J Clin Monit Comput - StO2 guided early resuscitation in subjects with severe sepsis or septic shock: a pilot randomised trial.

Tópicos

{ activ(1138) subject(705) human(624) }
{ intervent(3218) particip(2042) group(1664) }
{ patient(2837) hospit(1953) medic(668) }
{ assess(1506) score(1403) qualiti(1306) }
{ model(2220) cell(1177) simul(1124) }
{ method(984) reconstruct(947) comput(926) }
{ state(1844) use(1261) util(961) }
{ data(1714) softwar(1251) tool(1186) }
{ blood(1257) pressur(1144) flow(957) }
{ monitor(1329) mobil(1314) devic(1160) }
{ medic(1828) order(1363) alert(1069) }
{ time(1939) patient(1703) rate(768) }
{ activ(1452) weight(1219) physic(1104) }
{ measur(2081) correl(1212) valu(896) }
{ chang(1828) time(1643) increas(1301) }
{ clinic(1479) use(1117) guidelin(835) }
{ compound(1573) activ(1297) structur(1058) }
{ research(1218) medic(880) student(794) }
{ use(976) code(926) identifi(902) }
{ implement(1333) system(1263) develop(1122) }
{ detect(2391) sensit(1101) algorithm(908) }
{ system(1976) rule(880) can(841) }
{ patient(2315) diseas(1263) diabet(1191) }
{ treatment(1704) effect(941) patient(846) }
{ surgeri(1148) surgic(1085) robot(1054) }
{ error(1145) method(1030) estim(1020) }
{ care(1570) inform(1187) nurs(1089) }
{ search(2224) databas(1162) retriev(909) }
{ spatial(1525) area(1432) region(1030) }
{ record(1888) medic(1808) patient(1693) }
{ model(2656) set(1616) predict(1553) }
{ sampl(1606) size(1419) use(1276) }
{ first(2504) two(1366) second(1323) }
{ health(1844) social(1437) communiti(874) }
{ use(1733) differ(960) four(931) }
{ drug(1928) target(777) effect(648) }
{ survey(1388) particip(1329) question(1065) }
{ estim(2440) model(1874) function(577) }
{ model(3404) distribut(989) bayesian(671) }
{ can(774) often(719) complex(702) }
{ imag(1947) propos(1133) code(1026) }
{ data(1737) use(1416) pattern(1282) }
{ inform(2794) health(2639) internet(1427) }
{ imag(1057) registr(996) error(939) }
{ bind(1733) structur(1185) ligand(1036) }
{ sequenc(1873) structur(1644) protein(1328) }
{ method(1219) similar(1157) match(930) }
{ featur(3375) classif(2383) classifi(1994) }
{ imag(2830) propos(1344) filter(1198) }
{ network(2748) neural(1063) input(814) }
{ imag(2675) segment(2577) method(1081) }
{ take(945) account(800) differ(722) }
{ studi(2440) review(1878) systemat(933) }
{ motion(1329) object(1292) video(1091) }
{ framework(1458) process(801) describ(734) }
{ problem(2511) optim(1539) algorithm(950) }
{ learn(2355) train(1041) set(1003) }
{ concept(1167) ontolog(924) domain(897) }
{ algorithm(1844) comput(1787) effici(935) }
{ extract(1171) text(1153) clinic(932) }
{ method(1557) propos(1049) approach(1037) }
{ design(1359) user(1324) use(1319) }
{ control(1307) perform(991) simul(935) }
{ general(901) number(790) one(736) }
{ featur(1941) imag(1645) propos(1176) }
{ case(1353) use(1143) diagnosi(1136) }
{ howev(809) still(633) remain(590) }
{ data(3963) clinic(1234) research(1004) }
{ studi(1410) differ(1259) use(1210) }
{ risk(3053) factor(974) diseas(938) }
{ perform(999) metric(946) measur(919) }
{ research(1085) discuss(1038) issu(1018) }
{ system(1050) medic(1026) inform(1018) }
{ import(1318) role(1303) understand(862) }
{ model(2341) predict(2261) use(1141) }
{ visual(1396) interact(850) tool(830) }
{ perform(1367) use(1326) method(1137) }
{ studi(1119) effect(1106) posit(819) }
{ health(3367) inform(1360) care(1135) }
{ model(3480) simul(1196) paramet(876) }
{ ehr(2073) health(1662) electron(1139) }
{ data(2317) use(1299) case(1017) }
{ age(1611) year(1155) adult(843) }
{ signal(2180) analysi(812) frequenc(800) }
{ cost(1906) reduc(1198) effect(832) }
{ group(2977) signific(1463) compar(1072) }
{ gene(2352) biolog(1181) express(1162) }
{ data(3008) multipl(1320) sourc(1022) }
{ patient(1821) servic(1111) care(1106) }
{ use(2086) technolog(871) perceiv(783) }
{ can(981) present(881) function(850) }
{ analysi(2126) use(1163) compon(1037) }
{ structur(1116) can(940) graph(676) }
{ high(1669) rate(1365) level(1280) }
{ cancer(2502) breast(956) screen(824) }
{ result(1111) use(1088) new(759) }
{ decis(3086) make(1611) patient(1517) }
{ process(1125) use(805) approach(778) }
{ method(1969) cluster(1462) data(1082) }
{ method(2212) result(1239) propos(1039) }

Resumo

