Advances in burn care.

Abstract:

PURPOSE OF REVIEW:This article reviews and critiques new developments in the critical care of burn patients. RECENT FINDINGS:The practice of restrictive transfusion is slowly gaining traction. Abdominal compartment syndrome is associated with resuscitation volumes of 300 ml/kg per 24 h, and percutaneous decompression may be a treatment option. Adrenal insufficiency is common, but whom and when to treat are unclear. Imaging or noninvasive monitoring may confirm renal perfusion before urine output, and the concept of permissive hypovolemia should be explored. There is progress in the laboratory in smoke inhalation and myocardial depression, but no human translation. Antibiotic pharmacokinetics in large burns are unpredictable, and so aminoglycosides (measurable concentrations) are not obsolete. Selective digestive decontamination remains controversial. Nutritional predictions by formula are inaccurate. Oxandrolone is safe and effective in promoting anabolism in large burns. Deep venous thrombosis prophylaxis remains guided only by expert opinion. Females fare worse than male patients after burns. SUMMARY:The application of the scientific method to burn care is improving slowly. Randomized controlled trials are becoming more common. There is a need for translation of excellent animal work to the human arena.

journal_name

Curr Opin Crit Care

authors

Namias N

doi

10.1097/MCC.0b013e328263888f

subject

Has Abstract

pub_date

2007-08-01 00:00:00

pages

405-10

issue

4

eissn

1070-5295

issn

1531-7072

pii

00075198-200708000-00008

journal_volume

13

pub_type

杂志文章,评审
  • Uncertainty in end-of-life care.

    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

    authors: Ridley S,Fisher M

    更新日期:2013-12-01 00:00:00

  • Effects of alcohol on the heart.

    abstract::Some evidence suggests that light to moderate alcohol consumption protects against cardiovascular diseases. However, this cardioprotective effect of alcohol consumption in adults is absent at the population level. Approximately 20 to 30% of patients admitted to a hospital are alcohol abusers. In medical practice, it i...

    journal_title:Current opinion in critical care

    pub_type: 杂志文章,评审

    doi:10.1097/00075198-200110000-00004

    authors: Spies CD,Sander M,Stangl K,Fernandez-Sola J,Preedy VR,Rubin E,Andreasson S,Hanna EZ,Kox WJ

    更新日期:2001-10-01 00:00:00

  • Safety of vitamin C in sepsis: a neglected topic.

    abstract:PURPOSE OF REVIEW:Although vitamin C is essentially a nontoxic vitamin; however, it is important to be aware regarding the safety of high doses before the wide clinical use. RECENT FINDINGS:Minor side effects of vitamin C have been reported, many being reported in earlier studies. High doses of vitamin C (up to 1.5 g/...

    journal_title:Current opinion in critical care

    pub_type: 杂志文章,评审

    doi:10.1097/MCC.0000000000000622

    authors: Khoshnam-Rad N,Khalili H

    更新日期:2019-08-01 00:00:00

  • Postoperative sepsis.

    abstract:PURPOSE OF REVIEW:Postoperative sepsis is a major cause of surgical associated morbidity and mortality. Our goal is to describe its incidence, pathophysiology, and contributing factors. In addition, we will review preventive measures and treatment options that may possibly reduce its healthcare burden. RECENT FINDINGS...

    journal_title:Current opinion in critical care

    pub_type: 杂志文章,评审

    doi:10.1097/MCC.0b013e328348bee2

    authors: Fried E,Weissman C,Sprung C

    更新日期:2011-08-01 00:00:00

  • Nutritional and metabolic supplementation for the injured brain: an update.

    abstract:PURPOSE OF REVIEW:Energy dysfunction is increasingly recognized as a key factor in the pathogenesis of acute brain injury (ABI). This one characterized by a high metabolic rate and nitrogen loss is often associated with an undernutrition support. We review the metabolism evolution and nutritional status in brain injure...

    journal_title:Current opinion in critical care

    pub_type: 杂志文章,评审

    doi:10.1097/MCC.0000000000000588

    authors: Quintard H,Ichai C

    更新日期:2019-04-01 00:00:00

  • Cardiogenic pulmonary edema: mechanisms and treatment - an intensivist's view.

