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：:Health care providers rely on quality continuing education programs to increase their knowledge and to acquire new skills. Participation in programs such as CVVH: Implications for Clinical Practice-the Patient, the Circuit, the Team can potentially improve patient outcomes. While this study identifies critical care nu...
journal_title：Critical care nursing clinics of North America
pub_type： 杂志文章
doi：
更新日期：1998-06-01 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：:Organ transplantation has become a viable treatment option for end-stage organ disease. With the advent of immunosuppressive medication and vastly improved preservation practices and surgical techniques, it is now possible to transplant an increasing number and variety of organs. In their role as direct care givers to...
journal_title：Critical care nursing clinics of North America
pub_type： 杂志文章,评审
doi：
更新日期：1994-09-01 00:00:00
abstract：:Sex and gender-based differences in responses to infection and sepsis are evident. Estrogens increase immune function, sometimes to the point of inducing autoimmune disease. Testosterone suppresses immune function, sometimes leading to a worsened outcome following traumatic injury. Therapies using sex hormones to impr...
journal_title：Critical care nursing clinics of North America
pub_type： 杂志文章,评审
doi：10.1016/s0899-5885(02)00028-x
更新日期：2003-03-01 00:00:00
abstract：:The incidence of gastrointestinal trauma is low in comparison with solid organ injury to the abdomen. The most commonly injured organs are the small bowel and colon. Knowledge of the mechanism of injury alerts the nurse to areas of potential injury and guides the clinical examination. Because of the delayed presentati...
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：:September 11, 2001 is a date we will all remember. For the nurses at the Virginia Hospital Center-Arlington, however, the day is particularly important, as these nurses work at the official hospital for the Pentagon. This article provides an insider's view of the events of the day and the lessons learned. ...
journal_title：Critical care nursing clinics of North America
pub_type： 杂志文章
doi：10.1016/s0899-5885(02)00072-2
更新日期：2003-06-01 00:00:00
abstract：:Trauma providers are engaged in a constant struggle to improve quality and to assure positive outcomes in an unpredictable disease process. Traditional quality assurance has been unsuccessful in achieving these goals. Continuous quality improvement methodologies hold promise as the tools to balance quality, outcomes, ...
journal_title：Critical care nursing clinics of North America
pub_type： 杂志文章,评审
doi：
更新日期：1994-09-01 00:00:00
abstract：:Despite recent advances in critical care and cardiopulmonary support, mortality from septic shock and its complications remains high. Effective therapies are needed to halt the progression of SIRS and the septic cascade prior to development of shock and organ ischemia/dysfunction. Such therapies are directed at preven...
journal_title：Critical care nursing clinics of North America
pub_type： 杂志文章,评审
doi：
更新日期：1994-06-01 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：:Heart failure is a complex disease that interacts with other organ systems, such as the lungs, kidneys, and the liver, in a complex manner. The stages of heart failure often define the acuity and onset of disease symptoms and progression as well as treatment measures, in addition to the patient's functional class. As ...
journal_title：Critical care nursing clinics of North America
pub_type： 杂志文章,评审
doi：10.1016/j.cnc.2018.11.006
更新日期：2019-03-01 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：:The balloon pressure waveform provides the clinician with a valuable tool for assessing the operating environment within the balloon and the catheter. The use of a calibrated balloon pressure waveform allows the clinician to assess gas leakage and catheter restriction alarms and implement corrective action. By combini...
journal_title：Critical care nursing clinics of North America
pub_type： 杂志文章,评审
doi：
更新日期：1996-12-01 00:00:00
abstract：:Advances in medical technology during the past 3 decades altered the scenarios of our dying. It is now possible to prolong life, with the frightening reality that we also can extend death. This paper examines challenges to dying well in America, defines key end-of-life dilemmas faced by critical care nurses, and exami...
journal_title：Critical care nursing clinics of North America
pub_type： 杂志文章
doi：10.1016/s0899-5885(01)00004-1
更新日期：2002-06-01 00:00:00
abstract：:Dating from the inception of percutaneous coronary angioplasty, restenosis has been the postprocedural Achilles heel. Despite a decade of research, with a myriad of mechanical devices and pharmacologic agents, this vexing problem has yet to be resolved. Although intracoronary stents have proved effective at restenosis...
journal_title：Critical care nursing clinics of North America
pub_type： 杂志文章,评审
doi：
更新日期：1999-09-01 00:00:00
abstract：:Knowledge of NO and its role in the human body currently is limited. Further scientific research involving this unique molecule will expand its clinical usefulness. It is an exciting era in research,involving numerous body processes and systems. The initial work on pulmonary vascular response in newborns who have PPHN...
journal_title：Critical care nursing clinics of North America
pub_type： 杂志文章,评审
doi：10.1016/j.ccell.2004.02.004
更新日期：2004-06-01 00:00:00
abstract：:Patients with chronic liver diseases sustain impairment to immune systems, which worsens over time. These defects in their host defense lead to risks of bacterial infections and increased morbidity. Providers should have heightened surveillance for infectious diseases and suspect one with any acute change in status. P...
