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7 results on '"Kjer, C. K. W."'

3. Pantoprazole in Patients at Risk for Gastrointestinal Bleeding in the ICU

Author

Krag, Mette, Marker, Søren, Perner, Anders, Wetterslev, Jørn, Wise, Matt P, Schefold, Joerg C, Keus, Frederik, Guttormsen, Anne B, Bendel, Stepani, Borthwick, Mark, Lange, Theis, Rasmussen, Bodil S, Siegemund, Martin, Bundgaard, Helle, Elkmann, Thomas, Jensen, Jacob V, Nielsen, Rune D, Liboriussen, Lisbeth, Bestle, Morten H, Elkjær, Jeanie M, Palmqvist, Dorte F, Bäcklund, Minna, Laake, Jon H, Bådstøløkken, Per M, Grönlund, Juha, Breum, Olena, Walli, Akil, Winding, Robert, Iversen, Susanne, Jarnvig, Inge-Lise, White, Jonathan O, Brand, Björn, Madsen, Martin B, Quist, Lars, Thornberg, Klaus J, Møller, Anders, Wiis, Jørgen, Granholm, Anders, Anthon, Carl T, Meyhoff, Tine S, Hjortrup, Peter B, Aagaard, Søren R, Andreasen, Jo B, Sørensen, Christina A, Haure, Pernille, Hauge, Jacob, Hollinger, Alexa, Scheuzger, Jonas, Tuchscherer, Daniel, Vuilliomenet, T, Takala, J, Jakob, S. M., Vang, M. L., Pælestik, K. B., Andersen, K. L. D., van der Horst, I. C. C., Dieperink, W., Fjølner, J., Kjer, C. K. W., Sølling, C, Sølling, C. G., Karttunen, J., Morgan, M. P. G., Sjøbø, B., Engstrøm, J., Agerholm-Larsen, B, Møller, Morten H, Rasmussen, Bodil Steen, Aagaard, Søren Rosborg, Bønding Andreasen, Jo, Ankjær Sørensen, Christina, Christensen, Pernille Haure, Levin, Marianne, Klemmesen Jensen, Käte, Lundberg, Lillian Skov Søndergaard, Critical care, Anesthesiology, Peri-operative and Emergency medicine (CAPE), Cardiovascular Centre (CVC), and Critical Care

Subjects
Pantoprazole/adverse effects, Male, INTENSIVE-CARE-UNIT, intraveneuze injecties, law.invention, Proton Pump Inhibitors/adverse effects, intensive care afdelingen, 0302 clinical medicine, Randomized controlled trial, law, overlevingsanalyse, Risk Factors, adults, Medicine, maagzweren, Artikkel, Single-Blind Method, 030212 general & internal medicine, 610 Medicine & health, Pantoprazole, enkele blindering, volwassenen, General Medicine, Middle Aged, Intensive care unit, Intensive Care Units, Injections, Intravenous, STRESS-ULCER PROPHYLAXIS, Female, psychosocial stress, Gastrointestinal Hemorrhage, kritieke ziekte, medicine.drug, medicine.medical_specialty, Gastrointestinal bleeding, risicofactoren, Peptic Ulcer, Randomization, bijwerkingen, Gastrointestinal Hemorrhage/epidemiology, Critical Illness, Placebo, Peptic Ulcer/prevention & control, psychosociale stress, PROTON-PUMP INHIBITORS, 03 medical and health sciences, Medisinske Fag: 700 [VDP], Stress, Physiological, Internal medicine, SCORE, Humans, VDP::Medisinske Fag: 700, Aged, gastro-intestinale bloeding, SEPSIS, business.industry, intravenous injections, 030208 emergency & critical care medicine, Proton Pump Inhibitors, pantaprazole, ta3121, medicine.disease, Survival Analysis, Confidence interval, Critical Illness/mortality, Relative risk, adverse effects, business, single-blind methoden, protonpompremmers
Abstract

