Abstract:
BACKGROUND:The initial management of a trauma patient is a critical and demanding period. The use of extended focused assessment sonography for trauma (eFAST) has become more prevalent in trauma rooms, raising questions about the real "added value" of chest X-rays (CXRs) and pelvic X-rays (PXR), particularly in haemodynamically stable trauma patients. The aim of this study was to evaluate the effectiveness of a management protocol integrating eFAST and excluding X-rays in stable trauma patients. METHODS:This was a prospective, interventional, single-centre study including all primary blunt trauma patients admitted to the trauma bay with a suspicion of severe trauma. All patients underwent physical examination and eFAST (assessing abdomen, pelvis, pericardium and pleura) before a whole-body CT scan (WBCT). Patients fulfilling all stability criteria at any time in transit from the scene of the accident to the hospital were managed in the trauma bay without chest and PXR. RESULTS:Amongst 430 patients, 148 fulfilled the stability criteria (stability criteria group) of which 122 (82 %) had no X-rays in the trauma bay. No diagnostic failure with an immediate clinical impact was identified in the stability criteria group (SC group). All cases of pneumothorax requiring chest drainage were identified by eFAST associated with a clinical examination before the WBCT scan in the SC group. The time spent in the trauma bay was significantly shorter for the SC group without X-rays compared to those who received any X-ray (25 [20; 35] vs. 38 [30; 60] min, respectively; p < 0.0001). An analysis of the cost and radiation exposure showed savings of 7000 Є and 100 mSv, respectively. CONCLUSIONS:No unrecognized diagnostic with a clinical impact due to the lack of CXR and PXR during the initial management of stable trauma patients was observed. The eFAST associated with physical examination provided the information necessary to safely complete the WBCT scan. It allowed a sensible cost and radiation saving.
journal_name
Ann Intensive Carejournal_title
Annals of intensive careauthors
Hamada SR,Delhaye N,Kerever S,Harrois A,Duranteau Jdoi
10.1186/s13613-016-0166-0subject
Has Abstractpub_date
2016-12-01 00:00:00pages
62issue
1issn
2110-5820pii
10.1186/s13613-016-0166-0journal_volume
6pub_type
杂志文章abstract::Although improving, the mortality from septic shock still remains high despite increased international awareness. As a consequence, much effort has focused on alternative treatment strategies in an effort to improve outcomes. The application of blood purification therapies to improve immune homeostasis has been sugges...
journal_title:Annals of intensive care
pub_type: 杂志文章,评审
doi:10.1186/s13613-019-0530-y
更新日期:2019-05-14 00:00:00
abstract:BACKGROUND:Lactate is a robust prognostic marker for the outcome of critically ill patients. Several small studies reported that metformin users have higher lactate levels at ICU admission without a concomitant increase in mortality. However, this has not been investigated in a larger cohort. We aimed to determine whet...
journal_title:Annals of intensive care
pub_type: 杂志文章
doi:10.1186/s13613-020-00652-0
更新日期:2020-03-26 00:00:00
abstract:BACKGROUND:Glucose control is an important issue in post-operative patients. The objective here was to compare two insulin infusion lines by syringe pumps to assess the impact of medical devices on glycaemic variability in surgical patients under intensive insulin therapy. This open, prospective, single-centre randomis...
journal_title:Annals of intensive care
pub_type: 杂志文章
doi:10.1186/s13613-017-0298-x
更新日期:2017-12-01 00:00:00
abstract::The death of a loved one is often an ordeal and a tragedy for those who witness it, as death is not merely the end of a life, but also the end of an existence, the loss of a unique individual who is special and irreplaceable. In some situations, end-of-life signs, such as agonal gasps, can be an almost unbearable "sig...
journal_title:Annals of intensive care
pub_type: 杂志文章,评审
doi:10.1186/2110-5820-4-23
更新日期:2014-07-08 00:00:00
abstract:BACKGROUND:We performed a meta-analysis of randomized controlled trials (RCTs) to determine if daily bathing with chlorhexidine decreased hospital-acquired BSIs in critically ill patients. METHODS:We searched the MEDLINE, EMBASE, and Cochrane Central Register of Controlled Trials databases to identify randomized contr...
journal_title:Annals of intensive care
pub_type: 杂志文章
doi:10.1186/s13613-015-0073-9
更新日期:2015-12-01 00:00:00
abstract:BACKGROUND:Aneurysmal subarachnoid hemorrhage (SAH) is a serious condition associated with high mortality rates and long-term disability. We investigated the impact of fluid balance on neurologic outcome after adjustment for possible confounders related to intensive care therapy and extra-cerebral organ failure during ...
journal_title:Annals of intensive care
pub_type: 杂志文章
doi:10.1186/s13613-016-0128-6
更新日期:2016-12-01 00:00:00
abstract::This review examines the available evidence for targeting a specific mean arterial pressure (MAP) in sepsis resuscitation. The clinical data suggest that targeting an MAP of 65-70 mmHg in patients with septic shock who do not have chronic hypertension is a reasonable first approximation. Whereas in patients with chron...
