Abstract:
OBJECTIVE:To determine the blood discard volume, as a multiple of deadspace, that is required for accurate arterial blood gas and electrolyte testing from arterial catheters. DESIGN:Prospective, controlled, crossover trial. SETTING:Eighteen-bed intensive care unit of a metropolitan teaching hospital. PATIENTS:A total of 84 critically ill patients with a 20-gauge, radial arterial cannulae, pressure monitoring transducer set, and stable oxygenation. INTERVENTIONS:System deadspace (priming volume from sampling port to catheter tip) was established. Patients had six 0.5-mL arterial blood samples taken sequentially in random order using discard volumes of 1, 1.5, 2, 2.3, and 3.6 times the deadspace (experimental values) and 5.5 times the deadspace (control). MEASUREMENTS AND MAIN RESULTS:Samples were analyzed for Pao(2), Sao(2), pH, Paco(2), HCO(3)-, Na+, and K+. We performed repeated-measures analysis of variance with post hoc linear contrasts and compared mean experimental and control values. The smallest discard volumes that provided measurements that were statistically equal to control were twice the deadspace (Pao(2), p =.563; Sao(2), p =.371) and 3.6 times the deadspace (pH, p =.107; Paco(2), p=.519; HCO(3)-, p =.10). All discard volumes tested provided results that were statistically different from control for Na+ (p <.003) and K+ (p <.001). CONCLUSIONS:Many results were statistically different from control, although the actual discrepancies were very small. At clinically relevant levels of measurement, there was minimal variation between values obtained after a discard volume of twice the deadspace and control values. The level of error was clinically acceptable and within or close to the precision limits of the blood gas analyzer. Slight fluctuation in patient variables during sampling could also have contributed to the error. A blood discard volume of twice the deadspace is recommended for all variables. This will provide clinically accurate results and avoid the deleterious effects of unnecessary blood loss.
journal_name
Crit Care Medjournal_title
Critical care medicineauthors
Rickard CM,Couchman BA,Schmidt SJ,Dank A,Purdie DMdoi
10.1097/01.CCM.0000063448.98777.EFsubject
Has Abstractpub_date
2003-06-01 00:00:00pages
1654-8issue
6eissn
0090-3493issn
1530-0293journal_volume
31pub_type
临床试验,杂志文章abstract:OBJECTIVES:Acute renal failure is a complication in critically ill patients that has been associated with an excess risk of hospital mortality. Whether this reflects the severity of the disease or whether acute renal failure is an independent risk factor is unknown. The aim of this study was to analyze severity of illn...
journal_title:Critical care medicine
pub_type: 杂志文章,多中心研究
doi:10.1097/00003246-200209000-00016
更新日期:2002-09-01 00:00:00
abstract:OBJECTIVE:To determine the influence of a selective, sterile central nervous system surgery on immune reactivity, particularly whether a decrease of monocytic human leukocyte antigen-DR expression, indicating immunodepression, occurs after neurosurgery and if this measurement is useful for identification of patients wi...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/00003246-199512000-00006
更新日期:1995-12-01 00:00:00
abstract:OBJECTIVES:Previous workers have demonstrated that controlled mechanical ventilation results in diaphragm inactivity and elicits a rapid development of diaphragm weakness as a result of both contractile dysfunction and fiber atrophy. Limited data exist regarding the impact of pressure support ventilation, a commonly us...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/CCM.0b013e31823c8cc9
更新日期:2012-04-01 00:00:00
abstract:OBJECTIVE:To investigate the optimal rewarming rate following therapeutic hypothermia in a rate model of cardiopulmonary resuscitation. Both clinical and laboratory studies have demonstrated that mild therapeutic hypothermia following cardiopulmonary resuscitation improves myocardial and neurologic outcomes of cardiac ...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/CCM.0b013e3182a63fff
更新日期:2014-02-01 00:00:00
abstract:OBJECTIVE:The emergency department (ED) often serves as the first site for the recognition and treatment of patients with suspected severe sepsis. However, few evaluations of the national epidemiology and distribution of severe sepsis in the ED exist. We sought to determine national estimates of the number, timing, ED ...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/01.CCM.0000277043.85378.C1
更新日期:2007-08-01 00:00:00
abstract:OBJECTIVE:To evaluate the accuracies of the respiratory rate/tidal volume ratio (rate/volume ratio), minute volume, and negative inspired force in predicting weaning outcome in postoperative mechanically ventilated patients. DESIGN:A prospective, observational study. SETTING:Surgical intensive care unit of a 270-bed ...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/00003246-199702000-00010
更新日期:1997-02-01 00:00:00
abstract:OBJECTIVE:To evaluate the physiology and pharmacokinetics of a novel hemoglobin-based oxygen carrier of bovine origin. DESIGN:Randomized, single-blind, placebo-controlled, dose-escalation study. SETTING:The Upjohn Research Clinics (Kalamazoo, MI). SUBJECTS:Normal healthy adult men between the ages of 18 and 45 yrs. ...