The scientific community has agreed upon developing accurate monitoring of tissue perfusion and oxygenation to improve the management of subjects with sepsis. This pilot study aimed to investigate the feasibility of targeting tissue oxygen saturation (StO2) in addition to the currently recommended resuscitation goals, central venous pressure, mean arterial pressure and central venous oxygen saturation, in patients with severe sepsis or septic shock. A pilot, single-centre, randomised, non-blinded trial recruited 30 subjects with severe sepsis upon intensive care unit admission at an academic medical centre in France. Subjects were randomly assigned to a 6 h resuscitation strategy following the Surviving Sepsis Campaign guidelines with (experimental) or without (control) StO2. StO2 was measured over several muscles (masseter, deltoid and pectoral or thenar muscles), and a StO2 above 80 % over at least 2 muscles was the therapeutic goal. The primary outcome was evaluated as follows: 7-day mortality or worsening of SOFA score between day 7 and study onset, i.e., DSOFA > 0). Thirty subjects were included in the study over a period of 40 weeks. Fifteen subjects were included in each group. Monitoring of StO2 over three areas was performed in the experimental group. However, measures over the pectoral muscle provided poor results. At study day 7, there were 5/15 (33.3 %) subjects who died or had a DSOFA > 0 in the experimental arm and 4/15 (26.6 %) who died or had a DSOFA > 0 in the control arm (p = 1.00). This pilot study was the first randomised controlled trial using an algorithm derived from the SSC recommendations, which included StO2 as a treatment goal. However, the protocol showed no clear trend for or against targeting StO2.

Resumo Limpo

scientif communiti agre upon develop accur monitor tissu perfus oxygen improv manag subject sepsi pilot studi aim investig feasibl target tissu oxygen satur sto addit current recommend resuscit goal central venous pressur mean arteri pressur central venous oxygen satur patient sever sepsi septic shock pilot singlecentr randomis nonblind trial recruit subject sever sepsi upon intens care unit admiss academ medic centr franc subject random assign h resuscit strategi follow surviv sepsi campaign guidelin experiment without control sto sto measur sever muscl masset deltoid pector thenar muscl sto least muscl therapeut goal primari outcom evalu follow day mortal worsen sofa score day studi onset ie dsofa thirti subject includ studi period week fifteen subject includ group monitor sto three area perform experiment group howev measur pector muscl provid poor result studi day subject die dsofa experiment arm die dsofa control arm p pilot studi first randomis control trial use algorithm deriv ssc recommend includ sto treatment goal howev protocol show clear trend target sto

Resumos Similares

J Clin Monit Comput - Monitoring of intense neuromuscular blockade in a pig model. ( 0,710029609321223 )
Comput. Biol. Med. - Evaluation of different stimulation and measurement patterns based on internal electrode: application in cardiac impedance tomography. ( 0,682412040215946 )
Comput. Biol. Med. - Changes in the initial slope of the QRS in ischemic patients and normal subjects undergoing scintigraphy with dipyridamole. ( 0,674629302553445 )
Comput Methods Programs Biomed - Performance optimization of current focusing and virtual electrode strategies in retinal implants. ( 0,66582441699825 )
Int J Neural Syst - Electrophysiological responses from vagus nerve stimulation in rats. ( 0,662927428679342 )
J Clin Monit Comput - Spinal cord injury from electrocautery: observations in a porcine model using electromyography and motor evoked potentials. ( 0,662750649987002 )
J Clin Monit Comput - Augmentation of motor evoked potentials using multi-train transcranial electrical stimulation in intraoperative neurophysiologic monitoring during spinal surgery. ( 0,662082786462421 )
Comput Methods Programs Biomed - Development/global validation of a 6-month-old pediatric head finite element model and application in investigation of drop-induced infant head injury. ( 0,651698265457974 )
J Clin Monit Comput - Muscle relaxant use during intraoperative neurophysiologic monitoring. ( 0,649479429209193 )
J Telemed Telecare - A randomised trial of telemedicine-based treatment versus conventional hospitalisation in patients with severe COPD and exacerbation - effect on self-reported outcome. ( 0,648881090817589 )
