Abstract:
OBJECTIVE:To compare the effects of two different antibiotic regimes on the colonization and infection rates of critically ill pediatric patients. DESIGN:A prospective randomized trial. SETTING:A pediatric ICU in a university hospital. PATIENTS:Fifty critically ill pediatric patients who required intensive care for at least 4 days were randomly allocated to either the selective parenteral and enteral antisepsis regimen (treatment group, n = 25) or the control group (n = 25). INTERVENTIONS:The treatment group received oral nonabsorbable antimicrobial agents (polymyxin E, gentamicin, and amphotericin B) and parenteral cefotaxime, whereas the control group received either perioperative antibiotic prophylaxis or antibiotic therapy according to clinical or microbiological evidence of infection. RESULTS:Both groups were comparable for age, body weight, sex, and severity of illness. Colonization with Gram-negative microorganisms and yeasts in the oropharynx, and digestive and respiratory tracts increased rapidly up to 52% in the control group, whereas there was no colonization with these microorganisms in the treatment group. The occurrence rates of acquired secondary infections in the control and treatment groups were 36% and 8%, respectively (p less than .025). There were no differences between groups in the duration of intensive care or mortality rate. CONCLUSION:Selective oropharyngeal and gastrointestinal decontamination combined with systemic cefotaxime application allows for a significant reduction of the colonization rate with Gram-negative bacteria and yeasts in critically ill pediatric patients undergoing prolonged intensive care. In addition, it significantly reduces the Gram-negative infection rate of the respiratory system. However, this therapeutic approach does not alter ICU length of stay or mortality rate.
journal_name
Crit Care Medjournal_title
Critical care medicineauthors
Zobel G,Kuttnig M,Grubbauer HM,Semmelrock HJ,Thiel Wdoi
10.1097/00003246-199110000-00005subject
Has Abstractpub_date
1991-10-01 00:00:00pages
1242-6issue
10eissn
0090-3493issn
1530-0293journal_volume
19pub_type
临床试验,杂志文章,随机对照试验abstract::Clinical impressions about the problem of defibrillation during states of acid-base imbalance and hypoxia have been influenced by studies involving the effect of these derangements on the ventricular fibrillation threshold. Based on body weight, energy requirements for defibrillation in normal dogs were compared to re...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/00003246-197507000-00003
更新日期:1975-07-01 00:00:00
abstract::Twenty preterm infants in respiratory distress, each with an umbilical catheter in place, were studied during their first 24 h of hospitalization, to determine the effects of continuous transcutaneous oxygen (PtcO2) monitoring on the frequency of arterial blood gas (ABG) determinations and on the incidence of hypoxia ...
journal_title:Critical care medicine
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1097/00003246-198402000-00009
更新日期:1984-02-01 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:To characterize the rates of accidental removal of endotracheal tubes, nasogastric tubes, central venous catheters, and arterial catheters. To assess the efficacy of corrective measures aimed at reducing the accidental removal of these devices. DESIGN:Prospective, observational, and interventional study. S...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/00003246-200001000-00010
更新日期:2000-01-01 00:00:00
abstract:OBJECTIVE:To assess the number of adult critical care beds in Asian countries and regions in relation to population size. DESIGN:Cross-sectional observational study. SETTING:Twenty-three Asian countries and regions, covering 92.1% of the continent's population. PARTICIPANTS:Ten low-income and lower-middle-income eco...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/CCM.0000000000004222
更新日期:2020-05-01 00:00:00
abstract::Ventricular fibrillation (VF) can masquerade as asystole. We report a 54-yr-old male in cardiac arrest who, on surface ECG, appeared to be in VF or asystole. A bedside intracardiac recording using a transmyocardial pacing wire showed the true rhythm to be atrial fibrillation (AF) with high grade atrioventricular block...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/00003246-198704000-00013
更新日期:1987-04-01 00:00:00
abstract::Reproducibility of thermal-dye extravascular lung water (EVLW) estimation by a lung water computer was studied by performing ten consecutive measurements in 45 critically ill patients. EVLW ranged over a wide spectrum from 187 to 1163 ml (2.4 to 18.6 ml/kg). The mean coefficient of variation of ten consecutive measure...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/00003246-198706000-00014
更新日期:1987-06-01 00:00:00
abstract:OBJECTIVE:To analyze the effects of an extracorporeal bioartificial liver containing alginate bead-entrapped hepatocytes on pigs with ischemia-induced acute hepatic failure. DESIGN:Prospective animal study. SETTING:University and INSERM laboratory. SUBJECTS:Fifteen Large White/Pietrin female pigs weighing 20-30 kg. ...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/00003246-200203000-00027
更新日期:2002-03-01 00:00:00
abstract:BACKGROUND:Hemorrhage in trauma is a significant challenge, accounting for 30% to 40% of all fatalities, second only to central nervous system injury as a cause of death. However, hemorrhagic death is the leading preventable cause of mortality in combat casualties and typically occurs within 6 to 24 hrs of injury. In c...
