Abstract:
OBJECTIVE:To determine the maternal morbidity and mortality in patients with eclampsia admitted to an intensive care unit (ICU), and to establish the efficacy of the Acute Physiology and Chronic Health Evaluation (APACHE) II score, the organ system failure score as defined by Knaus, and the Glasgow Coma Scale (GCS) score in predicting outcome. DESIGN:Retrospective analysis of a 3.5-yr period. SETTING:Surgical ICU in a university hospital. PATIENTS:A total of 105 patients who were admitted with a diagnosis of eclampsia were studied. INTERVENTIONS:None. MEASUREMENTS AND MAIN RESULTS:The data captured included the reason for admission, maternal age, gestational age, parity, number of seizures, duration of ICU stay, anticonvulsant therapy, drug therapy, GCS score, APACHE II score, and the occurrence of organ failure. Of the 126 patients with eclampsia who were admitted to the ICU, records of 105 patients (83%) were found. The overall mortality was 10.5% (n = 11). The mean age, gestation, parity, number of preadmission seizures, and duration of stay were similar in survivors and nonsurvivors. Although the APACHE II score was significantly higher in nonsurvivors, multiple logistic regression analysis suggested that the goodness-of-fit scores for GCS and APACHE II were similar (38.29 vs. 38.01). The GCS scores of survivors were significantly higher than those of nonsurvivors (10.61 vs. 5.0; p<.001). Respiratory failure was the most common organ failure in both groups. The mean number of organ failures was higher in nonsurvivors compared with survivors (2.9 vs. 1.3; p<.001). An occurrence of more than two organ failures that persisted for >48 hrs was invariably associated with a fatal outcome. Anticonvulsant therapy consisted of magnesium sulfate or phenytoin and a midazolam infusion. Only one patient (0.9%) had a seizure, and this occurred en route to the ICU. No seizures occurred after admission to the ICU. CONCLUSIONS:The organ system failure score and the GCS score are good predictors of outcome in eclampsia. Apart from the GCS score, other variables in the APACHE II score are not valuable for outcome prediction. The low GCS score in nonsurvivors suggests that closer attention to the neurologic management may be beneficial. A prospective study is indicated to validate these findings.
journal_name
Crit Care Medjournal_title
Critical care medicineauthors
Bhagwanjee S,Paruk F,Moodley J,Muckart DJdoi
10.1097/00003246-200001000-00020subject
Has Abstractpub_date
2000-01-01 00:00:00pages
120-4issue
1eissn
0090-3493issn
1530-0293journal_volume
28pub_type
杂志文章abstract::Percutaneous cholecystostomy was employed successfully as an alternative to cholecystectomy for the treatment of acute cholecystitis with perforation in an elderly woman. The procedure, performed portably in the cardiac care unit, was selected because progressive cardiac and renal decompensation made the patient an ex...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/00003246-198508000-00017
更新日期:1985-08-01 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...
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更新日期:2014-03-01 00:00:00
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journal_title:Critical care medicine
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doi:10.1097/CCM.0b013e3181cb1158
更新日期:2010-02-01 00:00:00
abstract::Twenty-one patients who underwent cardiopulmonary bypass for myocardial revascularization received postoperatively controlled mechanical ventilation (CMV) or intermittent mandatory ventilation (IMV), with or without positive end-expiratory pressure (PEEP). Functional residual capacity (FRC), right-to-left intrapulmona...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/00003246-197611000-00002
更新日期:1976-11-01 00:00:00
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journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/00003246-200202000-00023
更新日期:2002-02-01 00:00:00
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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
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journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/00003246-199104000-00013
更新日期:1991-04-01 00:00:00
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journal_title:Critical care medicine
pub_type: 杂志文章,多中心研究,随机对照试验
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更新日期:2006-02-01 00:00:00
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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
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journal_title:Critical care medicine
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doi:10.1097/00003246-199406000-00023
更新日期:1994-06-01 00:00:00
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doi:10.1097/00003246-199810000-00028
更新日期:1998-10-01 00:00:00
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journal_title:Critical care medicine
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doi:10.1097/00003246-199908000-00035
更新日期:1999-08-01 00:00:00
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doi:10.1097/CCM.0b013e3181760e5d
更新日期:2008-06-01 00:00:00
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doi:10.1097/00003246-200301000-00005
更新日期:2003-01-01 00:00:00
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doi:10.1097/CCM.0b013e31819ded31
更新日期:2009-05-01 00:00:00
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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:OBJECTIVE:Although hepatic cytochrome P-450 protein concentrations are altered following endotoxin shock, changes in P-450 isoforms in sepsis have not been fully investigated. The aim of this study was to determine whether the major P-450 isoform in rat liver (i.e., CYP1A2) is down-regulated during the progression of s...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/01.CCM.0000109453.57709.E2
更新日期:2004-02-01 00:00:00
abstract:OBJECTIVE:To describe a case of hepatic subcapsular hematoma causing an acute Budd-Chiari-like syndrome, leading to hepatic compartment syndrome, which combines compression of intrahepatic vessels on CT, acute liver failure, and refractory shock. DESIGN:Case report. SETTING:Surgical ICU of a university teaching hospi...
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doi:10.1097/CCM.0000000000001403
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doi:10.1097/01.CCM.0000261886.65063.CC
更新日期:2007-05-01 00:00:00
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更新日期:1997-10-01 00:00:00
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doi:10.1097/01.CCM.0000218814.77568.BC
更新日期:2006-06-01 00:00:00
abstract:OBJECTIVE:To investigate the relationship between behavioral alterations and changes in monoaminergic systems provoked by ischemia-reperfusion liver injury in rats. DESIGN:Prospective, randomized, controlled animal study. SETTING:University animal laboratory. SUBJECTS:Male Wistar rats. INTERVENTIONS:Acute liver fai...
journal_title:Critical care medicine
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doi:10.1097/00003246-199804000-00021
更新日期:1998-04-01 00:00:00
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doi:10.1097/01.ccm.0000182801.48137.13
更新日期:2005-10-01 00:00:00
abstract:OBJECTIVE:Cardiac surgery is frequently followed by postoperative delirium, which is associated with increased 1-year mortality, late cognitive deficits, and higher costs. Currently, there are no recommendations for pharmacologic prevention of postoperative delirium. Impaired cholinergic transmission is believed to pla...
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pub_type: 杂志文章,随机对照试验
doi:10.1097/CCM.0b013e31819da780
更新日期:2009-05-01 00:00:00
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journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/00003246-199010000-00001
更新日期:1990-10-01 00:00:00
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journal_title:Critical care medicine
pub_type: 杂志文章,多中心研究,随机对照试验
doi:10.1097/CCM.0000000000002818
更新日期:2018-02-01 00:00:00
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更新日期:2005-06-01 00:00:00
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pub_type: 杂志文章
doi:10.1097/01.ccm.0000134264.88332.37
更新日期:2004-09-01 00:00:00