Abstract:
OBJECTIVE:The value of different algorithms that estimate cardiac output (CO) by analysis of a peripheral arterial blood pressure (ABP) waveform has not been definitively identified. In this investigation, we developed a testing data set containing a large number of radial ABP waveform segments and contemporaneous reference CO by thermodilution measurements, collected in an intensive care unit (ICU) patient population during routine clinical operations. We employed this data set to evaluate a set of investigational algorithms, and to establish a public resource for the meaningful comparison of alternative CO-from-ABP algorithms. DESIGN:A retrospective comparative analysis of eight investigational CO-from-ABP algorithms using the Multiparameter Intelligent Monitoring in Intensive Care II database. SETTING:Mixed medical/surgical ICU of a university hospital. PATIENTS:A total of 120 cases. INTERVENTIONS:None. MEASUREMENTS:CO estimated by eight investigational CO-from-ABP algorithms, and CO(TD) as a reference. MAIN RESULTS:All investigational methods were significantly better than mean arterial pressure (MAP) at estimating direction changes in CO(TD). Only the formula proposed by Liljestrand and Zander in 1928 was a significantly better quantitative estimator of CO(TD) compared with MAP (95% limits-of-agreement with CO(TD): -1.76/+1.41 L/min versus -2.20/+1.82 L/min, respectively; p < 0.001, per the Kolmogorov-Smirnov test). The Liljestrand method was even more accurate when applied to the cleanest ABP waveforms. Other investigational algorithms were not significantly superior to MAP as quantitative estimators of CO. CONCLUSIONS:Based on ABP data recorded during routine intensive care unit (ICU) operations, the Liljestrand and Zander method is a better estimator of CO(TD) than MAP alone. Our attempts to fully replicate commercially-available methods were unsuccessful, and these methods could not be evaluated. However, the data set is publicly and freely available, and developers and vendors of CO-from-ABP algorithms are invited to test their methods using these data.
journal_name
Crit Care Medjournal_title
Critical care medicineauthors
Sun JX,Reisner AT,Saeed M,Heldt T,Mark RGdoi
10.1097/CCM.0b013e3181930174subject
Has Abstractpub_date
2009-01-01 00:00:00pages
72-80issue
1eissn
0090-3493issn
1530-0293pii
00003246-200901000-00011journal_volume
37pub_type
杂志文章abstract:OBJECTIVE:To evaluate partial occlusion in patients with pulmonary hypertension with regard to a) the degree to which it leads to overestimation of pulmonary artery occlusion pressure (Ppao) and b) identification of factors that could enhance its recognition. DESIGN:Observational descriptive study. SETTING:Medical in...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/00003246-200301000-00015
更新日期:2003-01-01 00:00:00
abstract:OBJECTIVE:Acute renal failure remains a major challenge in critical care medicine. Both neutrophils and chemokines have been proposed as key components in the development of acute renal failure. Although the Duffy antigen receptor for chemokines (DARC) is present in several tissues and a highly specific ligand for vari...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/01.ccm.0000280570.82885.32
更新日期:2007-09-01 00:00:00
abstract:OBJECTIVE:To determine a meta-analytical definition of the discriminant power of Ranson's signs in the prediction of acute pancreatitis severity and outcome, and of their information content, also compared with clinical judgment. DATA SOURCES:Two hundred eleven studies since 1974, reporting any predictive system for a...
journal_title:Critical care medicine
pub_type: 杂志文章,meta分析
doi:10.1097/00003246-199910000-00035
更新日期:1999-10-01 00:00:00
abstract::The ability of ACTH-(1-24) to prolong survival and to extend the deadline for effective blood reinfusion has been studied in a model of lethal hypovolemic shock in the rat. Anesthetized rats were bled to a mean arterial pressure of 18 to 25 mm Hg and then subjected to one of the following iv treatments: a) saline; b) ...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/00003246-199008000-00014
更新日期:1990-08-01 00:00:00
abstract:OBJECTIVES:Extracellular mitochondrial DNA and N-formyl peptides released following tissue damage may contribute to systemic inflammation through stimulation of the innate immune system. In this review, we evaluate existing in vivo human data regarding a role for mitochondrial DNA and N-formyl peptides in producing sys...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/CCM.0000000000003381
更新日期:2018-12-01 00:00:00
abstract:OBJECTIVE:Most intensive care deaths beyond the first few days of critical illness are attributable to nonresolving organ failure, either due to or coinciding with sepsis. One of the mechanisms that is thought to contribute to the pathogenesis of organ failure is microvascular thrombosis. Recently, we reported signific...
