Abstract:
INTRODUCTION:Monitoring of hemodynamic and volumetric parameters after severe burns is of critical importance. Pulmonary artery catheters, however, have been associated with many risks. Our aim was to show the feasibility of continuous monitoring with minimally invasive transpulmonary thermodilution (TPTD) in severely burned pediatric patients. METHODS:This prospective cohort study was conducted in patients with severe burns over 40% of the total body surface area (TBSA) who were admitted to the hospital within 96 hours after sustaining the injury. TPTD measurements were performed using the PiCCO system (Pulsion Medical Systems, Munich, Germany). Cardiac Index (CI), Intrathoracic Blood Volume Index (ITBVI) (Stewart-Hamilton equation), Extravascular Lung Water Index (EVLWI) and Systemic Vascular Resistance Index (SVRI) measurements were recorded twice daily. Statistical analysis was performed using one-way repeated measures analysis of variance with the post hoc Bonferroni test for intra- and intergroup comparisons. RESULTS:Seventy-nine patients with a mean age (±SD) of 9 ± 5 years and a mean TBSA burn (±SD) of 64% ± 20% were studied. CI significantly increased compared to level at admission and was highest 3 weeks postburn. ITBVI increased significantly starting at 8 days postburn. SVRI continuously decreased early in the perioperative burn period. EVLWI increased significantly starting at 9 days postburn. Young children (0 to 5 years old) had a significantly increased EVLWI and decreased ITBVI compared to older children (12 to 18 years old). EVLWI was significantly higher in patients who did not survive burn injury. CONCLUSIONS:Continuous PiCCO measurements were performed for the first time in a large cohort of severely burned pediatric patients. The results suggest that hyperdynamic circulation begins within the first week after burn injury and continues throughout the entire intensive care unit stay.
journal_name
Crit Carejournal_title
Critical care (London, England)authors
Branski LK,Herndon DN,Byrd JF,Kinsky MP,Lee JO,Fagan SP,Jeschke MGdoi
10.1186/cc10147subject
Has Abstractpub_date
2011-01-01 00:00:00pages
R118issue
2eissn
1364-8535issn
1466-609Xpii
cc10147journal_volume
15pub_type
杂志文章相关文献
CRITICAL CARE文献大全abstract:INTRODUCTION:The present study assessed the opinion of general practitioners (GPs) concerning their relationships with intensivists. METHODS:An anonymous questionnaire was mailed to 7,239 GPs. GPs were asked about their professional activities, postgraduate intensive care unit (ICU) training, the rate of patient admit...
journal_title:Critical care (London, England)
pub_type: 杂志文章
doi:10.1186/cc9061
更新日期:2010-01-01 00:00:00
abstract::This article is one of ten reviews selected from the Annual Update in Intensive Care and Emergency medicine 2017. Other selected articles can be found online at http://ccforum.com/series/annualupdate2017 . Further information about the Annual Update in Intensive Care and Emergency Medicine is available from http://www...
journal_title:Critical care (London, England)
pub_type: 杂志文章,评审
doi:10.1186/s13054-017-1642-0
更新日期:2017-03-21 00:00:00
abstract:BACKGROUND:Frailty is a state of vulnerability to poor resolution of homeostasis after a stressor event and is strongly associated with adverse outcomes. Therefore, the assessment of frailty may be an essential part of evaluation in any healthcare encounter that might result in an escalation of care. The purpose of the...
journal_title:Critical care (London, England)
pub_type: 杂志文章,多中心研究
doi:10.1186/s13054-018-2136-4
更新日期:2018-09-22 00:00:00
abstract::Providing effective analgesia and adequate sedation is a generally accepted goal of intensive care medicine. Due to its rapid, organ independent and predictable metabolism the short acting opioid remifentanil might be particularly useful for analgesia-based sedation in the intensive care unit (ICU). This hypothesis wa...
journal_title:Critical care (London, England)
pub_type: 评论,社论
doi:10.1186/cc2421
更新日期:2004-02-01 00:00:00
abstract:BACKGROUND:Mottling around the knee, reflecting a reduced skin blood flow, is predictive of mortality in patients with septic shock. However, the causative pathophysiology of mottling remains unknown. We hypothesized that the cutaneous hypoperfusion observed in the mottled area is related to regional endothelial dysfun...
journal_title:Critical care (London, England)
pub_type: 杂志文章
doi:10.1186/s13054-017-1742-x
更新日期:2017-06-23 00:00:00
abstract::Coronavirus disease (COVID-19) is an emerging viral infection that is rapidly spreading across the globe. SARS-CoV-2 belongs to the same coronavirus class that caused respiratory illnesses such as severe acute respiratory syndrome (SARS) and Middle East respiratory syndrome (MERS). During the SARS and MERS outbreaks, ...
journal_title:Critical care (London, England)
pub_type: 杂志文章,评审
doi:10.1186/s13054-020-03231-8
更新日期:2020-09-23 00:00:00
abstract:BACKGROUND:The lack of a patent source of infection after 24 hours of management of shock considered septic is a common and disturbing scenario. We aimed to determine the prevalence and the causes of shock with no diagnosis 24 hours after its onset, and to compare the outcomes of patients with early-confirmed septic sh...