J Clin Monit Comput - Quantification of the proportion of motor neurons recruited by transcranial electrical stimulation during intraoperative motor evoked potential monitoring. ( 0,648145200789287 )
Med Biol Eng Comput - Estimating nerve excitation thresholds to cutaneous electrical stimulation by finite element modeling combined with a stochastic branching nerve fiber model. ( 0,642505373881077 )
Med Biol Eng Comput - Conduction block of whole nerve without onset firing using combined high frequency and direct current. ( 0,638629351178685 )
Med Biol Eng Comput - Electrical stimulation for the suppression of pathological tremor. ( 0,633932046250064 )
Med Biol Eng Comput - Towards the development of a novel experimental shoulder simulator with rotating scapula and individually controlled muscle forces simulating the rotator cuff. ( 0,632669921608125 )
Med Biol Eng Comput - Comparison of spinal cord stimulation profiles from intra- and extradural electrode arrangements by finite element modelling. ( 0,631360322240364 )
Med Biol Eng Comput - Safety of multi-channel stimulation implants: a single blocking capacitor per channel is not sufficient after single-fault failure. ( 0,630672775974223 )
J. Med. Internet Res. - Feasibility of an eHealth service to support collaborative depression care: results of a pilot study. ( 0,621634424662098 )
Comput. Biol. Med. - Simulating a dual-array electrode configuration to investigate the influence of skeletal muscle fatigue following functional electrical stimulation. ( 0,620901746487679 )
Med Biol Eng Comput - Advanced biofeedback from surface electromyography signals using fuzzy system. ( 0,61927361312585 )
Comput. Biol. Med. - Classification algorithms for the identification of structural injury in TBI using brain electrical activity. ( 0,619135118039266 )
Med Biol Eng Comput - Transmembrane potential generated by a magnetically induced transverse electric field in a cylindrical axonal model. ( 0,618795430278162 )
Comput Math Methods Med - Application of computational lower extremity model to investigate different muscle activities and joint force patterns in knee osteoarthritis patients during walking. ( 0,61822786227041 )
Telemed J E Health - Effectiveness of home telehealth in comorbid diabetes and hypertension: a randomized, controlled trial. ( 0,616589970611166 )
Med Biol Eng Comput - The influence of skeletal muscle anisotropy on electroporation: in vivo study and numerical modeling. ( 0,615549603818807 )
J Telemed Telecare - Electronic follow-up of facial lacerations in the emergency department. ( 0,613898335471038 )
Comput Math Methods Med - Spreading out muscle mass within a Hill-type model: a computer simulation study. ( 0,61388826678064 )
Comput Math Methods Med - Noninvasive measurement of conductivity anisotropy at larmor frequency using MRI. ( 0,613427018367929 )
Med Biol Eng Comput - Optical monitoring of neural networks evoked by focal electrical stimulation on microelectrode arrays using FM dyes. ( 0,612465610061728 )
Int J Neural Syst - Computational modeling of transcranial direct current stimulation in the child brain: implications for the treatment of refractory childhood focal epilepsy. ( 0,612362322780179 )
J Telemed Telecare - A walking intervention for postmenopausal women using mobile phones and Interactive Voice Response. ( 0,611656689669424 )
Med Biol Eng Comput - Synthesis of optimal electrical stimulation patterns for functional motion restoration: applied to spinal cord-injured patients. ( 0,610859937477446 )
Comput Math Methods Med - An approach for simulation of the muscle force modeling it by summation of motor unit contraction forces. ( 0,610089218746014 )
J Med Syst - A randomized trial of population-based clinical decision support to manage health and resource use for Medicaid beneficiaries. ( 0,609699390660281 )
Comput Methods Programs Biomed - A passive movement method for parameter estimation of a musculo-skeletal arm model incorporating a modified hill muscle model. ( 0,609049393283838 )
Med Biol Eng Comput - Sensorimotor cortical response during motion reflecting audiovisual stimulation: evidence from fractal EEG analysis. ( 0,607305074354988 )
Med Biol Eng Comput - Deformation and pressure propagation in deep tissue during mechanical painful pressure stimulation. ( 0,607130190405846 )
J. Med. Internet Res. - Supervised patient self-testing of warfarin therapy using an online system. ( 0,601734916535459 )