journal_title:Annals of intensive care
pub_type: 杂志文章
doi:10.1186/s13613-015-0085-5
更新日期:2015-12-01 00:00:00
abstract:BACKGROUND:The impact of neutropenia in critically ill immunocompromised patients admitted in a context of acute respiratory failure (ARF) remains uncertain. The primary objective was to assess the prognostic impact of neutropenia on outcomes of these patients. Secondary objective was to assess etiology of ARF accordin...
journal_title:Annals of intensive care
pub_type: 杂志文章
doi:10.1186/s13613-020-00764-7
更新日期:2020-10-22 00:00:00
abstract:BACKGROUND:Despite advances in the management of bloodstream infections (BSI) caused by Candida spp., the mortality still remains high in critically ill patients. The worldwide epidemiology of yeast-related BSI is subject to changing species distribution and resistance patterns, challenging antifungal treatment strateg...
journal_title:Annals of intensive care
pub_type: 杂志文章
doi:10.1186/s13613-020-00755-8
更新日期:2020-10-16 00:00:00
abstract:: Multiple experimental and human trials have shown that microcirculatory alterations are frequent in sepsis. In this review, we discuss the characteristics of these alterations, the various mechanisms potentially involved, and the implications for therapy. Sepsis-induced microvascular alterations are characterized by ...
journal_title:Annals of intensive care
pub_type: 杂志文章
doi:10.1186/2110-5820-1-27
更新日期:2011-07-19 00:00:00
abstract::Anemia and red blood cell (RBC) transfusion occur frequently in hospitalized patients with cardiac disease. In this narrative review, we report the epidemiology of anemia and RBC transfusion in hospitalized adults and children (excluding premature neonates) with cardiac disease, and on the outcome of anemic and transf...
journal_title:Annals of intensive care
pub_type: 杂志文章,评审
doi:10.1186/2110-5820-4-16
更新日期:2014-06-02 00:00:00
abstract:BACKGROUND:Hyperglycaemia is commonplace in the adult intensive care unit (ICU), associated with increased morbidity and mortality. Effective glycaemic control (GC) can reduce morbidity and mortality, but has proven difficult. STAR is a proven, effective model-based ICU GC protocol that uniquely maintains normo-glycaem...
journal_title:Annals of intensive care
pub_type: 杂志文章
doi:10.1186/s13613-017-0351-9
更新日期:2018-01-10 00:00:00
abstract:BACKGROUND:Empirical antimicrobial therapy (EAT) is a challenge for community-acquired, hospital-acquired and ventilator-associated pneumonia, particularly in the context of the increasing occurrence of third-generation cephalosporin-resistant Enterobacterales (3GCR-E), including extended-spectrum beta-lactamase Entero...
journal_title:Annals of intensive care
pub_type: 杂志文章
doi:10.1186/s13613-020-00754-9
更新日期:2020-10-29 00:00:00
abstract:BACKGROUND:The Lung Injury Score (LIS) remains a commonly utilized measure of lung injury severity though the additive value of LIS to predict ARDS outcomes over the recent Berlin definition of ARDS, which incorporates severity, is not known. METHODS:We tested the association of LIS (in which scores range from 0 to 4,...
journal_title:Annals of intensive care
pub_type: 杂志文章
doi:10.1186/2110-5820-4-4
更新日期:2014-02-18 00:00:00
abstract:BACKGROUND:Patients in the intensive care unit (ICU) are more prone to drug-drug interactions (DDIs). The software and charts that indicate all interactions may not be proper for clinical usage. This study aimed to identify the main drug classes associated with clinically significant DDIs in cardiothoracic ICU and cate...
journal_title:Annals of intensive care
pub_type: 杂志文章
doi:10.1186/s13613-015-0086-4
更新日期:2015-12-01 00:00:00
abstract:BACKGROUND:Extracorporeal cardiopulmonary resuscitation (ECPR) has been considered in selected candidates with potentially reversible causes during a limited period. Candidate selection and the identification of predictable conditions are important factors in determining outcomes during CPR in the emergency department ...
journal_title:Annals of intensive care
pub_type: 杂志文章
doi:10.1186/s13613-017-0309-y
更新日期:2017-08-30 00:00:00
abstract:: Human serum albumin (HSA) has been used for a long time as a resuscitation fluid in critically ill patients. It is known to exert several important physiological and pharmacological functions. Among them, the antioxidant properties seem to be of paramount importance as they may be implied in the potential beneficial ...
journal_title:Annals of intensive care
pub_type: 杂志文章
doi:10.1186/2110-5820-3-4
更新日期:2013-02-15 00:00:00
abstract:BACKGROUND:Assessment of maximum respiratory pressures is a common practice in intensive care because it can predict the success of weaning from ventilation. However, the reliability of measurements through an intubation catheter has not been compared with standard measurements. The aim of this study was to compare max...
journal_title:Annals of intensive care
pub_type: 杂志文章
doi:10.1186/s13613-018-0362-1
更新日期:2018-01-30 00:00:00
abstract:BACKGROUND:SARS coronavirus 2 (SARS-CoV-2) is responsible for high morbidity and mortality worldwide, mostly due to the exacerbated inflammatory response observed in critically ill patients. However, little is known about the kinetics of the systemic immune response and its association with survival in SARS-CoV-2+ pati...
