Abstract:
OBJECTIVE:We previously reported improved oxygenation, but no change, in rates of extracorporeal membrane oxygenation (ECMO) use or death among infants with persistent pulmonary hypertension of the newborn who received inhaled nitric oxide (NO) with conventional ventilation, irrespective of lung disease. The goal of our study was to determine whether treatment with inhaled NO improves oxygenation and clinical outcomes in infants with persistent pulmonary hypertension of the newborn and associated lung disease who are ventilated with high-frequency oscillatory ventilation (HFOV). DESIGN:Single-center, prospective, randomized, controlled trial. SETTING:Newborn intensive care unit of a tertiary care teaching hospital. PATIENTS:We studied infants with a gestational age of > or =34 wks who were receiving mechanical ventilatory support and had echocardiographic and clinical evidence of pulmonary hypertension and hypoxemia (PaO2 < or =100 mm Hg on FIO2 = 1.0), despite optimal medical management Infants with congenital heart disease, diaphragmatic hernia, or other major anomalies were excluded. INTERVENTIONS:The treatment group received inhaled NO, whereas the control group did not. Adjunct therapies and ECMO criteria were the same in the two groups of patients. Investigators and clinicians were not masked as to treatment assignment, and no crossover of patients was permitted. MEASUREMENTS AND MAIN RESULTS:Primary outcome variables were mortality and use of ECMO. Secondary outcomes included change in oxygenation and duration of mechanical ventilatory support and supplemental oxygen therapy. Forty-two patients were enrolled. Baseline oxygenation and clinical characteristics were similar in the two groups of patients. Infants in the inhaled NO group (n = 21) had improved measures of oxygenation at 15 mins and 1 hr after enrollment compared with infants in the control group (n = 20). Fewer infants in the inhaled NO group compared with the control group were treated with ECMO (14% vs. 55%, respectively; p = .007). Mortality did not differ with treatment assignment. CONCLUSIONS:Among infants ventilated by HFOV, those receiving inhaled NO had a reduced need for ECMO. We speculate that HFOV enhances the effectiveness of inhaled NO treatment in infants with persistent pulmonary hypertension of the newborn and associated lung disease.
journal_name
Crit Care Medjournal_title
Critical care medicineauthors
Christou H,Van Marter LJ,Wessel DL,Allred EN,Kane JW,Thompson JE,Stark AR,Kourembanas Sdoi
10.1097/00003246-200011000-00031subject
Has Abstractpub_date
2000-11-01 00:00:00pages
3722-7issue
11eissn
0090-3493issn
1530-0293journal_volume
28pub_type
临床试验,杂志文章,随机对照试验abstract:OBJECTIVES:The Fragility Index, which represents the number of patients responsible for a statistically significant finding, has been suggested as an aid for interpreting the robustness of results from clinical trials. A small Fragility Index indicates that the statistical significance of a trial depends on only a few ...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/CCM.0000000000003527
更新日期:2019-03-01 00:00:00
abstract:OBJECTIVE:The Acute Respiratory Distress Syndrome Network protocol recommends limiting tidal volume and plateau pressure; it also recommends increasing respiratory rate to prevent hypercapnia. We tested a strategy that combines the low tidal volume with lower respiratory rates and minimally invasive CO2 removal. SUBJE...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/CCM.0000000000000312
更新日期:2014-06-01 00:00:00
abstract::Oxygen availability during cardiopulmonary bypass was assessed in 22 patients under hypothermic and relatively normothermic conditions. The patients were divided into two groups, 17 of whom received ACD blood and 5, CPD blood. The mean P50 for all patients fell from a preoperative value of 25.9 +/- 2.4 (SD) to 15.6 +/...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/00003246-197705000-00007
更新日期:1977-05-01 00:00:00
abstract::The endothelium is a highly dynamic cell layer that is involved in a multitude of physiologic functions, including the control of vasomotor tone, the trafficking of cells and nutrients, the maintenance of blood fluidity, and the growth of new blood vessels. Over the past several decades, advances in basic research of ...