journal_title:Critical care medicine
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1097/00003246-199605000-00006
更新日期:1996-05-01 00:00:00
abstract:OBJECTIVE:Despite concern over the appropriateness and quality of care provided in an intensive care unit (ICU) at the end of life, the number of Americans who receive ICU care at the end of life is unknown. We sought to describe the use of ICU care at the end of life in the United States using hospital discharge data ...
journal_title:Critical care medicine
pub_type: 杂志文章,多中心研究
doi:10.1097/01.ccm.0000114816.62331.08
更新日期:2004-03-01 00:00:00
abstract:OBJECTIVES:To quantitate duplex Doppler measurements of splanchnic perfusion to determine if these measurements are reproducible in euvolemic humans and if such measurements are sensitive to mild degrees of systemic hypovolemia. DESIGN:Prospective, nonrandomized, controlled trial. SETTING:Clinical research center. P...
journal_title:Critical care medicine
pub_type: 临床试验,杂志文章
doi:10.1097/00003246-199503000-00013
更新日期:1995-03-01 00:00:00
abstract:OBJECTIVE:Treatment of preterm infants with respiratory distress syndrome (RDS) with exogenous surfactant has greatly improved clinical outcome. Some infants require multiple doses, and it has not been studied whether these large amounts of exogenous surfactant disturb endogenous surfactant metabolism in humans. We stu...
journal_title:Critical care medicine
pub_type: 临床试验,杂志文章
doi:10.1097/00003246-200010000-00001
更新日期:2000-10-01 00:00:00
abstract:OBJECTIVE:To test the hypothesis that the hypocalcemia and hypoparathyroidism that follow severe burn injury are related to up-regulation of the parathyroid gland calcium-sensing receptor (CaR), which may reduce the set-point for suppression of circulating parathyroid hormone by blood calcium. DESIGN:A controlled but ...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/00003246-200012000-00024
更新日期:2000-12-01 00:00:00
abstract::An 8-yr-old child suffered traumatic bilateral pneumothoraces and a ruptured right main bronchus. Surgical repair of the bronchus was postponed for 18 h after a definite diagnosis was established due to severe hypoxemia and hypercarbia. Only left endobronchial high-frequency ventilation with muscle relaxation correcte...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/00003246-198712000-00019
更新日期:1987-12-01 00:00:00
abstract:OBJECTIVE:To determine the limits of agreement between the cardiac output and volumetric data estimated by impedance cardiography with the cardiac output determined by thermodilution and the left ventricular ejection fraction and end-diastolic volume estimated from left ventriculography. DESIGN:A prospective study. S...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/00003246-199709000-00023
更新日期:1997-09-01 00:00:00
abstract:OBJECTIVE:To characterize the endothelium-dependent and endothelium-independent components of abnormal pulmonary vascular tone in canine oleic acid lung injury. DESIGN:Prospective, interventional study. SETTING:University laboratory. SUBJECTS:Twenty anesthetized mongrel dogs. INTERVENTIONS:Right heart catheterizati...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/00003246-200207000-00028
更新日期:2002-07-01 00:00:00
abstract::During the control period in this study, small premature infants, 1500 g in birth weight, had insensible water loss (IWL) of 2.28 g/kg/hr (equivlaent to 54 ml/kg/day), which is considerably higher than in full term infants. Under phototherapy, there was a significant increase in IWL (3.14 g/kg/hr) associated with incr...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/00003246-197511000-00006
更新日期:1975-11-01 00:00:00
abstract::Arterial catheterization for blood gas analysis and direct monitoring of blood pressure in infants and children can be attended by a variety of complications, which limit its use to short periods of time. An improved technique, consisting of elimination of stopcocks, the use of a continuous flushing system adapted for...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/00003246-197605000-00010
更新日期:1976-05-01 00:00:00
abstract:OBJECTIVE:To test the effects of three hemoglobin solutions on liver function and hepatic morphology after resuscitation from severe hemorrhagic shock. DESIGN:Prospective study. SETTING:Laboratory. SUBJECTS:Thirty-three beagle dogs. INTERVENTION:Hemorrhagic shock was induced in anesthetized dogs by removal of blood...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/00003246-199604000-00019
更新日期:1996-04-01 00:00:00
abstract:OBJECTIVE:The elevation of the percentage of regulatory CD4+CD25+ T lymphocytes (Treg) has been recently described during septic shock. The objective of the present study was to investigate whether this increased percentage was due to Treg proliferation. DESIGN:Observational study. SETTING:Adult intensive care units ...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/01.ccm.0000145999.42971.4b
