Abstract:
OBJECTIVE:To determine whether mortality rates among intensive care unit (ICU) patients differ according to the time of ICU admission, we compared the death rates for patients admitted during weekday day shifts and off hours (from 6:30 pm to 8:29 am the next day for night shifts, from Saturday 1:00 pm to Monday 8:29 am for weekends, and from 8:30 am to 8:29 am the following morning for public holidays). METHODS:Retrospective cohort study of data collected prospectively from 23 ICUs located in the Paris metropolitan region, France. Between January 2000 and December 2003, 51,643 patients were admitted to these ICUs. Patients were grouped according to their day and time of admission and compared using univariable and multivariable analyses. INTERVENTIONS:None. MEASUREMENTS AND MAIN RESULTS:Of the 51,643 patients admitted to ICUs, 33,857 (65.6%) were admitted during off hours. These latter patients were less critically ill than those admitted during day shifts, had fewer failed organs, required fewer support procedures, and their crude in-hospital mortality was lower (20.7 vs. 24.5%, p < .0001). After adjustment for initial disease severity, in-hospital mortality was not higher for off-hours admissions than weekday day admissions and even remained slightly lower (adjusted odds ratio, 0.93; 95% confidence interval, 0.87-0.98). CONCLUSIONS:Admission during off hours is common. In our ICUs, off-hours admissions were not associated with higher mortality and might even be associated with a lower death rate.
journal_name
Crit Care Medjournal_title
Critical care medicineauthors
Luyt CE,Combes A,Aegerter P,Guidet B,Trouillet JL,Gibert C,Chastre Jdoi
10.1097/01.CCM.0000249832.36518.11subject
Has Abstractpub_date
2007-01-01 00:00:00pages
3-11issue
1eissn
0090-3493issn
1530-0293journal_volume
35pub_type
杂志文章abstract:OBJECTIVES:Lung-protective ventilation for acute respiratory distress syndrome aims for providing sufficient oxygenation and carbon dioxide clearance, while limiting the harmful effects of mechanical ventilation. "Flow-controlled ventilation", providing a constant expiratory flow, has been suggested as a new lung-prote...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/CCM.0000000000004209
更新日期:2020-03-01 00:00:00
abstract::Because determining cardiac output is difficult in premature infants, little is known about the hemodynamic effects of PEEP in this age group. We used pulsed-wave Doppler echocardiography to assess the hemodynamic effects of PEEP increments in ten premature infants with respiratory distress syndrome. At a PEEP of 4 cm...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/00003246-198707000-00007
更新日期:1987-07-01 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::Given the limitations of high-dose diuretics and vasodilators and the increasing literature showing that inotropes, regardless of the dose used, have a detrimental effect on mortality, a variety of new agents are under investigation for the treatment of pulmonary and systemic congestion and restoration of cardiac outp...
journal_title:Critical care medicine
pub_type: 杂志文章,评审
doi:10.1097/01.CCM.0000296810.74724.8D
更新日期:2008-01-01 00:00:00
abstract::Sepsis and resulting multiple system organ failure are the leading causes of mortality in intensive care units. Although it is generally appreciated that rampant, deregulated inflammatory pathways play a major role in sepsis, a comprehensive understanding based on the integrated response of multiple signal transductio...
journal_title:Critical care medicine
pub_type: 杂志文章,评审
doi:10.1097/00003246-200301001-00001
更新日期:2003-01-01 00:00:00
abstract:OBJECTIVE:To determine whether the energy expenditure of mechanically ventilated multiple trauma patients correlates with the severity of injury and illness indices before important systemic infection has complicated the clinical course, and to compare the energy expenditure with the energy expenditure expected from th...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/00003246-199912000-00013
更新日期:1999-12-01 00:00:00
abstract:OBJECTIVE:Transarterial chemoembolization is a widely used therapy for the treatment of hepatocellular carcinoma. A rare adverse event is acute respiratory distress syndrome from pulmonary embolization of Lipiodol, an iodinated oil commonly used during the procedure. The objective of this report is to describe an atypi...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/CCM.0000000000000307
更新日期:2014-06-01 00:00:00
abstract:BACKGROUND:Venous thromboembolic disease is among the most common causes of morbidity and mortality during pregnancy. The clinical evaluation alone is insufficient for the diagnosis of venous thromboembolic disease, and the normal pregnant state makes this evaluation even more challenging. DIAGNOSIS:Objective testing ...