    abstract:PURPOSE OF REVIEW:This review summarizes current understanding of the pathophysiology of cardiogenic pulmonary edema, its causes and treatment. RECENT FINDINGS:The pathobiology and classification of pulmonary edema is more complex than the hydrostatic vs. permeability dichotomy of the past. Mechanisms of alveolar flui...

    journal_title:Current opinion in critical care

    pub_type: 杂志文章,评审

    doi:10.1097/MCC.0000000000000626

    authors: Ingbar DH

    更新日期:2019-08-01 00:00:00

  • The epithelium in acute lung injury/acute respiratory distress syndrome.

    abstract:PURPOSE OF REVIEW:The mechanisms of epithelial injury in acute lung injury/acute respiratory distress syndrome have been of interest since the syndrome was first described. Cell therapies to replace injured epithelium are a futuristic dream; however, there is ongoing research to achieve this goal. We review research re...

    journal_title:Current opinion in critical care

    pub_type: 杂志文章,评审

    doi:10.1097/MCC.0b013e3282f417a0

    authors: Gropper MA,Wiener-Kronish J

    更新日期:2008-02-01 00:00:00

  • Interventions to decrease the morbidity and mortality associated with implantable cardioverter-defibrillator shocks.

    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

    authors: Bradfield JS,Buch E,Shivkumar K

    更新日期:2012-10-01 00:00:00

  • Recent developments in percutaneous tracheostomy: improving techniques and expanding roles.

    abstract:PURPOSE OF REVIEW:The purpose of this review is to provide an update of recent developments pertaining to the use of percutaneous tracheostomy. Percutaneous tracheostomy has been established as an alternative to open surgical tracheostomy, but many key questions about the optimal use of this procedure remain unanswered...

    journal_title:Current opinion in critical care

    pub_type: 杂志文章,评审

    doi:10.1097/01.ccx.0000170680.09759.f2

    authors: Bardell T,Drover JW

    更新日期:2005-08-01 00:00:00

  • High-frequency oscillatory ventilation: still a role?

    abstract:PURPOSE OF REVIEW:In light of emerging data from clinical trials, the place of high-frequency oscillatory ventilation (HFOV) in the management of acute respiratory distress syndrome (ARDS) is uncertain. This review provides an overview of these new clinical data and also explores new areas of investigation for HFOV in ...

    journal_title:Current opinion in critical care

    pub_type: 杂志文章,评审

    doi:10.1097/MCC.0000000000000387

    authors: Ng J,Ferguson ND

    更新日期:2017-04-01 00:00:00

  • Neuroprognostication after cardiac arrest in the light of targeted temperature management.

    abstract:PURPOSE OF REVIEW:Delayed awakening after targeted temperature management (TTM) and sedation is frequent among cardiac arrest patients. Differentiating between prolonged coma and irreversible cerebral damage can be challenging, therefore the utilization of a multimodal approach is recommended by international guideline...

    journal_title:Current opinion in critical care

    pub_type: 杂志文章,评审

    doi:10.1097/MCC.0000000000000406

    authors: Oddo M,Friberg H

    更新日期:2017-06-01 00:00:00

  • Coagulation pattern in critical liver dysfunction.

    abstract:PURPOSE OF REVIEW:This article reviews the current literature dealing with pathophysiology, diagnostics, bleeding management, and thromboprophylaxis in patients with acute and chronic liver dysfunction. RECENT FINDINGS:Routine coagulation tests such as prothrombin time and International Normalized Ratio (INR) are not ...

    journal_title:Current opinion in critical care

    pub_type: 杂志文章,评审

    doi:10.1097/MCC.0b013e32835ebb52

    authors: Schaden E,Saner FH,Goerlinger K

    更新日期:2013-04-01 00:00:00

  • Research: advances in cell biology relevant to critical illness.

    abstract::During the past decade, enormous advances have been made in cell biology. Major advances included the publication of the human genome sequence, the development of proteomics, and DNA microarray technologies and techniques to selectively "silence" genes using short strands of double-stranded RNA. Some areas of great pr...

