Abstract:
OBJECTIVE:To evaluate carbamezapine (CBZ) for neuritic pain relief in Guillain-Barré syndrome (GBS) patients in the intensive care unit (ICU). DESIGN:Prospective, double-blind, randomly allocated cross-over study days. SETTING:ICU in a tertiary care university hospital. PARTICIPANTS:Twelve consecutive, conscious adult (22-54 yrs) patients with GBS during recovery from the muscular weakness and receiving pressure-support ventilation in the ICU. All patients complained of severe backache and/or leg cramps and tenderness in muscles, and they required opioids for pain relief. INTERVENTIONS:CBZ (100 mg every 8 hrs) or equivalent placebo was given to nursing staff in coded powder form. Medication was given to patients through a nasogastric feeding tube. The same coded medicine was given for 3 days, and after a 1-day omission, a second set of coded powder was given for the next 3 days in a randomized, double-blind, crossover fashion. Pethidine (1 mg x kg(-1)) was given intravenously in between, if the pain score was >2. Group 1 (n = 6) patients were given a placebo on the first 3 days, followed by CBZ. Group 2 (n = 6) patients were given CBZ on the first 3 days, followed by a placebo. MEASUREMENTS AND MAIN RESULTS:In these two study periods of different medications, we observed and scored pain (1, no pain; 5, severe pain), sedation (1, alert; 6, asleep, does not respond to verbal command), and total pethidine requirement per day. In group 1 patients, a significant (p < .001) improvement in the sedation score and a low requirement for pethidine was observed 3 days later, when CBZ was started. However, in group 2 patients, a gradual increase in the pethidine requirement and a high sedation score were noteworthy in the later days of placebo medication. Observations were also analyzed for CBZ days vs. placebo days. Overall, the pain score (1.7 +/- 0.8) during the CBZ period of both regimens was significantly (p < .001) lower than during the placebo days (3.1 +/- 0.9). Significantly higher doses of pethidine (3.7 +/- 0.9 mg/kg/day) were used on the placebo days than on the CBZ days (1.7 +/- 1.0 mg/kg/day). CONCLUSION:The pain in GBS has a dual origin, and we recommend CBZ as an adjuvant to treat pain in GBS patients, during the recovery phase in the ICU, to reduce the narcotic requirement.
journal_name
Crit Care Medjournal_title
Critical care medicineauthors
Tripathi M,Kaushik Sdoi
10.1097/00003246-200003000-00009subject
Has Abstractpub_date
2000-03-01 00:00:00pages
655-8issue
3eissn
0090-3493issn
1530-0293journal_volume
28pub_type
临床试验,杂志文章,随机对照试验abstract:OBJECTIVE:Physiologic and pathologic comparison of two modes of assisted ventilation, nasal intermittent positive-pressure ventilation (NIPPV) and synchronized intermittent mandatory ventilation (SIMV), in spontaneously breathing term newborn piglets with saline lavage-induced lung injury. DESIGN:After inducing acute ...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/01.CCM.0000295311.61378.7D
更新日期:2008-01-01 00:00:00
abstract:OBJECTIVES:Preliminary studies have suggested that low doses of corticosteroids might rapidly improve hemodynamics in late septic shock treated with catecholamines. We examined the effect of hydrocortisone on shock reversal, hemodynamics, and survival in this particular setting. DESIGN:Prospective, randomized, double-...
journal_title:Critical care medicine
pub_type: 临床试验,杂志文章,多中心研究,随机对照试验
doi:10.1097/00003246-199804000-00010
更新日期:1998-04-01 00:00:00
abstract:OBJECTIVES:There is growing recognition that high-quality care for patients and families in the ICU requires exemplary interprofessional collaboration and communication. One important aspect is how the ICU team makes complex decisions. However, no recommendations have been published on interprofessional shared decision...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/CCM.0000000000003870
更新日期:2019-09-01 00:00:00
abstract::Bacterial translocation and ileal and cecal injury have been shown to occur 24 h after limited periods of hemorrhagic shock. The present studies were performed to determine the temporal sequence of mucosal injury, permeability, and bacterial translocation after hemorrhagic shock. The results indicated that bacterial t...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/00003246-199005000-00014
更新日期:1990-05-01 00:00:00
abstract::Previously, we determined that a colloid concentration of about 3% was optimal for resuscitation of lethal ischemic intestinal shock model in rats. Maximal volumes of lactated Ringer's solution (RL) alone only expanded plasma volume (PV) to 80% of preshock level, while increasing volumes of 3% albumin (ALB) in RL line...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/00003246-199001000-00014
更新日期:1990-01-01 00:00:00
abstract:BACKGROUND:Remarkable progress has been made during the last decade in defining the molecular mechanisms that underlie septic shock. This rapidly expanding field is leading to new therapeutic opportunities in the management of severe sepsis. AIM:To provide the clinician with a timely summary of the molecular biology o...