journal_title:Critical care medicine
pub_type: 杂志文章,评审
doi:10.1097/01.ccm.0000183157.15533.4c
更新日期:2005-10-01 00:00:00
abstract::Critical care clinicians no longer consider family members as visitors in the intensive care unit. Family-centered care has emerged from the results of qualitative and quantitative studies evaluating the specific needs of families of patients dying in the intensive care unit. In addition, interventional studies have e...
journal_title:Critical care medicine
pub_type: 杂志文章,评审
doi:10.1097/01.CCM.0000237049.44246.8C
更新日期:2006-11-01 00:00:00
abstract:OBJECTIVE:When treating patients with cardiac arrest with mild therapeutic hypothermia, a reliable and easy-to-use temperature probe is desirable. This study was conducted to investigate the accuracy and safety of tracheal temperature as a measurement of body temperature. DESIGN:Observational cohort study. SETTING:Em...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/CCM.0b013e3181e47a20
更新日期:2010-07-01 00:00:00
abstract::The EEGs of 40 infants paralyzed with D-tubocurarine or pancuronium during the neonatal period were reviewed retrospectively. The 23 infants who survived were re-examined at 1-3 yr of age. Sixteen infants had normal or mildly abnormal EEGs in the neonatal period; 3 died of nonneurologic causes; the remainder were norm...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/00003246-198312000-00004
更新日期:1983-12-01 00:00:00
abstract:OBJECTIVE:To determine the maternal morbidity and mortality in patients with eclampsia admitted to an intensive care unit (ICU), and to establish the efficacy of the Acute Physiology and Chronic Health Evaluation (APACHE) II score, the organ system failure score as defined by Knaus, and the Glasgow Coma Scale (GCS) sco...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/00003246-200001000-00020
更新日期:2000-01-01 00:00:00
abstract:OBJECTIVES:Despite the universal proliferation of emergency medical services programs throughout the United States since 1970, only a few have ever documented a valid lifesaving effect, particularly in large, urban centers. The purpose of this study was to demonstrate the effect of specialized physician supervision on ...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/00003246-199309000-00009
更新日期:1993-09-01 00:00:00
abstract:OBJECTIVE:Granulocyte colony-stimulating factor is widely prescribed to hasten recovery from cancer chemotherapy-induced neutropenia and has been reported to induce pulmonary toxicity. However, circumstances and mechanisms of this toxicity remain poorly known. DESIGN:To reproduce a routine situation in cancer patients...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/00003246-200209000-00027
更新日期:2002-09-01 00:00:00
abstract:OBJECTIVE:To address issues of antibiotic dosing during sustained low-efficiency dialysis by using available pharmacokinetic data, intermittent and continuous renal replacement therapy dialysis guidelines, and our experience with sustained low-efficiency dialysis. DATA RESOURCES:Published clinical trials, case reports...
journal_title:Critical care medicine
pub_type: 杂志文章,评审
doi:10.1097/CCM.0b013e318206c3b2
更新日期:2011-03-01 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:OBJECTIVES:Preliminary studies have suggested that low doses of corticosteroids might rapidly improve hemodynamics in late septic shock treated with catecholamines. We examined the effect of hydrocortisone on shock reversal, hemodynamics, and survival in this particular setting. DESIGN:Prospective, randomized, double-...
journal_title:Critical care medicine
pub_type: 临床试验,杂志文章,多中心研究,随机对照试验
doi:10.1097/00003246-199804000-00010
更新日期:1998-04-01 00:00:00
abstract::In a prospective randomized trial in patients with a history of preoperative pulmonary hypertension who were undergoing surgery for valvular replacement or annuloplasty, the effects of ketanserin (KET) (12 patients) and sodium nitroprusside (SNP) (14 patients) on the systemic and pulmonary circulation and pulmonary sh...
journal_title:Critical care medicine
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1097/00003246-198907000-00003
更新日期:1989-07-01 00:00:00
abstract::The disciplines of critical care and palliative care may initially seem to be polar opposites, yet they share fundamental features. Both focus on the sickest patients in the healthcare system. Each discipline's primary goal-extending life for critical care and comfort and quality of life for palliative care-represents...
