Abstract:
PURPOSE OF REVIEW:We discuss the goals of resuscitation, in both the early and the later phases, measures of organ perfusion, fluid responsiveness and the consequences of tissue edema. RECENT FINDINGS:The cost of over-aggressive fluid resuscitation is increased organ failure and mortality. In anticipation of the upcoming trials on early goal-directed therapy, we explore strategies to maximize effectiveness of resuscitation. Furthermore, we review recent data on the choice of fluid therapy. SUMMARY:Rapid diagnosis and early fluid resuscitation are crucial to patients with septic shock, initially with the primary goal to relieve the overt tissue hypoxia. Early fluid therapy is important with the caveat that patients must show an increase in their cardiac output. Beyond 6-12 h further positive fluid balance may not usefully improve tissue oxygenation and may be counterproductive.
journal_name
Curr Opin Crit Carejournal_title
Current opinion in critical careauthors
Douglas JJ,Walley KRdoi
10.1097/MCC.0000000000000116subject
Has Abstractpub_date
2014-08-01 00:00:00pages
378-84issue
4eissn
1070-5295issn
1531-7072journal_volume
20pub_type
杂志文章,评审abstract:PURPOSE OF REVIEW:Severe acute respiratory syndrome (SARS) is a new disease that caused large outbreaks in several countries in the first half of 2003, resulting in infection in more than 8000 people and more than 900 deaths. During that time, a large body of literature rapidly emerged describing the clinical disease, ...
journal_title:Current opinion in critical care
pub_type: 杂志文章,评审
doi:10.1097/00075198-200402000-00009
更新日期:2004-02-01 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: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:The ultimate goal of cardiopulmonary resuscitation is long-term neurologically intact survival. Despite numerous well-designed studies, the medications currently used in advanced cardiac life support have not demonstrated success in this regard. This review describes the novel therapeutics under inves...
journal_title:Current opinion in critical care
pub_type: 杂志文章,评审
doi:10.1097/MCC.0b013e328364d7b1
更新日期:2013-10-01 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::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::The care of critically ill patients and the advent of the modern day intensive care unit (ICU) present a large person power and cost burden to society. The high cost of critical care is attributed to high overhead expenses (eg, experienced staff and equipment), high resource utilization (eg, pharmaceutical resources, ...
journal_title:Current opinion in critical care
pub_type: 杂志文章,评审
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更新日期:2001-08-01 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: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:To discuss the role of microcirculatory abnormalities in critically ill patients and the link between systemic hemodynamics and microvascular perfusion. RECENT FINDINGS:Microcirculatory alterations have been repeatedly observed in patients with severe sepsis, but recent findings show that these also ...
journal_title:Current opinion in critical care
pub_type: 杂志文章,评审
doi:10.1097/MCC.0b013e3283383621
更新日期:2010-06-01 00:00:00
abstract:PURPOSE OF REVIEW:Mechanical ventilation is a cornerstone of ICU treatment. Because of its interaction with blood flow and intra-abdominal pressure, mechanical ventilation has the potential to alter hepato-splanchnic perfusion, abdominal organ function and thereby outcome of the most critically ill patients. RECENT FI...
journal_title:Current opinion in critical care
pub_type: 杂志文章
doi:10.1097/MCC.0b013e3283374b1c
更新日期:2010-04-01 00:00:00
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
更新日期:2019-08-01 00:00:00
abstract:PURPOSE OF REVIEW:Statins are effective lipid-lowering agents used extensively in medical practice. This review summarizes the evidence for statin treatment of cardiovascular patients in the intensive care unit and briefly discusses the role of statins in prevention and treatment of sepsis as a potential future applica...
journal_title:Current opinion in critical care
pub_type: 杂志文章,评审
doi:10.1097/01.ccx.0000235207.00322.96
更新日期:2006-08-01 00:00:00
abstract:PURPOSE OF REVIEW:The aim of this review is to summarize important publications in enhanced recovery during 2010-2011 and to highlight key themes. Specifically, we focus on updated systematic reviews of high-quality clinical trials of enhanced recovery in colorectal surgery, exemplar studies of enhanced recovery in oth...
journal_title:Current opinion in critical care
pub_type: 杂志文章,评审
doi:10.1097/MCC.0b013e3283558968
更新日期:2012-08-01 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::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:We reviewed the topic of quality of life and prognosis of out-of-hospital cardiac arrest survivors, focusing on more recent developments. RECENT FINDINGS:In 2003 to 2004, published experiences from Canada, the United States, and Europe indicate that the quality of life among out-of-hospital cardiac a...
journal_title:Current opinion in critical care
pub_type: 杂志文章,评审
doi:10.1097/01.ccx.0000125494.84614.fb
更新日期:2004-06-01 00:00:00
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
更新日期:2008-02-01 00:00:00
abstract:PURPOSE OF REVIEW:There are few first-hand accounts that describe the history of outcome prediction in critical care. This review summarizes the authors' personal perspectives about the development and evolution of Acute Physiology and Chronic Health Evaluation over the past 35 years. RECENT FINDINGS:We emphasize what...
journal_title:Current opinion in critical care
pub_type: 历史文章,杂志文章,评审
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更新日期:2014-10-01 00:00:00
abstract:PURPOSE OF REVIEW:Securing the airway to provide sufficient oxygenation and ventilation is of paramount importance in the management of all types of emergency patients. Particularly in severely injured patients, strategies should be adapted according to useful recent literature findings. RECENT FINDINGS:The role of ou...
journal_title:Current opinion in critical care
pub_type: 杂志文章,评审
doi:10.1097/MCC.0000000000000160
更新日期:2014-12-01 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: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:The liver comprises a multitude of parenchymal and nonparenchymal cells with diverse metabolic, hemodynamic and immune functions. Available monitoring options consist of 'static' laboratory parameters, quantitative tests of liver function based on clearance, elimination or metabolite formation and sco...
journal_title:Current opinion in critical care
pub_type: 杂志文章,评审
doi:10.1097/MCC.0b013e3283361813
更新日期:2010-04-01 00:00:00
abstract::Radiocontrast nephropathy may in part be mediated by generation of reactive oxygen species causing direct toxic damage to renal tubular epithelial cell and renal medullary ischemia. Data from experimental studies indicated that antioxidants, eg, acetylcysteine, may prevent radiocontrast-induced nephropathy. Recently, ...
journal_title:Current opinion in critical care
pub_type: 杂志文章,评审
doi:10.1097/00075198-200112000-00004
更新日期:2001-12-01 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: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: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
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更新日期:2019-12-01 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::Cardiac arrest survival rates remain low despite increased access to advanced cardiac life support. Survival from cardiac arrest is, at least in part, related to the perfusion pressures and blood flow achieved during cardiopulmonary resuscitation (CPR). A number of alternative CPR devices have been developed that aim ...
journal_title:Current opinion in critical care
pub_type: 杂志文章,评审
doi:10.1097/00075198-200206000-00004
更新日期:2002-06-01 00:00:00
abstract:PURPOSE OF REVIEW:We sought to review the evidence supporting neurocritical care as a distinct specialty of medicine. RECENT FINDINGS:Over the past 20 years, neuro-intensive care units have evolved from neurosurgical units focused primarily on postoperative monitoring to units that provide comprehensive medical and sp...
journal_title:Current opinion in critical care
pub_type: 杂志文章,评审
doi:10.1097/MCC.0b013e32808255c6
更新日期:2007-04-01 00:00:00