Abstract:
OBJECTIVE:To study whether noninvasive pressure support ventilation (NIPSV) with helium/oxygen (He/oxygen), which can reduce dyspnea, PaCO2, and work of breathing more than NIPSV with air/oxygen in decompensated chronic obstructive pulmonary disease, could have beneficial consequences on outcome and hospitalization costs. DESIGN:Prospective, randomized, multicenter study. SETTING:Intensive care units of three tertiary care university hospitals. PATIENTS:All patients with chronic obstructive pulmonary disease admitted to the intensive care units for NIPSV during a 24-month period. INTERVENTIONS:Patients were randomized to NIPSV with air/oxygen or He/oxygen. NIPSV settings, number of daily trials, decision to intubate, and intensive care unit and hospital discharge criteria followed standard practice guidelines. RESULTS:A total of 123 patients (male/female ratio, 71:52; age, 71 +/- 10 yrs, Acute Physiology and Chronic Health Evaluation II, 17 +/- 4) were included. Intubation rate (air/oxygen 20% vs. He/oxygen 13%) and length of stay in the intensive care unit (air/oxygen 6.2 +/- 5.6 vs. He/oxygen 5.1 +/- 4 days) were comparable. The post-intensive care unit hospital stay was lower with He/oxygen (air/oxygen 19 +/- 12 vs. He/oxygen 13 +/- 6 days, p < .002). Cost of NIPSV gases was higher with He/oxygen, but total hospitalization costs were lower by $3,348 per patient with He/oxygen. No complications were associated with the use of He/oxygen. CONCLUSION:He/oxygen did not significantly reduce intubation rate or intensive care unit stay, but hospital stay was shorter and total costs were lower. He/oxygen NIPSV can be safely administered and could prove to be a cost-effective strategy.
journal_name
Crit Care Medjournal_title
Critical care medicineauthors
Jolliet P,Tassaux D,Roeseler J,Burdet L,Broccard A,D'Hoore W,Borst F,Reynaert M,Schaller MD,Chevrolet JCdoi
10.1097/01.CCM.0000055369.37620.EEsubject
Has Abstractpub_date
2003-03-01 00:00:00pages
878-84issue
3eissn
0090-3493issn
1530-0293journal_volume
31pub_type
临床试验,杂志文章,多中心研究,随机对照试验abstract:OBJECTIVES:a) To investigate whether the patient work of breathing needed to trigger inspiration is affected by the type of ventilator delivering pressure-support ventilation for mechanically ventilated pediatric patients. b) To determine whether changes in oxygen consumption (VO2) trend with changes in work of breathi...
journal_title:Critical care medicine
pub_type: 临床试验,杂志文章,随机对照试验
doi:
更新日期:1994-12-01 00:00:00
abstract:OBJECTIVE:The use of corticosteroids in patients with sepsis or septic shock has been controversial for many decades. Clinical studies have reported beneficial, as well as negative results. We conducted a meta-analysis to assess the clinical evidence and to evaluate treatment effects in specific subgroups of patients. ...
journal_title:Critical care medicine
pub_type: 杂志文章,meta分析
doi:10.1097/00003246-199507000-00021
更新日期:1995-07-01 00:00:00
abstract:OBJECTIVES:To determine the incidence and characteristics of children with brain death in the pediatric intensive care unit (ICU), and to assess the incidence of the clinical triad (Turner's triad) of central diabetes insipidus, low glucose demand, and low CO2 production. DESIGN:Retrospective review of medical records...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/00003246-199408000-00014
更新日期:1994-08-01 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:OBJECTIVES:We investigated whether patients with chronic obstructive pulmonary disease could safely receive noninvasive ventilation outside of the ICU. DESIGN:Retrospective cohort study. SETTING:Twelve states with ICU utilization flag from the State Inpatient Database from 2014. PATIENTS:Patients greater than or equ...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/CCM.0000000000003660
更新日期:2019-05-01 00:00:00
abstract:OBJECTIVES:To determine the amount of spontaneous variability of cardiac output over time in critically ill patients, and to determine the effect of mechanical ventilation on cardiac output variability over time. DESIGN:Case series. SETTING:Medical intensive care unit in a Veterans Affairs Medical Center. PATIENTS:T...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/00003246-199402000-00012
更新日期:1994-02-01 00:00:00
abstract:OBJECTIVE:Isoflurane, a volatile anesthetic agent, has been recognized for its potential neuroprotective properties and has antiapoptotic effects. We examined whether isoflurane posttreatment is protective against early brain injury after subarachnoid hemorrhage and determined whether this effect needs sphingosine-rela...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/CCM.0b013e3182474bc1
更新日期:2012-06-01 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:OBJECTIVE:To examine the association between the performance of a tracheostomy and intensive care unit and postintensive care unit mortality, controlling for treatment selection bias and confounding variables. DESIGN:Prospective, observational, cohort study. SETTING:Twelve French medical or surgical intensive care un...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/01.CCM.0000251134.96055.A6
更新日期:2007-01-01 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:OBJECTIVE:To determine the relative distribution of fluid within the extracellular fluid volume (ECFV) and the effect on oxygen delivery after infusing either normal saline or 5% albumin in cardiac surgical patients. DESIGN:Prospective, randomized, unblinded, interventional study. SETTING:Cardiac surgical intensive c...