journal_title:Critical care medicine
pub_type: 杂志文章,评审
doi:10.1097/CCM.0b013e31819267fb
更新日期:2009-01-01 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:OBJECTIVES:Our understanding of the acute respiratory distress syndrome in children is limited, and literature is dominated by investigations in adult patients. Recent preclinical studies suggest that the susceptibility to and severity of acute respiratory distress syndrome in children could differ from that in adults....
journal_title:Critical care medicine
pub_type: 杂志文章,meta分析,评审
doi:10.1097/CCM.0000000000001388
更新日期:2016-04-01 00:00:00
abstract:OBJECTIVES:To measure energy expenditure in critically ill children and compare it with the energy expenditure predicted by recommended formulas, and relate the measured energy expenditure to nutritional and clinical indices. DESIGN:A prospective, clinical study. SETTING:Tertiary care pediatric intensive care unit in...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/00003246-200004000-00042
更新日期:2000-04-01 00:00:00
abstract:OBJECTIVE:Emergency preservation and resuscitation (EPR) comprise a novel approach for resuscitation of exsanguination cardiac arrest victims. EPR uses a cold aortic flush to induce deep hypothermic preservation, followed by resuscitation with cardiopulmonary bypass. Development of a rat EPR model would enable study of...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/01.CCM.0000253398.61666.0D
更新日期:2007-02-01 00:00:00
abstract::We analyzed 35 samples of fresh frozen plasma (FFP), finding mean concentrations of 535 mg/dl glucose, 172 mEq/L sodium, 73 mEq/L chloride, 3.5 mEq/L potassium, 15 mEq/L bicarbonate, and 5.5 g/dl protein with 60% albumin. Thus, FFP is a hyperosmolal, hyperglycemic, hypernatremic, and hypochloremic solution which may b...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/00003246-198602000-00015
更新日期:1986-02-01 00:00:00
abstract:OBJECTIVE:To examine the frequency of obtaining Institutional Review Board (IRB) approval and informed consent in critical care research. DATA SOURCES AND DATA EXTRACTION:One-year retrospective review of original critical care research in humans published in seven journals, including American Journal of Respiratory an...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/00003246-199809000-00035
更新日期:1998-09-01 00:00:00
abstract:OBJECTIVE:To describe mechanical ventilation settings in adult patients treated for an acute respiratory distress syndrome with extracorporeal membrane oxygenation and assess the potential impact of mechanical ventilation settings on ICU mortality. DESIGN:Retrospective observational study. SETTING:Three international...
journal_title:Critical care medicine
pub_type: 杂志文章,多中心研究
doi:10.1097/CCM.0000000000000753
更新日期:2015-03-01 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:OBJECTIVE:Pathogens that cause pneumonia may be treated in a targeted fashion by antibiotics, but if this therapy fails, then treatment involves only nonspecific supportive measures, independent of the inciting infection. The purpose of this study was to determine whether host response is similar after disparate infect...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/CCM.0b013e3181b4a76b
更新日期:2010-01-01 00:00:00
abstract:OBJECTIVES:Although highly active antiretroviral therapy has led to improved survival in HIV-infected individuals, outcomes for HIV-infected patients with sepsis in the post-highly active antiretroviral therapy era are conflicting. Access to highly active antiretroviral therapy and healthcare disparities continue to af...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/CCM.0000000000001003
更新日期:2015-08-01 00:00:00
abstract:OBJECTIVES:Peripherally inserted central catheters are increasingly used in ICU as an alternative to centrally inserted central catheters for IV infusion. However, their reliability for hemodynamic measurements with transpulmonary thermodilution is currently unknown. We investigated the agreement between transpulmonary...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/CCM.0000000000003917
更新日期:2019-10-01 00:00:00
abstract:OBJECTIVES:To measure the impact of staged implementation of full versus partial ABCDE bundle on mechanical ventilation duration, ICU and hospital lengths of stay, and cost. DESIGN:Prospective cohort study. SETTING:Two medical ICUs within Montefiore Healthcare Center (Bronx, NY). PATIENTS:One thousand eight hundred ...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/CCM.0000000000003765
更新日期:2019-07-01 00:00:00
abstract:OBJECTIVE:To compare prone positioning and continuous rotational therapy with respect to oxygenation and hemodynamics in patients suffering from adult respiratory distress syndrome (ARDS). DESIGN:Randomized, prospective pilot study. SETTING:Intensive care unit at a university hospital. PATIENTS:Twenty-six mechanical...