journal_title:Critical care medicine
pub_type: 杂志文章,评审
doi:10.1097/01.ccm.0000129669.21649.40
更新日期:2004-05-01 00:00:00
abstract:OBJECTIVES:a) To quantify the use of do-not-resuscitate orders in a tertiary care children's hospital; and b) to characterize the circumstances in which such orders are written. DESIGN:Retrospective chart review. SETTING:University teaching hospital. PATIENTS:All inpatients who died in an urban children's hospital o...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/00003246-199301000-00012
更新日期:1993-01-01 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::We studied prospectively 40 critically ill neurosurgical patients who required prolonged mechanical ventilation to determine the current incidence of stress-related gastroduodenal erosions and ulcers, and to assess endoscopically the efficacy of acid-reducing prophylactic treatment. Nineteen patients were randomized t...
journal_title:Critical care medicine
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1097/00003246-199003000-00004
更新日期:1990-03-01 00:00:00
abstract:OBJECTIVE:To simultaneously determine perceived vs. practiced adherence to recommended interventions for the treatment of severe sepsis or septic shock. DESIGN:One-day cross-sectional survey. SETTING:Representative sample of German intensive care units stratified by hospital size. PATIENTS:Adult patients with severe...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/CCM.0b013e318186b6f3
更新日期:2008-10-01 00:00:00
abstract:OBJECTIVES:To show that subjective estimate of patient's condition is related to objective cognitive and functional outcome in cardiac arrest survivors. DESIGN:Longitudinal cohort study. SETTING:ICU and Neuropsychology Service in two hospitals in Switzerland. PATIENTS:Fifty survivors included from a prospective coho...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/CCM.0000000000002946
更新日期:2018-04-01 00:00:00
abstract:OBJECTIVE:To determine the financial impact of a sepsis protocol designed for use in the emergency department. DESIGN:Retrospective analysis of a before-after study testing the implications of sepsis protocol. SETTING:Academic, tertiary care hospital in the United States. PATIENTS:Persons with septic shock presentin...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/01.CCM.0000261886.65063.CC
更新日期:2007-05-01 00:00:00
abstract:OBJECTIVE:To investigate the effect of early administration of granulocyte colony-stimulating factor (G-CSF) on hospital mortality in nonneutropenic patients with septic shock, excluding patients with melioidosis. DESIGN:A randomized, placebo-controlled, double-blinded clinical trial. SETTING AND PATIENTS:Adult patie...
journal_title:Critical care medicine
pub_type: 杂志文章,随机对照试验
doi:10.1097/01.CCM.0B013E318161E480
更新日期:2008-02-01 00:00:00
abstract:OBJECTIVE:In 2003, critical care and infectious disease experts representing 11 international organizations developed management guidelines for the use of corticosteroid therapy in patients with sepsis and septic shock that would be of practical use for the bedside clinician, under the auspices of the Surviving Sepsis ...
journal_title:Critical care medicine
pub_type: 杂志文章,评审
doi:10.1097/01.ccm.0000142983.15421.11
更新日期:2004-11-01 00:00:00
abstract:OBJECTIVE:To document the effects of propofol on the hemodynamic and inflammatory responses to endotoxemia in an animal model. DESIGN:Randomized, prospective laboratory study. SETTING:University experimental laboratory. SUBJECTS:Thirty-two male rats. INTERVENTIONS:The animals were randomly assigned to one of four g...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/00003246-200004000-00032
更新日期:2000-04-01 00:00:00
abstract::Clinically, asystole or a bradyarrhythmia may follow countershock of ventricular fibrillation (VF) in up to 40% of attempts. This study evaluated the effects of artificial cardiac pacing, calcium chloride (CaCl2), and epinephrine in postcountershock asystole/bradycardia. Micromanometer catheters were positioned in the...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/00003246-198509000-00001
更新日期:1985-09-01 00:00:00
abstract:OBJECTIVES:The purposes of this report are to a) describe the University of Michigan experience with venoarterial or venovenous extracorporeal life support for severe pediatric pulmonary rescue therapy, and b) examine survivors and nonsurvivors for differences that might be useful for examination in future, prospective...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/00003246-199208000-00008
更新日期:1992-08-01 00:00:00
abstract:OBJECTIVES:Anxiety results from the anticipation of a threat and might be associated with poor outcome in the critically ill. This study aims at showing that anxiety at admission in critically ill patients is associated with new organ failure over the first 7 days of ICU hospitalization independently of baseline organ ...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/CCM.0000000000004495
更新日期:2020-10-01 00:00:00
