Abstract:
PURPOSE OF REVIEW:We sought to review the evidence supporting neurocritical care as a distinct specialty of medicine. RECENT FINDINGS:Over the past 20 years, neuro-intensive care units have evolved from neurosurgical units focused primarily on postoperative monitoring to units that provide comprehensive medical and specialized neurological support for patients with life-threatening neurological diseases. In addition to standard interventions, areas of expertise unique to neurocritical care include management of intracranial pressure, hemodynamic augmentation to improve cerebral blood flow, therapeutic hypothermia, and advanced neuromonitoring (i.e. continuous electroencephalography, brain-tissue oxygen, and microdialysis). Neurointensivists defragment care by focusing on the interplay between the brain and other systems, and by integrating all aspects of neurological and medical management into a single care plan. Outcomes research has established that victims of traumatic brain injury and hemorrhagic stroke experience reduced mortality, better functional outcomes, and reduced length of stay when cared for by neurointensivists in a dedicated neuro-intensive care unit. In the US a national system for accrediting training programs and certifying intensivists with special qualifications in neurocritical care is currently being established by the United Council of Neurologic Subspecialties. SUMMARY:Neurocritical care is one of the newest subspecialties of medicine and is at the forefront of bringing effective new therapies to patients with life-threatening neurological diseases.
journal_name
Curr Opin Crit Carejournal_title
Current opinion in critical careauthors
Rincon F,Mayer SAdoi
10.1097/MCC.0b013e32808255c6subject
Has Abstractpub_date
2007-04-01 00:00:00pages
115-21issue
2eissn
1070-5295issn
1531-7072pii
00075198-200704000-00002journal_volume
13pub_type
杂志文章,评审abstract:PURPOSE OF REVIEW:There is correlation between quality of bystander cardiopulmonary resuscitation and patient survival. Recent developments in defibrillator technology enable recording of cardiopulmonary resuscitation quality, and have shown quality of professional cardiopulmonary resuscitation far from guidelines' lev...
journal_title:Current opinion in critical care
pub_type: 杂志文章,评审
doi:10.1097/MCC.0b013e3282f827d3
更新日期:2008-06-01 00:00:00
abstract::The purpose of this report is to provide information regarding preparation for disaster management from the perspective of ICU physicians. Both a framework toward ICU preparation for disaster management and a guide to the relevant literature are presented. Our objective is to show that the understanding of disaster pr...
journal_title:Current opinion in critical care
pub_type: 杂志文章,评审
doi:10.1097/00075198-200212000-00021
更新日期:2002-12-01 00:00:00
abstract:PURPOSE OF REVIEW:The risk of adverse outcome in patients undergoing major surgery is affected both by cardiorespiratory fitness, and the presence and severity of comorbidities. Accurate risk stratification is essential for the identification of patients who may benefit from specific perioperative management strategies...
journal_title:Current opinion in critical care
pub_type: 杂志文章,评审
doi:10.1097/MCC.0b013e32832e067c
更新日期:2009-08-01 00:00:00
abstract::Cardiac arrest survival rates remain low despite increased access to advanced cardiac life support. Survival from cardiac arrest is, at least in part, related to the perfusion pressures and blood flow achieved during cardiopulmonary resuscitation (CPR). A number of alternative CPR devices have been developed that aim ...
journal_title:Current opinion in critical care
pub_type: 杂志文章,评审
doi:10.1097/00075198-200206000-00004
更新日期:2002-06-01 00:00:00
abstract::Radiocontrast nephropathy may in part be mediated by generation of reactive oxygen species causing direct toxic damage to renal tubular epithelial cell and renal medullary ischemia. Data from experimental studies indicated that antioxidants, eg, acetylcysteine, may prevent radiocontrast-induced nephropathy. Recently, ...
