Abstract:
OBJECTIVE:To investigate the effect of early administration of granulocyte colony-stimulating factor (G-CSF) on hospital mortality in nonneutropenic patients with septic shock, excluding patients with melioidosis. DESIGN:A randomized, placebo-controlled, double-blinded clinical trial. SETTING AND PATIENTS:Adult patients with septic shock admitted to the Royal Darwin Hospital Intensive Care Unit. INTERVENTIONS:Patients were randomized to receive G-CSF or placebo intravenously daily for 10 days, in addition to routine management of septic shock. MEASUREMENTS:Primary outcome was hospital mortality. Secondary outcomes included intensive care unit mortality, intensive care unit and hospital length of stay, ventilator hours, and time to resolution of shock. Patient comorbidities, baseline and daily physiology, and organ function were collected. RESULTS:Of 166 patients enrolled, 83 were allocated to receive G-CSF (81 included in analysis) and 83 were allocated to receive placebo. At baseline, 30% of patients had diabetes, 18% were known to have renal impairment or failure, and 38% had a history of hazardous alcohol use. The two groups had similar comorbidities at baseline and a similar severity of illness. The in-hospital mortality was 27% in the G-CSF group and 25% in the placebo group. Secondary end points were not different between groups. There was a higher rate of new organ failure in G-CSF-treated patients than placebo-treated patients (50% vs. 33%, p = .03), most of which was accounted for by new liver dysfunction (11% vs. 1%, p = .007). There was no significant difference in the proportion of patients with troponin I of >0.08 mg/L (78% vs. 66%, p = .09), and the prevalence of acute myocardial infarction (6% vs. 4%, p = .55) was not different during the study. The median peak troponin I level was higher in the G-CSF group (0.5 vs. 0.14 mg/L, p = .007), but baseline levels were not available. CONCLUSION:G-CSF does not improve outcomes in patients with septic shock, excluding melioidosis. Increased hepatic dysfunction and higher peak troponin levels in patients receiving G-CSF have not been reported in previous clinical trials and warrant further investigation.
journal_name
Crit Care Medjournal_title
Critical care medicineauthors
Stephens DP,Thomas JH,Higgins A,Bailey M,Anstey NM,Currie BJ,Cheng ACdoi
10.1097/01.CCM.0B013E318161E480subject
Has Abstractpub_date
2008-02-01 00:00:00pages
448-54issue
2eissn
0090-3493issn
1530-0293pii
00003246-200802000-00012journal_volume
36pub_type
杂志文章,随机对照试验abstract:OBJECTIVE:A 3-yr study funded by the U.S. Department of Health and Human Services was conducted to identify potential barriers to and opportunities for increasing the number hospitals with donation after cardiac death (DCD) protocols, the support of DCD by individuals involved in the donation request process, and the n...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/CCM.0b013e3181691b2b
更新日期:2008-04-01 00:00:00
abstract:OBJECTIVE:To determine whether the absence or presence of clinical pharmacists in intensive care units (ICUs) results in differences in mortality rates, length of ICU stay, and ICU charges for Medicare patients with nosocomial-acquired infections, community-acquired infections, and sepsis. DESIGN, SETTING, AND PATIENT...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/CCM.0b013e31818f2269
更新日期:2008-12-01 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:OBJECTIVE:To determine the incidence and risk factors of chronic critical illness after severe blunt trauma. DESIGN:Prospective observational cohort study (NCT01810328). SETTING:Two level-one trauma centers in the United States. PATIENTS:One hundred thirty-five adult blunt trauma patients with hemorrhagic shock who ...
