Abstract:
PURPOSE OF REVIEW:Blunt cerebrovascular injuries (BCVI) are a rare but potentially devastating injury with stroke rates up to 50%. Over the past decade, the recognition and subsequent management of these injuries has undergone a marked evolution. This review will focus on the rationale for BCVI screening, imaging options, and treatment modalities. RECENT FINDINGS:There are no prospective randomized controlled trials evaluating the management of BCVI. Available studies support screening a high-risk patient population based upon injury mechanism and constellation of associated injuries using multidetector-row (16-slice or greater) computed tomographic angiography (CTA). Although the ideal regimen of antithrombotic therapy has yet to be determined, treatment with either anticoagulation or antiplatelet agents has been shown to reduce BCVI-related stroke rate. SUMMARY:Cerebrovascular injuries (CVI) are now diagnosed in approximately 1% of blunt trauma patients. The recognition of a clinically silent period allows for injury screening based upon mechanism of trauma and the patient's injury pattern. Following identification of injuries in asymptomatic patients, prompt initiation of antithrombotic therapy reduces the incidence of stroke.
journal_name
Curr Opin Crit Carejournal_title
Current opinion in critical careauthors
Burlew CC,Biffl WLdoi
10.1097/MCC.0b013e32833ee8b4subject
Has Abstractpub_date
2010-12-01 00:00:00pages
587-95issue
6eissn
1070-5295issn
1531-7072journal_volume
16pub_type
杂志文章,评审abstract:PURPOSE OF REVIEW:To investigate the impact of critical illness polyneuropathy and critical illness myopathy on short-term and long-term patient outcome. RECENT FINDINGS:In the acute-care setting, critical illness polyneuropathy and critical illness myopathy are important causes of acute paralysis in critically ill co...
journal_title:Current opinion in critical care
pub_type: 杂志文章,评审
doi:10.1097/01.ccx.0000168530.30702.3e
更新日期:2005-08-01 00:00:00
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
更新日期:2004-08-01 00:00:00
abstract:PURPOSE OF REVIEW:To summarize new concepts regarding the occurrence, prevention, and management of medical complications following subarachnoid hemorrhage. RECENT FINDINGS:Data regarding the impact of common medical complications after subarachnoid hemorrhage on delayed cerebral ischemia and neurological outcome afte...
journal_title:Current opinion in critical care
pub_type: 杂志文章,评审
doi:10.1097/01.ccx.0000216571.80944.65
更新日期:2006-04-01 00:00:00
abstract:PURPOSE OF REVIEW:When classic examinations such as bronchoalveolar lavage are not contributory in the etiologic diagnosis of unresolving acute respiratory distress syndrome, surgical lung biopsy would appear to be useful to determine the specific cause, particularly infection or postaggressive fibrosis, which could be...
journal_title:Current opinion in critical care
pub_type: 杂志文章,评审
doi:10.1097/MCC.0b013e3282f33e42
更新日期:2008-02-01 00:00:00
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
更新日期:2019-04-01 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
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:There is significant controversy for perioperative fluid management. This review discusses the evidence from clinical studies, basic research, and systematic reviews to provide a summary of the current best practice in this area. RECENT FINDINGS:Recent evidence has challenged the long-held contention...
journal_title:Current opinion in critical care
pub_type: 杂志文章,评审
doi:10.1097/MCC.0b013e3283632f1f
更新日期:2013-08-01 00:00:00
abstract:PURPOSE OF REVIEW:Care of the injured patient is a dynamic process. Hemorrhage remains the primary cause of preventable death after trauma. Rapid and effective early care can improve survival and outcomes. Emerging therapies to address traumatic hemorrhage will be discussed. RECENT FINDINGS:Current concepts in trauma ...
journal_title:Current opinion in critical care
pub_type: 杂志文章,评审
doi:10.1097/MCC.0b013e328331f57c
更新日期:2009-12-01 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:To review the challenges and limitations of randomized clinical trials in acute respiratory distress syndrome, with special emphasis on those pertaining to ventilatory management. RECENT FINDINGS:Superbly executed randomized trials of ventilatory strategy have garnered deserved attention from the cri...
journal_title:Current opinion in critical care
pub_type: 杂志文章,评审
doi:10.1097/01.ccx.0000198996.22072.4a
更新日期:2006-02-01 00:00:00
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
更新日期:2015-12-01 00:00:00
abstract:PURPOSE OF REVIEW:The purpose of this review is to provide an overview of the immune response to major surgery, and the ways in which it may be modulated to improve postoperative outcomes. RECENT FINDINGS:Data from patients who have undergone a variety of tissue injuries (surgery, burns, sepsis, trauma) have shown the...
