Abstract:
OBJECTIVE:The high incidence of lower lobe collapse in adult intensive care patients is well described. We aimed to document the incidence and distribution of acute lobar collapse in the pediatric intensive care setting. The influence of anatomical and pathophysiological differences between the adult and pediatric respiratory tract will be considered. DESIGN:Retrospective review of chest radiograph series. SETTING:Tertiary referral center for pediatric intensive care and the Department of Diagnostic Radiology in a large teaching hospital in England. PATIENTS:Cohort of 160 patients receiving intensive care during a 2-yr period (age range, 6 days-18 yrs; median, 23 months). INTERVENTIONS:None MEASUREMENTS AND MAIN RESULTS:Twenty-four of 160 children (15%) developed acute lobar collapse during their intensive care unit admission. Isolated right upper lobe collapse occurred in 14 patients, right upper lobe in association with one or more other lobes in five patients, and lobar collapse other than the right upper lobe in five patients. The development of lobar collapse and, in particular, right upper lobe collapse was associated with a lower median age (no collapse, 26 months; lobar collapse, 8 months; right upper lobe collapse, 4 months). Lobar collapse was significantly associated with the requirement for mechanical ventilation during admission (chi-square, 12.18; p = .005). It was observed in association with both high and low endotracheal tube positions. CONCLUSION:The predominance of upper lobe and, in particular, right upper lobe collapse observed in pediatric intensive care patients contrasts with the high incidence of lower lobe collapse in their adult counterparts. Multiple interrelated factors are likely to be contributory and include the following: a) anatomical and physiological differences between adults and children; b) the pathophysiology of childhood respiratory disease; c) more critical positioning of endotracheal tubes in younger patients and their movement with patient positioning.
journal_name
Crit Care Medjournal_title
Critical care medicineauthors
Thomas K,Habibi P,Britto J,Owens CMdoi
10.1097/00003246-199908000-00035subject
Has Abstractpub_date
1999-08-01 00:00:00pages
1594-7issue
8eissn
0090-3493issn
1530-0293journal_volume
27pub_type
杂志文章abstract:OBJECTIVES:Prophylactic levetiracetam is currently used in ~40% of patients with intracerebral hemorrhage, and the potential impact of levetircetam on health-related quality of life is unknown. We tested the hypothesis that prophylactic levetiracetam is independently associated with differences in cognitive function he...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/CCM.0000000000003272
更新日期:2018-09-01 00:00:00
abstract::The heart rate variability (HRV) of 82 patients exhibiting sinus rhythm and admitted for possible myocardial infarction (MI) was evaluated. Using a simple information entropy measure to quantify the HRV, patients subsequently diagnosed with MI or experiencing significant dysrhythmia (n = 35) exhibited less entropy (0....
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/00003246-198801000-00014
更新日期:1988-01-01 00:00:00
abstract:BACKGROUND AND METHODS:We postulated that low-dose heparin (10 IU/kg.hr) administered as a continuous iv infusion may prevent or ameliorate the induction of thrombin-induced disseminated intravascular coagulation in baboons under general anesthesia. In a nonrandomized experiment lasting 8 hrs, animals were divided into...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/00003246-199109000-00017
更新日期:1991-09-01 00:00:00
abstract:OBJECTIVE:To determine the impact of Acinetobacter baumannii (AB) acquisition in intensive care unit (ICU) patients on mortality and length of stay (LOS). DESIGN:Pairwise matched 1:1 case-control study. SETTING:Medical-surgical ICU in a tertiary health care institution. PATIENTS:During 16 months, all patients admitt...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/00003246-199909000-00015
更新日期:1999-09-01 00:00:00
abstract::Total parenteral nutrition (TPN) increases CO2 production (VCO2) in patients on intermittent positive-pressure ventilation who cannot match their CO2 excretion to the CO2 load, leading to an increase in PaCO2. We studied gas exchange and blood gas values in six patients with chronic respiratory failure, who were venti...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/00003246-198507000-00005
更新日期:1985-07-01 00:00:00
abstract:OBJECTIVES:To examine perceptions of nurses and physicians in regard to ethical decision-making climate in the ICU and to test the hypothesis that the worse the ethical decision-making climate, the greater the discordance between nurses' and physicians' rating of ethical decision-making climate with physicians hypothes...
journal_title:Critical care medicine
pub_type: 杂志文章,多中心研究
doi:10.1097/CCM.0000000000004017
更新日期:2019-12-01 00:00:00
abstract:OBJECTIVES:To determine the point prevalence of medication errors at the time of transition of care from an ICU to non-ICU location and assess error types and risk factors for medication errors during transition of care. DESIGN:This was a multicenter, retrospective, 7-day point prevalence study. SETTING:Fifty-eight I...