journal_title：Critical care nursing clinics of North America
pub_type： 杂志文章,评审
doi：10.1016/j.ccell.2010.04.002
更新日期：2010-09-01 00:00:00
abstract：:The greatest threats to America's public health include accidental importation of deadly diseases by international travelers and the release of biologic weapons by our adversaries. The greatest failure is unpreparedness because international travel and dispersion of biologic agents by our enemies are inevitable. An ef...
journal_title：Critical care nursing clinics of North America
pub_type： 杂志文章,评审
doi：10.1016/s0899-5885(02)00079-5
更新日期：2003-06-01 00:00:00
abstract：:Availability of oxygen and adequate blood flow to wounded tissues are important factors for the prevention of impaired wound healing. Oxygen is essential for the growth of new blood vessels, formation of collagen, and the prevention of infection. Subcutaneous tissue oximetry, an experimental technology for evaluating ...
journal_title：Critical care nursing clinics of North America
pub_type： 杂志文章,评审
doi：
更新日期：1995-06-01 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：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：:Major traumatic wounds cause a chain of complex localized and systemic events. Understanding these physiologic processes, potential complications, and treatment priorities can assist the nurse in facilitating wound healing and optimizing patient outcomes. ...
journal_title：Critical care nursing clinics of North America
pub_type： 杂志文章,评审
doi：
更新日期：1996-06-01 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：:Transition from hospital to home is a vulnerable period for older adults with multiple chronic conditions. A pilot of the Transitional Care Model at a community hospital reduced readmission rates for patients with heart failure by 48%. This article shares the experience of a large metropolitan health care system in ex...
journal_title：Critical care nursing clinics of North America
pub_type： 杂志文章,评审
doi：10.1016/j.ccell.2014.08.009
更新日期：2014-12-01 00:00:00
abstract：:Because of their diverse education, experience, and practice settings, nurses are uniquely qualified to be first receivers, care givers, and leaders in any large-scale public health emergency. Many nurses, however, continue to feel inadequately prepared to function effectively in these types of situations. Great strid...
journal_title：Critical care nursing clinics of North America
pub_type： 杂志文章,评审
doi：10.1016/j.ccell.2007.10.008
更新日期：2008-03-01 00:00:00
abstract：:This article summarizes a critical analysis of 18 studies that examined the link between hand washing and infection. Although several factors made it difficult to evaluate the effect of hand washing, the authors conclude that (1) hand washing can add incremental value to infection-control strategies in acute care sett...
journal_title：Critical care nursing clinics of North America
pub_type： 杂志文章,评审
doi：
更新日期：1995-12-01 00:00:00
abstract：:Workplace violence is increasing, but through education, prevention, and man aging escalating crises, critical care nurses can help to minimize the negative consequences of violence. Critical care nurses are particularly prone to acts of aggression and acts of violence due to the stressful environment for them, their ...
journal_title：Critical care nursing clinics of North America
pub_type： 杂志文章,评审
doi：
更新日期：1997-06-01 00:00:00
abstract：:Critical care nurses constitute front-line care provision for patients in the intensive care unit (ICU). Hypoxemic respiratory compromise/failure is a primary reason that patients require ICU admission and mechanical ventilation. Critical care nurses must possess advanced knowledge, skill, and judgment when caring for...
journal_title：Critical care nursing clinics of North America
pub_type： 杂志文章,评审
doi：10.1016/j.cnc.2016.07.003
更新日期：2016-12-01 00:00:00
abstract：:IPV presents a serious health risk to many women. Emergency and critical care nurses are in a prime position for identification of and intervention with these women. Careful assessment and recognition of symptoms and conditions associated with IPV helps nurses to identify victims and potential victims. Building a trus...
journal_title：Critical care nursing clinics of North America
pub_type： 杂志文章,评审
doi：10.1016/j.ccell.2006.05.013
更新日期：2006-09-01 00:00:00
abstract：:Acute respiratory distress syndrome (ARDS) represents the ultimate pulmonary response to a wide range of injuries, from septicemia to trauma. Optimal nutrition is vital to enhancing oxygen delivery, supporting adequate cardiac contractility and respiratory musculature, eliminating fluid and electrolyte imbalances, and...
journal_title：Critical care nursing clinics of North America
pub_type： 杂志文章,评审
doi：10.1016/j.ccell.2004.04.001
更新日期：2004-09-01 00:00:00
abstract：:The crisis of near-drowning for the family and friends of the victim has been well documented. The emergency services personnel also are at risk for crisis as a result of the unique stressors they face because of their involvement with these critically injured young children. Mitchell's model for CISD is a pro-active ...
journal_title：Critical care nursing clinics of North America
pub_type： 杂志文章
doi：
更新日期：1991-06-01 00:00:00
