Abstract：
:This brief overview of the role of source control in sepsis emphasizes the underlying principles rather than the empiric evidence from well-performed clinical studies. The reasons for this are several. First there is a paucity of high-level published evidence, with few rigorous large clinical series, and even fewer clinical trials. Second, the decision-making process in the individual patient is complex, and often not amenable to study using the design of a randomized controlled trial, for decisions involve consideration not only of the underlying disease but of the stability of the patient, the presence of comorbidities, and the prior surgical history, all factors that can heavily influence the decision to choose one therapeutic option rather than another. The scope of the topic is large, and the space limited. Interested readers are referred to more detailed discussions such as that found in the background to the recommendations on source control in the guidelines of the Surviving Sepsis Campaign.(1) Source control is a core treatment modality in the management of the patient with severe sepsis or septic shock. Its optimal use assumes a comprehensive knowledge of biologic principles, the complexities of the septic response, and the range of surgical and nonsurgical options, and a combination of therapeutic aggressiveness and judicious caution in the clinician charged with making the decision. As every intensivist learns, appropriate source-control intervention can rapidly alter the course of sepsis to a more favorable direction, and suboptimal decision-making can change a difficult clinical challenge into a nightmare.
journal_name
Crit Care Nurs Clin North Amjournal_title
Critical care nursing clinics of North Americaauthors
Marshall JC,Al Naqbi Adoi
10.1016/j.ccell.2010.12.006subject
Has Abstractpub_date
2011-03-01 00:00:00pages
99-114issue
1eissn
0899-5885issn
1558-3481pii
S0899-5885(10)00091-2journal_volume
23pub_type
杂志文章,评审abstract：:Sepsis and septic shock are complex, clinical conditions associated with high morbidity and mortality rates. There are evidence-based guidelines outlining priority care areas for sepsis, including early screening outside the intensive care unit. Nurses are directly involved with patient care and must be able to provid...
journal_title：Critical care nursing clinics of North America
pub_type： 杂志文章,评审
doi：10.1016/j.cnc.2018.05.005
更新日期：2018-09-01 00:00:00
abstract：:This article describes the pathophysiologic changes that occur with aging as they relate to cancer and cytotoxic therapies, implications related to drug therapy, and complications of treatment modalities as they relate to older persons with cancer who may potentially be admitted to the intensive care unit. Knowledge o...
journal_title：Critical care nursing clinics of North America
pub_type： 杂志文章,评审
doi：10.1016/j.ccell.2013.09.007
更新日期：2014-03-01 00:00:00
abstract：:This article reviews how to identify and risk-stratify patients at risk for developing coronary artery disease (CAD) or who already have CAD (or coronary risk equivalents), and how to manage their lipids. This discussion is directed toward nurses, nurse practitioners, and physician assistants, who can and should play ...
journal_title：Critical care nursing clinics of North America
pub_type： 杂志文章,评审
doi：10.1016/j.ccell.2008.03.014
更新日期：2008-09-01 00:00:00
abstract：:Critically ill obese patients have many challenging pulmonary problems. The first key is to understand pathophysiology in the pulmonary system related to obesity. Second, it is important to identify the altered physical assessments and diagnostics that occur because of the pulmonary pathophysiology of obesity. Lastly,...
journal_title：Critical care nursing clinics of North America
pub_type： 杂志文章,评审
doi：10.1016/j.ccell.2009.07.015
更新日期：2009-09-01 00:00:00
abstract：:The detailed evaluation of a patient for liver transplant candidacy involves health care professionals from various disciplines to ensure that liver transplantation is optimal for patient morbidity and mortality from the medical and psychosocial perspective. The national liver allocation policy is complex and should b...
journal_title：Critical care nursing clinics of North America
pub_type： 杂志文章,评审
doi：10.1016/j.ccell.2010.05.002
更新日期：2010-09-01 00:00:00
abstract：:Interventional nutritional support is a complex therapeutic entity. Metabolic complications associated with this therapy are numerous. It is imperative to monitor electrolytes very closely during parenteral and enteral nutritional support and to correct deficiencies or to compensate for increases in serum concentratio...
journal_title：Critical care nursing clinics of North America
pub_type： 杂志文章
doi：
更新日期：1993-03-01 00:00:00
abstract：:Several studies suggest that the incidence of brain tumors is rising, an increase that cannot be accounted for by improved diagnostic abilities. Brain tumors can be subdivided according to their histology and location. When approached from this standpoint, survival statistics and treatment options can vary greatly. Un...
journal_title：Critical care nursing clinics of North America
pub_type： 杂志文章,评审
doi：
更新日期：1995-03-01 00:00:00
abstract：:The purpose of this article is to provide an appreciation for a significant risk to quality of care affecting patients receiving mechanical ventilation: unplanned extubation. A summary of the current literature provides evidence-based recommendations for how to minimize this potentially dangerous complication. In addi...