journal_title:Critical care medicine
pub_type: 杂志文章,评审
doi:10.1097/CCM.0b013e31817e2ec5
更新日期:2008-07-01 00:00:00
abstract::A patient with brainstem infarction met the clinical criteria for brain death but had persistent EEG activity, complicating our decision to withdraw life support. We evaluated cerebral blood flow with xenon-enhanced computed tomography (Xe/CT), which documented the absence of posterior circulation flow and persistent,...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/00003246-198705000-00014
更新日期:1987-05-01 00:00:00
abstract:BACKGROUND:Hemoglobin (Hb) induces vasoconstriction by heme group binding nitric oxide in an irreversible fashion. Recent in vitro studies indicate that the thiol groups in Hb reversibly bind nitric oxide and participate in trans-nitrosylation reactions with other thiols. Sepsis is a pathophysiologic state characterize...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/00003246-200211000-00015
更新日期:2002-11-01 00:00:00
abstract::The focus on improving education in critical care medicine must begin early in medical school training and further be promoted during residency if there is to be an increase in intensivists in the hospital workforce. This is "critical" to healthcare reform movements that are endorsing full-time critical care coverage ...
journal_title:Critical care medicine
pub_type: 杂志文章,评审
doi:10.1097/01.CCM.0000252917.25301.18
更新日期:2007-02-01 00:00:00
abstract:OBJECTIVE:The aim of the present study was to characterize pulmonary surfactant properties in children undergoing cardiovascular surgery with cardiopulmonary bypass. DESIGN:Prospective clinical trial. SETTING:University hospital pediatric intensive care unit. PATIENTS:Fifty pediatric patients with congenital cardiac...
journal_title:Critical care medicine
pub_type: 临床试验,杂志文章
doi:10.1097/00003246-200301000-00045
更新日期:2003-01-01 00:00:00
abstract:OBJECTIVE:To measure patients' risk for acquiring antibiotic-resistant microorganisms associated with intensive care unit admission. DESIGN:Prospective, observational study. SETTING:Ten public hospitals including one university medical center. PATIENTS:Consecutive patients admitted to ten intensive care units. INTE...
journal_title:Critical care medicine
pub_type: 杂志文章,多中心研究
doi:10.1097/01.CCM.0000059437.01924.97
更新日期:2003-04-01 00:00:00
abstract:OBJECTIVE:The aim of this study is to test the hypothesis that recruitment maneuvers (RMs) might act differently in models of pulmonary (p) and extrapulmonary (exp) acute lung injury (ALI) with similar transpulmonary pressure changes. DESIGN:Prospective, randomized, controlled experimental study. SETTING:University r...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/CCM.0b013e3181760e5d
更新日期:2008-06-01 00:00:00
abstract:OBJECTIVE:To investigate the interaction and involvement of hydrogen sulfide and transient receptor potential vanilloid type 1 in the pathogenesis of sepsis. Hydrogen sulfide has been demonstrated to be involved in many inflammatory states including sepsis. Its contribution in neurogenic inflammation has been suggested...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/CCM.0b013e3181c0df00
更新日期:2010-02-01 00:00:00
abstract:BACKGROUND AND METHODS:This study was designed to test whether dopexamine, a dopaminergic and beta 2-adrenergic agonist, would a) increase systemic oxygen delivery (DO2) in endotoxic dogs, and b) interfere with the ability of resting skeletal muscle to extract oxygen. There were three treatment groups (n = 6 in each gr...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/00003246-199102000-00015
更新日期:1991-02-01 00:00:00
abstract:OBJECTIVES:In this study, we evaluated the inflammatory response in patients with severe acute respiratory infection due to the Middle East respiratory syndrome and non-Middle East respiratory syndrome and assessed the presence of distinct inflammatory subphenotypes using latent class analysis. DESIGN:Prospective coho...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/CCM.0000000000004724
更新日期:2021-02-01 00:00:00
abstract:OBJECTIVE:To report two cases of severe reactive hemophagocytic syndrome (RHS), to discuss their impact, and to present evidence that RHS may be a constitutive part of multiple organ dysfunction syndrome (MODS). DESIGN:Case-report. SETTING:Pediatric intensive care unit (PICU). PATIENTS:Two patients with RHS and MODS...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/00003246-200009000-00038
更新日期:2000-09-01 00:00:00
