Central venous pressure measurement is associated with improved outcomes in septic patients: an analysis of the MIMIC-III database.

Abstract:

PURPOSE:Measurement of central venous pressure (CVP) can be a useful clinical tool. However, the formal utility of CVP measurement in preventing mortality in septic patients has never been proven. METHODS:The Medical Information Mart for Intensive Care III (MIMIC-III) database was searched to identify septic patients with and without CVP measurements. The primary outcome was 28-day mortality. Multivariate regression was used to elucidate the relationship between CVP measurement and 28-day mortality, and propensity score matching (PSM) and an inverse probability of treatment weighing (IPTW) were employed to validate our findings. RESULTS:A total of 10,275 patients were included in our study, of which 4516 patients (44%) underwent CVP measurement within 24 h of intensive care unit (ICU) admission. The risk of 28-day mortality was reduced in the CVP group (OR 0.60 (95% CI 0.51-0.70; p < 0.001)). Patients in the CVP group received more fluid on day 1 and had a shorter duration of mechanical ventilation and vasopressor use, and the reduction in serum lactate was greater than that in the no CVP group. The mediating effect of serum lactate reduction was significant for the whole cohort (p = 0.04 for the average causal mediation effect (ACME)) and patients in the CVP group with an initial CVP level below 8 mmHg (p = 0.04 for the ACME). CONCLUSION:CVP measurement was associated with decreased risk-adjusted 28-day mortality among patients with sepsis and was proportionally mediated through serum lactate reduction.

journal_name

Crit Care

authors

Chen H,Zhu Z,Zhao C,Guo Y,Chen D,Wei Y,Jin J

doi

10.1186/s13054-020-03109-9

subject

Has Abstract

pub_date

2020-07-14 00:00:00

pages

433

issue

1

eissn

1364-8535

issn

1466-609X

pii

10.1186/s13054-020-03109-9

journal_volume

24

pub_type

杂志文章
  • Effect of antiviral therapy on the outcomes of mechanically ventilated patients with herpes simplex virus detected in the respiratory tract: a systematic review and meta-analysis.

    abstract:BACKGROUND:Herpes simplex virus (HSV) is frequently detected in the respiratory tract of mechanically ventilated patients. The aim of this study was to assess current evidence to determine whether antiviral therapy is associated with better outcomes in these patients. METHODS:MEDLINE, ISI Web of Science, Cochrane Data...

    journal_title:Critical care (London, England)

    pub_type: 杂志文章

    doi:10.1186/s13054-020-03296-5

    authors: Hagel S,Scherag A,Schuierer L,Hoffmann R,Luyt CE,Pletz MW,Kesselmeier M,Weis S

    更新日期:2020-09-29 00:00:00

  • New versus old blood - the debate continues.

    abstract::Since the inception of blood banking, refinements in laboratory processes have allowed for progressively longer storage times of red blood cells. Whilst advantageous for the logistics of stock management, the clinical impact of the duration of red blood cell storage prior to transfusion remains uncertain, and a topic ...

    journal_title:Critical care (London, England)

    pub_type: 评论,杂志文章

    doi:10.1186/cc8878

    authors: Laurie J,Wyncoll D,Harrison C

    更新日期:2010-01-01 00:00:00

  • Simplified lung ultrasound protocol shows excellent prediction of extravascular lung water in ventilated intensive care patients.

    abstract:INTRODUCTION:Ultrasound of the lung and quantification of B lines was recently introduced as a novel tool to detect overhydration. In the present study, we aimed to evaluate a four-region protocol of lung ultrasound to determine the pulmonary fluid status in ventilated patients in the intensive care unit. METHODS:Fift...

    journal_title:Critical care (London, England)

    pub_type: 杂志文章

    doi:10.1186/s13054-015-0756-5

    authors: Enghard P,Rademacher S,Nee J,Hasper D,Engert U,Jörres A,Kruse JM

    更新日期:2015-02-06 00:00:00

  • Sedation practices and clinical outcomes in mechanically ventilated patients in a prospective multicenter cohort.

    abstract:OBJECTIVES:We sought to study the association between sedation status, medications (benzodiazepines, opioids, and antipsychotics), and clinical outcomes in a resource-limited setting. DESIGN:A longitudinal study of critically ill participants on mechanical ventilation. SETTING:Five intensive care units (ICUs) in four...

