Abstract:
OBJECTIVE:Our first objective was to determine a blood lactate threshold predictive of survival in human immunodeficiency virus patients experiencing lactic acidosis related to nucleoside analogs, and second, to test l-carnitine for the treatment of patients exceeding that threshold. DESIGN:a) Retrospective study using data from personal and published observations to determine the lactate threshold between survivors and nonsurvivors in human immunodeficiency virus patients being treated with nucleoside analogs. b) Prospective multicenter open trial to test l-carnitine treatment of human immunodeficiency virus patients receiving nucleoside analogs. SETTING:Medical intensive care units of four teaching hospitals and one general hospital. PATIENTS:Retrospective analysis of data from 39 human immunodeficiency virus patients (five personal cases and 34 patients from the literature) receiving nucleoside-analog treatment from which lactate values were available. An additional six patients with high lactate values were included as a pilot study testing the use of l-carnitine therapy. MEASUREMENTS AND MAIN RESULTS:An initial lactate level of 9 mmol/L, which gave good positive and negative predictive values, was determined as a threshold between survivors and nonsurvivors for the patients receiving nucleoside-analog treatment. Six patients with initial lactate levels >10 mmol/L were prospectively treated with l-carnitine; three survived beyond the end of the study. CONCLUSIONS:The blood lactate levels in human immunodeficiency virus patients receiving nucleoside-analog therapy can predict mortality in these patients. The preliminary data from this pilot study suggest that l-carnitine may be helpful for patients who have nucleoside-analog-related lactic acidosis with blood lactate levels >10 mmol/L. Further studies will be necessary to affirm the therapeutic efficacy of l-carnitine in this setting.
journal_name
Crit Care Medjournal_title
Critical care medicineauthors
Claessens YE,Cariou A,Monchi M,Soufir L,Azoulay E,Rouges P,Goldgran-Toledano D,Branche F,Dhainaut JFdoi
10.1097/01.CCM.0000053649.69377.08subject
Has Abstractpub_date
2003-04-01 00:00:00pages
1042-7issue
4eissn
0090-3493issn
1530-0293journal_volume
31pub_type
临床试验,杂志文章,多中心研究abstract:OBJECTIVES:To assess the variability in short-term sepsis mortality by hospital among Centers for Medicare and Medicaid Services beneficiaries in the United States during 2013-2014. DESIGN:A retrospective cohort design. SETTING:Hospitalizations from 3,068 acute care hospitals that participated in the Centers for Medi...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/CCM.0000000000003324
更新日期:2018-11-01 00:00:00
abstract:OBJECTIVE:High-frequency oscillation has been proposed for use in adult acute respiratory distress syndrome. However, limited data are available on the effect of pressure amplitude and rate (Hz) on tidal volumes delivered during high-frequency oscillation in adults. DESIGN:Prospective, animal model, lung injury study....
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/00003246-200301000-00035
更新日期:2003-01-01 00:00:00
abstract::Ventricular fibrillation (VF) can masquerade as asystole. We report a 54-yr-old male in cardiac arrest who, on surface ECG, appeared to be in VF or asystole. A bedside intracardiac recording using a transmyocardial pacing wire showed the true rhythm to be atrial fibrillation (AF) with high grade atrioventricular block...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/00003246-198704000-00013
更新日期:1987-04-01 00:00:00
abstract:OBJECTIVES:Cardiac arrest etiology may be an important source of between-patient heterogeneity, but the impact of etiology on organ injury is unknown. We tested the hypothesis that asphyxial cardiac arrest results in greater neurologic injury than cardiac etiology cardiac arrest (ventricular fibrillation cardiac arrest...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/CCM.0000000000003070
更新日期:2018-06-01 00:00:00
abstract:OBJECTIVE:To investigate relationships between acute adrenergic stress, plasma catecholamine concentrations, and beta 2-adrenergic receptors. DESIGN:Prospective, descriptive study. SETTING:Emergency medical service at a university hospital. PATIENTS:Twenty-seven patients with out-of-hospital cardiac arrest (n = 11),...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/00003246-199704000-00015
更新日期:1997-04-01 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:OBJECTIVES:Formal guidelines recommend that therapeutic hypothermia be considered after in-hospital cardiac arrest. The rate of therapeutic hypothermia use after in-hospital cardiac arrest and details about its implementation are unknown. We aimed to determine the use of therapeutic hypothermia for adult in-hospital ca...