journal_title：Critical care nursing clinics of North America
pub_type： 杂志文章
doi：10.1016/j.ccell.2012.06.004
更新日期：2012-09-01 00:00:00
abstract：:Liver transplantation has evolved into an accepted treatment for many suffering from end-stage liver failure. The complex nature of the liver results in every organ system being impacted by either the failing or the transplanted liver. Organ shortage remains problematic, and work to ensure maximizing the organ donor p...
journal_title：Critical care nursing clinics of North America
pub_type： 杂志文章,评审
doi：10.1016/j.ccell.2011.08.002
更新日期：2011-09-01 00:00:00
abstract：:Integration of flexible visitation into a large health system requires concentrated effort. Evaluating impact on patient, family, and staff outcomes is important to facilitate changes and ensure visiting policy success. The medical intensive care unit staff participated in a collaborative quality improvement effort to...
journal_title：Critical care nursing clinics of North America
pub_type： 杂志文章
doi：10.1016/j.cnc.2020.02.007
更新日期：2020-06-01 00:00:00
abstract：:Sedation is a necessary component of care for the critically ill. Oversedation, however, is associated with immediate complications and long-term problems, termed post-intensive care unit syndrome. It also contributes to unnecessary costs of care. This article describes the physical, functional, psychiatric, and cogni...
journal_title：Critical care nursing clinics of North America
pub_type： 杂志文章,评审
doi：10.1016/j.cnc.2016.02.003
更新日期：2016-06-01 00:00:00
abstract：:The critical care nurse caring for the postoperative bleeding patient must have a thorough knowledge of basic hemostatic principles and inherited and acquired disorders. Early recognition and treatment of bleeding problems reduces surgical morbidity and mortality; therefore astute clinical observations and a thorough ...
journal_title：Critical care nursing clinics of North America
pub_type： 杂志文章
doi：
更新日期：1990-12-01 00:00:00
abstract：:Commendable long-term care of cardiac transplant recipients begins with excellent discharge preparation. Routine follow-up allows for prompt detection of myriad problems commonly associated with long-term survival after transplantation. Long-term complications, including rejection, infection, hypertension, nephrotoxic...
journal_title：Critical care nursing clinics of North America
pub_type： 杂志文章,评审
doi：
更新日期：2000-03-01 00:00:00
abstract：:Escherichia coli is a bacterium that is an important part of the intestinal tract; however, it has the potential to become pathogenic. Shiga toxin-producing E coli (STEC) is a leading cause of E coli infections and has led to outbreaks in North America. Transmission is through ingestion of contaminated food sources, a...
journal_title：Critical care nursing clinics of North America
pub_type： 杂志文章,评审
doi：10.1016/j.cnc.2017.10.013
更新日期：2018-03-01 00:00:00
abstract：:This article has reviewed some of the current airway management practices as well as technologic advances in adult tracheal tube design in the critically ill patient. Although the primary goals of airway protection and facilitation of positive pressure ventilation remain unchanged, a better understanding of the limita...
journal_title：Critical care nursing clinics of North America
pub_type： 杂志文章,评审
doi：
更新日期：1999-03-01 00:00:00
abstract：:A basic understanding of metabolic alterations that occur following neurotrauma is essential for addressing nutritional requirements. Interventions must be research based and must focus on the support of metabolic alterations, minimizing the effect of catabolism and optimizing caloric delivery to meet metabolic demand...
journal_title：Critical care nursing clinics of North America
pub_type： 杂志文章,评审
doi：
更新日期：2000-12-01 00:00:00
abstract：:In critical care, nurses are expected to react quickly to urgent and emergent situations. It is imperative that nurses have the ability to recognize signs and symptoms in patients that require diagnostic intervention. This article begins with a brief description of angiography and its role in the critical care environ...
journal_title：Critical care nursing clinics of North America
pub_type： 杂志文章
doi：10.1016/j.ccell.2009.10.007
更新日期：2010-03-01 00:00:00
abstract：:Intracerebral arteriovenous malformations (AVM) are a complex medical emergency in neonates. AVMs are congenital communications between the arterial and venous circulation. Occurring early in gestation, they may enlarge over time, promulgating a left-to-right shunt. This volume overload can present as severe congestiv...
journal_title：Critical care nursing clinics of North America
pub_type： 杂志文章
doi：
更新日期：1992-09-01 00:00:00
abstract：:Sudden cardiac death accounts for up to one half of the heart failure deaths each year. Thus, an understanding of the possible mechanisms, markers, and treatments of sudden cardiac death is an important component in the care of this patient population. This article discusses recent hypotheses as well as both preventat...
