Abstract:
OBJECTIVE:We investigated whether serum levels of neuron-specific enolase (NSE) and S-100beta protein could be used to evaluate cerebral injury and to predict outcome in severe sepsis and severe septic shock. DESIGN:Prospective study. SETTING:University hospital. PATIENTS AND MEASUREMENTS:In 170 consecutively enrolled patients with severe sepsis and septic shock, serum S-100beta and NSE were measured daily during four consecutive days after intensive care unit admission. Admission Glasgow Coma Scale before sedation and daily Sequential Organ Failure Assessment scores were recorded in all patients. Acute encephalopathy was defined as either a state of agitation, confusion, irritability, and convulsions (type A) or characterized by somnolence, stupor, and coma (type B) and persistently observed during 72 hrs after withdrawing sedation. When clinically indicated, contrast computed tomography or magnetic resonance imaging were performed to evaluate brain injury. MAIN RESULTS:S-100beta and NSE increased in, respectively, 72 (42%) and 90 (53%) patients. High biomarker levels were associated with the maximum Sequential Organ Failure Assessment scores (p = .001), and the highest values were found in patients who died early, within 4 days of inclusion (p = .005). Low consciousness encephalopathy type B was more frequently observed in patients with elevated S-100beta (p = .004). S-100beta levels of >or=4 microg/L were associated with severe brain ischemia or hemorrhage, and values of <2 microg/L were found in patients with diffuse cerebral embolic infarction lesions. High S-100beta levels were associated with higher intensive care unit mortality (p = .04) and represented the strongest independent predictor of intensive care unit survival, whereas NSE and the Glasgow Coma Scale failed to predict fatal outcome. CONCLUSIONS:S-100beta and NSE are frequently increased and associated with brain injury in patients with severe sepsis and septic shock. S-100beta levels more closely reflected severe encephalopathy and type of brain lesions than NSE and the Glasgow Coma Scale.
journal_name
Crit Care Medjournal_title
Critical care medicineauthors
Nguyen DN,Spapen H,Su F,Schiettecatte J,Shi L,Hachimi-Idrissi S,Huyghens Ldoi
10.1097/01.CCM.0000217218.51381.49subject
Has Abstractpub_date
2006-07-01 00:00:00pages
1967-74issue
7eissn
0090-3493issn
1530-0293journal_volume
34pub_type
杂志文章abstract:OBJECTIVE:Head-to-head comparison of the success rate of jejunal placement of a new electromagnetically visualized jejunal tube with that of the endoscopic technique in critically ill patients. DESIGN:: Prospective, randomized clinical trial. SETTING:Two intensive care units at a university hospital. PATIENTS:: A to...
journal_title:Critical care medicine
pub_type: 杂志文章,随机对照试验
doi:10.1097/CCM.0b013e3181fb7b5f
更新日期:2011-01-01 00:00:00
abstract::As of October 1985, 37 candidates have passed the final examination in intensive care for the Diploma of Fellow of the Faculty of Anaesthetists, Royal Australasian College of Surgeons (FFARACS). In September 1984, 23 of these successful candidates responded to a questionnaire seeking information on their educational e...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/00003246-198606000-00015
更新日期:1986-06-01 00:00:00
abstract:OBJECTIVE:Heatstroke requires active body cooling and organ failure supportive care. Although heat waves are expected to recur over the next decades, little is known about the risk factors for mortality in heatstroke patients. We examined the prognosis and risk factors for hospital mortality in patients with heatstroke...