journal_title:Current opinion in critical care
pub_type: 杂志文章,评审
doi:10.1097/00075198-200112000-00004
更新日期:2001-12-01 00:00:00
abstract::Tracheostomy is one of the most common surgical procedures in the intensive care unit. Since the introduction of percutaneous techniques, tracheostomy has become increasingly popular. The technique is relatively easy, and the early and late complication rates are relatively low.It is unknown at which moment tracheosto...
journal_title:Current opinion in critical care
pub_type: 杂志文章
doi:10.1097/00075198-200008000-00005
更新日期:2000-08-01 00:00:00
abstract:PURPOSE OF REVIEW:Therapeutic hypothermia following out-of-hospital cardiac arrest improves neurological recovery. Coupled with neurological benefit, multiple complications including infection have been associated with therapeutic hypothermia following out-of-hospital cardiac arrest. In this review, we will discuss the...
journal_title:Current opinion in critical care
pub_type: 杂志文章,评审
doi:10.1097/MCC.0000000000000125
更新日期:2014-10-01 00:00:00
abstract:PURPOSE OF REVIEW:This article reviews current concepts in perioperative pulmonary management. RECENT FINDINGS:Preoperative risk assessment tools for perioperative pulmonary complications (POPCs) are evolving for both children and adults. Intraoperative management strategies have a demonstrable effect on outcomes. Lat...
journal_title:Current opinion in critical care
pub_type: 杂志文章,评审
doi:10.1097/MCC.0b013e328348bfc8
更新日期:2011-08-01 00:00:00
abstract:PURPOSE OF REVIEW:To review advances over the last year in the prevention, diagnosis and management of acute pancreatitis. RECENT FINDINGS:Obesity is an independent risk factor for severity in acute pancreatitis, and heavy alcohol consumption for the development of necrosis in severe acute pancreatitis. Biochemical ma...
journal_title:Current opinion in critical care
pub_type: 杂志文章,评审
doi:10.1097/MCC.0b013e3282f6a3f9
更新日期:2008-04-01 00:00:00
abstract:PURPOSE OF REVIEW:Vascular permeability is traditionally explained by Starling's principle, describing two opposing forces across the endothelial cell line to maintain compartments in balance. Several contradictions to this principle have recently questioned its validity. RECENT FINDINGS:Hydraulic conductivity is kept...
journal_title:Current opinion in critical care
pub_type: 杂志文章,评审
doi:10.1097/MCC.0b013e3283632d5e
更新日期:2013-08-01 00:00:00
abstract:PURPOSE OF REVIEW:Management of the patient with traumatic brain injury is a rapidly advancing field, characterized in recent years by an improved understanding of intracranial pathophysiology and ways in which outcomes can be improved. Many traditional therapies, such as fluid restriction and hyperventilation, have be...
journal_title:Current opinion in critical care
pub_type: 杂志文章,评审
doi:10.1097/00075198-200312000-00007
更新日期:2003-12-01 00:00:00
abstract:PURPOSE OF REVIEW:To explore the origin of myths and their progression toward dogma. The process of debunking myths in the neurocritical care unit (NCCU) is facilitated if nurses are involved early during the process. RECENT FINDINGS:Current and past practices in the NCCU were reviewed through our personal experiences...
journal_title:Current opinion in critical care
pub_type: 杂志文章,评审
doi:10.1097/MCC.0000000000000075
更新日期:2014-04-01 00:00:00
abstract:PURPOSE OF REVIEW:Uncertainty surrounding medical decision-making is particularly important during end-of-life decision-making. Doubts about the patient's best interests and prognostic accuracy may lead to conflict. RECENT FINDINGS:Many authors have suggested recently that medical attitudes to uncertainty need review....
journal_title:Current opinion in critical care
pub_type: 杂志文章,评审
doi:10.1097/MCC.0000000000000030
更新日期:2013-12-01 00:00:00
abstract:PURPOSE OF REVIEW:This article reviews the results of case series and trials which evaluated venovenous extracorporeal membrane oxygenation (VV-ECMO) for severe respiratory failure. Potential indications of the technique in this setting are discussed. RECENT FINDINGS:Major technological improvements in extracorporeal ...
