Abstract:
OBJECTIVE:To develop clinical practice guidelines for the use of restraining therapies to maintain physical and psychological safety of adult and pediatric patients in the intensive care unit. PARTICIPANTS:A multidisciplinary, multispecialty task force of experts in critical care practice was convened from the membership of the American College of Critical Care Medicine (ACCM), the Society of Critical Care Medicine (SCCM), and the American Association of Critical Care Nurses (AACN). EVIDENCE:The task force members reviewed the published literature (MEDLINE articles, textbooks, etc.) and provided expert opinion from which consensus was derived. Relevant published articles were reviewed individually for validity using the Cochrane methodology (http://hiru.mcmaster.ca/cochrane/ or www.cochrane.org). CONSENSUS PROCESS:The task force met as a group and by teleconference to identify the pertinent literature and derive consensus recommendations. Consideration was given to both the weight of scientific information within the literature and expert opinion. Draft documents were composed by a task force steering committee and debated by the task force members until consensus was reached by nominal group process. The task force draft then was reviewed, assessed, and edited by the Board of Regents of the ACCM. After steering committee approval, the draft document was reviewed and approved by the SCCM Council. CONCLUSIONS:The task force developed nine recommendations with regard to the use of physical restraints and pharmacologic therapies to maintain patient safety in the intensive care unit.
journal_name
Crit Care Medjournal_title
Critical care medicineauthors
Maccioli GA,Dorman T,Brown BR,Mazuski JE,McLean BA,Kuszaj JM,Rosenbaum SH,Frankel LR,Devlin JW,Govert JA,Smith B,Peruzzi WT,American College of Critical Care Medicine, Society of Critical Care Medicine.doi
10.1097/01.CCM.0000095463.72353.ADsubject
Has Abstractpub_date
2003-11-01 00:00:00pages
2665-76issue
11eissn
0090-3493issn
1530-0293journal_volume
31pub_type
杂志文章,评审abstract::Standard techniques for measuring pulmonary resistance (RP) to gas flow in newborn infants yield results that are widely dispersed and difficult to interpret. The purpose of this study is to describe and evaluate a new improved method for determining RP which utilizes a sinusoidal pressure wave generator. Measurements...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/00003246-198307000-00015
更新日期:1983-07-01 00:00:00
abstract:OBJECTIVE:Emergency preservation and resuscitation (EPR) comprise a novel approach for resuscitation of exsanguination cardiac arrest victims. EPR uses a cold aortic flush to induce deep hypothermic preservation, followed by resuscitation with cardiopulmonary bypass. Development of a rat EPR model would enable study of...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/01.CCM.0000253398.61666.0D
更新日期:2007-02-01 00:00:00
abstract:OBJECTIVE:To compare the outcomes and the short- and long-term complications of percutaneous translaryngeal tracheostomy (TLT) and surgical tracheostomy (ST). DESIGN:Prospective, randomized clinical trial with 1-yr double-blind follow-up. SETTING:A general intensive care unit of a university hospital. PATIENTS:A tot...
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.0000163401.77581.86
更新日期:2005-05-01 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:OBJECTIVE:Acute renal failure can be treated with continuous renal replacement therapy (CRRT) or intermittent hemodialysis. There is no difference in mortality, although patients treated with CRRT may have a higher rate of renal recovery. Given these considerations, an estimate of the costs by modality may help in choo...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/01.CCM.0000045182.90302.B3
更新日期:2003-02-01 00:00:00
abstract::A survey of acute care/blood gas laboratories was conducted through the memberships of the Society of Critical Care Medicine ( SCCM ) and the National Association of Medical Directors of Respiratory Care ( NAMDRC ). Data were obtained from 227 laboratories and analyzed for operational characteristics, personnel, analy...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/00003246-198406000-00014
更新日期:1984-06-01 00:00:00
abstract:OBJECTIVES:Palliative care is now recognized as an essential component of comprehensive care in serious illness that interferes with quality of life. We explored utilization of palliative care in spontaneous intracerebral hemorrhage at a population level using a large national database. DESIGN:Population based cross-s...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/CCM.0000000000001391
更新日期:2016-03-01 00:00:00
abstract:OBJECTIVE:This survey was designed to study current practices in the monitoring and treatment of patients with severe head injury in the United States. DATA SOURCES:The collected data represent answers to telephone interviews of nurse managers, clinical specialists, and staff nurses specializing in neurotrauma care at...