journal_title:Critical care medicine
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1097/00003246-200101000-00014
更新日期:2001-01-01 00:00:00
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 ou...
journal_title:Critical care medicine
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1097/00003246-200011000-00031
更新日期:2000-11-01 00:00:00
abstract:OBJECTIVE:To study the rate of elimination of ethanol after a major burn trauma. DESIGN:Prospective, controlled study. SETTING:National burns unit in a Swedish university hospital. PATIENTS AND SUBJECTS:Eight consecutive patients suffering from 18%-72% total burned surface area and nine healthy male control subjects...
journal_title:Critical care medicine
pub_type: 临床试验,杂志文章
doi:10.1097/00003246-199912000-00003
更新日期:1999-12-01 00:00:00
abstract:OBJECTIVES:Vital organ hypoperfusion significantly contributes to the dismal survival rates observed with manual cardiopulmonary resuscitation after cardiac arrest. The impedance threshold device is a valve which reduces air entry into lungs during chest recoil between chest compressions, producing a potentially benefi...
journal_title:Critical care medicine
pub_type: 杂志文章,meta分析
doi:10.1097/CCM.0b013e318170ba80
更新日期:2008-05-01 00:00:00
abstract::This report documents the validity of clinical measurements of oxygen consumption (VO2) and carbon dioxide production (VCO2) made with a new metabolic gas monitor (MGM) suitable for use in critically ill patients receiving mechanical ventilatory support. Paired samples of inspired and expired gases were obtained, and ...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/00003246-198710000-00012
更新日期:1987-10-01 00:00:00
abstract:OBJECTIVE:To assess the effect of diisopropyl phenol (propofol), with and without Intralipid, on the cardiopulmonary system and on thromboxane production in endotoxic pigs. DESIGN:Prospective, randomized animal study. SETTING:Animal research laboratory at a major teaching hospital. SUBJECTS:Twenty-four pigs, divided...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/01.CCM.0000070445.76287.6E
更新日期:2003-07-01 00:00:00
abstract:OBJECTIVE:The role of systemic corticosteroids in pathophysiology and treatment of acute respiratory distress syndrome is controversial. Use of prehospital systemic corticosteroid therapy may prevent the development of acute respiratory distress syndrome and improve hospital outcomes. DESIGN:This is a preplanned retro...
journal_title:Critical care medicine
pub_type: 杂志文章,多中心研究
doi:10.1097/CCM.0b013e31828a1fc7
更新日期:2013-07-01 00:00:00
abstract:OBJECTIVE:To define a biomarker panel to predict organ dysfunction, shock, and in-hospital mortality in emergency department (ED) patients with suspected sepsis. DESIGN:Prospective observational study. SETTING:EDs of ten academic medical centers. PATIENTS:There were 971 patients enrolled. INCLUSION CRITERIA:1) ED p...
journal_title:Critical care medicine
pub_type: 杂志文章,多中心研究
doi:10.1097/CCM.0b013e318192fd9d
更新日期:2009-01-01 00:00:00
abstract::Clonidine may be a source of serious toxicity when ingested by toddlers. We describe 11 cases of clonidine ingestion by toddlers (mean dose 0.15 mg/kg; range 0.01 to 0.57). The source of the clonidine was a grand-parent in six of 11 cases. Symptoms included altered level of consciousness (n = 11), miosis (n = 5), brad...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/00003246-199010000-00014
更新日期:1990-10-01 00:00:00
abstract:OBJECTIVE:To perform an analysis of the quality of life of survivors after ICU discharge. DESIGN:Prospective study. SETTING:Medical-surgical ICU of a Spanish reference hospital. PATIENTS:Patients (n = 606) admitted in a 6-month period. METHOD:A questionnaire regarding quality of life issues was completed at the tim...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/00003246-199209000-00012
更新日期:1992-09-01 00:00:00
abstract::Right ventricular size and contractility were evaluated using two-dimensional echocardiography during the first days of respiratory support in 23 patients requiring mechanical ventilation for acute respiratory failure. Nine patients had normal echocardiographic right ventricular function, and nine other patients had a...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/00003246-198511000-00035
更新日期:1985-11-01 00:00:00
abstract:OBJECTIVE:To describe three female patients of one family with different phenotypes of the same mutation of the ornithine transcarbamylase gene. X-linked inherited ornithine transcarbamylase deficiency is the most frequent urea cycle disorder. Many of the hemizygous males die during the neonatal period. Women, who are ...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/00003246-200201000-00035
更新日期:2002-01-01 00:00:00