journal_title:Critical care (London, England)
pub_type: 杂志文章,多中心研究
doi:10.1186/s13054-016-1537-5
更新日期:2016-11-06 00:00:00
abstract:INTRODUCTION:Sepsis is the leading cause of acute kidney injury (AKI) in critical patients. The optimal timing of initiating renal replacement therapy (RRT) in septic AKI patients remains controversial. The objective of this study is to determine the impact of early or late initiation of RRT, as defined using the simpl...
journal_title:Critical care (London, England)
pub_type: 杂志文章
doi:10.1186/cc10252
更新日期:2011-01-01 00:00:00
abstract:INTRODUCTION:The FloTrac/Vigileo (Edwards Lifesciences, Irvine, CA, USA) allows pulse pressure-derived cardiac output measurement without external calibration. Software modifications were performed in order to eliminate initially observed deficits. The aim of this study was to assess changes in cardiac output determine...
journal_title:Critical care (London, England)
pub_type: 杂志文章
doi:10.1186/cc7739
更新日期:2009-01-01 00:00:00
abstract:INTRODUCTION:Takotsubo cardiomyopathy (TCM) is a life-threatening systemic consequence early after subarachnoid hemorrhage (SAH), but precise hemodynamics and related outcome have not been studied. The purpose of this study was to investigate the TCM-induced cardiac function by transpulmonary thermodilution and its imp...
journal_title:Critical care (London, England)
pub_type: 杂志文章
doi:10.1186/s13054-014-0482-4
更新日期:2014-08-12 00:00:00
abstract:INTRODUCTION:Patients admitted to intensive care following surgery for faecal peritonitis present particular challenges in terms of clinical management and risk assessment. Collaborating surgical and intensive care teams need shared perspectives on prognosis. We aimed to determine the relationship between dynamic asses...
journal_title:Critical care (London, England)
pub_type: 杂志文章,多中心研究
doi:10.1186/s13054-015-0931-8
更新日期:2015-05-05 00:00:00
abstract::The rate of oxygen consumption by certain tissues is impaired when mice or rats are injected with lipopolysaccharide. A similar change in the rate of oxygen consumption is observed when Caco-2 human enterocyte-like cells are incubated in vitro with cytomix, a cocktail of cytokines containing tumor necrosis factor, IL-...
journal_title:Critical care (London, England)
pub_type: 杂志文章,评审
doi:10.1186/cc1824
更新日期:2002-12-01 00:00:00
abstract::The impressive benefits related to the use of tight glucose control by intensive insulin therapy have not been reproduced until now in multicenter large-scale prospective randomized trials. Although the reasons for these failures are not entirely clear, we suggest the use of a stepwise approach - Safe, Effective Gluco...
journal_title:Critical care (London, England)
pub_type: 杂志文章
doi:10.1186/cc6889
更新日期:2008-01-01 00:00:00
abstract::Type 2 diabetes has reached epidemic proportions in many parts of the world. The disease is projected to continue to increase and double within the foreseeable future. Dysglycaemia develops in the form of hyperglycaemia, hypoglycaemia and marked glucose variability in critically ill adults whether they are known to ha...
journal_title:Critical care (London, England)
pub_type: 杂志文章,评审
doi:10.1186/cc9266
更新日期:2010-01-01 00:00:00
abstract::The use of corticosteroids in septic shock remains controversial. It has been demonstrated that high doses of steroids (30 mg/kg methylprednisolone) for short periods of time are not beneficial. More recent studies using smaller doses (200-300 mg/day hydrocortisone) for longer periods of time have shown beneficial eff...
journal_title:Critical care (London, England)
pub_type: 杂志文章,评审
doi:10.1186/cc1537
更新日期:2002-10-01 00:00:00
abstract:INTRODUCTION:Control of blood glucose (BG) in critically ill patients is considered important, but is difficult to achieve, and often associated with increased risk of hypoglycemia. We examined the use of a computerized insulin dosing algorithm to manage hyperglycemia with particular attention to frequency and conditio...
journal_title:Critical care (London, England)
pub_type: 杂志文章
doi:10.1186/cc8129
更新日期:2009-01-01 00:00:00
abstract:INTRODUCTION:Delirium occurs in most ventilated patients and is independently associated with more deaths, longer stay, and higher cost. Guidelines recommend monitoring of delirium in all intensive care unit (ICU) patients, though few data exist in non-ventilated patients. The study objective was to determine the relat...
journal_title:Critical care (London, England)
pub_type: 杂志文章
doi:10.1186/cc3729
更新日期:2005-08-01 00:00:00
abstract:BACKGROUND:Coronavirus disease 2019 (COVID-19) has become a public health emergency of global concern. We aimed to explore the risk factors of 14-day and 28-day mortality and develop a model for predicting 14-day and 28-day survival probability among adult hospitalized patients with COVID-19. METHODS:In this multicent...