    journal_title:Critical care (London, England)

    pub_type: 杂志文章,多中心研究

    doi:10.1186/s13054-019-2394-9

    authors: Aragón RE,Proaño A,Mongilardi N,de Ferrari A,Herrera P,Roldan R,Paz E,Jaymez AA,Chirinos E,Portugal J,Quispe R,Brower RG,Checkley W

    更新日期:2019-04-17 00:00:00

  • National survey and point prevalence study of sedation practice in UK critical care.

    abstract:BACKGROUND:The present study was designed to (1) establish current sedation practice in UK critical care to inform evidence synthesis and potential future primary research and (2) to compare practice reported via a survey with actual practice assessed in a point prevalence study (PPS). METHODS:UK adult general critica...

    journal_title:Critical care (London, England)

    pub_type: 杂志文章

    doi:10.1186/s13054-016-1532-x

    authors: Richards-Belle A,Canter RR,Power GS,Robinson EJ,Reschreiter H,Wunsch H,Harvey SE

    更新日期:2016-10-27 00:00:00

  • Our favorite unproven ideas for future critical care.

    abstract::The future of critical care medicine will be shaped not only by the evidence-validated foundations of science, but also by innovations based on unproven and, in many cases, untested concepts and thoughtful visions of scientists and clinicians familiar with the complex problems actually faced in clinical practice. Clin...

    journal_title:Critical care (London, England)

    pub_type: 杂志文章,评审

    doi:10.1186/cc11507

    authors: Marini JJ,Vincent JL,Wischmeyer P,Singer M,Gattinoni L,Ince C,Gan TJ

    更新日期:2013-01-01 00:00:00

  • "Think. Check. Submit." to avoid predatory publishing.

    abstract:: ...

    journal_title:Critical care (London, England)

    pub_type: 信件

    doi:10.1186/s13054-018-2244-1

    authors: Cortegiani A,Shafer SL

    更新日期:2018-11-14 00:00:00

  • A 10-second fluid challenge guided by transthoracic echocardiography can predict fluid responsiveness.

    abstract:INTRODUCTION:The accurate assessment of intravascular volume status for the therapy of severe hypovolemia and shock is difficult and critical to critically ill patients. Non-invasive evaluation of fluid responsiveness by the rapid infusion of a very limited amount of volume is an important clinical goal. This study aim...

    journal_title:Critical care (London, England)

    pub_type: 杂志文章

    doi:10.1186/cc13891

    authors: Wu Y,Zhou S,Zhou Z,Liu B

    更新日期:2014-05-27 00:00:00

  • Multiple organ failure after trauma affects even long-term survival and functional status.

    abstract:BACKGROUND:The aim of this study was to assess the incidence of organ failure in trauma patients treated in an intensive care unit (ICU), and to study the relationship between organ failure and long-term survival and functional status. METHODS:This is a cohort study of all adult ICU trauma patients admitted to a unive...

    journal_title:Critical care (London, England)

    pub_type: 杂志文章

    doi:10.1186/cc6111

    authors: Ulvik A,Kvåle R,Wentzel-Larsen T,Flaatten H

    更新日期:2007-01-01 00:00:00

  • Clinical review: Intensive care follow-up--what has it told us?

    abstract::The majority of intensive care practitioners, until comparatively recently, was content to discharge surviving patients to the care of referring primary specialty colleagues who would undertake subsequent inpatient and outpatient care. With the exception of mortality statistics from clinical studies, the practitioners...

    journal_title:Critical care (London, England)

    pub_type: 杂志文章,评审

    doi:10.1186/cc1532

    authors: Broomhead LR,Brett SJ

    更新日期:2002-10-01 00:00:00

  • Endotoxemia-induced inflammation and the effect on the human brain.

    abstract:INTRODUCTION:Effects of systemic inflammation on cerebral function are not clear, as both inflammation-induced encephalopathy as well as stress-hormone mediated alertness have been described. METHODS:Experimental endotoxemia (2 ng/kg Escherichia coli lipopolysaccharide [LPS]) was induced in 15 subjects, whereas 10 ser...

    journal_title:Critical care (London, England)

    pub_type: 临床试验,杂志文章

    doi:10.1186/cc9001

    authors: van den Boogaard M,Ramakers BP,van Alfen N,van der Werf SP,Fick WF,Hoedemaekers CW,Verbeek MM,Schoonhoven L,van der Hoeven JG,Pickkers P