journal_title:Current opinion in critical care
pub_type: 杂志文章,评审
doi:10.1097/MCC.0b013e328357f090
更新日期:2012-10-01 00:00:00
abstract::Clinicians are increasingly aware that fungal pathogens are a significant cause of morbidity and mortality in hospitalized patients. Historically, these infections occurred in severely immunocompromised patients who were undergoing treatment for hematological malignancy or solid organ transplantation. Currently, howev...
journal_title:Current opinion in critical care
pub_type: 杂志文章,评审
doi:10.1097/00075198-200108000-00005
更新日期:2001-08-01 00:00:00
abstract:PURPOSE OF REVIEW:The liver comprises a multitude of parenchymal and nonparenchymal cells with diverse metabolic, hemodynamic and immune functions. Available monitoring options consist of 'static' laboratory parameters, quantitative tests of liver function based on clearance, elimination or metabolite formation and sco...
journal_title:Current opinion in critical care
pub_type: 杂志文章,评审
doi:10.1097/MCC.0b013e3283361813
更新日期:2010-04-01 00:00:00
abstract:PURPOSE OF REVIEW:This review will discuss the rationale and clinical utility of percutaneous left ventricular assist devices in the management of patients with cardiogenic shock. RECENT FINDINGS:Left ventricular assist devices maintain partial or total circulatory support in case of severe left ventricular failure. C...
journal_title:Current opinion in critical care
pub_type: 杂志文章,评审
doi:10.1097/MCC.0b013e3282efd5bc
更新日期:2007-10-01 00:00:00
abstract:PURPOSE OF REVIEW:Since the 1980s, hypocaloric feeding has been regularly proposed in the critically ill, although there is no clear definition available, nor evidence-based strategy to support it. We aim to define hypocaloric feeding based on indirect calorimetric data and to discuss patient-relevant clinical outcomes...
journal_title:Current opinion in critical care
pub_type: 杂志文章,评审
doi:10.1097/MCC.0b013e3280895d47
更新日期:2007-04-01 00:00:00
abstract:PURPOSE OF REVIEW:Traumatic injury continues to be a significant cause of morbidity and mortality in the year 2011. In addition, the healthcare expenditures and lost years of productivity represent significant economic cost to the affected individuals and their communities. Helicopters have been used to transport traum...
journal_title:Current opinion in critical care
pub_type: 杂志文章,评审
doi:10.1097/MCC.0b013e32834c5655
更新日期:2011-12-01 00:00:00
abstract:PURPOSE OF REVIEW:To discuss the clear rationale for evidence-based medicine (EvBM) in the challenging realms of resuscitation research, yet also provide case examples in which even the well designed, multicentered randomized clinical trial may have had unrecognized limitations, and thus misleading results. This is whe...
journal_title:Current opinion in critical care
pub_type: 杂志文章,评审
doi:10.1097/MCC.0000000000000413
更新日期:2017-06-01 00:00:00
abstract:PURPOSE OF REVIEW:Antimicrobials are very commonly used drugs in the intensive care setting. Extensive research has been conducted in recent years to describe their pharmacokinetics/pharmacodynamics in order to maximize the pharmacological benefit and patient outcome. Translating these new findings into clinical practi...
journal_title:Current opinion in critical care
pub_type: 杂志文章,评审
doi:10.1097/MCC.0000000000000229
更新日期:2015-10-01 00:00:00
abstract:PURPOSE OF REVIEW:Modern technologies allow visualization of microcirculatory disorders. This review describes how the coagulatory inhibitors antithrombin and activated protein C (APC) can improve microcirculation in sepsis and transplantation. RECENT FINDINGS:The effects of antithrombin and APC on microcirculatory di...