journal_title:Annals of intensive care
pub_type: 杂志文章
doi:10.1186/s13613-020-00798-x
更新日期:2021-01-13 00:00:00
abstract:BACKGROUND:Acute kidney injury (AKI) occurs in up to 50% of all critically ill patients and hemodynamic abnormalities are assumed to contribute, but their nature and share is still unclear. We explored the associations between hemodynamic variables, including cardiac index and right ventricular function, and the occurr...
journal_title:Annals of intensive care
pub_type: 杂志文章
doi:10.1186/s13613-019-0513-z
更新日期:2019-03-13 00:00:00
abstract:Introduction:Acute respiratory failure is the main reason for admission to the intensive care unit (ICU) in HIV-infected adults. There is little data about the epidemiology of respiratory viruses in this population. Methods:HIV-infected adults admitted to two intensive care units over a 6-year period for an acute resp...
journal_title:Annals of intensive care
pub_type: 杂志文章
doi:10.1186/s13613-020-00738-9
更新日期:2020-09-14 00:00:00
abstract::The 2018 Paris Intensive Care symposium entitled "Update in Neurocritical Care" was organized in Paris, June 21-22, 2018, under the auspices of the French Intensive Care Society. This 2-day post-graduate educational symposium comprised several chapters, aiming first to provide all-board intensivists with current stand...
journal_title:Annals of intensive care
pub_type: 杂志文章,评审
doi:10.1186/s13613-019-0523-x
更新日期:2019-04-16 00:00:00
abstract:BACKGROUND:Optimal sedation and analgesia is a challenge in paediatric intensive care units (PICU) because of difficulties in scoring systems and specific metabolism inducing tolerance and withdrawal. Excessive sedation is associated with prolonged mechanical ventilation and hospitalisation. Adult and paediatric data s...
journal_title:Annals of intensive care
pub_type: 杂志文章
doi:10.1186/s13613-017-0256-7
更新日期:2017-12-01 00:00:00
abstract:BACKGROUND:Intravenous crystalloid solutions are administered commonly for critically ill patients. We performed this meta-analysis of randomized trials with trial sequential analysis (TSA) to evaluate effects of chloride content of intravenous crystalloid solutions on clinical outcomes among critically ill adult patie...
journal_title:Annals of intensive care
pub_type: 杂志文章
doi:10.1186/s13613-019-0506-y
更新日期:2019-02-13 00:00:00
abstract:BACKGROUND:The consequences of the ageing population concerning ICU hospitalisation need to be adequately described. We believe that this discussion should be disease specific. A focus on respiratory infections is of particular interest, because it is strongly associated with old age. Our objective was to assess trends...
journal_title:Annals of intensive care
pub_type: 杂志文章
doi:10.1186/s13613-018-0430-6
更新日期:2018-08-15 00:00:00
abstract:BACKGROUND:The echocardiography working group of the European Society of Intensive Care Medicine recognized the need to provide structured guidance for future CCE research methodology and reporting based on a systematic appraisal of the current literature. Here is reported this systematic appraisal. METHODS:We conduct...
journal_title:Annals of intensive care
pub_type: 杂志文章,评审
doi:10.1186/s13613-020-00662-y
更新日期:2020-04-25 00:00:00
abstract:: Thrombocytopenia is a very frequent disorder in the intensive care unit. Many etiologies should be searched, and therapeutic approaches differ according to these different causes. However, no guideline exists regarding optimum practices for these situations in critically ill patients. We present recommendations for t...
journal_title:Annals of intensive care
pub_type: 杂志文章
doi:10.1186/2110-5820-2-42
更新日期:2012-08-28 00:00:00
abstract:BACKGROUND:Occlusion pressure at 100 ms (P0.1), defined as the negative pressure measured 100 ms after the initiation of an inspiratory effort performed against a closed respiratory circuit, has been shown to be well correlated with central respiratory drive and respiratory effort. Automated P0.1 measurement is availab...
journal_title:Annals of intensive care
pub_type: 杂志文章
doi:10.1186/s13613-019-0576-x
更新日期:2019-09-13 00:00:00
abstract:BACKGROUND:Many maneuvers assessing fluid responsiveness (minifluid challenge, lung recruitment maneuver, end-expiratory occlusion test, passive leg raising) are considered as positive when small variations in cardiac index, stroke volume index, stroke volume variation or pulse pressure variation occur. Pulse contour a...
journal_title:Annals of intensive care
pub_type: 杂志文章
doi:10.1186/s13613-019-0590-z
更新日期:2019-10-11 00:00:00
abstract:BACKGROUND:Sepsis-associated acute kidney injury (SA-AKI) is an independent risk factor for death in patients with sepsis, but treatment for it is limited. To improve the diagnosis and treatment of SA-AKI, we must first understand its pathogenesis. Recently, interleukin (IL)-17A has been shown to be associated with the...
journal_title:Annals of intensive care
pub_type: 杂志文章
doi:10.1186/s13613-016-0157-1
更新日期:2016-12-01 00:00:00