    更新日期:2010-01-01 00:00:00

  • Considerations for initial therapy in the treatment of acute heart failure.

    abstract::The diagnosis of patients presenting to the emergency department with acute heart failure (AHF) is challenging due to the similarity of AHF symptoms to other conditions such as chronic obstructive pulmonary disease and pneumonia. Additionally, because AHF is most common in an older population, the presentation of coex...

    journal_title:Critical care (London, England)

    pub_type: 杂志文章,评审

    doi:10.1186/s13054-015-1114-3

    authors: Peacock WF,Cannon CM,Singer AJ,Hiestand BC

    更新日期:2015-11-10 00:00:00

  • Longitudinal changes of inflammatory parameters and their correlation with disease severity and outcomes in patients with COVID-19 from Wuhan, China.

    abstract:BACKGROUND:Coronavirus disease 2019 (COVID-19) is a newly emerging infectious disease and rapidly escalating epidemic caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). The pathogenesis of COVID-19 remains to be elucidated. We aimed to clarify correlation of systemic inflammation with disease s...

    journal_title:Critical care (London, England)

    pub_type: 杂志文章

    doi:10.1186/s13054-020-03255-0

    authors: Zeng Z,Yu H,Chen H,Qi W,Chen L,Chen G,Yan W,Chen T,Ning Q,Han M,Wu D

    更新日期:2020-08-27 00:00:00

  • Leukodepleted versus nonleukodepleted red blood cell transfusion in septic patients: a microcirculatory vision.

    abstract::Storage time and residual leukocytes in red blood cell (RBC) units may be deleterious by increasing the accumulation of leukocyte-derived cytokines and by raising the adhesion of RBCs to endothelium. Leukodepleted RBC transfusion may reduce the incidence of infection and organ dysfunction. However, the influence of le...

    journal_title:Critical care (London, England)

    pub_type: 评论,杂志文章

    doi:10.1186/cc13811

    authors: Tanaka S,Harrois A,Duranteau J

    更新日期:2014-04-01 00:00:00

  • Urine sodium concentration to predict fluid responsiveness in oliguric ICU patients: a prospective multicenter observational study.

    abstract:BACKGROUND:Oliguria is one of the leading triggers of fluid loading in patients in the intensive care unit (ICU). The purpose of this study was to assess the predictive value of urine Na(+) (uNa(+)) and other routine urine biomarkers for cardiac fluid responsiveness in oliguric ICU patients. METHODS:We conducted a pro...

    journal_title:Critical care (London, England)

    pub_type: 杂志文章,多中心研究

    doi:10.1186/s13054-016-1343-0

    authors: Legrand M,Le Cam B,Perbet S,Roger C,Darmon M,Guerci P,Ferry A,Maurel V,Soussi S,Constantin JM,Gayat E,Lefrant JY,Leone M,support of the AZUREA network.

    更新日期:2016-05-29 00:00:00

  • Impaired Ca(2+) release contributes to muscle weakness in a rat model of critical illness myopathy.

    abstract:BACKGROUND:Critical illness myopathy is an acquired skeletal muscle disorder with severe myosin loss and muscle weakness frequently seen in intensive care unit (ICU) patients. It is unknown if impaired excitation-contraction coupling contributes to the muscle weakness. METHODS:We used a unique ICU model where rats wer...

    journal_title:Critical care (London, England)

    pub_type: 杂志文章

    doi:10.1186/s13054-016-1417-z

    authors: Llano-Diez M,Cheng AJ,Jonsson W,Ivarsson N,Westerblad H,Sun V,Cacciani N,Larsson L,Bruton J

    更新日期:2016-08-10 00:00:00

  • Multidisciplinary care for tracheostomy patients: a systematic review.

    abstract:INTRODUCTION:Appropriate care for patients with tracheostomies in hospital settings is an important issue. Each year more than 7000 patients receive tracheostomies in Australia and New Zealand alone. Many of these tracheostomy patients commence their care in the intensive care unit (ICU) and once stabilised are then tr...

    journal_title:Critical care (London, England)

    pub_type: 杂志文章,评审

    doi:10.1186/cc8159

    authors: Garrubba M,Turner T,Grieveson C

    更新日期:2009-01-01 00:00:00

  • Alveolar microstrain and the dark side of the lung.

    abstract::Mechanical ventilation associated lung injury (VALI) negatively impacts the outcomes of critically ill patients. Research during the past two decades has led to a better understanding of key physiologic mechanisms of injury, yet uncertainty over the topographical distribution of these mechanisms continues to fuel cont...