journal_title：Critical care nursing clinics of North America
pub_type： 杂志文章
doi：
更新日期：1993-12-01 00:00:00
abstract：:In 2002, the Joint Commission on Accreditation of Health Care Organizations (JCAHO) reviewed 23 reports of death or injury that were related to mechanical ventilation. Nineteen of those events resulted in death, and 4 resulted in coma; 65% were related to alarms. The issues included delayed or no response to the alarm...
journal_title：Critical care nursing clinics of North America
pub_type： 杂志文章,评审
doi：10.1016/j.ccell.2006.01.002
更新日期：2006-06-01 00:00:00
abstract：:Thoracic trauma is frequently complicated by the development of Adult Respiratory Distress Syndrome (ARDS). Over the past 20 years numerous articles and book chapter have explored the causes and clinical course of the syndrome. There still remains debate, however, concerning the pathophysiology and most effective trea...
journal_title：Critical care nursing clinics of North America
pub_type： 杂志文章
doi：
更新日期：1993-12-01 00:00:00
abstract：:Respiratory syncytial virus is a highly infectious virus that commonly causes bronchiolitis and leads to high morbidity and a low, but important, incidence of mortality. Supportive therapy is the foundation of management. Hydration/nutrition and respiratory support are important evidence-based interventions. For child...
journal_title：Critical care nursing clinics of North America
pub_type： 杂志文章,评审
doi：10.1016/j.ccell.2012.07.008
更新日期：2012-12-01 00:00:00
abstract：UNLABELLED:NO has been used successfully to treat PPHN, reducing the need for ECMO. NO has also been used in the cardiac catheterization laboratory to determine if pulmonary hypertension will decrease with NO. Patients who do not respond to NO are at higher risk after open-heart surgery, because their pulmonary hyperte...
journal_title：Critical care nursing clinics of North America
pub_type： 杂志文章,评审
doi：10.1016/s0899-5885(03)00032-7
更新日期：2002-03-01 00:00:00
abstract：:Aging is a multidimensional process that involves the physical, psychosocial, and spiritual domains. The reserves in each of these areas are challenged during the stressful experience of acute and critical care illness and hospitalization. It is imperative that hospital nursing staff recognize the vulnerability of the...
journal_title：Critical care nursing clinics of North America
pub_type： 杂志文章
doi：10.1016/j.ccell.2007.05.008
更新日期：2007-09-01 00:00:00
abstract：:Insight into the experience of family-member decision making regarding treatment of incompetent ICU patients can be gained through an exploration of the literature regarding the ICU environment, normative bioethics, and the decision-making process (see Fig. 1). The review of these relevant bodies of literature has sug...
journal_title：Critical care nursing clinics of North America
pub_type： 杂志文章,评审
doi：
更新日期：1997-03-01 00:00:00
abstract：:Clinician involvement in critical care research will be essential if we are ever to achieve optimal patient outcomes. Educators and unit leadership play a pivotal role in facilitating, mentoring, and coaching clinicians both conduct research on important issues or problems in critical care and to ensure that practice ...
journal_title：Critical care nursing clinics of North America
pub_type： 杂志文章,评审
doi：
更新日期：2001-03-01 00:00:00
abstract：:The health care culture must change. Florence Nightingale wrote [8] "deep-rooted and universal is the conviction that to give a medicine is to be doing something, or rather everything and to give air, warmth, cleanliness etc. is to do nothing." Hygiene care practices and mobility activities are fundamental and indepen...
journal_title：Critical care nursing clinics of North America
pub_type： 杂志文章,评审
doi：10.1016/j.ccell.2006.08.006
更新日期：2006-12-01 00:00:00
abstract：:Transplant pharmacotherapy evolves as new agents are investigated and approved for use. Clinical immunosuppression has been plagued with maintaining a balance between rejection of the transplanted organ and complications of over-immunosuppression, including infection and malignancy. Clinicians must understand current ...
journal_title：Critical care nursing clinics of North America
pub_type： 杂志文章,评审
doi：10.1016/s0899-5885(03)00041-8
更新日期：2002-03-01 00:00:00
abstract：:Septic shock is the leading cause of death in critical care units. New research in the management of septic shock is focused on the use of immune-based therapy such as antiendotoxin monoclonal antibodies. The object of this therapy is to neutralize endotoxin and prevent the progression of the pathophysiologic events o...
journal_title：Critical care nursing clinics of North America
pub_type： 杂志文章
doi：
更新日期：1993-06-01 00:00:00
abstract：:In order for nurses to be effective advocates, they must practice in an environment that fosters competency, collaboration, communication, and ethical values. This article addresses the meaning of advocacy, explores whether nurses can be effective advocates in complex practice environments, identifies barriers to advo...
journal_title：Critical care nursing clinics of North America
pub_type： 杂志文章
doi：
更新日期：1995-06-01 00:00:00