journal_title:Current opinion in critical care
pub_type: 杂志文章,评审
doi:10.1097/01.ccx.0000244121.54495.f7
更新日期:2006-10-01 00:00:00
abstract:PURPOSE OF REVIEW:Although providing palliative care in the ICU has become a priority, the success of different methods to integrate palliative care into the ICU has varied. This review examines the current evidence supporting the different models of palliative care delivery and highlights areas for future study. RECE...
journal_title:Current opinion in critical care
pub_type: 杂志文章,评审
doi:10.1097/MCC.0000000000000149
更新日期:2014-12-01 00:00:00
abstract::Successes in machine-based extracorporeal support for different organ functions stimulated research in the field of liver support approximately 50 years ago. Initial failure to improve outcome using detoxification methods like dialysis, blood and plasma exchange, or plasmapheresis over sorbents fueled interest in biol...
journal_title:Current opinion in critical care
pub_type: 杂志文章,评审
doi:10.1097/00075198-200204000-00014
更新日期:2002-04-01 00:00:00
abstract:PURPOSE OF REVIEW:Acute kidney injury (AKI) is a frequent finding in critically ill patients and is associated with adverse outcomes. With the purpose of improving outcome of AKI, the Kidney Disease: Improving Global Outcomes (KDIGO) group, a group of experts in critical care nephrology, has presented a set of guidelin...
journal_title:Current opinion in critical care
pub_type: 杂志文章,评审
doi:10.1097/MCC.0000000000000039
更新日期:2013-12-01 00:00:00
abstract:PURPOSE OF REVIEW:To discuss the role of the invasive monitoring techniques pulmonary artery catheter (PAC) and transpulmonary thermodilution (TPD) for cardiopulmonary monitoring in the critically ill patient. RECENT FINDINGS:Characterization of the nature of hemodynamic alterations and hemodynamic optimization can be...
journal_title:Current opinion in critical care
pub_type: 杂志文章,评审
doi:10.1097/MCC.0b013e3283609194
更新日期:2013-06-01 00:00:00
abstract:PURPOSE OF REVIEW:To outline evidence that suggests increased intestinal epithelial apoptosis (programmed cell death) plays an important role in critical illness of infectious and noninfectious origin. RECENT FINDINGS:Both human and animal studies demonstrate that the gut epithelium has increased levels of cellular de...
journal_title:Current opinion in critical care
pub_type: 杂志文章,评审
doi:10.1097/00075198-200304000-00013
更新日期:2003-04-01 00:00:00
abstract:PURPOSE OF REVIEW:Despite the progress made over the past 20 years in the treatment of septic shock, mortality remains high. Microcirculatory disorders raise considerable interest aiming to improve the understanding of the physiopathology of septic shock and its management. RECENT FINDINGS:Numerous experimental and cl...
journal_title:Current opinion in critical care
pub_type: 杂志文章,评审
doi:10.1097/MCC.0000000000000217
更新日期:2015-08-01 00:00:00
abstract:PURPOSE OF REVIEW:Temporary circulatory support (TCS) with short-term mechanical circulatory support (MCS) devices is increasingly used as a salvage therapy for patients with refractory cardiogenic shock. This article provides an overview of current devices, their indications and management, and discusses results of re...
journal_title:Current opinion in critical care
pub_type: 杂志文章,评审
doi:10.1097/MCC.0000000000000520
更新日期:2018-08-01 00:00:00
abstract:PURPOSE OF REVIEW:Implantable cardioverter-defibrillator (ICD) implantation is the standard of care for secondary prevention in patients with previous cardiac arrest and for primary prevention in appropriately selected patients with cardiomyopathy. However, ICD therapies and the arrhythmias that trigger these therapies...
journal_title:Current opinion in critical care
pub_type: 杂志文章,评审
doi:10.1097/MCC.0b013e328357ae68
更新日期:2012-10-01 00:00:00