Abstract:
OBJECTIVES:To review the intensive care unit experience of patients with admitted or acquired nosocomial endocarditis (NE) defined according to the Duke criteria. DESIGN:Prospective, cohort study. SETTING:University teaching hospital. PATIENTS:We reviewed the records of 22 patients documented with NE during a 6-yr period from 1992 to 1997. INTERVENTIONS:None. MEASUREMENTS AND MAIN RESULTS:Twenty-two patients (9 women/13 men) aged 38-83 yrs (mean 65+/-9 yrs) had a NE (prevalence of 5 per 1,000 admissions). For six patients, NE was the reason for the admission to the intensive care unit. For 17 patients, the time elapsed between admission and diagnosis of NE was 39+/-25 days. Sixteen patients were predisposed to infection and seven had underlying heart conditions that put them at risk for acute endocarditis: three prosthetic valves, two valvular diseases, and two cardiac pacemakers. In 21 cases (one unknown portal of entry), NE was the consequence of bacteremia related to a medical or surgical procedure: 11 intravascular devices, eight surgical wounds, one tracheal procedure, and one leg ulceration. The bacteriologic agents detected in blood cultures were: staphylococci (n = 17), Streptococcus (n = 2), Pseudomonas aeruginosa (n = 2), and Candida (n = 2). Fourteen patients underwent echocardiography according to cardiac signs (cardiac failure, new cardiac murmur, or embolic event). For the eight remainders, echocardiography was performed systematically because of fever and positive blood cultures. The lesions detected by 21 transthoracic and 17 transesophageal echocardiographs were the following: vegetations (n = 19), myocardial abscesses (n = 5), and valvular perforation (n = 1). On 16 surgical indications, only five patients underwent surgery because the others were in too poor of a condition. The overall mortality was 68% (n = 15) and was directly associated with NE in 36% of cases (n = 8). Seven patients (28%) were discharged 34 days after the diagnosis of endocarditis. CONCLUSIONS:NE is a frequent nosocomial infection that occurs late during hospitalization. Persistent fever with positive blood cultures is sufficient symptomology to promptly perform an echocardiogram. The poor prognosis is related to the poor condition of those patients who cannot be referred for surgical treatment.
journal_name
Crit Care Medjournal_title
Critical care medicineauthors
Gouëllo JP,Asfar P,Brenet O,Kouatchet A,Berthelot G,Alquier Pdoi
10.1097/00003246-200002000-00015subject
Has Abstractpub_date
2000-02-01 00:00:00pages
377-82issue
2eissn
0090-3493issn
1530-0293journal_volume
28pub_type
杂志文章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 cos...
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:10.1097/01.CCM.0000055369.37620.EE
更新日期:2003-03-01 00:00:00
abstract::It has become accepted that nitric oxide serves important functions in biological systems as a second messenger. Another diatomic gaseous molecule, carbon monoxide (CO), is also rapidly gaining acceptance as a signaling agent. Some of the activities of CO are analogous to those of nitric oxide in the vascular system a...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:
更新日期:2001-01-01 00:00:00
abstract:OBJECTIVE:When treating patients with cardiac arrest with mild therapeutic hypothermia, a reliable and easy-to-use temperature probe is desirable. This study was conducted to investigate the accuracy and safety of tracheal temperature as a measurement of body temperature. DESIGN:Observational cohort study. SETTING:Em...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/CCM.0b013e3181e47a20
更新日期:2010-07-01 00:00:00
abstract:OBJECTIVES:The association between tobacco smoke exposure and critical illness is not well studied, largely because obtaining an accurate smoking history from critically ill patients is difficult. Biomarkers can provide quantitative data on active and secondhand cigarette smoke exposure. We sought to compare cigarette ...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/CCM.0b013e3181fa4196
更新日期:2011-01-01 00:00:00
abstract:OBJECTIVE:Hematopoietic stem cell transplant (HSCT) recipients admitted to the intensive care unit (ICU) have high mortality. The prognostic importance of peripheral blood stem cell source in critically ill HSCT recipients and the performance of Acute Physiology and Chronic Health Evaluation (APACHE) III have not been ...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/01.CCM.0000065761.51367.2D
更新日期:2003-06-01 00:00:00
abstract:OBJECTIVE:To determine the effects of stimulation of vascular dopaminergic receptor subtype 1 (dopamine-1) receptors in the renal and mesenteric vascular beds of a neonatal model. DESIGN:Prospective, unblinded, dose-response evaluation in an awake animal. SETTING:University research laboratory. SUBJECTS:Thirty newbo...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/00003246-199610000-00018
更新日期:1996-10-01 00:00:00
abstract:OBJECTIVES:The purpose of this study was to determine the accuracy of clinical diagnoses compared to autopsy findings in critically ill patients in the current medical era. DESIGN:We conducted a retrospective, blinded review of matched medical records and postmortem findings in patients who died between June 2006 and ...