Background\ud\udProphylaxis for gastrointestinal stress ulceration is frequently given to patients in the intensive care unit (ICU), but its risks and benefits are unclear.\udMethods\ud\udIn this European, multicenter, parallel-group, blinded trial, we randomly assigned adults who had been admitted to the ICU for an acute condition (i.e., an unplanned admission) and who were at risk for gastrointestinal bleeding to receive 40 mg of intravenous pantoprazole (a proton-pump inhibitor) or placebo daily during the ICU stay. The primary outcome was death by 90 days after randomization.\udResults\ud\udA total of 3298 patients were enrolled; 1645 were randomly assigned to the pantoprazole group and 1653 to the placebo group. Data on the primary outcome were available for 3282 patients (99.5%). At 90 days, 510 patients (31.1%) in the pantoprazole group and 499 (30.4%) in the placebo group had died (relative risk, 1.02; 95% confidence interval [CI], 0.91 to 1.13; P=0.76). During the ICU stay, at least one clinically important event (a composite of clinically important gastrointestinal bleeding, pneumonia, Clostridium difficile infection, or myocardial ischemia) had occurred in 21.9% of patients assigned to pantoprazole and 22.6% of those assigned to placebo (relative risk, 0.96; 95% CI, 0.83 to 1.11). In the pantoprazole group, 2.5% of patients had clinically important gastrointestinal bleeding, as compared with 4.2% in the placebo group. The number of patients with infections or serious adverse reactions and the percentage of days alive without life support within 90 days were similar in the two groups.\udConclusions\ud\udAmong adult patients in the ICU who were at risk for gastrointestinal bleeding, mortality at 90 days and the number of clinically important events were similar in those assigned to pantoprazole and those assigned to placebo. (Funded by Innovation Fund Denmark and others; SUP-ICU ClinicalTrials.gov number, NCT02467621. opens in new tab.)

Published
2018
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4. Pantoprazole in Patients at Risk for Gastrointestinal Bleeding in the ICU

Author

Krag, M., Marker, S., Perner, A., Wetterslev, J., Wise, M. P., Schefold, J. C., Keus, F., Guttormsen, A. B., Bendel, S., Borthwick, M., Lange, T., Rasmussen, B. S., Siegemund, M., Bundgaard, H., Elkmann, T., Jensen, J. V., Nielsen, R. D., Liboriussen, L., Bestle, M. H., Elkjær, J. M., Palmqvist, D. F., Backlund, M., Laake, J. H., Badstolokken, P. M., Gronlund, J., Breum, O., Walli, A., Winding, R., Iversen, S., Jarnvig, I. -L., White, J. O., Brand, B., Madsen, M. B., Quist, L., Thornberg, K. J., Møller, A., Wiis, J., Granholm, A., Anthon, C. T., Meyhoff, T. S., Hjortrup, P. B., Aagaard, S. R., Andreasen, J. B., Sorensen, C. A., Haure, P., Hauge, J., Hollinger, A., Scheuzger, J., Tuchscherer, D., Vuilliomenet, T., Takala, J., Jakob, S. M., Vang, M. L., Paelestik, K. B., Andersen, K. L. D., van der Horst, I. C. C., Dieperink, W., Fjolner, J., Kjer, C. K. W., Solling, C., Solling, C. G., Karttunen, J., Morgan, M. P. G., Sjobo, B., Engstrom, J., Agerholm-Larsen, B., Møller, M. H., Krag, M., Marker, S., Perner, A., Wetterslev, J., Wise, M. P., Schefold, J. C., Keus, F., Guttormsen, A. B., Bendel, S., Borthwick, M., Lange, T., Rasmussen, B. S., Siegemund, M., Bundgaard, H., Elkmann, T., Jensen, J. V., Nielsen, R. D., Liboriussen, L., Bestle, M. H., Elkjær, J. M., Palmqvist, D. F., Backlund, M., Laake, J. H., Badstolokken, P. M., Gronlund, J., Breum, O., Walli, A., Winding, R., Iversen, S., Jarnvig, I. -L., White, J. O., Brand, B., Madsen, M. B., Quist, L., Thornberg, K. J., Møller, A., Wiis, J., Granholm, A., Anthon, C. T., Meyhoff, T. S., Hjortrup, P. B., Aagaard, S. R., Andreasen, J. B., Sorensen, C. A., Haure, P., Hauge, J., Hollinger, A., Scheuzger, J., Tuchscherer, D., Vuilliomenet, T., Takala, J., Jakob, S. M., Vang, M. L., Paelestik, K. B., Andersen, K. L. D., van der Horst, I. C. C., Dieperink, W., Fjolner, J., Kjer, C. K. W., Solling, C., Solling, C. G., Karttunen, J., Morgan, M. P. G., Sjobo, B., Engstrom, J., Agerholm-Larsen, B., and Møller, M. H.