    journal_title:Critical care (London, England)

    pub_type: 评论,杂志文章,评审

    doi:10.1186/cc6160

    authors: Oeckler RA,Hubmayr RD

    更新日期:2007-01-01 00:00:00

  • Alarms in the intensive care unit: how can the number of false alarms be reduced?

    abstract::Many alarms, as they now exist in most monitoring systems, are not usually perceived as helpful by the medical staff because of the high incidence of false alarms. This paper gives an overview of the problems related to their current design and the objectives of monitoring. The current approaches used to improve the s...

    journal_title:Critical care (London, England)

    pub_type: 杂志文章,评审

    doi:10.1186/cc1021

    authors: Chambrin MC

    更新日期:2001-08-01 00:00:00

  • Antimicrobial resistance and patient outcomes: the hazards of adjustment.

    abstract::Outcomes studies of infections with resistant bacteria often do not account appropriately for intermediate variables--events in the causal pathway between the exposure and the outcome--when controlling for confounders. We discuss how failure to distinguish between confounders and intermediate variables can bias the an...

    journal_title:Critical care (London, England)

    pub_type: 杂志文章,评审

    doi:10.1186/cc5019

    authors: Schwaber MJ,Carmeli Y

    更新日期:2006-01-01 00:00:00

  • The influence of body composition on therapeutic hypothermia: a prospective observational study of patients after cardiac arrest.

    abstract:INTRODUCTION:Patients after out-of-hospital cardiac arrest (OHCA) benefit from therapeutic hypothermia for 24 hours. The time needed to reach hypothermia (target temperature of 32 degrees C to 34 degrees C) varies widely. In this study, we explore the relation between measures of body composition and the time needed to...

    journal_title:Critical care (London, England)

    pub_type: 杂志文章

    doi:10.1186/cc6954

    authors: Jimmink JJ,Binnekade JM,Paulus F,Mathus-Vliegen EM,Schultz MJ,Vroom MB

    更新日期:2008-01-01 00:00:00

  • High serum cortisol level is associated with increased risk of delirium after coronary artery bypass graft surgery: a prospective cohort study.

    abstract:INTRODUCTION:The pathophysiology of postoperative delirium remains poorly understood. The purpose of this study was to examine the relationship between serum cortisol level and occurrence of early postoperative delirium in patients undergoing coronary artery bypass graft (CABG) surgery. METHODS:A total of 243 patients...

    journal_title:Critical care (London, England)

    pub_type: 杂志文章

    doi:10.1186/cc9393

    authors: Mu DL,Wang DX,Li LH,Shan GJ,Li J,Yu QJ,Shi CX

    更新日期:2010-01-01 00:00:00

  • Glial fibrillary acidic protein as a biomarker in severe traumatic brain injury patients: a prospective cohort study.

    abstract:INTRODUCTION:Glial fibrillary acidic protein (GFAP) may serve as a serum marker of traumatic brain injury (TBI) that can be used to monitor biochemical changes in patients and gauge the response to treatment. However, the temporal profile of serum GFAP in the acute period of brain injury and the associated utility for ...

    journal_title:Critical care (London, England)

    pub_type: 杂志文章

    doi:10.1186/s13054-015-1081-8

    authors: Lei J,Gao G,Feng J,Jin Y,Wang C,Mao Q,Jiang J

    更新日期:2015-10-12 00:00:00

  • Successful treatment of severe sepsis and diarrhea after vagotomy utilizing fecal microbiota transplantation: a case report.

    abstract:INTRODUCTION:Dysbiosis of intestinal microbiota likely plays an important role in the development of gut-derived infections, making it a potential therapeutic target against sepsis. However, experience with fecal microbiota transplantation (FMT) in the treatment of sepsis and knowledge of the underlying mechanisms are ...

    journal_title:Critical care (London, England)

    pub_type: 杂志文章

    doi:10.1186/s13054-015-0738-7

    authors: Li Q,Wang C,Tang C,He Q,Zhao X,Li N,Li J

    更新日期:2015-02-09 00:00:00

  • Investigation of microcirculation in patients with venoarterial extracorporeal membrane oxygenation life support.

    abstract:BACKGROUND:Microcirculatory dysfunction develops in both septic and cardiogenic shock patients, and it is associated with poor prognosis in patients with septic shock. Information on the association between microcirculatory dysfunction and prognosis in cardiogenic shock patients with venoarterial extracorporeal membran...

    journal_title:Critical care (London, England)

    pub_type: 杂志文章

    doi:10.1186/s13054-018-2081-2

    authors: Yeh YC,Lee CT,Wang CH,Tu YK,Lai CH,Wang YC,Chao A,Huang CH,Cheng YJ,Chen YS,NTUH Center of Microcirculation Medical Research (NCMMR).