journal_title:Critical care medicine
pub_type: 杂志文章,多中心研究
doi:10.1097/00003246-199503000-00023
更新日期:1995-03-01 00:00:00
abstract:OBJECTIVE:Insulin reduces morbidity and mortality among critically ill patients, but the molecular mechanisms of its effect remain unknown. Insulin is a well-known inhibitor of glycogen synthase kinase-3, which may play an important role in systemic inflammation and shock. Here we investigate the role of blood glucose ...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/01.CCM.0000215457.83953.E3
更新日期:2006-05-01 00:00:00
abstract::Previously, we determined that a colloid concentration of about 3% was optimal for resuscitation of lethal ischemic intestinal shock model in rats. Maximal volumes of lactated Ringer's solution (RL) alone only expanded plasma volume (PV) to 80% of preshock level, while increasing volumes of 3% albumin (ALB) in RL line...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/00003246-199001000-00014
更新日期:1990-01-01 00:00:00
abstract::In a prospective randomized study to determine whether prevention of colonization of Gram-negative bacteria results in prevention of Gram-negative bacterial infections, 96 intensive care patients were randomly allocated into a control group and a study group. The study group received oral nonabsorbable antimicrobial a...
journal_title:Critical care medicine
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1097/00003246-198811000-00001
更新日期:1988-11-01 00:00:00
abstract:OBJECTIVE:To describe the philosophy and approach to patient care called evidence based medicine, and to highlight how it can enhance the practice of intensive care. DATA SOURCES:We searched MEDLINE, reference lists, and our personal files to identify relevant literature. STUDY SELECTION:Articles on intensive care pr...
journal_title:Critical care medicine
pub_type: 杂志文章,评审
doi:10.1097/00003246-199602000-00025
更新日期:1996-02-01 00:00:00
abstract:OBJECTIVE:To date, no study has systematically investigated the impact of drowning-induced asphyxia on hemostasis. Our objective was to test the hypothesis that asphyxia induces bleeding by hyperfibrinolytic disseminated intravascular coagulation. DESIGN:Observational study. SETTING:A 2,100-bed tertiary care facility...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/CCM.0000000000001273
更新日期:2015-11-01 00:00:00
abstract:OBJECTIVE:To compare two forms of continuous renal replacement therapy, continuous venovenous hemofiltration (CVVH) vs. continuous venovenous hemodialysis (CVVHD), in terms of the removal of inflammatory mediators from the blood of patients with systemic inflammatory response syndrome and acute renal failure. DESIGN:R...
journal_title:Critical care medicine
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1097/00003246-199812000-00027
更新日期:1998-12-01 00:00:00
abstract::Trauma is the leading cause of both morbidity and mortality in the pediatric population, and traumatic injury causes > 50% of all childhood deaths. Significant mortality rates have been reported for children with traumatic brain injury. Although children have better survival rates as compared with adults with traumati...
journal_title:Critical care medicine
pub_type: 杂志文章,评审
doi:10.1097/00003246-200211001-00003
更新日期:2002-11-01 00:00:00
abstract:OBJECTIVE:To determine risk factors for nosocomial pneumonia in critically ill trauma patients. DESIGN:Prospective cohort study. SETTING:The trauma intensive care unit (ICU) of a 1500-bed tertiary-care hospital. PATIENTS:All critically ill trauma patients (n = 103) admitted consecutively between November 1995 and Oc...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/00003246-200102000-00015
更新日期:2001-02-01 00:00:00
abstract:OBJECTIVE:To examine the frequency with which quality of life and treatment limitation were discussed in formal family meetings for long-stay intensive care unit patients with high risk for mortality and morbidity. DESIGN:Descriptive observational study. SETTING:Five intensive care units. PATIENTS:One hundred sixtee...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/CCM.0b013e318232d8c4
更新日期:2012-02-01 00:00:00
abstract:OBJECTIVE:Blood loss and transfusion are frequent among patients undergoing liver surgery. Concerns have been raised about the safety and efficacy of transfusing stored blood. The influence of transfusing fresh vs. stored blood on the liver has not been studied to date. We tested the hypothesis that transfusion of stor...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/CCM.0b013e3182711b38
更新日期:2013-03-01 00:00:00
abstract:OBJECTIVES:Recently, the definition of sepsis has changed from a physiologic derangement (Sepsis-1 and -2) to organ dysfunction (Sepsis-3) based. We sought to determine the concordance between the different sepsis phenotypes and how that affected mortality. DESIGN:Retrospective, multicenter study. SETTING:Three acade...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/CCM.0000000000004449
更新日期:2020-09-01 00:00:00
abstract:OBJECTIVES:To compare in the same patient with septic shock, respective effects of epinephrine, norepinephrine, and the combination of norepinephrine and dobutamine (5 microg/kg/min) on systemic hemodynamic parameters and gastric mucosal perfusion using gastric tonometry and laser-Doppler flowmetry techniques. DESIGN:...