journal_title:Critical care medicine
pub_type: 杂志文章,多中心研究
doi:10.1097/CCM.0b013e318287f2c4
更新日期:2013-06-01 00:00:00
abstract:OBJECTIVE:Recent in vivo studies of both septic humans and animals demonstrate that leukocyte delivery is attenuated to sites remote from the primary infection. The mechanisms for this are not entirely clear. L-selectin is integral to rolling, the first step in leukocyte recruitment to an inflammatory site. L-selectin ...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/00003246-200101000-00024
更新日期:2001-01-01 00:00:00
abstract::During the treatment of 26 shocked patients, measurements were made of the central blood to peripheral skin temperature gradient. No significant correlation was found between this gradient and cardiac index (CI), or systemic vascular resistance (SVR) or its index (SVRI). There was no significant correlation between th...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/00003246-198709000-00010
更新日期:1987-09-01 00:00:00
abstract:OBJECTIVES:Radial artery pressure is known to differ from central arterial pressure in normal patients (distal pulse amplification) and in the early postcardiopulmonary bypass period. The adequacy of the radial artery as a site for blood pressure monitoring in critically ill patients receiving high-dose vasopressors ha...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/00003246-199810000-00014
更新日期:1998-10-01 00:00:00
abstract:OBJECTIVE:Cortisol clearance is reduced in sepsis and may contribute to the development of impaired adrenocortical function that is thought to contribute to the pathophysiology of critical illness-related corticosteroid insufficiency. We sought to assess adrenocortical function using computer-assisted numerical modelin...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/CCM.0000000000000721
更新日期:2015-03-01 00:00:00
abstract:OBJECTIVE:To study the effect of early and continuous venovenous hemofiltration (CVVH) on the plasma concentrations of several humoral mediators of inflammation and subsequent organ dysfunction in septic patients. DESIGN:Randomized, controlled trial. SETTING:Intensive care unit of a tertiary hospital. PATIENTS:Twent...
journal_title:Critical care medicine
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1097/00003246-200201000-00016
更新日期:2002-01-01 00:00:00
abstract:OBJECTIVES:To evaluate knowledge translation after publication of the target temperature management 33°C versus 36°C after out-of-hospital cardiac arrest trial and associated patient outcomes. Our primary hypothesis was that target temperature management at 36°C was rapidly adopted in Australian and New Zealand ICUs. S...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/CCM.0000000000003339
更新日期:2018-11-01 00:00:00
abstract:OBJECTIVES:To assess trends in the use of extracorporeal membrane oxygenation for poisoning in the United States. DESIGN:Retrospective cohort study. SETTING:The National Poison Data System, the databased owned and managed by the American Association of Poison Control Centers, the organization that supports and accred...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/CCM.0000000000004401
更新日期:2020-08-01 00:00:00
abstract:OBJECTIVE:To investigate the relationship between nitric oxide production, endotoxemia, and hemodynamic alterations in human septic shock. DESIGN:Prospective study. SETTING:A 32-bed intensive care unit in a university referral hospital. PATIENTS:Two groups of septic patients with shock (n = 13) or without shock (n =...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/00003246-199502000-00009
更新日期:1995-02-01 00:00:00
abstract:OBJECTIVE:The aim of this study was to evaluate the relationship of patient care variables to survival and functional outcome in the pediatric population with traumatic brain injury. DESIGN:Retrospective chart review. SETTING:A 16-bed pediatric critical care unit in an academic community children's hospital. PATIENT...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/00003246-200207000-00038
更新日期:2002-07-01 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:Sepsis-induced multi-organ failure continues to have a high mortality. The liver is an organ central to the disease pathogenesis. The objective of this study was to identify the liver proteins that change in abundance with sepsis and subsequently identify new drug targets. DESIGN:Proteomic discovery study an...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/01.ccm.0000281858.44387.a2
更新日期:2007-10-01 00:00:00
abstract:OBJECTIVE:To test whether spectral indices derived from the electroencephalogram (EEG), and especially the bispectral index (BIS), can be used as measures of neurologic status in unsedated, critically ill patients. DESIGN:Prospective, observational study. SETTING:Medical intensive care unit (ICU) of a university-affi...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/00003246-200110000-00024
更新日期:2001-10-01 00:00:00
abstract:OBJECTIVE:With limited community services, the complex rehabilitation period after critical illness is often the responsibility of family members who, as a result, may experience negative health outcomes. The objectives of this research were to a) identify aspects of the caregiving situation that are associated with ca...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/01.ccm.0000190428.71765.31
更新日期:2006-01-01 00:00:00
abstract:OBJECTIVE:Monitoring of ventilation performance during cardiopulmonary resuscitation would be desirable to improve the quality of cardiopulmonary resuscitation. To investigate the potential for measuring ventilation rate and inspiration time, we calculated the correlation in waveform between transthoracic impedance mea...