journal_title:Critical care medicine
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1097/00003246-200112000-00011
更新日期:2001-12-01 00:00:00
abstract:OBJECTIVE:The objective of the present study was to determine whether selective inflammatory cytokine concentrations within cerebrospinal fluid are useful markers for the differential diagnosis of aseptic and bacterial meningitis within neurosurgical patients. DESIGN:Prospective, open-label, observational, cohort stud...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/CCM.0000000000001188
更新日期:2015-11-01 00:00:00
abstract::We evaluated 95 extubated neonates to determine if certain risk factors could predict the development of laryngeal injury. Risk factors were recorded prospectively during the intubation period and correlated with laryngeal injury determined by laryngoscopy after extubation. Duration of intubation greater than or equal...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/00003246-198306000-00007
更新日期:1983-06-01 00:00:00
abstract::The right atrial pressure (Pra) was compared to the pulmonary capillary wedge pressure (Pcw) in 54 patients. In patients with heart disease, the correlation of Pra with Pcw was poor. However, in patients without clinical heart disease, Pra approximated Pcw, in both absolute number and change. This finding was independ...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/00003246-197805000-00010
更新日期:1978-05-01 00:00:00
abstract:OBJECTIVE:Acute lung injury secondary to smoke inhalation is a major source of morbidity and mortality in burn patients. We tested the hypothesis that nebulized epinephrine would ameliorate pulmonary dysfunction secondary to acute lung injury by reducing airway hyperemia and edema formation and mediating bronchodilatat...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/CCM.0b013e318207ec52
更新日期:2011-04-01 00:00:00
abstract:OBJECTIVES:To synthesize the literature describing interventions to improve hand hygiene in ICUs, to evaluate the quality of the extant research, and to outline the type, and efficacy, of interventions described. DATA SOURCES:Systematic searches were conducted in November 2016 using five electronic databases: Medline,...
journal_title:Critical care medicine
pub_type: 杂志文章,评审
doi:10.1097/CCM.0000000000002691
更新日期:2017-11-01 00:00:00
abstract:BACKGROUND:Increased cardiac index, oxygen delivery (DO2), and oxygen consumption (VO2) patterns were shown to characterize the physiologic status of surviving high-risk surgical patients, and indicate increased metabolic needs; relatively normal DO2 and VO2 values were found to characterize the sequential pattern of n...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/00003246-199105000-00014
更新日期:1991-05-01 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:OBJECTIVES:Although pentoxifylline produces various beneficial effects following adverse circulatory conditions, it is not known whether this agent has any effects on gut lipid metabolism after trauma-hemorrhage and resuscitation. The aim of this study, therefore, was to determine whether or not administration of pento...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/00003246-199801000-00023
更新日期:1998-01-01 00:00:00
abstract:OBJECTIVES:To determine the point prevalence of medication errors at the time of transition of care from an ICU to non-ICU location and assess error types and risk factors for medication errors during transition of care. DESIGN:This was a multicenter, retrospective, 7-day point prevalence study. SETTING:Fifty-eight I...
journal_title:Critical care medicine
pub_type: 杂志文章,多中心研究
doi:10.1097/CCM.0000000000003633
更新日期:2019-04-01 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:To determine whether treatment with patient-controlled analgesia (PCA) alone or in combination with nonsteroidal anti-inflammatory drugs can prevent postoperative pulmonary complications after cardiac surgery, when compared with conventional nurse-controlled analgesia. DESIGN:Randomized controlled trial. SE...
journal_title:Critical care medicine
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1097/00003246-199910000-00025
更新日期:1999-10-01 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::Because an acute coronary thrombotic event may be viewed as the main trigger of sudden cardiac arrest, urgent coronary angiography followed by percutaneous coronary intervention appeared as a promising tool in the early postresuscitation phase. Unfortunately, large randomized trials, which have unequivocally demonstra...
journal_title:Critical care medicine
pub_type: 杂志文章,评审
doi:10.1097/ccm.0b013e31818a8ae6
更新日期:2008-11-01 00:00:00
abstract:OBJECTIVES:Ventilator-associated pneumonia diagnosis remains a debatable topic. New definitions of ventilator-associated conditions involving worsening oxygenation have been recently proposed to make surveillance of events possibly linked to ventilator-associated pneumonia as objective as possible. The objective of the...
journal_title:Critical care medicine
pub_type: 杂志文章,随机对照试验
doi:10.1097/CCM.0000000000000674
更新日期:2015-01-01 00:00:00
abstract::We used metoprolol orally or iv in 25 patients with multifocal atrial tachycardia that was complicating severe cardiopulmonary illness, and we observed its effect on heart rate and rhythm, BP, and arterial blood gases. All patients showed a dramatic slowing of heart rate, averaging 54.0 +/- 4.0 beat/min (p less than ....
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/00003246-198701000-00004
更新日期:1987-01-01 00:00:00
abstract:BACKGROUND:Glycemic control is increasingly being recognized as a priority in the treatment of critically ill patients. Titration and monitoring of insulin infusions involve frequent blood glucose measurement to achieve target glucose ranges and prevent adverse events related to hypoglycemia. Therefore, it is imperativ...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/01.ccm.0000189939.10881.60
更新日期:2005-12-01 00:00:00
abstract:OBJECTIVE:To determine if intracranial pressure monitor placement in patients with acute liver failure is associated with significant clinical outcomes. DESIGN:Retrospective multicenter cohort study. SETTING:Academic liver transplant centers comprising the U.S. Acute Liver Failure Study Group. PATIENTS:Adult critica...
journal_title:Critical care medicine
pub_type: 杂志文章,多中心研究
doi:10.1097/CCM.0000000000000144
更新日期:2014-05-01 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::High-risk patients who survived general (noncardiac) surgery were observed to have cardiac index (CI) values averaging 4.5 L/min.m2, oxygen delivery (DO2) greater than 600 ml/min.m2, and oxygen consumption (VO2) 170 ml/min.m2 during the first 2 or three days postoperatively. Patients who subsequently died maintained r...
journal_title:Critical care medicine
pub_type: 杂志文章,评审
doi:
更新日期:1990-01-01 00:00:00