更新日期:2004-11-01 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:OBJECTIVES:To develop a valid, reliable measure that reflected the environment of respectfulness within the ICU setting. DESIGN:We developed a preliminary survey instrument based on conceptual domains of respect identified through prior qualitative analyses of ICU patient, family member, and clinician perspectives. Th...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/CCM.0000000000003069
更新日期:2018-06-01 00:00:00
abstract:OBJECTIVES:To describe long-term survival in patients with severe acute respiratory distress syndrome and assess differences in patient characteristics and outcomes among those who receive rescue therapies (prone position ventilation, inhaled nitric oxide, or inhaled epoprostenol) versus conventional treatment. DESIGN...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/CCM.0000000000000322
更新日期:2014-07-01 00:00:00
abstract:OBJECTIVES:1) To evaluate the prognostic roles of quantitative CT and pulmonary function tests and 2) to assess the association of dynamic strain and ventilation heterogeneity during unassisted spontaneous breathing with 90-day survival in patients with paraquat poisoning. DESIGN:Prospective study. SETTING:A universi...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/CCM.0000000000003518
更新日期:2019-02-01 00:00:00
abstract::To achieve normocarbia during conventional mechanical ventilation, ventilator settings are determined initially on the basis of body weight. The best ventilator settings for CO2 elimination during high-frequency jet ventilation (HFJV) have not been so clearly defined. A recent study has suggested that eucarbia will be...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/00003246-198801000-00012
更新日期:1988-01-01 00:00:00
abstract:OBJECTIVES:To determine the incidence and epidemiologic characteristics of cardiac arrests among tracheal intubations in PICUs. DESIGN:Retrospective cohort study of prospectively collected data. SETTING:Twenty-five diverse PICUs. PATIENTS:Critically ill children requiring tracheal intubation in PICUs. INTERVENTIONS...
journal_title:Critical care medicine
pub_type: 杂志文章,多中心研究
doi:10.1097/CCM.0000000000001741
更新日期:2016-09-01 00:00:00
abstract:OBJECTIVE:Our aim was to determine the frequency and the clinical and epidemiologic characteristics of sepsis in a hospital-based population in Colombia. DESIGN:Prospective cohort. SETTING:Ten general hospitals in the four main cities of Colombia. PATIENTS:Consecutive patients admitted in emergency rooms, intensive ...
journal_title:Critical care medicine
pub_type: 杂志文章,多中心研究
doi:10.1097/CCM.0b013e318218a35e
更新日期:2011-07-01 00:00:00
abstract:OBJECTIVES:Racial/ethnic differences in palliative care resource use after stroke have been recognized, but it is unclear whether patient or hospital characteristics drive this disparity. We sought to determine whether palliative care use after intracerebral hemorrhage and ischemic stroke differs between hospitals serv...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/CCM.0000000000002762
更新日期:2017-12-01 00:00:00
abstract:OBJECTIVES:ICU admission delays can negatively affect patient outcomes, but emergency department volume and boarding times may also affect these decisions and associated patient outcomes. We sought to investigate the effect of emergency department and ICU capacity strain on ICU admission decisions and to examine the ef...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/CCM.0000000000002993
更新日期:2018-05-01 00:00:00
abstract:OBJECTIVE:Opioids are frequently used during mechanical ventilation for severe viral infection in infancy. Opioid receptors have immunomodulatory properties, but nothing is known about their antiviral effects. We therefore aimed to investigate the role of opioid receptors in virus-induced airway inflammation. PATIENTS...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/CCM.0b013e31826767a8
更新日期:2013-01-01 00:00:00
abstract:OBJECTIVE:Initial success with chimeric antigen receptor-modified T cell therapy for relapsed/refractory acute lymphoblastic leukemia is leading to expanded use through multicenter trials. Cytokine release syndrome, the most severe toxicity, presents a novel critical illness syndrome with limited data regarding diagnos...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/CCM.0000000000002053
更新日期:2017-02-01 00:00:00
abstract:OBJECTIVES:To review the intensive care unit experience of patients with admitted or acquired nosocomial endocarditis (NE) defined according to the Duke criteria. DESIGN:Prospective, cohort study. SETTING:University teaching hospital. PATIENTS:We reviewed the records of 22 patients documented with NE during a 6-yr p...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/00003246-200002000-00015
更新日期:2000-02-01 00:00:00