journal_title:Critical care medicine
pub_type: 杂志文章,随机对照试验
doi:10.1097/CCM.0b013e31816f7bae
更新日期:2008-05-01 00:00:00
abstract:OBJECTIVES:Sepsis, a life-threatening organ dysfunction caused by a dysregulated host response to infection, is a leading cause of death and disability among children worldwide. Identifying sepsis in pediatric patients is difficult and can lead to treatment delay. Our objective was to assess the host proteomic response...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/CCM.0000000000004083
更新日期:2020-01-01 00:00:00
abstract:OBJECTIVE:Isoflurane, a volatile anesthetic agent, has been recognized for its potential neuroprotective properties and has antiapoptotic effects. We examined whether isoflurane posttreatment is protective against early brain injury after subarachnoid hemorrhage and determined whether this effect needs sphingosine-rela...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/CCM.0b013e3182474bc1
更新日期:2012-06-01 00:00:00
abstract:OBJECTIVE:To determine whether clinically relevant airspace concentrations of beta2-adrenergic agonists stimulated maximal alveolar fluid clearance rates and to determine whether beta2 agonist therapy decreased pulmonary edema in experimental acute lung injury. DESIGN:Prospective randomized laboratory investigation. ...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/01.ccm.0000129489.34416.0e
更新日期:2004-07-01 00:00:00
abstract:OBJECTIVE:To determine the ability of somatosensory evoked potentials (SEP) compared with clinical findings to monitor and predict recovery in patients suffering from closed head injury with predominantly diffuse axonal injury (DAI). DESIGN:Prospective cohort study. SETTING:Neurologic intensive care unit (ICU) of a u...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/00003246-200103000-00005
更新日期:2001-03-01 00:00:00
abstract:OBJECTIVE:Sepsis and severe trauma result in endothelial activation and damage. The activated endothelium expresses adhesion receptors that control leukocyte trafficking. After activation, some adhesion molecules are also released into plasma as soluble forms. The present study was designed to compare the expression of...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/00003246-200204000-00015
更新日期:2002-04-01 00:00:00
abstract:OBJECTIVE:To define changes in intramyocardial pH and PCO2 during cardiac arrest and resuscitation. DESIGN:Prospective and observational trial. SETTING:Mammalian research laboratory utilizing a porcine model of cardiac arrest. SUBJECTS:Sixteen domestic pigs. INTERVENTIONS:Ventricular fibrillation was induced by an ...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/00003246-199306000-00020
更新日期:1993-06-01 00:00:00
abstract:OBJECTIVE:In patients undergoing surgical repair of aortic dissection, false lumen perfusion during cardiopulmonary bypass may produce central nervous system damage, myocardial ischemia, aortic rupture, and death. We describe a method to detect false lumen perfusion at the beginning of retrograde aortic perfusion that ...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/00003246-200006000-00026
更新日期:2000-06-01 00:00:00
abstract::The tradition of clinical ultrasound in the hands of physicians who provide critical care to the most acutely ill patients stretches back into the 1980s and is rich with experiences from surgical, emergency medicine, and other practices. Now, as critical care ultrasound explodes around the world, it is important to re...
journal_title:Critical care medicine
pub_type: 历史文章,杂志文章
doi:10.1097/01.CCM.0000260623.38982.83
更新日期:2007-05-01 00:00:00
abstract:OBJECTIVE:To determine how top loads with different doses of carbon monoxide (CO)-saturated saline solutions (CO-saline) affect microvascular and systemic hemodynamics and to delineate the corresponding biochemical mechanisms. DESIGN:Prospective study. SETTING:University research laboratory. SUBJECTS:Male Golden Syr...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/01.CCM.0000259533.84180.C7
更新日期:2007-04-01 00:00:00
abstract:OBJECTIVE:To compare the effects of cardiac surgery with and without extracorporeal circulation on the mechanics of the respiratory system, lung, and chest wall. We also determined the time course of those effects. DESIGN:Prospective, controlled study. SETTING:An eight-bed, cardiac-surgical intensive care unit at a u...