abstract:OBJECTIVE:In children, like in adults, tracheal intubation is a painful procedure that may induce hypertension, tachycardia, and other undesirable hemodynamic disorders. Although premature neonates are very sensitive to pain and vulnerable to its long-term effects, the need for sedation before tracheal intubation is st...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/01.CCM.0000108883.58081.E3
更新日期:2004-02-01 00:00:00
abstract:OBJECTIVES:To perform a scoping literature review of cognitive, psychiatric, and quality of life outcomes in adults undergoing extracorporeal membrane oxygenation for any indication. DATA SOURCES:We searched PubMed, EMBASE, Cochrane Library, Web of Science, CINAHL, and PsycINFO from inception to June 2019. STUDY SELE...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/CCM.0000000000004488
更新日期:2020-10-01 00:00:00
abstract:BACKGROUND:Noncuffed, percutaneously inserted central venous catheters (CVCs) are widely used and cause at least 250,000 bloodstream infections (BSIs) in U.S. hospitals each year. We report a prospective study to determine whether inflammation at the insertion site is predictive of CVC-related BSI. METHODS:Percutaneou...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/00003246-200212000-00003
更新日期:2002-12-01 00:00:00
abstract:OBJECTIVE:The Sequential Organ Failure Assessment (SOFA) score was developed to quantify the severity of patients' illness, based on the degree of organ dysfunction. This study aimed to evaluate the accuracy and the reliability of SOFA scoring. DESIGN:Prospective study. SETTING:Adult intensive care unit (ICU) in a te...
journal_title:Critical care medicine
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1097/01.ccm.0000178178.02574.ab
更新日期:2005-09-01 00:00:00
abstract:OBJECTIVE:To assess the feasibility and safety of delivering early goal-directed sedation compared with standard sedation. DESIGN:Pilot prospective, multicenter, randomized, controlled trial. SETTING:Six ICUs. PATIENTS:Critically ill adults mechanically ventilated for greater than 24 hours. INTERVENTIONS:Patients r...
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.0b013e31828a437d
更新日期:2013-08-01 00:00:00
abstract:OBJECTIVES:To provide an overview of key elements of the Affordable Care Act. To evaluate ways in which the Affordable Care Act will likely impact the practice of critical care medicine. To describe strategies that may help health systems and providers effectively adapt to changes brought about by the Affordable Care A...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/CCM.0000000000001431
更新日期:2016-03-01 00:00:00
abstract:OBJECTIVES:To investigate family perceptions of having a nurse participating in family conferences and to assess the psychologic well being of the same families after ICU discharge. DESIGN:Mixed-method design with a qualitative study embedded in a single-center randomized study. SETTING:Twelve-bed medical-surgical IC...
journal_title:Critical care medicine
pub_type: 杂志文章,随机对照试验
doi:10.1097/CCM.0000000000001632
更新日期:2016-06-01 00:00:00
abstract:OBJECTIVE:To present electron micrographs of lung tissue obtained from a patient exposed to high ventilatory pressures in the context of pulmonary dysfunction and pulmonary hypertension. DESIGN:Case report. SETTING:Adult intensive care unit of a university-affiliated teaching hospital. PATIENTS:A patient exposed to ...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/00003246-200210000-00030
更新日期:2002-10-01 00:00:00
abstract:BACKGROUND:Procalcitonin (PCT), a marker of bacterial sepsis, may also act as a mediator of the inflammatory response to infection, and thus influence outcome. OBJECTIVE:To investigate the relationship between PCT, interleukin (IL)-10, tumor necrosis factor (TNF), organ failure, and mortality in pediatric septic shock...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/00003246-200007000-00068
更新日期:2000-07-01 00:00:00
abstract:OBJECTIVE:To describe a severe axonal polyneuropathy that follows acute respiratory failure and, in turn, causes continued ventilator dependence and paralysis after resolution of the primary illness. DESIGN:Retrospective chart review of three patients and prospective analysis of two patients. SETTING:Respiratory and ...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/00003246-199302000-00020
更新日期:1993-02-01 00:00:00
abstract::Intralipid elimination patterns were compared in 25 healthy controls, 12 patients recovering from uncomplicated cholecystectomy, and 25 critically ill patients. The intravenous fat tolerance test revealed a similar fractional removal rate (k2) in healthy controls and critically ill patients, but k2 was increased in ch...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/00003246-198605000-00009
更新日期:1986-05-01 00:00:00