journal_title:Critical care medicine
pub_type: 评论,杂志文章
doi:10.1097/01.CCM.0000235666.40378.60
更新日期:2006-09-01 00:00:00
abstract:OBJECTIVES:Over 2,500 children undergo hematopoietic stem cell transplantation in the United States each year, and up to 35% require PICU support for life-threatening complications. PICU mortality has dropped from 85% to 44%, but interpretation is confounded by significant cohort heterogeneity. Reports conflict regardi...
journal_title:Critical care medicine
pub_type: 杂志文章,多中心研究
doi:10.1097/CCM.0000000000001085
更新日期:2015-09-01 00:00:00
abstract:OBJECTIVE:To determine the activation of nuclear factor-[kappa]B in peripheral blood CD14+ monocyte/macrophages and CD3+, CD4+, and CD8+ T cells in children with sepsis. DESIGN:Observational study. SETTING:University hospital. PATIENTS:Twenty-six children with sepsis (nine females and 17 males, aged between 10 days ...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/01.ccm.0000284502.38701.e6
更新日期:2007-10-01 00:00:00
abstract:OBJECTIVE:Circulating serum levels of procalcitonin rise significantly during bacterial infection. Because calcitonin is known to be a monocyte chemoattractant, we investigated whether procalcitonin, a prohormone of calcitonin, also affects leukocyte migration. DESIGN:Prospective, controlled in vitro study. SETTING:U...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/00003246-200205000-00025
更新日期:2002-05-01 00:00:00
abstract:OBJECTIVE:To determine the long-term outcome of noninvasive ventilation in chronic obstructive pulmonary disease patients who refused intubation for acute hypercapnic respiratory failure. DESIGN:Prospective, observational study. SETTING:Noninvasive ventilation unit in an acute regional hospital in Hong Kong. METHODS...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/01.CCM.0000108879.86838.4F
更新日期:2004-02-01 00:00:00
abstract::We previously reported that small volume infusions of 7.5% NaCl in 6% dextran-70 (HSD) are superior to equal volumes of normal saline (NS) or 7.5% NaCl in the ability to resuscitate animals from an otherwise lethal hemorrhage. In the present experiment, we evaluated organ blood flow in unanesthetized swine bled 46 ml/...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/00003246-198712000-00009
更新日期:1987-12-01 00:00:00
abstract:BACKGROUND:Septic shock represents the major cause of infection-associated mortality in the intensive care unit. The possibility that combination antibiotic therapy of bacterial septic shock improves outcome is controversial. Current guidelines do not recommend combination therapy except for the express purpose of broa...
journal_title:Critical care medicine
pub_type: 杂志文章,评审
doi:10.1097/CCM.0b013e3181eb3ccd
更新日期:2010-09-01 00:00:00
abstract::Accurate assessment and rapid decision-making are essential to save lives and improve performance in critical care medicine. Real-time point-of-care ultrasound has become an invaluable adjunct to the clinical evaluation of critically ill and injured patients both for pre- and in-hospital situations. However, a high le...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/01.CCM.0000260680.16213.26
更新日期:2007-05-01 00:00:00
abstract:OBJECTIVE:Information booklets have not been assessed by the families of intensive care unit (ICU) patients. This study explored the information that the relatives of adult ICU patients wanted to find in the information booklets. DESIGN:Multicenter survey. SETTING:Twenty-three French ICUs. SUBJECTS:One close relativ...
journal_title:Critical care medicine
pub_type: 杂志文章,多中心研究
doi:10.1097/CCM.0b013e3181a03063
更新日期:2009-07-01 00:00:00
abstract:OBJECTIVES:Increases in exhaled nitric oxide have been demonstrated to originate from the lungs of rats after septic lung injury. The aim of this study was to investigate whether treatment with the nitric oxide synthase inhibitor N-nitro-L-arginine methyl ester (L-NAME) would prevent lipopolysaccharide (LPS)-induced in...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/00003246-199802000-00033
更新日期:1998-02-01 00:00:00