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. PATIENTS:A total of 320 consecutive pediatric patients with traumatic brain injuries admitted to our pediatric critical care unit between 1992 and 1996. INTERVENTIONS:Patients were managed using our standard traumatic brain injury protocol. MEASUREMENTS AND MAIN RESULTS:A total of 230 patient variables encompassing demographic data, prehospital, emergency department, and pediatric critical care unit care were recorded. A total of 79 patients were severely injured, with admitting Glasgow Coma Scale scores of < or =10. There were 18 deaths. Only two patients survived without cognition. Ninety-five of 302 survivors required inpatient rehabilitation. Of these, 73 were old enough to be compared using FIMTM scores. At the time of discharge from rehabilitation, 52 patients (71%) were functioning independently, 20 (27%) were moderately dependent, and one patient was completely dependent. Analysis of variables with respect to survival revealed that an inability to maintain a cerebral perfusion pressure of > or =50 mm Hg on the first pediatric critical care unit day (p =.0002) and the presence of bradycardia in the emergency department (p =.0139) were the strongest factors associated with mortality. By using the regression equation generated from this model, we could correctly identify survivors and nonsurvivors with a predictive value of 94%. CONCLUSIONS:The ability to maintain a cerebral perfusion pressure of > or =50 mm Hg was the single most important predictor of traumatic brain injury survival in this study. This suggests that monitoring and optimizing cerebral perfusion pressure is critical to the management of these patients. The relationship between cognitive outcome and therapeutic interventions used to optimize cerebral perfusion pressure is unclear and requires further evaluation in a large prospective study.
journal_name
Crit Care Medjournal_title
Critical care medicineauthors
Hackbarth RM,Rzeszutko KM,Sturm G,Donders J,Kuldanek AS,Sanfilippo DJdoi
10.1097/00003246-200207000-00038subject
Has Abstractpub_date
2002-07-01 00:00:00pages
1630-5issue
7eissn
0090-3493issn
1530-0293journal_volume
30pub_type
杂志文章abstract:OBJECTIVE:To review published studies of the influence of platelet factor 4 (PF4) and other cationic proteins on the generation of activated protein C (APC) by the thrombomodulin-protein C system. DATA SOURCE:Using the PubMed citation index, literature published from 1973 to 2003 regarding cationic proteins, PF4, and ...
journal_title:Critical care medicine
pub_type: 杂志文章,评审
doi:10.1097/01.ccm.0000126359.92825.e9
更新日期:2004-05-01 00:00:00
abstract:OBJECTIVES:To determine whether aerosolized antibiotics can be delivered efficiently to the lower respiratory tract in mechanically ventilated patients and to define possible clinical responses to these agents. DESIGN:Prospective serial study with cases as their own control. SETTING:A 10-bed respiratory care unit for...
journal_title:Critical care medicine
pub_type: 临床试验,杂志文章
doi:10.1097/00003246-199801000-00013
更新日期:1998-01-01 00:00:00
abstract:OBJECTIVES:: To determine the relationship between intra-abdominal sepsis-induced high mobility group-box 1 and diaphragm contractile performance and to determine the inhibitory effects of antibodies for high mobility group-box 1 and receptor for advanced glycation end-products on septic peritonitis-induced diaphragmat...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/CCM.0b013e3181a930f7
更新日期:2009-09-01 00:00:00
abstract:OBJECTIVES:The primary objective of this study was to identify which patient demographic, patient health, and hospital characteristics were associated with in-hospital mortality. A secondary objective was to determine the relative influence of these characteristics on mortality. DESIGN AND SETTING:Public-use data for ...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/CCM.0b013e31825bc92f
更新日期:2012-11-01 00:00:00
abstract::Amikacin was introduced as the primary aminoglycoside in our hospital to prevent the further development of multiply resistant Gram-negative organisms. This study compares clinical and microbiological data before and after institution of this policy to evaluate the influence on clinical outcome in patients as well as ...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/00003246-199006000-00005
更新日期:1990-06-01 00:00:00
