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 nonconvulsive seizures, which are frequent and possibly associated with harm. Cerebral ischemia, such as that from vasospasm after subarachnoid hemorrhage, can be detected earlier by EEG and quantitative EEG (qEEG). Highly skilled technicians and subspecialty-trained physicians are needed to generate good quality EEG and to interpret these data. qEEG allows more efficient interpretation of large amounts of EEG and may trigger prespecified alarms. Currently, there is little high-quality data on cEEG to define indications, cost-saving potential, and impact on outcome. A few studies have demonstrated how cEEG can be integrated into multimodality brain monitoring of severely brain-injured patients. SUMMARY:cEEG should be considered as an integral part of multimodality monitoring of the injured brain, particularly in patients at risk for nonconvulsive seizure or ischemia. Automated alarms may help establish cEEG monitoring as an integral part of brain monitoring. All neurological ICUs that routinely care for patients with refractory status epilepticus should have the capability to perform cEEG monitoring. Further research determining the impact on outcome and making EEG monitoring more user friendly may help move this technique out of the subspecialized ICU setting into the general ICU environment. In the future, it may be possible to use specific EEG parameters as endpoints for therapeutic interventions.
journal_name
Curr Opin Crit Carejournal_title
Current opinion in critical careauthors
Kurtz P,Hanafy KA,Claassen Jdoi
10.1097/MCC.0b013e3283294947subject
Has Abstractpub_date
2009-04-01 00:00:00pages
99-109issue
2eissn
1070-5295issn
1531-7072pii
00075198-200904000-00006journal_volume
15pub_type
杂志文章,评审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
更新日期:2006-10-01 00:00:00
abstract:PURPOSE OF REVIEW:To describe the current knowledge about clinical and microbiological diagnosis of nonventilated hospital-acquired pneumonia (NV-HAP). RECENT FINDINGS:NV-HAP is emerging as a new challenge for clinicians, particularly because VAP incidence has been decreasing. The clinical diagnosis of NV-HAP uses the...
journal_title:Current opinion in critical care
pub_type: 杂志文章,评审
doi:10.1097/MCC.0000000000000525
更新日期:2018-10-01 00:00:00
abstract:PURPOSE OF REVIEW:Selenium is a trace element essential to human health. Critical illness is associated with the generation of oxygen free radicals resulting in a condition of oxidative stress. Supplementing critically ill patients with antioxidant nutrients may improve survival. Selenium levels can be low due to redis...
journal_title:Current opinion in critical care
pub_type: 杂志文章,评审
doi:10.1097/01.ccx.0000216581.80051.d6
更新日期:2006-04-01 00:00:00
abstract:PURPOSE OF REVIEW:Efforts to improve outcomes from acute kidney injury (AKI) have focussed on timely diagnosis and effective delivery of basic patient care. Electronic alerts (e-alerts) for AKI have attracted interest as a tool to facilitate this. Initial feasibility has already been demonstrated; this review will disc...
journal_title:Current opinion in critical care
pub_type: 杂志文章,评审
doi:10.1097/MCC.0000000000000245
更新日期:2015-12-01 00:00:00
abstract::Reactive oxygen species are reactive, partially reduced derivatives of molecular oxygen (O 2 ). Important reactive oxygen species in biologic systems include superoxide radical anion, hydrogen peroxide, and hydroxyl radical. Closely related species include the hypohalous acids, particularly hypochlorous acid; chlorami...
journal_title:Current opinion in critical care
pub_type: 杂志文章,评审
doi:10.1097/00075198-200202000-00002
更新日期:2002-02-01 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:Despite the improvements in its management, community-acquired pneumonia (CAP) still exhibits high global morbidity and mortality rates, especially in elderly patients. This review focuses on the most recent findings on the epidemiology, cause, diagnosis and management of CAP. RECENT FINDINGS:There i...
journal_title:Current opinion in critical care
pub_type: 杂志文章,评审
doi:10.1097/MCC.0000000000000550
更新日期:2018-12-01 00:00:00
abstract:PURPOSE OF REVIEW:Fluid removal and relief of congestion are central to treatment of acute heart failure. Diuretics have been the decongestive mainstay but their known limitations have led to the exploration of alternative strategies. This review compares diuretics with ultrafiltration and examines the recent evidence ...
journal_title:Current opinion in critical care
pub_type: 杂志文章,评审
doi:10.1097/MCC.0000000000000134
更新日期:2014-10-01 00:00:00
abstract:PURPOSE OF REVIEW:The present review will discuss the usefulness of ultrasound in the ICU in assessing hemodynamic instability in various critical care conditions. We will discuss how to interpret echocardiographic findings in critically ill patients including the physiological consequences of mechanical ventilation. ...
journal_title:Current opinion in critical care
pub_type: 杂志文章,评审
doi:10.1097/MCC.0b013e32830e6d81
更新日期:2008-10-01 00:00:00
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
更新日期:2003-10-01 00:00:00
abstract:PURPOSE OF REVIEW:Despite decades of advances in prehospital and in-hospital medical care, patients with out-of-hospital cardiac arrest continue to have poor neurologic and cardiac function following otherwise successful resuscitation. This review examines the mechanisms and therapeutic strategies currently under devel...
