Abstract:
PURPOSE OF REVIEW:In the 1980s, we witnessed tremendous advances in trauma care including trauma system development, advanced trauma life support, damage control surgery and ICU resuscitation. As a result, patients who used to bleed to death in the operating room survived. However, many went on to develop multiple organ failure (MOF) and in the mid-1990s, an epidemic of abdominal compartment syndrome (ACS) that emerged in these MOF survivors stimulated fundamental changes in early management of patients arriving in shock with severe bleeding. RECENT FINDINGS:In the early 2000s, a massive transfusion protocol (emphasizing aggressive use of fresh frozen plasma) coupled with hypotensive resuscitation and rapid hemorrhage control were implemented and refined at a busy level I trauma center in Houston, Texas, USA. These changes were associated with a 50% reduction in mortality in massive transfusion patients, and ACS virtually disappeared. SUMMARY:ACS is a modifiable link in the MOF cascade to death after severe shock. However, as ACS disappears, MOF is still occurring. Although fewer patients are dying of MOF, it remains the leading cause of prolonged ICU stays and long-term disability. This experience underscores the importance of ongoing epidemiologic characterization of postinjury MOF.
journal_name
Curr Opin Crit Carejournal_title
Current opinion in critical careauthors
Gonzalez EA,Moore FAdoi
10.1097/MCC.0b013e3283409d16subject
Has Abstractpub_date
2010-12-01 00:00:00pages
570-4issue
6eissn
1070-5295issn
1531-7072pii
00075198-201012000-00011journal_volume
16pub_type
社论abstract::Increased knowledge of the mechanisms that determine respiratory failure has led to the development of new technologies aimed at improving ventilatory treatment. Proportional assist ventilation and neurally adjusted ventilatory assist have been designed with the goal of improving patient-ventilator interaction by matc...
journal_title:Current opinion in critical care
pub_type: 杂志文章,评审
doi:10.1097/00075198-200302000-00010
更新日期:2003-02-01 00:00:00
abstract:PURPOSE OF REVIEW:This review intends to summarize the recent findings regarding the presence of increased oxidative stress in critically ill patients and its potential pathophysiologic role, as well as the results of recent clinical trials of antioxidant therapies. RECENT FINDINGS:Several lines of evidence confirm th...
journal_title:Current opinion in critical care
pub_type: 杂志文章,评审
doi:10.1097/00075198-200308000-00003
更新日期:2003-08-01 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: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: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 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:The use of neuromuscular blocking agents (NMBAs) in patients with acute respiratory distress syndrome (ARDS) and acute lung injury remains controversial, although frequent. This review analyzes the effects of NMBAs on thoracopulmonary mechanics, gas exchange, patient outcome and their potential advers...
journal_title:Current opinion in critical care
pub_type: 杂志文章,评审
doi:10.1097/mcc.0b013e3283220e60
更新日期:2009-02-01 00:00:00
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::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: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: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: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: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: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
更新日期:2016-02-01 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: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: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::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::Critical illness polyneuropathy (CIP) is a syndrome that was first extensively described in the early 1980s, mainly in patients with failure to wean from mechanical ventilation. The syndrome is further characterized by limb muscle weakness, usually more pronounced distally than proximally, and is often accompanied by ...
journal_title:Current opinion in critical care
pub_type: 杂志文章,评审
doi:10.1097/00075198-200208000-00006
更新日期:2002-08-01 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:PURPOSE OF REVIEW:The gut has long been hypothesized to be the 'motor' of multiple organ dysfunction syndrome. This review serves as an update on new data elucidating the role of the gut as the propagator of organ failure in critical illness. RECENT FINDINGS:Under basal conditions, the gut absorbs nutrients and serves...
journal_title:Current opinion in critical care
pub_type: 杂志文章,评审
doi:10.1097/MCC.0000000000000386
更新日期:2017-04-01 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: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:In this review, we focus on the dual face of antibiotic therapy in the critically ill that must harmonize the need for early, appropriate and adequate antibiotic therapy in the individual-infected patient with the obligation to limit antibiotic selection pressure as much as possible to preserve its fu...
journal_title:Current opinion in critical care
pub_type: 杂志文章,评审
doi:10.1097/MCC.0000000000000645
更新日期:2019-10-01 00:00:00
abstract:PURPOSE OF REVIEW:To describe current antimicrobial resistance in ESKAPE Gram-negative microorganisms and their situation in the ICUs, the implication of the so-called high-risk clones (HiRCs) involved in the spread of antimicrobial resistance as well as relevance of the COVID-19 pandemic in the potential increase of r...
journal_title:Current opinion in critical care
pub_type: 杂志文章,评审
doi:10.1097/MCC.0000000000000755
更新日期:2020-10-01 00:00:00
abstract:PURPOSE OF REVIEW:To provide a summary of the recent literature on extracorporeal membrane oxygenation (ECMO) in adults with severe acute respiratory distress syndrome (ARDS), focusing on advances in equipment, current conventional and unconventional indications, complications, and future applications. RECENT FINDINGS...
journal_title:Current opinion in critical care
pub_type: 杂志文章,评审
doi:10.1097/MCC.0000000000000170
更新日期:2015-02-01 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: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:Treatment protocols targeting the rapid administration of appropriate antibiotics and hemodynamic support are now recognized as a key measure in the initial care of patients presenting with severe sepsis and septic shock. Strong evidence exists showing that time parameters, particularly in the emergen...
journal_title:Current opinion in critical care
pub_type: 杂志文章,评审
doi:10.1097/MCC.0b013e3282e7d8e1
更新日期:2007-10-01 00:00:00
abstract:PURPOSE OF REVIEW:End-of-life care and communication deficits are important sources of conflicts within ICU teams and with patients or families. This narrative review describes recent studies on how to improve palliative care and surrogate decision-making in ICUs and compares the results with previously published liter...
journal_title:Current opinion in critical care
pub_type: 杂志文章,评审
doi:10.1097/MCC.0b013e328358d417
更新日期:2012-12-01 00:00:00