abstract:OBJECTIVE:To examine the longitudinal outcome of a cohort of mechanically ventilated patients admitted to an acute care respiratory unit after critical illness. DESIGN, SETTING, AND PATIENTS:Prospective, observational study of 210 consecutive patients admitted to a respiratory unit of an acute, tertiary care universit...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/01.CCM.0000287589.16724.B2
更新日期:2007-11-01 00:00:00
abstract:OBJECTIVE:To test the hypothesis that a pretransport Pediatric Risk of Mortality (PRISM) score underestimates the requirement for both intensive care and interventions during pediatric interhospital transport. DESIGN:Prospective, descriptive study. SETTING:All children were treated in a regional hospital and then tra...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/00003246-199401000-00020
更新日期:1994-01-01 00:00:00
abstract::Simple insertion of a nasogastric (NG) tube was successful in only 52 of 100 anesthetized intubated patients. After the larynx was manually pulled forward, the NG tube was successfully inserted in 33 patients. In the remaining 15 patients, the NG tube was inserted only with the aid of a finger or a laryngoscope used w...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/00003246-198503000-00013
更新日期:1985-03-01 00:00:00
abstract:OBJECTIVES:Sepsis remains a serious clinical problem despite intensive research efforts and numerous attempts to improve outcome by modifying the inflammatory response. Substance P, the principal ligand for the neurokinin-1 receptor, is a potent proinflammatory mediator that exacerbates inflammatory responses and cardi...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/CCM.0000000000002075
更新日期:2017-02-01 00:00:00
abstract:OBJECTIVES:Milrinone is a phosphodiesterase F-III inhibitor with positive inotropic and vasodilating activities. We investigated the hemodynamic response and pharmacokinetics of intravenous milrinone in patients with acute heart failure. DESIGN:Double-blind studies: a prospective, multicenter, double-blind, dose-findi...
journal_title:Critical care medicine
pub_type: 临床试验,杂志文章,多中心研究
doi:10.1097/00003246-199609000-00010
更新日期:1996-09-01 00:00:00
abstract:OBJECTIVE:To compare four different methods of endotracheal lidocaine administration with respect to the site of administration. DESIGN:Randomized controlled trial. SETTING:University hospital. PATIENTS:Thirty-two female patients (43.6 +/- 11.5 years old) undergoing elective gynecologic operations with an anesthesio...
journal_title:Critical care medicine
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1097/00003246-199107000-00015
更新日期:1991-07-01 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:OBJECTIVES:Critical care ultrasonography has become established within ICUs as a diagnostic tool and to guide management strategies and practical procedures. Following an international consensus statement in 2011, various national professional societies and organizations have sought to develop and deliver training prog...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/CCM.0000000000003626
更新日期:2019-03-01 00:00:00
abstract::Ten infants with acquired subglottic stenosis were treated successfully using the anterior cricoid split operation. Eight had been preterm infants who required endotracheal intubation and assisted ventilation for the respiratory distress syndrome. Two had been born at term; 1 required mechanical ventilation for aspira...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/00003246-198404000-00012
更新日期:1984-04-01 00:00:00
abstract:BACKGROUND AND METHODS:A study was performed to examine the effects of the calcium-channel blocker levemopamil on neurologic outcome and neuropathology in a clinically relevant model of complete global cerebral ischemia (ventricular fibrillation in cats). Levemopamil was administered to cats starting 5 mins after resus...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/00003246-199201000-00025
更新日期:1992-01-01 00:00:00
abstract:OBJECTIVES:Approximately one in every four patients who present to the emergency department with sepsis progresses to septic shock within 72 hours of arrival. In this study, we describe key patient characteristics present within 4 hours of emergency department arrival that are associated with developing septic shock be...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/CCM.0000000000000861
更新日期:2015-05-01 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:OBJECTIVE:To compare the ability of two methods--Acute Physiology and Chronic Health Evaluation (APACHE II) and Mortality Prediction Model (MPM)--to predict hospital outcome for a large group of intensive care patients from Britain and Ireland. DESIGN:Prospective, multicenter, cohort study. SETTING:Twenty-six general...