journal_title:Critical care (London, England)
pub_type: 杂志文章,多中心研究
doi:10.1186/s13054-020-03123-x
更新日期:2020-07-16 00:00:00
abstract::Body cell mass (BCM) is the metabolically active cell mass involved in O₂ consumption, CO₂ production and energy expenditure. BCM measurement has been suggested as a tool for the evaluation of nutritional status. Since BCM is closely related to energy expenditure, it could also represent a good reference value for the...
journal_title:Critical care (London, England)
pub_type: 评论,杂志文章
doi:10.1186/cc13852
更新日期:2014-05-01 00:00:00
abstract::A relative immunosuppression is observed in patients after sepsis, trauma, burns, or any severe insults. It is currently proposed that selected patients will benefit from treatment aimed at boosting their immune systems. However, the host immune response needs to be considered in context with pathogen-type, timing,and...
journal_title:Critical care (London, England)
pub_type: 杂志文章,评审
doi:10.1186/cc13787
更新日期:2014-03-24 00:00:00
abstract:INTRODUCTION:The aim of the present study was to investigate the relationship between the blood IL-6 level, the blood glucose level, and glucose control in septic patients. METHODS:This retrospective observational study in a general ICU of a university hospital included a total of 153 patients with sepsis, severe seps...
journal_title:Critical care (London, England)
pub_type: 杂志文章
doi:10.1186/cc11301
更新日期:2012-12-12 00:00:00
abstract:BACKGROUND:The short-term and long-term consequences of the most frequent painful procedures performed in the ICU are unclear. This study aimed to identify the risk factors associated with pain-related discomfort perceived by critically ill patients during the whole ICU stay as self-reported by patients at the end of t...
journal_title:Critical care (London, England)
pub_type: 杂志文章
doi:10.1186/s13054-020-03396-2
更新日期:2020-12-07 00:00:00
abstract::This review documents important progress made in 2013 in the field of critical care respirology, in particular with regard to acute respiratory failure and acute respiratory distress syndrome. Twenty-five original articles published in the respirology and critical care sections of Critical Care are discussed in the fo...
journal_title:Critical care (London, England)
pub_type: 杂志文章,评审
doi:10.1186/s13054-014-0577-y
更新日期:2014-10-15 00:00:00
abstract::The previous review in this series introduced the notion of data description and outlined some of the more common summary measures used to describe a dataset. However, a dataset is typically only of interest for the information it provides regarding the population from which it was drawn. The present review focuses on...
journal_title:Critical care (London, England)
pub_type: 杂志文章
doi:10.1186/cc1473
更新日期:2002-04-01 00:00:00
abstract:INTRODUCTION:Pre-hospital triage is a key element in a trauma system that aims to admit patients to the most suitable trauma center, and may decrease intra-hospital mortality. We evaluated the performance of a pre-hospital procedure in a regional trauma system through measurements of the quality of pre-hospital medical...
journal_title:Critical care (London, England)
pub_type: 杂志文章
doi:10.1186/s13054-015-0835-7
更新日期:2015-03-18 00:00:00
abstract:BACKGROUND:Inhaled nitric oxide (iNO) is a rescue therapy for severe hypoxemia in patients with acute respiratory distress syndrome (ARDS). Pooled data from clinical trials have signaled a renal safety warning for iNO therapy, but the significance of these findings in daily clinical practice is unclear. We used primary...
journal_title:Critical care (London, England)
pub_type: 杂志文章
doi:10.1186/s13054-016-1566-0
更新日期:2016-11-30 00:00:00
abstract:INTRODUCTION:This study aimed to examine the long-term outcome for patients with end-stage renal failure (ESRF) who survived multiple-organ failure. METHODS:We performed a review of databases from the renal medicine service and intensive care units (ICU) of the participating hospitals within Imperial College Healthcar...
journal_title:Critical care (London, England)
pub_type: 杂志文章
doi:10.1186/cc7867
更新日期:2009-01-01 00:00:00
abstract:INTRODUCTION:Management of daily activities in ICUs is challenging. ICU shift leaders, charge nurses and intensivists have to make several immediate ad hoc decisions to enable the fluent flow of ICU activities. Even though the management of ICU activities is quite well delineated by international consensus guidelines, ...
journal_title:Critical care (London, England)
pub_type: 杂志文章
doi:10.1186/cc10341
更新日期:2011-08-08 00:00:00
abstract::Mechanotransduction holds the underlying mechanisms of ventilator-induced lung injury. Research on this subject, however, could be difficult for clinicians, especially when results are controversial. A recent study by Li and co-workers is used as an example, to explain how to critically read literatures related to bas...
journal_title:Critical care (London, England)
pub_type: 评论,社论
doi:10.1186/cc6131
更新日期:2007-01-01 00:00:00
abstract:INTRODUCTION:It is recognized that administration of insulin with glucose decreases catabolic response in sepsis. The aim of the present study was to compare the effects of two levels of insulinaemia on glucose metabolism and energy expenditure in septic patients and volunteers. METHODS:Glucose uptake, oxidation and s...
journal_title:Critical care (London, England)
pub_type: 杂志文章
doi:10.1186/cc2868
更新日期:2004-08-01 00:00:00