journal_title:Critical care medicine
pub_type: 杂志文章,多中心研究
doi:10.1097/CCM.0000000000002697
更新日期:2017-12-01 00:00:00
abstract::Pulmonary mechanics were studied in ten anemic preterm infants using an esophageal balloon and mask, before and after transfusion with 10 ml/kg of packed RBC. Their mean birth weight was 1212 +/- 323 g and gestational age was 29.27 +/- 2.4 wk. Transfusions were carried out at a mean postnatal age of 41.9 +/- 21.8 days...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/00003246-199012000-00010
更新日期:1990-12-01 00:00:00
abstract:OBJECTIVES:To assess in-hospital neurologic (CNS) complications in adult patients undergoing veno-venous extracorporeal membrane oxygenation for respiratory failure. DESIGN:Retrospective analysis of the Extracorporeal Life Support Organization's data registry. SETTING:Data reported to Extracorporeal Life Support Orga...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/CCM.0000000000002502
更新日期:2017-08-01 00:00:00
abstract:OBJECTIVE:To determine xanthine oxidase activity, free radical concentrations, and lipid peroxidation in patients with sepsis syndrome compared with noninfected critically ill patients. DESIGN:A prospective observational study. SETTING:A nine-bed intensive care unit in a university teaching hospital trust. PATIENTS:...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/00003246-199610000-00008
更新日期:1996-10-01 00:00:00
abstract::Paranasal sinusitis is reported as a complication of prolonged nasal intubation and the source of sepsis in adult intensive care patients. In surgical neonates with congenital malformations, prolonged intubation with a nasotracheal (NT) or NG tube is often necessary, but sinusitis with complicating sepsis is seldom re...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:
更新日期:1989-09-01 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:Subarachnoid hemorrhage results in significant long-lasting neurologic sequelae. Here, we investigated whether human albumin improves long-term outcomes in experimental subarachnoid hemorrhage and whether neurovascular remodeling is involved in the protection of albumin. DESIGN:Laboratory investigation. SET...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/CCM.0000000000001193
更新日期:2015-10-01 00:00:00
abstract::Subcutaneous, transcutaneous, and conjunctival oxygen tensions (PscO2, PtcO2, and PcjO2, respectively) were measured in anesthetized dogs subjected sequentially to normoxia, hyperoxia, and hypoxia. Intravascular pressure, hemodynamic and oxygen transport variables were measured simultaneously. PtcO2 and PcjO2 closely ...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/00003246-198812000-00011
更新日期:1988-12-01 00:00:00
abstract::Pentoxifylline has been shown to increase red blood cell malleability, thus increasing capillary blood flow in a number of disease states. The present study was undertaken to determine whether pentoxifylline might improve tissue oxygenation after anesthesia and during an operation in rats. Rats were anesthetized and d...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/00003246-198702000-00001
更新日期:1987-02-01 00:00:00
abstract:OBJECTIVE:The demand for intensive care beds far exceeds their availability in many European countries. Consequently, many critically ill patients occupy hospital beds outside intensive care units, throughout the hospital. The outcome of patients who fit intensive care unit admission criteria but are hospitalized in re...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/01.ccm.0000133021.22188.35
更新日期:2004-08-01 00:00:00
abstract::This study evaluated the effects of varying colloid concentrations and infusion volumes on survival and plasma volume expansion in rats subjected to an intestinal ischemic shock. Up to 10% solutions of albumin and dextran-40 in lactated Ringer's solution, infused over a 6-h period, had the same effects on hematocrit (...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/00003246-198509000-00003
更新日期:1985-09-01 00:00:00
abstract:OBJECTIVE:To examine the effect of glycosylated recombinant human tumor necrosis factor binding protein-1 (r-hTNF binding protein-1), the extracellular domain of the tumor necrosis factor receptor p55 produced in mammalian cells, in a rabbit model of circulatory shock due to Escherichia coli. DESIGN:Prospective, rando...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/00003246-199506000-00014
更新日期:1995-06-01 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:To review the physiology of the regulation and determinants of heart rate and the significance in the management of critically ill patients. DATA SOURCES:The MEDLINE database, references from selected articles, and the author's personal database. DATA SYNTHESIS:This review begins with the regulation of card...
journal_title:Critical care medicine
pub_type: 杂志文章,评审
doi:10.1097/CCM.0b013e318232e50c
更新日期:2012-01-01 00:00:00
abstract:OBJECTIVE:To identify factors associated with granting or refusing intensive care unit (ICU) admission, to analyze ICU characteristics and triage decisions, and to describe mortality in admitted and refused patients. DESIGN:Observational, prospective, multiple-center study. SETTING:Four university hospitals and seven...