Published
2018

5. Delirium and effect of circadian light in the intensive care unit:a retrospective cohort study

Author

Estrup, S, Kjer, C K W, Poulsen, L M, Gøgenur, I, Mathiesen, O, Estrup, S, Kjer, C K W, Poulsen, L M, Gøgenur, I, and Mathiesen, O

Abstract

BACKGROUND: Delirium is a serious condition often experienced by critically ill patients in intensive care units (ICUs). The role of circadian light for this condition is unclear. The aim of this study was to describe incidence of delirium, risk factors for delirium, and the association between delirium and circadian light for patients in the ICU.METHODS: This is a retrospective cohort study of all patients at a Danish ICU from 1 August 2015 to 31 January 2016. Exclusion criteria were heavy sedation, no Confusion Assessment Method for the ICU (CAM-ICU) scores, or inability to communicate in Danish. Delirium was defined as at least one positive CAM-ICU score or treatment with haloperidol. Three of nine beds at the ICU had a circadian light installation. Allocation to ICU beds with or without circadian light depended on availability at admission. Risk factors for development of delirium were analyzed by simple and multiple logistic regression.RESULTS: We included 183 patients in the study. The incidence of delirium was 28% (95% CI 22, 35). Allocation to beds with or without circadian lighting was not associated with delirium incidence (OR 1.14; 95% CI 0.55, 2.37; P = 0.73). We found that Simplified Acute Physiology Score II (SAPS II) (OR 1.03; 95% CI 1.01, 1.06; P = 0.002), and dexmedetomidine was associated with delirium (OR 4.14; 95% CI 1.72, 10.03; P = 0.002).CONCLUSION: In this population of patients admitted to an ICU during 6 months, the incidence of delirium was 28%. We did not find an association between circadian light and development of delirium.

Published
2018

7. Follow-up after intensive care treatment:a questionnaire survey of intensive care aftercare in Denmark

Author

Kjer, C K W, Estrup, S, Poulsen, L M, Mathiesen, O, Kjer, C K W, Estrup, S, Poulsen, L M, and Mathiesen, O

Abstract

BACKGROUND: Rehabilitation efforts after treatment in the intensive care unit (ICU) are termed intensive care aftercare. It includes both early in-hospital follow-up after ICU-discharge and late follow-up after hospital discharge. This study aims to investigate the current ICU-aftercare activities in Denmark.METHODS: We conducted an electronic questionnaire survey, which was distributed by e-mail to the heads of all 31 general ICUs in Denmark. Specialized ICUs were not included. The questionnaire was divided into the following sections: early ICU-aftercare, late ICU-aftercare, future development and demographics.RESULTS: Thirty-one ICUs were invited to participate. The response rate was 100%. Overall, 26 of 31 ICUs (84%) offered ICU-aftercare, with the following distribution: early ICU-aftercare (58%), late ICU-aftercare (57%) and both (29%). There were no significant associations between hospital size and provision of ICU-aftercare. For early ICU-aftercare, the most common eligibility criteria were based on ICU length of stay (LOS) (44%) and a decision based upon doctors' discretion (22%). Incidence of guidelines for early ICU-aftercare (44%) and checklists at patient contact (35%) were sparse. The most common early ICU-aftercare items were as follows: respiratory care (82%), tracheostomy care (59%) and nutritional care (59%). For late ICU-aftercare, the most common eligibility criterion was LOS (41%). Guidelines (71%), but not checklist at patient contact (35%), were more common. Most frequent late ICU-aftercare interventions were review of ICU-diaries (59%) and patient charts (53%).CONCLUSION: Eighty-four per cent of Danish ICUs offered ICU-aftercare to their patients. There was an abundant heterogeneity of eligibility criteria and ICU-aftercare interventions.

Published
2017

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