journal_title:Critical care medicine
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1097/00003246-199905000-00021
更新日期:1999-05-01 00:00:00
abstract:OBJECTIVES:Clinical applications of inhaled nitric oxide (NO) therapy resulted in the development of delivery systems and monitoring devices applicable to routine clinical care. This article presents the various components necessary for an adequate clinical use of inhaled NO, and discusses the NO gas mixture cylinders,...
journal_title:Critical care medicine
pub_type: 杂志文章,评审
doi:10.1097/00003246-199804000-00033
更新日期:1998-04-01 00:00:00
abstract:BACKGROUND:We have previously described a method for the precise delivery of inhaled nitric oxide (iNO) via a conventional, continuous-flow, pressure-limited, time-cycled ventilator. Because of the augmented effect of iNO decreasing pulmonary vascular resistance with high-frequency oscillatory ventilation (HFOV), we de...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/00003246-199911000-00038
更新日期:1999-11-01 00:00:00
abstract:OBJECTIVES:To measure pulmonary capillary pressure and pulmonary artery occlusion pressures both during control conditions and during acute lung injury and to evaluate the effects of inotropic therapy and volume loading on these measurements after lung injury. DESIGN:Prospective, randomized, controlled laboratory tria...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/00003246-200202000-00023
更新日期:2002-02-01 00:00:00
abstract:OBJECTIVE:To evaluate the prognostic value of short-latency median nerve somatosensory evoked potentials and brainstem auditory evoked potentials in outcome prediction for comatose cardiac arrest patients treated with hypothermia. DESIGN:Prospective, randomized, controlled trial of mild hypothermia after out-of-hospit...
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.0000171536.63641.d9
更新日期:2005-08-01 00:00:00
abstract:OBJECTIVE:Keratinocyte growth factor (KGF) is expressed primarily by fibroblasts, is important for alveolar epithelial proliferation/function, and protects against lung injury in multiple animal models. We wished to determine whether acute lung injury/acute respiratory distress syndrome (ALI/ARDS) alveolar fluid induce...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/CCM.0b013e31819fc81a
更新日期:2009-05-01 00:00:00
abstract:OBJECTIVES:To determine the outcome of oxygen consumption (VO2) and energy expenditure after cessation of sedation in severe head-injured patients and to assess its usefulness as a predictor of neurologic severity. DESIGN:Prospective, descriptive study. SETTING:Neurosurgical intensive care unit (ICU) in a university ...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/00003246-199407000-00011
更新日期:1994-07-01 00:00:00
abstract:OBJECTIVE:To examine the hypothesis that heat stress applied after the administration of bacterial endotoxin is protective. DESIGN:Prospective, randomized, laboratory study. SETTING:University research laboratory. SUBJECTS:One hundred eleven adult male Sprague-Dawley rats (weight range 250 to 400 g). INTERVENTIONS:...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/00003246-199710000-00025
更新日期:1997-10-01 00:00:00
abstract:OBJECTIVES:Intensive insulin therapy with tight glucose control is known to result in reduced morbidity and mortality in inflammation-related critical illness. Tumor necrosis factor (TNF)-alpha induction in myocardial infarction may trigger inflammation and have detrimental effects on cardiomyocytes. This study was des...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/CCM.0b013e3181782335
更新日期:2008-05-01 00:00:00
abstract:OBJECTIVES:Sepsis results in organ dysfunction caused by a dysregulated host response, in part related to the immune response of a severe infection. Mesenchymal stromal cells are known to modulate the immune response, and expression of stromal cell-derived factor-1 regulates mobilization of neutrophils from the bone ma...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/CCM.0000000000004244
更新日期:2020-05-01 00:00:00
abstract:OBJECTIVE:Critically ill patients often develop large gastric residual volumes during nasogastric feeding as a result of poor gastroduodenal motility. Nasojejunal feeding may decrease the severity of this complication. The aim of this study was to determine whether nasojejunal feeding improved tolerance of enteral nutr...
journal_title:Critical care medicine
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1097/00003246-200203000-00016
更新日期:2002-03-01 00:00:00