journal_title:Critical care medicine
pub_type: 临床试验,杂志文章
doi:10.1097/00003246-200211000-00005
更新日期:2002-11-01 00:00:00
abstract:OBJECTIVES:: To characterize the epidemiology and burden of early-onset, nonnosocomial candidemia. DESIGN:: Retrospective review of Cardinal Health Outcomes Research Database, which comprises all acute care admissions at participating hospitals. SETTING:: A total of 176 acute care hospitals. PATIENTS:: All patients ...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/CCM.0b013e3181a0f95d
更新日期:2009-09-01 00:00:00
abstract:OBJECTIVES:Anaphylactic shock is associated with severe hypotension. Potassium channel blockers, such as 4-aminopyridine, induce vasoconstriction. The objective of this study was to test the ability of 4-aminopyridine to restore blood pressure and increase survival in anaphylactic shock. DESIGN:Experimental study. SE...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/CCM.0000000000001822
更新日期:2016-11-01 00:00:00
abstract:OBJECTIVE:To test the reliability and validity of a modified moral distress tool, originally developed for the nursing profession, on respiratory care practitioners. To describe the relationship between moral distress, career dissatisfaction, and job turnover in respiratory care. DESIGN:A 28-question survey was develo...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/01.CCM.0000248879.19054.73
更新日期:2006-12-01 00:00:00
abstract::Although recent clinical reports have noted hypokalemia after resuscitation from cardiac arrest, extensive animal work indicates that potassium is released from cells during ischemia. This study was undertaken to define the changes that occur in serum potassium ion during cardiac arrest and resuscitation in a canine m...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/00003246-198604000-00012
更新日期:1986-04-01 00:00:00
abstract:OBJECTIVE:Conventional outcomes research provides only percentage risk of such end points as mortality rate, utilization of resources, and/or broad groupings of multiple organ system dysfunction. These prognostications generally are not applicable to individual patients. The purpose of the present study was to determin...
journal_title:Critical care medicine
pub_type: 临床试验,杂志文章
doi:10.1097/00003246-200205000-00014
更新日期:2002-05-01 00:00:00
abstract:OBJECTIVE:Cytokine response after cardiac surgery may be genetically influenced. A study was carried out to investigate the relation between cytokine gene expression in peripheral blood mononuclear cells, genotype, and clinical events after cardiac surgery. DESIGN:A case-control study was performed. SETTING:Cardiac i...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/01.CCM.0000227647.77356.AB
更新日期:2006-08-01 00:00:00
abstract:OBJECTIVE:To determine whether a cellular phone would interfere with the operation of mechanical ventilators. DESIGN:Laboratory study. SETTING:University medical center. SUBJECTS:Fourteen mechanical ventilators. INTERVENTIONS:We evaluated change in operation and malfunction of the mechanical ventilators. MEASUREME...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/01.ccm.0000120061.01431.db
更新日期:2004-04-01 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:OBJECTIVES:To use a standardized tool for a multicenter assessment of antibiotic appropriateness in ICUs and identify local antibiotic stewardship improvement opportunities. DESIGN:Pilot point prevalence conducted on October 5, 2016; point prevalence survey conducted on March 1, 2017. SETTING:ICUs in 12 U.S. acute ca...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/CCM.0000000000004344
更新日期:2020-07-01 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::Colloid osmotic pressure (COP) was measured simultaneously with cardiorespiratory measurements in 103 surgical patients suspected of having circulatory problems. In a small subset of 28 patients, measurements were taken before, during, and after surgical operations. Similarly, data sets were taken before, during, and ...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/00003246-198303000-00010
更新日期:1983-03-01 00:00:00
abstract:OBJECTIVES:To determine whether excessive alcohol consumption increases the risk for intensive care unit (ICU)-acquired bacterial infection, especially ventilator-associated pneumonia (VAP), in nontrauma patients. DESIGN:Prospective observational cohort study. SETTING:A 21-bed polyvalent ICU in a university hospital....
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/CCM.0b013e318174dd75
更新日期:2008-06-01 00:00:00
abstract:OBJECTIVE:To determine the pharmacokinetics of fentanyl when used as a long-term continuous infusion for sedation/analgesia in mechanically ventilated critically ill infants and children. DESIGN:Prospective, case series. SETTING:A university hospital pediatric intensive care unit (ICU). PATIENTS:Nineteen mechanicall...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/00003246-199307000-00012
更新日期:1993-07-01 00:00:00
abstract::End tidal CO2 tension (PetCO2) and transcutaneous CO2 tension (PtcCO2) were compared with arterial CO2 (PaCO2) before and after withdrawal of mechanical ventilation in 20 patients predisposed to hypercarbia. With stable PaCO2 during mechanical ventilation, the correlation coefficient (r) between PaCO2 and PetCO2 was ....
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/00003246-198708000-00011
更新日期:1987-08-01 00:00:00