journal_title:Critical care medicine
pub_type: 杂志文章,多中心研究
doi:10.1097/00003246-199409000-00007
更新日期:1994-09-01 00:00:00
abstract:OBJECTIVE:As the Surviving Sepsis Campaign was assessing patient-level data over multiple countries, we sought to evaluate the use of a pragmatic and parsimonious severity-of-illness scoring system for patients with sepsis in an attempt to provide appropriate comparisons with practical application. DESIGN:Prospective,...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/CCM.0000000000000416
更新日期:2014-09-01 00:00:00
abstract:OBJECTIVE:To determine the association between symptomatic central venous line-related deep venous thrombosis and a mortality-adjusted measure of duration of mechanical ventilation in critically ill children with central venous lines. DESIGN:Retrospective matched cohort study. SETTING:Eleven pediatric intensive care ...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/CCM.0b013e31820eb8a1
更新日期:2011-05-01 00:00:00
abstract:OBJECTIVE:To determine the incidence and risk factors of chronic critical illness after severe blunt trauma. DESIGN:Prospective observational cohort study (NCT01810328). SETTING:Two level-one trauma centers in the United States. PATIENTS:One hundred thirty-five adult blunt trauma patients with hemorrhagic shock who ...
journal_title:Critical care medicine
pub_type: 杂志文章,多中心研究
doi:10.1097/CCM.0000000000002697
更新日期:2017-12-01 00:00:00
abstract:OBJECTIVE:To review the institutional experience of a national tertiary referral center for extracorporeal life support (ECLS) in severe varicella pneumonia. DATA SOURCES:Hospital records and ECLS flow sheets. STUDY SELECTION:All pediatric (nonneonatal) and adult patients who were treated for varicella pneumonia with...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/00003246-199706000-00014
更新日期:1997-06-01 00:00:00
abstract:OBJECTIVE:Neutropenia recovery may be associated with an increased risk of respiratory function deterioration. A history of pneumonia complicating neutropenia has been identified as the leading cause of adult respiratory distress syndrome during neutropenia recovery in patients receiving anticancer chemotherapy, sugges...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/00003246-200301000-00025
更新日期:2003-01-01 00:00:00
abstract:OBJECTIVES:Interventions that reduce the generation or the effects of reactive oxygen species exert controversial effects in animal models of lung injury, and these could be secondary to the pro-oxidant effects of antioxidants generally by their interaction with iron. We here describe the effects of N-acetylcysteine, d...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/01.ccm.0000199069.19193.89
更新日期:2006-02-01 00:00:00
abstract:OBJECTIVE:To provide a meta-analysis of current literature concerning the validation of thoracic impedance cardiography (TIC) and to explain the variations in the reported results from the differences in the studies. DATA SOURCES:A computer-assisted search of English-language, German, and Dutch literature was performe...
journal_title:Critical care medicine
pub_type: 杂志文章,meta分析
doi:10.1097/00003246-199906000-00053
更新日期:1999-06-01 00:00:00
abstract:OBJECTIVES:Case fatality in pregnancy-associated severe sepsis or septic shock appears reduced compared with nonpregnant women with severe sepsis or septic shock. It remains unclear if this difference is due to pregnancy or better baseline health status, among others. Our study compared adverse outcomes of pregnancy-as...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/CCM.0000000000003348
更新日期:2018-11-01 00:00:00
abstract::Comparative hemodynamic measurements recorded in 19 cases of septic shock associated with Neisseria meningitidis bacteremia and in 20 shock cases associated with bacteremia due to other Gram-negative bacilli showed a significantly higher incidence of early myocardial depression in the cases with meningococcal infectio...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/00003246-198412000-00003
更新日期:1984-12-01 00:00:00
abstract:OBJECTIVE:This study determined the time course for inhibition of lipopolysaccharide-induced acute lung injury following a single dose of genistein. In addition, the study investigated whether a multiple dosing schedule with genistein retained the inhibitory effects on acute lung injury, nuclear factor-kappaB activatio...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/01.CCM.0000049941.84695.BA
更新日期:2003-02-01 00:00:00
abstract:OBJECTIVE:To compare the results of cardiac output measurements obtained by lithium dilution and thermodilution. DESIGN:Case series, observational study. SETTING:High-dependency postoperative unit and intensive care unit of a teaching hospital. PATIENTS:Forty patients were studied. Thirty-four patients had undergoin...
journal_title:Critical care medicine
pub_type: 临床试验,杂志文章
doi:10.1097/00003246-199711000-00015
更新日期:1997-11-01 00:00:00
abstract:OBJECTIVE:Intrahospital transport of critically ill patients is often necessary for optimal patient care. However, transport of intensive care unit (ICU) patients within the hospital has been associated with a high rate of potentially detrimental complications. This study was designed to determine the occurrence rate o...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/00003246-199510000-00009
更新日期:1995-10-01 00:00:00