    journal_title:Current opinion in critical care

    pub_type: 杂志文章,评审

    doi:10.1097/01.ccx.0000130150.33814.71

    authors: Fink MP

    更新日期:2004-08-01 00:00:00

  • Severe cardiac disease in pregnancy, part II: impact of congenital and acquired cardiac diseases during pregnancy.

    abstract:PURPOSE OF REVIEW:Part II of this review gives an overview of the different maternal cardiac problems during pregnancy and their management, and developments over recent years. RECENT FINDINGS:Many studies published over the last 5 years provided new insights on different cardiac diseases in pregnancy. Publications di...

    journal_title:Current opinion in critical care

    pub_type: 杂志文章,评审

    doi:10.1097/01.ccx.0000179806.15328.b9

    authors: van Mook WN,Peeters L

    更新日期:2005-10-01 00:00:00

  • The glutamine debate in surgery and critical care.

    abstract:PURPOSE OF REVIEW:Glutamine (GLN) is a versatile amino acid, long believed to have important implications in ICU and surgical patients. An extensive body of data examining GLN supplementation of TPN demonstrated a consistent signal of improved outcomes. However, recently signals of risk have come from two large-scale m...

    journal_title:Current opinion in critical care

    pub_type: 杂志文章,评审

    doi:10.1097/MCC.0000000000000633

    authors: Wischmeyer PE

    更新日期:2019-08-01 00:00:00

  • Guidelines for severe infections: are they useful?

    abstract:PURPOSE OF REVIEW:The large variability in clinical practice plus the increasing awareness that certain processes of care are associated with improved medical outcomes has led to the development of clinical practice guidelines in serious infection. The evolution of guidelines and their impact on delivery of care in sev...

    journal_title:Current opinion in critical care

    pub_type: 杂志文章,评审

    doi:10.1097/01.ccx.0000244131.15484.4e

    authors: Cinel I,Dellinger RP

    更新日期:2006-10-01 00:00:00

  • Gut dysfunction in the ICU: diagnosis and management.

    abstract:PURPOSE OF REVIEW:Progress has been made in our understanding of gut dysfunction in critical illness. This review will outline new findings and give perspectives based on previous knowledge and concurrent advances in nutrition. RECENT FINDINGS:The relationship between gut dysfunction and poor outcomes in critical illn...

    journal_title:Current opinion in critical care

    pub_type: 杂志文章

    doi:10.1097/MCC.0000000000000813

    authors: Chapple LS,Plummer MP,Chapman MJ

    更新日期:2021-01-21 00:00:00

  • Update in intensive care medicine: acute liver failure. Initial management, supportive treatment and who to transplant.

    abstract:PURPOSE OF REVIEW:Acute liver failure (ALF) is associated with significant mortality. Although specific therapies may be available, the evidence base for these and for many aspects of supportive therapy has been slow to emerge. Liver transplantation continues to be a cornerstone of treatment, and the management of ALF,...

    journal_title:Current opinion in critical care

    pub_type: 杂志文章,评审

    doi:10.1097/MCC.0000000000000073

    authors: Willars C

    更新日期:2014-04-01 00:00:00

  • Education and simulation techniques for improving reliability of care.

    abstract:PURPOSE OF REVIEW:Multiple factors influence the dependability of intensive care provision. The management of a group of unstable, critically ill patients requires focused attention from the clinical team. Medical simulation is an important tool to improve safety and team work within the ICU. RECENT FINDINGS:The criti...

    journal_title:Current opinion in critical care

    pub_type: 杂志文章,评审

    doi:10.1097/MCC.0b013e3282f1bb32

    authors: Fox-Robichaud AE,Nimmo GR

    更新日期:2007-12-01 00:00:00

  • Continuous EEG monitoring: is it ready for prime time?

    abstract:PURPOSE OF REVIEW:Continuous electroencephalography (cEEG) is being used more frequently in intensive care units to detect epileptic activity and ischemia. This review analyzes clinical applications and limitations of cEEG as a routine neuromonitoring tool. RECENT FINDINGS:cEEG is primarily used to detect nonconvulsiv...

    journal_title:Current opinion in critical care

    pub_type: 杂志文章,评审

    doi:10.1097/MCC.0b013e3283294947

    authors: Kurtz P,Hanafy KA,Claassen J

    更新日期:2009-04-01 00:00:00

  • Perioperative pulmonary complications.