journal_title:Critical care medicine
pub_type: 评论,杂志文章,多中心研究
doi:10.1097/01.CCM.0000206469.33615.02
更新日期:2006-04-01 00:00:00
abstract:OBJECTIVE:To validate performance characteristics of the intensive care unit (ICU) admission mortality probability model, version III (MPM0-III) on Project IMPACT data submitted in 2004 and 2005. This data set was external from the MPM0-III developmental and internal validation data collected between 2001 and 2004. DE...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/CCM.0b013e31819ded31
更新日期:2009-05-01 00:00:00
abstract:OBJECTIVE:The administration of vasopressin during cardiopulmonary resuscitation (CPR) provides significantly more vital organ blood flow when compared with epinephrine during cardiac arrest in pigs. The effects of this potent vasoconstrictor on postresuscitation cardiovascular function remain unknown. The purpose of t...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/00003246-199612000-00014
更新日期:1996-12-01 00:00:00
abstract:OBJECTIVE:To examine the ways in which healthcare professionals work together in the ICU setting, through a consideration of the contextual, organizational, processual, and relational factors that impact their interprofessional collaboration. DESIGN:Data from over 350 hours of ethnographic observation and 35 semistruc...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/CCM.0000000000001136
更新日期:2015-09-01 00:00:00
abstract:OBJECTIVE:A hallmark of amniotic fluid embolism is the induction of coagulation defects. Little is known about the nature of these defects or the causative agent or agents. The purpose of this study was to assess the effects of meconium containing (native) meconium-amniotic-fluid infusion (MAFI) and meconium-free (cent...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/00003246-199902000-00042
更新日期:1999-02-01 00:00:00
abstract::Total parenteral nutrition (TPN) increases CO2 production (VCO2) in patients on intermittent positive-pressure ventilation who cannot match their CO2 excretion to the CO2 load, leading to an increase in PaCO2. We studied gas exchange and blood gas values in six patients with chronic respiratory failure, who were venti...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/00003246-198507000-00005
更新日期:1985-07-01 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:OBJECTIVE:To alert health professionals to the need for early detection and prevention of shock in critically ill patients. By describing the associations between intramucosal acidosis in the gut and multiple system organ failure, the author demonstrates how noninvasive measurement of gut intramucosal pH can be used to...
journal_title:Critical care medicine
pub_type: 杂志文章,评审
doi:10.1097/00003246-199302001-00017
更新日期:1993-02-01 00:00:00
abstract:OBJECTIVE:Gabexate mesilate is a synthetic protease inhibitor capable of inhibiting both coagulation and cytokine production by monocytes. To investigate whether gabexate mesilate is useful for the prevention of posttraumatic spinal cord injury, we examined its effect on compression trauma-induced spinal cord injury in...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/00003246-199705000-00026
更新日期:1997-05-01 00:00:00
abstract::This report is intended to familiarize the reader with the current legislation concerning state definitions of death, the pertinent judicial decisions concerning termination of life support and the current status of medical/ethical committees. However, it is of paramount importance to all health care personnel to beco...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:
更新日期:1982-01-01 00:00:00
abstract:OBJECTIVE:Resuscitation of hemorrhagic hypotension after traumatic brain injury is challenging. A hemoglobin-based oxygen carrier may offer advantages. The novel therapeutic hemoglobin-based oxygen carrier, polynitroxylated pegylated hemoglobin (PNPH), may represent a neuroprotective hemoglobin-based oxygen carrier for...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/CCM.0b013e318206b1fa
更新日期:2011-03-01 00:00:00
abstract::Fifteen patients with septic shock and perfusion failure received a 20-min infusion of glucose-insulin-potassium (GIK, glucose 50%, 1 g/kg body weight; insulin 1.5 U/kg, potassium, 10 mMol) after volume loading and vasoactive medication had failed to eliminate hypotension and lactacidemia. Hemodynamic and oxygen measu...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/00003246-198507000-00012
更新日期:1985-07-01 00:00:00
abstract::We analyzed 35 samples of fresh frozen plasma (FFP), finding mean concentrations of 535 mg/dl glucose, 172 mEq/L sodium, 73 mEq/L chloride, 3.5 mEq/L potassium, 15 mEq/L bicarbonate, and 5.5 g/dl protein with 60% albumin. Thus, FFP is a hyperosmolal, hyperglycemic, hypernatremic, and hypochloremic solution which may b...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/00003246-198602000-00015
