00:00:00

  • Identifying associations between diabetes and acute respiratory distress syndrome in patients with acute hypoxemic respiratory failure: an analysis of the LUNG SAFE database.

    abstract:BACKGROUND:Diabetes mellitus is a common co-existing disease in the critically ill. Diabetes mellitus may reduce the risk of acute respiratory distress syndrome (ARDS), but data from previous studies are conflicting. The objective of this study was to evaluate associations between pre-existing diabetes mellitus and ARD...

    journal_title:Critical care (London, England)

    pub_type: 杂志文章,多中心研究

    doi:10.1186/s13054-018-2158-y

    authors: Boyle AJ,Madotto F,Laffey JG,Bellani G,Pham T,Pesenti A,Thompson BT,O'Kane CM,Deane AM,McAuley DF,LUNG SAFE Investigators.,ESICM Trials Group.

    更新日期:2018-10-27 00:00:00

  • An overview of harms associated with beta-lactam antimicrobials: where do the carbapenems fit in?

    abstract::The US Institute of Medicine's focus on patient safety has motivated hospital administrators to facilitate a culture of safety. As a result, subcommittees of the pharmacy and therapeutics committee have emerged in many hospitals to focus on adverse events and patient safety. Antimicrobial harms have gained the attenti...

    journal_title:Critical care (London, England)

    pub_type: 杂志文章,评审

    doi:10.1186/cc6819

    authors: Owens RC Jr

    更新日期:2008-01-01 00:00:00