journal_title:Critical care medicine
pub_type: 杂志文章,评审
doi:10.1097/01.CCM.0000237347.94229.23
更新日期:2006-11-01 00:00:00
abstract::To determine the influence of arachidonic acid metabolites on acute lung injury induced by glass bead embolism, two groups of animals were studied before and after the pulmonary artery pressure was doubled by glass bead embolism. One group represented an untreated time control (n = 6) while the second group (n = 6) wa...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/00003246-198809000-00007
更新日期:1988-09-01 00:00:00
abstract:RATIONALE:Despite recent advances in critical care and ventilator management, acute lung injury and acute respiratory distress syndrome continue to cause significant morbidity and mortality. Granulocyte-macrophage colony stimulating factor may be beneficial for patients with acute respiratory distress syndrome. OBJECT...
journal_title:Critical care medicine
pub_type: 杂志文章,随机对照试验
doi:10.1097/CCM.0b013e31822d7bf0
更新日期:2012-01-01 00:00:00
abstract::Cerebral arteriovenous differences in oxygen content [C(a-v)O2] and glucose content [C(a-v)gluc] were used to predict outcome in 20 patients who remained comatose after resuscitation for cardiopulmonary arrest. Cerebral prognosis was good when C(a-v)O2 values were greater than 1.8 mMol/L and the oxygen glucose index (...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/00003246-198410000-00013
更新日期:1984-10-01 00:00:00
abstract:OBJECTIVE:To examine the accuracy of brain multimodal monitoring-consisting of intracranial pressure, brain tissue PO2, and cerebral microdialysis--in detecting cerebral hypoperfusion in patients with severe traumatic brain injury. DESIGN:Prospective single-center study. PATIENTS:Patients with severe traumatic brain ...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/CCM.0000000000000720
更新日期:2015-02-01 00:00:00
abstract::Recorded values (SpO2) of oxygen saturation from six noninvasive pulse oximeters were compared to each other and to the value from a cooximeter. Simultaneous measurements were obtained from each instrument in eight healthy nonsmoking volunteers rendered hypoxic greater than 70% SpO2. Functional arterial oxygen saturat...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/00003246-198907000-00016
更新日期:1989-07-01 00:00:00
abstract::In order to examine the prognostic value of pulmonary arterial hypertension (PAH) in patients with moderate and severe acute respiratory failure (ARF), 225 patients with ARF who had been treated with mechanical ventilation and admitted to our ICU during a 3-yr period (January, 1983 to January, 1986) were prospectively...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/00003246-198906000-00007
更新日期:1989-06-01 00:00:00
abstract:OBJECTIVES:To evaluate the prevalence of cardiac injury and its association with mortality in hospitalized patients infected with avian influenza A (H7N9) virus. DESIGN:Retrospective cohort study. SETTING:A total of 133 hospitals in 17 provinces, autonomous regions, and municipalities of mainland China that admitted ...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/CCM.0000000000004207
更新日期:2020-04-01 00:00:00
abstract:OBJECTIVE:Increasing evidence, including publication of the Transfusion Requirements in Critical Care trial in 1999, supports a lower hemoglobin threshold for RBC transfusion in ICU patients. However, little is known regarding the influence of this evidence on clinical practice over time in a large population-based coh...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/CCM.0b013e31828e9a49
更新日期:2013-10-01 00:00:00
abstract:OBJECTIVE:Pulmonary edema is a serious condition following brain injury of diverse etiologies, including large hemispheric infarctions. We have previously shown that treatment with hypertonic saline attenuates cerebral edema associated with experimental ischemic stroke. In a well-characterized animal model of large isc...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/01.ccm.0000150659.15558.23
更新日期:2005-01-01 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:OBJECTIVE:Acute renal tubular injury is a serious complication in the postoperative period, which is associated with high mortality and increased ICU stay. We aimed to demonstrate the protective effect of rhEPO against acute tubular injury induced by ischemia-reperfusion and to explore the mechanism of canonical transi...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/CCM.0000000000000542
更新日期:2014-10-01 00:00:00