J Med Syst - The effect of an auxiliary stimulation on motor function restoration by FES. ( 0,601700752550999 )
Med Biol Eng Comput - Spinal cord direct current stimulation: finite element analysis of the electric field and current density. ( 0,600881071592425 )
Med Biol Eng Comput - Is it possible to detect dendrite currents using presently available magnetic resonance imaging techniques? ( 0,59586721547055 )
Med Biol Eng Comput - Feasibility of monitoring muscle health in microgravity environments using Myoton technology. ( 0,595795296443339 )
Comput. Aided Surg. - A biomechanical study regarding the effect of tissue harvesting from the thorax on its movement during inspiration. ( 0,595339799713857 )
Comput Math Methods Med - Numerical simulations of MREIT conductivity imaging for brain tumor detection. ( 0,592438033461994 )
Med Biol Eng Comput - The effect of local anatomy on the electric field induced by TMS: evaluation at 14 different target sites. ( 0,589729454812443 )
IEEE J Biomed Health Inform - A physiological time series dynamics-based approach to patient monitoring and outcome prediction. ( 0,588889495709988 )
Int J Med Inform - Using EHR data to predict hospital-acquired pressure ulcers: a prospective study of a Bayesian Network model. ( 0,588338985351726 )
Med Biol Eng Comput - Measuring skin conductance over clothes. ( 0,586989581263534 )
Med Biol Eng Comput - Effect of membrane properties on skeletal muscle fiber excitability: a sensitivity analysis. ( 0,586436626499929 )
Comput. Biol. Med. - Muscle activity detection in electromyograms recorded during periodic movements. ( 0,585886203483771 )
Med Biol Eng Comput - Effects of muscle fibre shortening on the characteristics of surface motor unit potentials. ( 0,584681833242402 )
Appl Clin Inform - Evaluation of the pressure ulcer prevention clinical decision report for bedside nurses in acute care hospitals. ( 0,584111699556006 )
J Clin Monit Comput - Does intraoperative neurophysiological monitoring have predictive value for functional recovery following spinal cord injury? A case report. ( 0,581769541025102 )
Med Biol Eng Comput - Empirical quantification of internal and external rotation muscular co-activation ratios in healthy shoulders. ( 0,579373285692243 )
J. Med. Internet Res. - Adherence to a web-based physical activity intervention for patients with knee and/or hip osteoarthritis: a mixed method study. ( 0,577922064781186 )
Med Biol Eng Comput - Peculiarities of extracellular potentials produced by deep muscles. Part 1: single fibre potential fields. ( 0,577448520207567 )
Comput. Biol. Med. - Field distribution of epidural electrical stimulation. ( 0,577170500185182 )
Med Biol Eng Comput - Estimation of elbow flexion force during isometric muscle contraction from mechanomyography and electromyography. ( 0,574802363709229 )
Comput Math Methods Med - Modiolus-hugging intracochlear electrode array with shape memory alloy. ( 0,574418754428683 )
Int J Comput Assist Radiol Surg - fMRI assessment of upper extremity related brain activation with an MRI-compatible manipulandum. ( 0,573565865274684 )
Med Biol Eng Comput - Improved numerical approach for electrical modeling of biological cell clusters. ( 0,573420164822805 )
IEEE J Biomed Health Inform - Inverse estimation of multiple muscle activations from joint moment with muscle synergy extraction. ( 0,571527308434901 )
Comput Math Methods Med - The application of computer musculoskeletal modeling and simulation to investigate compressive tibiofemoral force and muscle functions in obese children. ( 0,571001063322739 )
Neural Comput - Intracellular dynamics of virtual place cells. ( 0,57039957779351 )
Comput. Biol. Med. - Modeling gender effects on electrical activity of single ventricular myocytes. ( 0,569727633286386 )
Med Biol Eng Comput - Axial head rotation increases facet joint capsular ligament strains in automotive rear impact. ( 0,569694690587854 )
Comput. Biol. Med. - Estimation of saline-mixed tissue conductivity and ablation lesion size. ( 0,569170843668804 )
Comput. Biol. Med. - Simulation of the microscopic process during initiation of stent thrombosis. ( 0,568499226366308 )
J. Med. Internet Res. - Use of home telemonitoring to support multidisciplinary care of heart failure patients in Finland: randomized controlled trial. ( 0,56762315074831 )
