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 trauma patients for the past 40 years, but there are conflicting data on the benefits of helicopter emergency medical service (HEMS) in civilian trauma systems. Debate persists regarding the mortality benefit, cost-effectiveness, and safety of helicopter usage, largely because the studies to date vary widely in design and generalizability to trauma systems serving heterogeneous populations and geography. Strict criteria should be established to determine when HEMS transport is warranted and most likely to positively affect patient outcomes. Individual trauma systems should conduct an assessment of their resources and needs in order to most effectively incorporate helicopter transport into their triage model. RECENT FINDINGS:Research suggests that HEMS improves mortality in certain subgroups of trauma patients, both after transport from the scene of injury and following interfacility transport. Studies examining the cost-effectiveness of HEMS had mixed results, but the majority found that it is a cost-effective tool. Safety remains an issue of contention with HEMS transport, as helicopters are associated with significant safety risk to the crew and patient. However, this risk may be justified provided there is a substantial mortality benefit to be gained. SUMMARY:Recent studies suggest that strict criteria should be established to determine when helicopter transport is warranted and most likely to positively affect patient outcomes. Individual trauma systems should conduct an assessment of their resources and needs in order to most effectively incorporate HEMS into their triage model. This will enable regional hospitals to determine if the costs and safety risks associated with HEMS are worthwhile given the potential benefits to patient morbidity and mortality.
journal_name
Curr Opin Crit Carejournal_title
Current opinion in critical careauthors
Plevin RE,Evans HLdoi
10.1097/MCC.0b013e32834c5655subject
Has Abstractpub_date
2011-12-01 00:00:00pages
596-600issue
6eissn
1070-5295issn
1531-7072journal_volume
17pub_type
杂志文章,评审abstract:PURPOSE OF REVIEW:To examine recent developments in preventing and treating postoperative acute renal dysfunction. To review contemporary issues concerning perioperative fluid and electrolyte management. RECENT FINDINGS:Renal dysfunction remains a major postoperative morbidity despite the advent of intermittent and co...
journal_title:Current opinion in critical care
pub_type: 杂志文章,评审
doi:10.1097/MCC.0b013e328348bef5
更新日期:2011-08-01 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:Cardiac arrest is one of the most challenging disease processes to study with clinical trials due to the emergent and unpredictable nature of these events and complexity of the patient population. In recent years, there has been a major push to complete more large, multicentre trials. In many cases, h...
journal_title:Current opinion in critical care
pub_type: 杂志文章,评审
doi:10.1097/MCC.0000000000000765
更新日期:2020-12-01 00:00:00
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 optio...
journal_title:Current opinion in critical care
pub_type: 杂志文章,评审
doi:10.1097/MCC.0b013e32833ee8b4
更新日期:2010-12-01 00:00:00
abstract:PURPOSE OF REVIEW:The comparison of morbidity, mortality, and length-of-stay outcomes in patients receiving critical care requires adjustment based on their presenting illness. These adjustments are made with severity-of-illness models. These models must be periodically updated to reflect current medical practices. Thi...
journal_title:Current opinion in critical care
pub_type: 杂志文章,评审
doi:10.1097/MCC.0b013e3283101643
更新日期:2008-10-01 00:00:00
abstract:PURPOSE OF REVIEW:Despite improved care of multiple injured patients, controversial data about the best time point for decompression and stabilization of spine fractures and spinal cord injuries are published. Some studies even question the value of surgical management. RECENT FINDINGS:In several mostly retrospective ...
journal_title:Current opinion in critical care
pub_type: 杂志文章,评审
doi:10.1097/MCC.0b013e328319650b
更新日期:2008-12-01 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: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:Survival of critically ill patients is frequently associated with significant functional impairment and reduced health-related quality of life. Early rehabilitation of ICU patients has recently been identified as an important focus for interdisciplinary ICU teams. However, the amount of rehabilitation...
journal_title:Current opinion in critical care
pub_type: 杂志文章,评审
doi:10.1097/MCC.0b013e328357f022
更新日期:2012-10-01 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: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: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: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:The purpose is to review the current application of extracorporeal life support (ECLS) in trauma patients. In addition, programmatic development is described. RECENT FINDINGS:ECLS use is increasing among trauma patients. Several recent studies among trauma patients report survival rates of 65-79%. De...
journal_title:Current opinion in critical care
pub_type: 杂志文章,评审
doi:10.1097/MCC.0000000000000366
更新日期:2016-12-01 00:00:00
abstract:PURPOSE OF REVIEW:This review describes the current intensive care management of acute liver failure (ALF) and the latest evidence for emerging therapies. RECENT FINDINGS:Mortality from ALF continues to improve and in some cases, medical therapy can negate the need for liver transplantation because of protocolized man...
journal_title:Current opinion in critical care
pub_type: 杂志文章,评审
doi:10.1097/MCC.0000000000000583
更新日期:2019-04-01 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:Successful treatment of cardiac arrest requires that an electrically stable and mechanically competent cardiac activity be promptly reestablished. However, many interventions used to attempt to reestablish cardiac activity may also inflict additional myocardial injury and, in turn, compromise resuscit...
journal_title:Current opinion in critical care
pub_type: 杂志文章,评审
doi:10.1097/00075198-200306000-00005
更新日期:2003-06-01 00:00:00
abstract::Positive-pressure ventilation alters stroke volume by transiently increasing intrathoracic pressure and thereby decreasing preload. This phasic variation in stroke volume results in a cyclic fluctuation in arterial pressure with a phase length equal to the respiratory rate. Measuring ventilation-induced arterial press...
journal_title:Current opinion in critical care
pub_type: 杂志文章,评审
doi:10.1097/00075198-200106000-00012
更新日期:2001-06-01 00:00:00
abstract:PURPOSE OF REVIEW:Status epilepticus is a neurological emergency associated with high morbidity and mortality. There is a lack of robust data to guide the management of this neurological emergency beyond the initial treatment. This review examines recent literature on treatment considerations including the choice of co...
journal_title:Current opinion in critical care
pub_type: 杂志文章,评审
doi:10.1097/MCC.0000000000000661
更新日期:2019-12-01 00:00:00
abstract:PURPOSE OF REVIEW:Acute respiratory distress syndrome has been considered a morphologic and functional expression of lung injury caused by a variety of insults. Two distinct forms of acute respiratory distress syndrome/acute lung injury are described, because there are differences between pulmonary acute respiratory di...
journal_title:Current opinion in critical care
pub_type: 杂志文章,评审
doi:10.1097/00075198-200502000-00003
更新日期:2005-02-01 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: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::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: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
更新日期:2005-02-01 00:00:00
abstract:PURPOSE OF REVIEW:Status epilepticus has a high morbidity and mortality. There are little definitive data to guide management; however, new recent data continue to improve understanding of management options of status epilepticus. This review examines recent advancements regarding the critical care management of status...
journal_title:Current opinion in critical care
pub_type: 杂志文章,评审
doi:10.1097/MCC.0000000000000392
更新日期:2017-04-01 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: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: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
更新日期:2007-12-01 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:Conventional intermittent hemodialysis and continuous veno-venous hemofiltration are the opposite poles of current treatment modalities for patients with acute renal failure in the intensive care unit. Because both intermittent and continuous renal replacement techniques have several disadvantages, al...
journal_title:Current opinion in critical care
pub_type: 杂志文章,评审
doi:10.1097/01.ccx.0000145101.58940.dc
更新日期:2004-12-01 00:00:00