journal_title:Current opinion in critical care
pub_type: 杂志文章,评审
doi:10.1097/MCC.0000000000000087
更新日期:2014-06-01 00:00:00
abstract:PURPOSE OF REVIEW:Although conventional anticonvulsant agents can terminate status epilepticus in most cases, a substantial minority of patients develops medically refractory status and requires more aggressive care. This review explores the options available. RECENT FINDINGS:Increasing numbers of previously unexpecte...
journal_title:Current opinion in critical care
pub_type: 杂志文章,评审
doi:10.1097/01.ccx.0000157079.72999.87
更新日期:2005-04-01 00:00:00
abstract:PURPOSE OF REVIEW:Ventilator weaning forms an integral part in critical care medicine and strategies to shorten duration are rapidly evolving alongside our knowledge of the relevant physiological processes. The purpose of the current review is to discuss new physiological and clinical insights in ventilator weaning tha...
journal_title:Current opinion in critical care
pub_type: 杂志文章
doi:10.1097/MCC.0000000000000790
更新日期:2021-02-01 00:00:00
abstract::Intra-abdominal infection continues to pose a significant threat to critically ill patients in the year 2000. A review of the current literature reveals that despite remarkable developments in critical care medicine and extensive study of patients with tertiary peritonitis, the associated mortality rate remains nearly...
journal_title:Current opinion in critical care
pub_type: 杂志文章,评审
doi:10.1097/00075198-200104000-00010
更新日期:2001-04-01 00:00:00
abstract:PURPOSE OF REVIEW:Increased use of advanced life-sustaining measures in patients with poor long-term expectations secondary to more chronic organ dysfunctions, comorbidities and/or a poor quality of life has become a worrying trend over the last decade. This can lead to futile, disproportionate or inappropriate care in...
journal_title:Current opinion in critical care
pub_type: 杂志文章,评审
doi:10.1097/MCC.0000000000000026
更新日期:2013-12-01 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
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 describe recent data about Acinetobacter baumannii pneumonia epidemiology and the therapeutic options including adjunctive nebulized therapy. RECENT FINDINGS:A. baumannii is a major cause of nosocomial pneumonia in certain geographic areas affecting mainly debilitated patients, with prolonged hosp...
journal_title:Current opinion in critical care
pub_type: 杂志文章,评审
doi:10.1097/MCC.0000000000000649
更新日期:2019-10-01 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:Fever is common in the ICU among patients with severe brain injury. Fever has been consistently shown to exacerbate brain injuries in animal models and has been consistently associated with poor outcome in human studies. However, whether fever control improves outcome and the ideal means of fever cont...
journal_title:Current opinion in critical care
pub_type: 杂志文章,评审
doi:10.1097/MCC.0000000000000070
更新日期:2014-04-01 00:00:00
abstract:PURPOSE OF REVIEW:Early prognostication in acute brain damage remains a challenge in the realm of critical care. There remains controversy over the most optimal methods that can be utilized to predict outcome. The utility of recently reported prognostic biomarkers and clinical methods will be reviewed. RECENT FINDINGS...
journal_title:Current opinion in critical care
pub_type: 杂志文章,评审
doi:10.1097/MCC.0b013e32835eba56
更新日期:2013-04-01 00:00:00
abstract::Nosocomial pneumonia is a dynamic disease with multiple etiologic agents and a changing natural history. The highest attack rates and mortality occur in patients with ventilator-associated pneumonia. Diagnosis of nosocomial pneumonia is often made by clinical criteria that are sensitive but lack specificity. The use o...
journal_title:Current opinion in critical care
pub_type: 杂志文章,评审
doi:10.1097/00075198-200210000-00009
更新日期:2002-10-01 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:Esophageal manometry has shown its usefulness to estimate transpulmonary pressure, that is lung stress, and the intensity of spontaneous effort in patients with acute respiratory distress syndrome. However, clinical uptake of esophageal manometry in ICU is still low. Thus, the purpose of review is to ...
journal_title:Current opinion in critical care
pub_type: 杂志文章,评审
doi:10.1097/MCC.0000000000000494
更新日期:2018-06-01 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:Transfusion of red blood cells in the trauma patient can be lifesaving. The question is how much and when? It is important to weigh the risks and benefits of red blood cell transfusions, as well alternatives to transfusion as these products are not benign. RECENT FINDINGS:We explore the evidence, and...
journal_title:Current opinion in critical care
pub_type: 杂志文章,评审
doi:10.1097/MCC.0b013e32801067f0
更新日期:2006-12-01 00:00:00
abstract:PURPOSE OF REVIEW:The purpose of this study is to review the prevalence and significance of gasping in patients experiencing cardiac arrest. RECENT FINDINGS:In a recent study by Bobrow et al., gasping was identified in 33% of patients who arrested after the arrival of emergency medical services (EMS). Patients who arr...
journal_title:Current opinion in critical care
pub_type: 杂志文章,评审
doi:10.1097/MCC.0b013e3283298e00
更新日期:2009-06-01 00:00:00
abstract:PURPOSE OF REVIEW:To provide an update on the progress of the multicenter, randomized, controlled trial of corticosteroids after significant head injury (CRASH). RECENT FINDINGS:After a successful pilot phase, the main phase of the CRASH Trial began in March 2001. By June 2002, 107 hospitals from 31 countries were par...
journal_title:Current opinion in critical care
pub_type: 临床试验,杂志文章,多中心研究,随机对照试验
doi:10.1097/00075198-200304000-00003
更新日期:2003-04-01 00:00:00
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
更新日期:2013-04-01 00:00:00
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
更新日期:2021-01-21 00:00:00