更新日期:1986-02-01 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
abstract:OBJECTIVE:To determine whether mechanical ventilation using high tidal volume is associated with nonpulmonary organ dysfunction that can be attenuated by dexamethasone. DESIGN:Prospective randomized animal intervention study. SETTING:Animal care facility in a university hospital. SUBJECTS:Sedated and tracheostomized...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/01.CCM.0000205663.92384.E7
更新日期:2006-04-01 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:OBJECTIVES:Hepatic ischemia-reperfusion is a major clinical problem with limited treatment options. The pathophysiology of hepatic ischemia-reperfusion is characterized by mitochondrial dysfunction and cellular energy deficits. Sirtuin 1 is an energy-sensing enzyme known to modulate mitochondrial biogenesis. We hypothe...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/CCM.0000000000001637
更新日期:2016-08-01 00:00:00
abstract::We describe the use of continuous negative extrathoracic pressure to treat successfully the adult respiratory distress syndrome in a 19-yr-old woman who resisted the application of positive airway pressure. Arterial hypoxemia was reversed with -26 cm H2O of extrathoracic pressure, produced by a modified Emerson iron l...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:
更新日期:1985-11-01 00:00:00
abstract:OBJECTIVE:Restoration of myocardial blood flow after ischemia triggers an inflammatory response involving toll-like receptors. Toll-like receptor 2 deficiency is associated with a reduced infarct size after myocardial ischemia and reperfusion. Because a marked mortality was observed in C3HeN wild-type mice, which was a...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/CCM.0b013e3181ef455b
更新日期:2010-10-01 00:00:00
abstract::Bradycardia is common in critical care units. It may be transient, asymptomatic and of little consequence, or life-threatening. Bradycardia may result from abnormalities of the sinus node, atrioventricular node, or the His-Purkinje system. It may also be precipitated by drug effects or enhanced vagal tone. Proper diag...
journal_title:Critical care medicine
pub_type: 杂志文章,评审
doi:10.1097/00003246-200010001-00003
更新日期:2000-10-01 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::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:OBJECTIVE:Acute aneurysmal subarachnoid hemorrhage (SAH) is a complex multifaceted disorder that plays out over days to weeks. Many patients with SAH are seriously ill and require a prolonged intensive care unit stay. Cardiopulmonary complications are common. The management of patients with SAH focuses on the anticipat...
journal_title:Critical care medicine
pub_type: 杂志文章,评审
doi:10.1097/CCM.0b013e318195865a
更新日期:2009-02-01 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
abstract:OBJECTIVE:Acute lung injury is a detrimental complication for victims of burn accidents. Airway obstruction plays an important role in pulmonary dysfunction in these patients. In this study, we tested the hypothesis that aerosolized anticoagulants will reduce the degree of airway obstruction and improve pulmonary funct...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/01.ccm.0000291647.18329.83
更新日期:2007-12-01 00:00:00
abstract:OBJECTIVES:Extracorporeal membrane oxygenation is used to stabilize severe cardiocirculatory and/or respiratory failure. However, extracorporeal membrane oxygenation is associated with a coagulopathy characterized by thromboembolic and hemorrhagic complications. This study aimed to characterize the pathomechanism of th...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/CCM.0000000000004286
更新日期:2020-05-01 00:00:00
abstract::These guidelines were developed to provide a reference for preparing policies on admission and discharge for pediatric intensive care units (PICUs). They represent a consensus opinion of physicians, nurses, and allied health care professionals. By using this document as a framework for developing multidisciplinary adm...
journal_title:Critical care medicine
pub_type: 指南,杂志文章,实务指引
doi:
更新日期:1999-04-01 00:00:00
abstract:OBJECTIVES:To compare the plasma volume (PV) expanding effect of a fast infusion rate with that of a slow infusion rate of a fixed volume of 5% albumin, of the synthetic colloids, 6% hydroxyethyl starch 130/0.4 and 4% gelatin, and of 0.9% NaCl in a rat sepsis model and to compare the plasma-expanding effect among these...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/CCM.0b013e318274157e
更新日期:2013-03-01 00:00:00