    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

    authors: Johnson DC,Kaplan LJ

    更新日期:2011-08-01 00:00:00

  • Integrating palliative care in the ICU.

    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

    authors: Hua M,Wunsch H

    更新日期:2014-12-01 00:00:00

  • Overview of ventilator-induced lung injury mechanisms.

    abstract:PURPOSE OF REVIEW:Mechanical ventilation is the main supportive therapy for patients with acute respiratory distress syndrome. As with any therapy, mechanical ventilation has side effects and may induce lung injury. This review will focus on stretch-dependent activation of alveolar epithelial and endothelial cells and ...

    journal_title:Current opinion in critical care

    pub_type: 杂志文章,评审

    doi:10.1097/00075198-200502000-00013

    authors: Lionetti V,Recchia FA,Ranieri VM

    更新日期:2005-02-01 00:00:00

  • Endpoints in resuscitation.

    abstract:PURPOSE OF REVIEW:Shock occurs because of a failure to deliver adequate oxygen to meet the metabolic demands of the body resulting in metabolic acidosis, inflammation, and coagulopathy. Resuscitation is the process of treating shock in an attempt to restore normal physiology. Various hemodynamic, metabolic, and regiona...

    journal_title:Current opinion in critical care

    pub_type: 杂志文章,评审

    doi:10.1097/MCC.0000000000000248

    authors: Connelly CR,Schreiber MA

    更新日期:2015-12-01 00:00:00

  • Perioperative haemodynamic therapy.

    abstract:PURPOSE OF REVIEW:To discuss the perioperative monitoring tools and targets for haemodynamic optimization and to assess the influence of goal-directed therapy (GDT) on organ function, complications and outcome in different categories of surgical patients. RECENT FINDINGS:The choice of perioperative haemodynamic monito...

    journal_title:Current opinion in critical care

    pub_type: 杂志文章,评审

    doi:10.1097/MCC.0b013e32833ab81e

    authors: Kirov MY,Kuzkov VV,Molnar Z

    更新日期:2010-08-01 00:00:00

  • Percutaneous left ventricular assist devices for treatment of patients with cardiogenic shock.

    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

    authors: Windecker S

    更新日期:2007-10-01 00:00:00

  • Microcirculatory disorders during septic shock.

    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

    authors: Ait-Oufella H,Bourcier S,Lehoux S,Guidet B

    更新日期:2015-08-01 00:00:00

  • What is the niche for extracorporeal membrane oxygenation in severe acute respiratory distress syndrome?

    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

    authors: Combes A,Bréchot N,Luyt CE,Schmidt M

    更新日期:2012-10-01 00:00:00

  • Ventilator-induced diaphragmatic dysfunction: what have we learned?

    abstract:PURPOSE OF REVIEW:The purpose of the review is to summarize and discuss recent research regarding the role of mechanical ventilation in producing weakness and atrophy of the diaphragm in critically ill patients, an entity termed ventilator-induced diaphragmatic dysfunction (VIDD). RECENT FINDINGS:Severe weakness of th...

    journal_title:Current opinion in critical care

    pub_type: 杂志文章,评审

    doi:10.1097/MCC.0000000000000272

    authors: Petrof BJ,Hussain SN

    更新日期:2016-02-01 00:00:00

  • Insulin: an endogenous cardioprotector.

    abstract::This review discusses the myocardial protective property of the insulin/glucose-insulin-potassium regimen and the mechanisms involved in this beneficial action. Several recent studies suggest that insulin not only is useful to control hyperglycemia and maintain glucose homeostasis but also may have the unique property...

    journal_title:Current opinion in critical care

    pub_type: 杂志文章,评审

    doi:10.1097/00075198-200310000-00007

    authors: Das UN

    更新日期:2003-10-01 00:00:00