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  • 1
    Electronic Resource
    Electronic Resource
    Prevalence, etiologies and outcome of the acute respiratory distress syndrome among hypoxemic ventilated patients (1999)
    Springer
    Intensive care medicine 25 (1999), S. 920-929 
    Details
    ISSN: 1432-1238
    Keywords: Key words Acute lung injury ; Acute respiratory distress syndrome ; Mechanical ventilation
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Objective: To evaluate the prevalence and outcome of the acute respiratory distress syndrome (ARDS) among patients requiring mechanical ventilation. Design: A prospective, multi-institutional, initial cohort study including 28-day follow-up. Settings: Thirty-six French intensive care units (ICUs) from a working group of the French Intensive Care Society (SRLF). Patients: All the patients entering the ICUs during a 14-day period were screened prospectively. Hypoxemic patients, defined as having a PaO2/FIO2 ratio (P/F) of 300 mmHg or less and receiving mechanical ventilation, were classified into three groups, according to the Consensus Conference on ARDS: group 1 refers to ARDS (P/F: 200 mmHg or less and bilateral infiltrates on the chest X-ray); group 2 to acute lung injury (ALI) without having criteria for ARDS (200 〈 P/F ≤ 300 mmHg and bilateral infiltrates) and group 3 to patients with P/F of 300 mmHg or less but having exclusion criteria from the previous groups. Results: Nine hundred seventy-six patients entered the ICUs during the study period, 43 % of them being mechanically ventilated and 213 (22 %) meeting the criteria for one of the three groups. Among all the ICU admissions, ARDS, ALI and group 3 patients amounted, respectively, to 6.9 % (67), 1.8 % (17) and 13.3 % (129) of the patients, and represented 31.5 %, 8.1 % and 60.2 % of the hypoxemic, ventilated patients. The overall mortality rate was 41 % and was significantly higher in ARDS patients than in the others (60 % vs 31 % p 〈 0.01). In group 3, 42 patients had P/F less than 200 mmHg associated with unilateral lung injury; mortality was significantly lower (40.5 %) than in the ARDS group. In the whole group of hypoxemic, ventilated patients, septic shock and severity indices but not oxygenation indices were significantly associated with mortality, while the association with immunosuppression revealed only a trend (p = 0.06). Conclusions: In this survey we found that very few patients fulfilled the ALI non-ARDS criteria and that the mortality of the group with ARDS was high.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/s001340050983
    Library Location Call Number Volume/Issue/Year Availability
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    Paper (German National Licenses)
    Fulltext
  • 2
    Electronic Resource
    Electronic Resource
    Clinical evaluation of a continuous intra-arterial blood gas system in critically ill patients (1996)
    Springer
    Intensive care medicine 22 (1996), S. 1162-1168 
    Details
    ISSN: 1432-1238
    Keywords: Blood gas monitor ; Critical care ; Equipment ; Acute respiratory distress syndrome ; Hypotension
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Objective To evaluate the clinical performance of a new, continuous intra-arterial blood gas monitoring system (CIABG) in abnormal ranges of blood gases, and during episodes of low blood pressure, in critically ill patients. Design Prospective study. Settings Medical ICU, University Hospital. Methods The CIABG system, based on fluorescent dyes, consists of a fiber-optic sensor introduced through an arterial catheter. Twenty-one sensors were evaluated in 15 acutely ill patients. A high failure rate (6/21) was found, due to the brittleness of the fibers. The bias, between CIABG and standard method, and precision were determined for each fiber and for the overall values. Analysis focused on the data collected in patients with arterial oxygen tension (PaO2) values below 75 mmHg, pH lower than 7.35 and arterial carbon dioxide partial pressure (PaCO2) values exceeding 50 mmHg and during episodes of low blood pressure. The accuracy of the CIABG to follow sequential changes in blood gases was studied among the abnormal values. Results Measurements with CIABG among the abnormal values showed biases of +2 mmHg, +0.1 mmHg and +0.005 for PaO2, PaCO2 and pH, respectively, and precisions of 9.0 mmHg, 3.5 mmHg and 0.027, respectively. Bias and precision were not influenced by hemodynamic instability. A substantial difference in the performance of individual CIABG was observed for PaO2 analysis, with 30% of the fibers having a much poorer performance than the others. The sensors were kept in place for 5±2 days and the drift rate per day was 0.005 for pH, 0.6 mmHg for PaCO2 and −1.2 mmHg for PaO2. Conclusion In situations of severe hypoxemia, hypercapnia and acidosis, the agreement between CIABG and arterial blood sampling (ABS) is better for PaCO2 and pH than for PaO2, and is not influenced by episodes of low blood pressure.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF01709330
    Library Location Call Number Volume/Issue/Year Availability
    BibTip Others were also interested in ...
    Paper (German National Licenses)
    Fulltext
  • 3
    Electronic Resource
    Electronic Resource
    Clinical evaluation of a continuous intra-arterial blood gas system in critically ill patients (1996)
    Springer
    Intensive care medicine 22 (1996), S. 1162-1168 
    Details
    ISSN: 1432-1238
    Keywords: Key words Blood gas monitor ; Critical care ; Equipment ; Acute respiratory distress syndrome ; Hypotension
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Objective: To evaluate the clinical performance of a new, continuous intra-arterial blood gas monitoring system (CIABG) in abnormal ranges of blood gases, and during episodes of low blood pressure, in critically ill patients. Design: Prospective study. Settings: Medical ICU, University Hospital. Methods: The CIABG system, based on fluorescent dyes, consists of a fiber-optic sensor introduced through an arterial catheter. Twenty-one sensors were evaluated in 15 acutely ill patients. A high failure rate (6/21) was found, due to the brittleness of the fibers. The bias, between CIABG and standard method, and precision were determined for each fiber and for the overall values. Analysis focused on the data collected in patients with arterial oxygen tension (PaO2) values below 75 mmHg, pH lower than 7.35 and arterial carbon dioxide partial pressure (PaCO2) values exceeding 50 mmHg and during episodes of low blood pressure. The accuracy of the CIABG to follow sequential changes in blood gases was studied among the abnormal values. Results: Measurements with CIABG among the abnormal values showed biases of +2 mmHg, +0.1 mmHg and +0.005 for PaO2, PaCO2 and pH, respectively, and precisions of 9.0 mmHg, 3.5 mmHg and 0.027, respectively. Bias and precision were not influenced by hemodynamic instability. A substantial difference in the performance of individual CIABG was observed for PaO2 analysis, with 30% of the fibers having a much poorer performance than the others. The sensors were kept in place for 5±2 days and the drift rate per day was 0.005 for pH, 0.6 mmHg for PaCO2 and –1.2 mmHg for PaO2. Conclusion: In situations of severe hypoxemia, hypercapnia and acidosis, the agreement between CIABG and arterial blood sampling (ABS) is better for PaCO2 and pH than for PaO2, and is not influenced by episodes of low blood pressure.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF01709330
    Library Location Call Number Volume/Issue/Year Availability
    BibTip Others were also interested in ...
    Paper (German National Licenses)
    Fulltext
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