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pub_type: 杂志文章
doi:10.1097/CCM.0b013e3182a275b1
更新日期:2014-02-01 00:00:00
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journal_title:Critical care medicine
pub_type: 杂志文章,评审
doi:10.1097/00003246-199909000-00005
更新日期:1999-09-01 00:00:00
abstract:OBJECTIVE:Pressure inflating the lung during mechanical ventilation is the difference between pressure applied at the airway opening (Pao) and pleural pressure (Ppl). Depending on the chest wall's contribution to respiratory mechanics, a given positive end-expiratory and/or end-inspiratory plateau pressure may be appro...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/01.CCM.0000215515.49001.A2
更新日期:2006-05-01 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::The intensive care unit (ICU) represents a hospital setting in which death and discussion about end-of-life care are common, yet these conversations are often difficult. Such difficulties arise, in part, because a family may be facing an unexpected poor prognosis associated with an acute illness or exacerbation and, i...
journal_title:Critical care medicine
pub_type: 杂志文章,评审
doi:10.1097/00003246-200102001-00006
更新日期:2001-02-01 00:00:00
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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:OBJECTIVE:To assess the statistical association of the Acute Physiology and Chronic Health Evaluation (APACHE II) score with multiple intervention and outcome variables in surgical ICU patients. DESIGN:Continuous data collection on every patient admitted to the surgical ICU for a 21-month period. MATERIALS AND METHOD...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/00003246-199108000-00013
更新日期:1991-08-01 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:OBJECTIVE:Addressing the quality gap in ICU-based palliative care is limited by uncertainty about acceptable models of collaborative specialist and generalist care. Therefore, we characterized the attitudes of physicians and nurses about palliative care delivery in an ICU environment. DESIGN:Mixed-methods study. SETT...
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pub_type: 杂志文章,多中心研究
doi:10.1097/CCM.0000000000002099
更新日期:2017-04-01 00:00:00
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pub_type: 杂志文章
doi:10.1097/01.ccm.0000278916.04569.23
更新日期:2007-09-01 00:00:00
abstract:OBJECTIVE:Currently 162-325 mg aspirin is recommended for the treatment of acute coronary syndrome. We tested the effect of an additional loading dose of 250 mg aspirin at the onset of acute coronary syndrome in patients who were already on chronic therapy with 100 mg aspirin. DESIGN:This was a prospective trial in pa...
journal_title:Critical care medicine
pub_type: 杂志文章,随机对照试验
doi:10.1097/CCM.0b013e3181de8b1e
更新日期:2010-06-01 00:00:00
abstract:BACKGROUND:Intensive care units (ICUs) are recognized as stressful environments. However, the conditions in which stressors may affect health professionals' performance and well-being and the conditions that potentially lead to impaired performance and staff psychological distress are not well understood. OBJECTIVES:T...
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pub_type: 杂志文章
doi:10.1097/CCM.0b013e31819c1496
更新日期:2009-04-01 00:00:00
abstract::The clearance of amikacin during hemodialysis (HD) was determined in eight critically ill patients. The dialysis period averaged 3.4 h with a blood flow of 200 ml/min. The average amikacin clearance between dialysis was 7.30 +/- 4.78 (SD) ml/min which increased to 37.5 +/- 8.01 ml/min during dialysis. The average seru...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/00003246-198805000-00010
更新日期:1988-05-01 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: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
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pub_type: 杂志文章
doi:10.1097/01.ccm.0000084805.15352.01
更新日期:2003-07-01 00:00:00
abstract::Capnography is a valuable tool in the management of cardiac arrest, since end-tidal CO2 (PetCO2) correlates well with cardiac output and there are no other suitable noninvasive ways to measure this important variable during resuscitation. Animal studies also suggest that PetCO2 correlates well with the likelihood of r...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/00003246-199004000-00002
更新日期:1990-04-01 00:00:00
abstract::Medical technology is a two-edged sword, capable of saving and improving life but also of ending and harming life. Finding the right stance toward technology requires great balance and sensitivity. It has seductive powers because of its expected benefits, the social and professional pressures to use it, and a frequent...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/01.CCM.0000065122.55187.22
更新日期:2003-05-01 00:00:00
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:OBJECTIVE:To determine whether the absence or presence of clinical pharmacists in intensive care units (ICUs) results in differences in mortality rates, length of ICU stay, and ICU charges for Medicare patients with nosocomial-acquired infections, community-acquired infections, and sepsis. DESIGN, SETTING, AND PATIENT...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/CCM.0b013e31818f2269
更新日期:2008-12-01 00:00:00
abstract:OBJECTIVES:To examine a hygroscopic condenser after clinical use and to describe the interaction of a hygroscopic condenser and a closed circuit suction system used simultaneously. DESIGN:Prospective evaluation of hygroscopic condensers used clinically, and laboratory investigation of a hygroscopic condenser used with...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:
更新日期:1994-10-01 00:00:00
abstract:OBJECTIVES:The Accreditation Council for Graduate Medical Education recently released new standards for supervision and duty hours for residency programs. These new standards, which will affect over 100,000 residents, take effect in July 2011. In response to these new guidelines, the Society of Critical Care Medicine c...
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pub_type: 杂志文章
doi:10.1097/CCM.0b013e318225776f
更新日期:2011-11-01 00:00:00
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journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/01.CCM.0000240231.76837.DC
更新日期:2006-10-01 00:00:00
abstract:SUBJECT:After transient global cerebral ischemia, selective vulnerable brain areas show delayed neurodegeneration with characteristics of apoptosis. Recent data demonstrate potent neuroprotective effects of the application of endogenous growth hormones such as brain-derived neurotrophic factor (BDNF) after focal cerebr...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/01.ccm.0000134223.09056.fc
更新日期:2004-09-01 00:00:00