J. Med. Internet Res. - Effectiveness of a Web-based intervention aimed at healthy dietary and physical activity behavior: a randomized controlled trial about users and usage. ( 0,566563603432601 )
Med Biol Eng Comput - Simulation of the complex countermovement jumping by means of a simple four-degrees-of-freedom model. ( 0,565951679212115 )
Comput Methods Programs Biomed - PODSE: a computer program for optimal design of trials with discrete-time survival endpoints. ( 0,565793547597026 )
Telemed J E Health - The use of a camera-enabled mobile phone to triage patients with nasal bone injuries. ( 0,565270656018516 )
J Telemed Telecare - Screening electroencephalograms are feasible in the emergency department. ( 0,564693803232862 )
J Telemed Telecare - Telehealth for improved glycaemic control in patients with poorly controlled diabetes after acute hospitalization - a preliminary study in Singapore. ( 0,564394904236303 )
Comput. Biol. Med. - Shivering heat production and body fat protect the core from cooling during body immersion, but not during head submersion: a structural equation model. ( 0,563788412043632 )
IEEE J Biomed Health Inform - An intelligent recovery progress evaluation system for ACL reconstructed subjects using integrated 3-D kinematics and EMG features. ( 0,562159756066114 )
Int J Med Inform - A novel method for inferring RFID tag reader recordings into clinical events. ( 0,559102489784657 )
Telemed J E Health - A mobile phone short message service improves perceived control of asthma: a randomized controlled trial. ( 0,558590797920814 )
Comput Math Methods Med - Trial-by-trial adaptation of movements during mental practice under force field. ( 0,557171947641152 )
Int J Neural Syst - Transcranial magnetic stimulation (TMS) modulates epileptiform discharges in patients with frontal lobe epilepsy: a preliminary EEG-TMS study. ( 0,556103723708004 )
Med Biol Eng Comput - Where does transcranial magnetic stimulation (TMS) stimulate? Modelling of induced field maps for some common cortical and cerebellar targets. ( 0,554200545996693 )
J Chem Inf Model - Engineering antimicrobial peptides with improved antimicrobial and hemolytic activities. ( 0,553701373525579 )
Comput. Biol. Med. - Empirical modeling of renal motion for improved targeting during focused ultrasound surgery. ( 0,551951822260719 )
Med Biol Eng Comput - The movement of a nerve in a magnetic field: application to MRI Lorentz effect imaging. ( 0,55176598689742 )
Comput Math Methods Med - Three-dimensional lower extremity joint loading in a carved ski and snowboard turn: a pilot study. ( 0,550923616245854 )
Med Biol Eng Comput - Glenohumeral stability during a hand-positioning task in previously injured shoulders. ( 0,550367173011334 )
Int J Med Robot - Mechatronic assistant system for dental drill handling. ( 0,550182985833287 )
Comput Math Methods Med - Optimisation of ionic models to fit tissue action potentials: application to 3D atrial modelling. ( 0,549778038583325 )
J Clin Monit Comput - Early goal-directed therapy based on endotracheal bioimpedance cardiography: a prospective, randomized controlled study in coronary surgery. ( 0,549071899941395 )
Telemed J E Health - Using nursing expertise and telemedicine to increase nursing collaboration and improve patient outcomes. ( 0,548721892990227 )
Med Biol Eng Comput - Protegemed2: an extended platform based on RFID to identify EME and improve the detection of microshocks. ( 0,547325555827452 )
Methods Inf Med - Slow adaptation of ventricular repolarization as a cause of arrhythmia? ( 0,546562825631518 )
Med Biol Eng Comput - An electrooptical muscle contraction sensor. ( 0,545463061669794 )
Int J Neural Syst - A new linear muscle fiber model for neural control of saccades. ( 0,542934816056443 )
Appl Clin Inform - Use of clinical decision support to improve the quality of care provided to older hospitalized patients. ( 0,542136920883905 )
Med Biol Eng Comput - Experimentally validated three-dimensional finite element model of the rat for mild traumatic brain injury. ( 0,541965135372917 )
Int J Neural Syst - On the midway to epilepsy: is cortical excitability normal in patients with isolated seizures? ( 0,541598381325331 )
J. Med. Internet Res. - Engagement in a diabetes self-management website: usage patterns and generalizability of program use. ( 0,541424068898125 )
Med Biol Eng Comput - Optimal chest compression in cardiopulmonary resuscitation depends upon thoracic and back support stiffness. ( 0,540396829778426 )