abstract:OBJECTIVE:The pathogenesis of acute gastric stress ulceration in the seriously ill is uncertain, and any role of Helicobacter pylori infection is unknown. We aimed to assess the relationship between H. pylori serological status and stress ulceration in seriously ill patients, as well as H. pylori serological status in ...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/00003246-199907000-00010
更新日期:1999-07-01 00:00:00
abstract:OBJECTIVE:To determine the ability of somatosensory evoked potentials (SEP) compared with clinical findings to monitor and predict recovery in patients suffering from closed head injury with predominantly diffuse axonal injury (DAI). DESIGN:Prospective cohort study. SETTING:Neurologic intensive care unit (ICU) of a u...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/00003246-200103000-00005
更新日期:2001-03-01 00:00:00
abstract::Several variables may account for the response of electrochemical skin surface PO2 sensors to anesthetic gases: cathode material and size, pH of the electrolyte and membrane material. These variables cannot be chosen arbitrarily and their influence has been tested with two types of sensors. In one type (LSC), a large ...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/00003246-198110000-00010
更新日期:1981-10-01 00:00:00
abstract:OBJECTIVE:To compare and evaluate the potential benefit of two different anticoagulation regimens during endotoxemia in an ovine model. DESIGN:Animal prospective randomized and controlled study following preliminary dose-range study conforming with the Guide for the Care and Use of Laboratory Animals as promulgated by...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/00003246-200212000-00013
更新日期:2002-12-01 00:00:00
abstract:OBJECTIVES:To outline both the preclinical and clinical data demonstrating surfactant alterations in acute lung injury, which provide the rationale for testing exogenous surfactant administration in this setting. We also review the results of the randomized, controlled clinical trials conducted to date that have evalua...
journal_title:Critical care medicine
pub_type: 杂志文章,评审
doi:10.1097/01.CCM.0000057911.19145.9F
更新日期:2003-04-01 00:00:00
abstract:OBJECTIVE:This study determines whether acid-base data obtained in the emergency department correlate with outcome from major vascular injury. DESIGN:Observational, retrospective record review of trauma patients requiring vascular repair (torso or extremity, January 1988 to December 1997). Data included age, Injury Se...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/01.ccm.0000125517.28517.74
更新日期:2004-05-01 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:Inadequate nutrition is common in critical illness due in part to gastric stasis. However, recent data suggest that altered small intestinal mucosal function may be a contributing factor. The aim of this study was to examine the effects of critical illness on sucrose absorption, permeability, and mucosal morp...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/CCM.0b013e31827ca2fa
更新日期:2013-05-01 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:OBJECTIVE:To compare the scales and predictive power for hospital mortality of three recent multiple organ dysfunction scores. DESIGN:Prospective, observational, validation cohort study. SETTING:A ten-bed medical-surgical intensive care unit in a Finnish tertiary care hospital. PATIENTS:Among the 591 consecutive pat...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/00003246-200208000-00005
更新日期:2002-08-01 00:00:00
abstract:OBJECTIVE:To determine whether preoperative plasma levels of B-type natriuretic peptide would allow for the prediction of perioperative and early postoperative cardiovascular support requirements and hospital bed usage after coronary artery surgery. DESIGN:A prospective observational cohort study. SETTING:A tertiary ...
journal_title:Critical care medicine
pub_type: 评论,杂志文章
doi:10.1097/01.ccm.0000150822.10160.0a
更新日期:2005-02-01 00:00:00
abstract::In the last three decades, numerous articles on plasma catecholamine concentrations in various settings have been published in the medical literature. Despite this abundance of information, no summary article has analyzed the species variations in circulating catecholamine concentrations. In this paper, the plasma cat...
journal_title:Critical care medicine
pub_type: 杂志文章,评审
doi:
更新日期:1989-11-01 00:00:00
abstract::Traumatic injuries occur in > 20 million children each year and are the leading source of death in children over the age of 1 yr. Mechanisms of injury and subsequent therapies for critically injured children are diverse. This review will focus on resources and management strategies for caring for the severely injured ...
journal_title:Critical care medicine
pub_type: 杂志文章,评审
doi:10.1097/00003246-200211001-00013
更新日期:2002-11-01 00:00:00
abstract:OBJECTIVES:We reviewed randomized trials of adult ICU patients of interventions hypothesized to reduce delirium burden to determine whether interventions that are more effective at reducing delirium duration are associated with a reduction in short-term mortality. DATA SOURCES:We searched CINHAHL, EMBASE, MEDLINE, and...
journal_title:Critical care medicine
pub_type: 杂志文章,meta分析,评审
doi:10.1097/CCM.0000000000000224
更新日期:2014-06-01 00:00:00