journal_title:Critical care medicine
pub_type: 杂志文章,多中心研究
doi:10.1097/CCM.0000000000003633
更新日期:2019-04-01 00:00:00
abstract:OBJECTIVES:To investigate attitudes and practices regarding oxygen therapy in intensive care units (ICUs) and to devise quantitative descriptive indices. SETTING:Canadian university-affiliated adult ICUs. PARTICIPANTS:Fifty-two medical directors of ICUs in 48 institutions. INTERVENTION:Structured postal questionnair...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/00003246-199912000-00033
更新日期:1999-12-01 00:00:00
abstract:OBJECTIVE:To investigate the mechanism by which methylprednisolone protects the liver from hypoxia-induced injury. DESIGN:Prospective control study using the isolated rat liver. SETTING:Animal research facility. SUBJECTS:Male, fasted, pathogen-free Sprague-Dawley rats. INTERVENTIONS:Low-flow hypoxia was produced by...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/01.CCM.0000066176.49774.CC
更新日期:2003-05-01 00:00:00
abstract:OBJECTIVES:Targeted temperature management has been shown to improve survival with good neurological outcome in patients after out-of-hospital cardiac arrest. The optimal approach to inducing and maintaining targeted temperature management, however, remains uncertain. The objective of this study was to evaluate these p...
journal_title:Critical care medicine
pub_type: 杂志文章,多中心研究
doi:10.1097/CCM.0000000000000551
更新日期:2014-12-01 00:00:00
abstract:OBJECTIVE:A comparison of federal Medicare databases to identify critical care medicine (CCM) use, cost discrepancies, and their possible causes. DESIGN:A 6-yr (1995-2000) retrospective analysis of Medicare hospital and CCM use and cost, comparing the Hospital Cost Report Information System (HCRIS) with Medicare Provi...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/01.CCM.0000257255.57899.5D
更新日期:2007-03-01 00:00:00
abstract::Varying concentrations of lipopolysaccharide (LPS) and mannan suspensions were mixed with either saline or plasma from normal volunteers, heated to 100 degrees C for 10 min, and then subjected to the limulus amebocyte lysate test (LAL). A positive LAL in saline required minimum LPS and mannan concentrations of 10(-11)...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/00003246-198512000-00016
更新日期:1985-12-01 00:00:00
abstract:OBJECTIVE:Significant mortality in patients with sepsis results from the development of multiple organ dysfunction syndrome. Small-volume resuscitation with 7.5% NaCl hypertonic saline has been proposed to restore physiologic hemodynamics in hemorrhagic shock. Therefore, we hypothesized that hypertonic saline resuscita...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/CCM.0b013e318173f982
更新日期:2008-06-01 00:00:00
abstract:OBJECTIVE:To define the epidemiology of broad-spectrum cephalosporin-resistant gram-negative bacilli in intensive care units (ICUs) during a nonoutbreak period, including the prevalence, the risk factors for colonization, the frequency of acquisition, and the rate of infection. DESIGN:Prospective cohort study. SETTIN...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/00003246-199906000-00026
更新日期:1999-06-01 00:00:00
abstract:OBJECTIVES:Thrombotic microangiopathy syndromes are a heterogeneous group of severe diseases that often require ICU admission. Prompt initiation of targeted therapies is required for atypical hemolytic uremic syndrome and thrombotic thrombocytopenic purpura, whereas there is no specific consensus therapy for Shiga toxi...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/CCM.0000000000003292
更新日期:2018-09-01 00:00:00
abstract:OBJECTIVES:To characterize the rates of accidental removal of endotracheal tubes, nasogastric tubes, central venous catheters, and arterial catheters. To assess the efficacy of corrective measures aimed at reducing the accidental removal of these devices. DESIGN:Prospective, observational, and interventional study. S...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/00003246-200001000-00010
更新日期:2000-01-01 00:00:00
abstract:OBJECTIVES:Ethicists advise that life-sustaining treatment decisions should be made in keeping with patient preferences. Until recently, there has been little systematic study of the impact of patient preferences on the use of various life-sustaining treatments or the consequent cost of hospital care. This prospective ...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/00003246-199611000-00009
更新日期:1996-11-01 00:00:00
abstract:OBJECTIVE:The receptor for advanced glycation end products mediates a variety of inflammatory responses. Soluble receptor for advanced glycation end products has been suggested to function as a decoy abrogating cellular activation. High-mobility group box 1 is a high-affinity binding ligand for the receptor for advance...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/CCM.0b013e3181de18bc
更新日期:2010-06-01 00:00:00
abstract:OBJECTIVE:The first 70 years of critical care can be considered a period of "industrial revolution-like" advancement in terms of progressing the understanding and care of critical illness. Unfortunately, like the industrial revolution's impact on the environment, advancing ICU care of increasingly elderly, immunosuppre...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/CCM.0000000000004783
更新日期:2021-02-01 00:00:00
abstract::Hypersensitivity reactions are defined as immunologically based adverse reactions to chemicals or medicinal agents. These reactions are common in the intensive care unit and can present as a simple, mildly symptomatic rash or as life-threatening anaphylactic reactions. Hypersensitivity reactions have traditionally bee...