journal_title:Critical care medicine
pub_type: 杂志文章,多中心研究
doi:10.1097/01.ccm.0000157752.26180.f1
更新日期:2005-04-01 00:00:00
abstract:OBJECTIVE:To investigate the role of regulatory T cells in the modulation of long-term immune dysfunction during experimental sepsis. It is well established that sepsis predisposes to development of a pronounced immunosuppression. Nevertheless, the mechanisms underlying the immune dysfunction after sepsis are still not...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/CCM.0b013e3181e78ad0
更新日期:2010-08-01 00:00:00
abstract:OBJECTIVES:Recently, recombinant angiotensin-converting enzyme 2 was shown to protect mice from acute lung injury, an effect attributed to reduced bioavailability of angiotensin II. Since angiotensin-converting enzyme 2 metabolizes angiotensin II to angiotensin-(1-7), we hypothesized that this effect is alternatively m...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/CCM.0b013e31828a6688
更新日期:2013-11-01 00:00:00
abstract::A closed system device with teflon needle, sideholes, and attached stopcock was designed and evaluated for diagnosis and evacuation of neonatal pneumothoraces. Experience with this device has demonstrated specific advantages over existing needles and techniques. Since the system is airtight, diagnosis of pneumothorax ...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/00003246-197811000-00007
更新日期:1978-11-01 00:00:00
abstract:OBJECTIVE:To study the course of gastric regional PCO2 (PrCO2) in patients with cardiogenic shock requiring intra-aortic balloon (IAB) counterpulsation and the prognostic value of PrCO2 in this patient population. DESIGN:A prospective, observational clinical study. SETTING:Medical intensive care unit in a university ...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/00003246-200010000-00013
更新日期:2000-10-01 00:00:00
abstract:OBJECTIVE:To prospectively evaluate the oxygenation effect of inhaled nitric oxide (INO) delivered during high-frequency oscillatory ventilation in adult patients with the acute respiratory distress syndrome and oxygenation failure. DESIGN Prospective, clinical study. SETTING:Intensive care unit of a university teachi...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/01.CCM.0000049953.86613.02
更新日期:2003-02-01 00:00:00
abstract:OBJECTIVES:The role of nitric oxide in mediating the early phase of hypotension and cardiovascular hyporeactivity in sepsis, and the cellular sources of inducible nitric oxide synthase expression under in vivo conditions, remain unclear. The objective of this study was to elucidate the time course and cellular location...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/00003246-199703000-00022
更新日期:1997-03-01 00:00:00
abstract:OBJECTIVES:To review the immunologic role of the cytokines and the specific role that tumor necrosis factor (TNF) plays in response to infection. The influence of bacterial lipopolysaccharide on TNF, the cytokine cascade, and resultant pathologies are also reviewed. DATA SOURCES:A MEDLINE search of the international E...
journal_title:Critical care medicine
pub_type: 杂志文章,评审
doi:
更新日期:1993-10-01 00:00:00
abstract:OBJECTIVE:Although the development of ventilator-associated pneumonia (VAP) is assumed to increase costs of intensive care unit stay, it is unknown whether prevention of VAP by means of oropharyngeal decontamination is cost-effective. Because of wide ranges of individual patient costs, crude cost comparisons did not sh...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/01.CCM.0000104111.61317.4B
更新日期:2004-01-01 00:00:00
abstract:OBJECTIVE:To review trial design issues related to control groups. DESIGN:Review of the literature with specific reference to critical care trials. MAIN RESULTS AND CONCLUSIONS:Performing randomized controlled trials in the critical care setting presents specific problems: studies include patients with rapidly lethal...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/CCM.0b013e3181922bf4
更新日期:2009-01-01 00:00:00
abstract:OBJECTIVE:Hematopoietic stem cell transplant (HSCT) recipients admitted to the intensive care unit (ICU) have high mortality. The prognostic importance of peripheral blood stem cell source in critically ill HSCT recipients and the performance of Acute Physiology and Chronic Health Evaluation (APACHE) III have not been ...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/01.CCM.0000065761.51367.2D
更新日期:2003-06-01 00:00:00
abstract::Cessation of massive hemoptysis after iatrogenic balloon catheter rupture of the pulmonary artery was observed after a 2-ml inflation of the balloon. A wedge angiogram showed a small cavity near the rupture. Secondary lobectomy was performed; however, the patient died 1 month later. Therapeutic approaches of this life...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/00003246-198703000-00021
更新日期:1987-03-01 00:00:00
abstract::Intravenous dobutamine was used in ten patients requiring aggressive therapy for massive pulmonary embolism with circulatory failure. Except in one patient who rapidly died, a 30-min dobutamine infusion (8.3 +/- 2.7 micrograms/kg . min) increased both cardiac index (from 1.7 +/- 0.4 to 2.3 +/- 0.6 L/min . m2, p less t...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/00003246-198512000-00004
更新日期:1985-12-01 00:00:00