    更新日期:2018-08-19 00:00:00

  • Fluid-limiting treatment strategies among sepsis patients in the ICU: a retrospective causal analysis.

    abstract:OBJECTIVE:In septic patients, multiple retrospective studies show an association between large volumes of fluids administered in the first 24 h and mortality, suggesting a benefit to fluid restrictive strategies. However, these studies do not directly estimate the causal effects of fluid-restrictive strategies, nor do ...

    journal_title:Critical care (London, England)

    pub_type: 杂志文章

    doi:10.1186/s13054-020-2767-0

    authors: Shahn Z,Shapiro NI,Tyler PD,Talmor D,Lehman LH

    更新日期:2020-02-22 00:00:00

  • Antibiotic therapeutic drug monitoring in intensive care patients treated with different modalities of extracorporeal membrane oxygenation (ECMO) and renal replacement therapy: a prospective, observational single-center study.

    abstract:BACKGROUND:Effective antimicrobial treatment is key to reduce mortality associated with bacterial sepsis in patients on intensive care units (ICUs). Dose adjustments are often necessary to account for pathophysiological changes or renal replacement therapy. Extracorporeal membrane oxygenation (ECMO) is increasingly bei...

    journal_title:Critical care (London, England)

    pub_type: 杂志文章

    doi:10.1186/s13054-020-03397-1

    authors: Kühn D,Metz C,Seiler F,Wehrfritz H,Roth S,Alqudrah M,Becker A,Bracht H,Wagenpfeil S,Hoffmann M,Bals R,Hübner U,Geisel J,Lepper PM,Becker SL

    更新日期:2020-11-25 00:00:00

  • Early sedation and clinical outcomes of mechanically ventilated patients: a prospective multicenter cohort study.

    abstract:INTRODUCTION:Sedation overuse is frequent and possibly associated with poor outcomes in the intensive care unit (ICU) patients. However, the association of early oversedation with clinical outcomes has not been thoroughly evaluated. The aim of this study was to assess the association of early sedation strategies with o...

    journal_title:Critical care (London, England)

    pub_type: 杂志文章,多中心研究

    doi:10.1186/cc13995

    authors: Tanaka LM,Azevedo LC,Park M,Schettino G,Nassar AP,Réa-Neto A,Tannous L,de Souza-Dantas VC,Torelly A,Lisboa T,Piras C,Carvalho FB,Maia Mde O,Giannini FP,Machado FR,Dal-Pizzol F,de Carvalho AG,dos Santos RB,Tierno PF,

    更新日期:2014-07-21 00:00:00

  • Activated protein C in septic shock: a propensity-matched analysis.

    abstract:INTRODUCTION:The use of human recombinant activated protein C (rhAPC) for the treatment of severe sepsis remains controversial despite multiple reported trials. The efficacy of rhAPC remains a matter of dispute. We hypothesized that patients with septic shock who were treated with rhAPC had an improved in-hospital mort...

    journal_title:Critical care (London, England)

    pub_type: 杂志文章

    doi:10.1186/cc10089

    authors: Sadaka F,O'Brien J,Migneron M,Stortz J,Vanston A,Taylor RW

    更新日期:2011-01-01 00:00:00

  • Utility of neuron-specific enolase in traumatic brain injury; relations to S100B levels, outcome, and extracranial injury severity.

    abstract:BACKGROUND:In order to improve assessment and outcome prediction in patients suffering from traumatic brain injury (TBI), cerebral protein levels in serum have been suggested as biomarkers of injury. However, despite much investigation, biomarkers have yet to reach broad clinical utility in TBI. This study is a 9-year ...

    journal_title:Critical care (London, England)

    pub_type: 杂志文章

    doi:10.1186/s13054-016-1450-y

    authors: Thelin EP,Jeppsson E,Frostell A,Svensson M,Mondello S,Bellander BM,Nelson DW

    更新日期:2016-09-08 00:00:00