journal_title:Critical care medicine
pub_type: 杂志文章,评审
doi:10.1097/CCM.0b013e3181de0c99
更新日期:2010-06-01 00:00:00
abstract:OBJECTIVES:To evaluate the timing of foregoing life-sustaining treatments in patients enrolled in a sepsis trial and to determine their influence on patient outcome and trial results. DESIGN:Subset of patients in a prospective, randomized, double-blind, placebo-controlled study. SETTING:Twenty-three academic medical ...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/00003246-199703000-00002
更新日期:1997-03-01 00:00:00
abstract::Critical Care Medicine encompasses an extremely broad scope. Examination questions were, therefore, chosen to cover a wide variety of critical care topics. A near Gaussian distribution of scores was found for all physician groups studied. We believe the low mean score of 15% reflects the general difficulty of the exam...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/00003246-198305000-00014
更新日期:1983-05-01 00:00:00
abstract:OBJECTIVE:One in five Americans dies following treatment in an intensive care unit (ICU), and evidence indicates the need to improve end-of-life care for ICU patients. We conducted this study to elicit the views and experiences of ICU directors regarding barriers to optimal end-of-life care and to identify the type, av...
journal_title:Critical care medicine
pub_type: 杂志文章,多中心研究
doi:10.1097/01.CCM.0000239233.63425.1D
更新日期:2006-10-01 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
abstract:OBJECTIVE:To determine whether low-dose dopamine administration reduces the incidence or severity of acute renal failure, need for dialysis, or mortality in patients with critical illness. DATA SOURCES AND STUDY SELECTION:We performed a MEDLINE search of literature published from 1966 to 2000 for studies addressing th...
journal_title:Critical care medicine
pub_type: 杂志文章,meta分析
doi:10.1097/00003246-200108000-00005
更新日期:2001-08-01 00:00:00
abstract:OBJECTIVE:To investigate glycemic dynamics and its relation with mortality in critically ill patients. We searched for differences in complexity of the glycemic profile between survivors and nonsurvivors in patients admitted to a multidisciplinary intensive care unit. DESIGN:Prospective, observational study, convenien...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/CCM.0b013e3181ce49cf
更新日期:2010-03-01 00:00:00
abstract:OBJECTIVE:Clinical trial designs that randomize patients to fixed treatment regimens may disrupt preexisting relationships between illness severity and level of therapy. The practice misalignments created by such designs may have unintended effects on trial results and safety. METHODS:To illustrate this problem, the T...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/01.CCM.0000266584.40715.A6
更新日期:2007-06-01 00:00:00
abstract:OBJECTIVE:To determine the long-term outcome of noninvasive ventilation in chronic obstructive pulmonary disease patients who refused intubation for acute hypercapnic respiratory failure. DESIGN:Prospective, observational study. SETTING:Noninvasive ventilation unit in an acute regional hospital in Hong Kong. METHODS...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/01.CCM.0000108879.86838.4F
更新日期:2004-02-01 00:00:00
abstract::During the control period in this study, small premature infants, 1500 g in birth weight, had insensible water loss (IWL) of 2.28 g/kg/hr (equivlaent to 54 ml/kg/day), which is considerably higher than in full term infants. Under phototherapy, there was a significant increase in IWL (3.14 g/kg/hr) associated with incr...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/00003246-197511000-00006
更新日期:1975-11-01 00:00:00
abstract::The authors determined the correction factor (Ct) for three sizes of commonly available central venous catheters. These catheters are used as the injectate catheter when a 2.5 Fr transthoracic thermistor is used to determine cardiac output by thermodilution. The valves for Ct were highly reproducible. These determinat...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/00003246-198112000-00014
更新日期:1981-12-01 00:00:00