journal_title:Current opinion in critical care
pub_type: 杂志文章,评审
doi:10.1097/MCC.0000000000000561
更新日期:2018-12-01 00:00:00
abstract:PURPOSE OF REVIEW:Early detection of gastrointestinal motility disturbances is a major goal to reduce the incidence of this potentially disastrous event by prophylactic managements and early goal-directed therapy in patients at risk. RECENT FINDINGS:Gastroparesis frequently results in the inability to feed critically ...
journal_title:Current opinion in critical care
pub_type: 杂志文章,评审
doi:10.1097/MCC.0b013e3283356679
更新日期:2010-04-01 00:00:00
abstract:PURPOSE OF REVIEW:Mechanical ventilation is a common intervention provided by pediatric intensivists. This fact notwithstanding, the management of mechanical ventilation in pediatrics is largely guided by a few pediatric trials along with careful interpretation and application of adult data. RECENT FINDINGS:A low tida...
journal_title:Current opinion in critical care
pub_type: 杂志文章,评审
doi:10.1097/MCC.0b013e32801297f9
更新日期:2007-02-01 00:00:00
abstract:PURPOSE OF REVIEW:In the past 12 years, atherosclerosis and the acute coronary syndromes have turned out to be thromboinflammatory diseases. Recent data suggest that inflammation also plays an important role in the pathogenesis and outcome of cardiogenic shock. This review will summarize recent advances in the understa...
journal_title:Current opinion in critical care
pub_type: 杂志文章,评审
doi:10.1097/01.ccx.0000139364.53198.fd
更新日期:2004-10-01 00:00:00
abstract:PURPOSE OF REVIEW:Delirium is frequently encountered in the ICU and is associated with significant adverse outcomes. The increasingly recognized consequences of ICU delirium should enhance efforts to improve recognition and management of this serious problem. We aim to review the recent literature on ICU delirium, incl...
journal_title:Current opinion in critical care
pub_type: 杂志文章,评审
doi:10.1097/MCC.0b013e32835132b9
更新日期:2012-04-01 00:00:00
abstract:PURPOSE OF REVIEW:There is growing evidence that bone health is impacted during and after critical illness in multiple ways. In this review, we provide a practical update on postcritical care bone loss with an insight on identification of persons at risk, prevention and treatment strategies. RECENT FINDINGS:Critical i...
journal_title:Current opinion in critical care
pub_type: 杂志文章,评审
doi:10.1097/MCC.0000000000000734
更新日期:2020-08-01 00:00:00
abstract:PURPOSE OF REVIEW:Survivorship or addressing impaired quality of life (QoL) in ICU survivors has been named 'the defining challenge of critical care' for this century to address this challenge; in addition to optimal nutrition, we must learn to employ targeted metabolic/muscle assessment techniques and utilize structur...
journal_title:Current opinion in critical care
pub_type: 杂志文章,评审
doi:10.1097/MCC.0000000000000748
更新日期:2020-08-01 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::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::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
更新日期:2001-10-01 00:00:00
abstract:PURPOSE OF REVIEW:Multimodal monitoring has emerged as a novel paradigm of care in acute brain injury, and in this context the value of noninvasive devices is increasingly under scrutiny. This narrative review summarizes recent clinical investigation focused on the role of automated infrared pupillometry (AIP) and opti...
journal_title:Current opinion in critical care
pub_type: 杂志文章,评审
doi:10.1097/MCC.0000000000000710
更新日期:2020-04-01 00:00:00
abstract:PURPOSE OF REVIEW:A significant number of patients hospitalized with heart failure are malnourished. Depletion of micronutrients, which is known to occur in heart failure for a variety of reasons, may contribute to myocardial abnormalities noted in heart failure. In this review, we focus on nutritional supplementation ...
journal_title:Current opinion in critical care
pub_type: 杂志文章,评审
doi:10.1097/MCC.0b013e32833e10d4
更新日期:2010-10-01 00:00:00
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
更新日期:2017-04-01 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:Stress ulcer prophylaxis (SUP) is considered standard of care in the majority of critically ill patients in the ICU. In this review, we will present the current evidence for the use of SUP in ICU patients, including data on the prevalence of gastrointestinal bleeding and the balance between benefits a...
journal_title:Current opinion in critical care
pub_type: 杂志文章,评审
doi:10.1097/MCC.0000000000000290
更新日期:2016-04-01 00:00:00
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
更新日期:2010-08-01 00:00:00
abstract::The introduction of mechanical ventilation in the intensive care unit environment had the merit of putting a potent life-saving tool in the physicians' hands in a number of situations; however, like most sophisticated technologies, it can cause severe side effects and eventually increase mortality if improperly applie...
journal_title:Current opinion in critical care
pub_type: 杂志文章,评审
doi:10.1097/00075198-200102000-00007
更新日期:2001-02-01 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