Abstract:
:This article provides an overview of some of the current issues involved in sedation and anxiolysis in the intensive care unit. The problems involved in trying to monitor sedation levels are discussed, as are some of the newer options available for physiologic monitoring of the central nervous system. The problem of abnormal mental states in the intensive care unit and the range of antidepressant therapy now available are also covered. The importance of sleep deprivation and the properties of the neuromuscular blockers are also discussed.
journal_name
Crit Care Clinjournal_title
Critical care clinicsauthors
Lowson SM,Sawh Sdoi
10.1016/s0749-0704(05)70043-9subject
Has Abstractpub_date
1999-01-01 00:00:00pages
119-41, viiissue
1eissn
0749-0704issn
1557-8232pii
S0749-0704(05)70043-9journal_volume
15pub_type
杂志文章,评审abstract::The role of extracorporeal membrane oxygenation (ECMO) in supporting adult refractory respiratory failure continues to evolve. Technical advances and the clinical challenges of H1N1 associated severe ARDS have spurred a resurgence of interest in ECMO. Published systematic review and pooled analyses point out the limit...
journal_title:Critical care clinics
pub_type: 杂志文章,评审
doi:10.1016/j.ccc.2011.05.009
更新日期:2011-07-01 00:00:00
abstract::This article describes the use of various scores and probabilities to clinically categorize patients in the adult intensive care unit. Some of the limitations of these severity measures are reviewed including variable definitions, timing of measurements, and whether models can be used for individual patients. Also, th...
journal_title:Critical care clinics
pub_type: 杂志文章,评审
doi:
更新日期:1993-07-01 00:00:00
abstract::Early recognition of the sepsis syndrome, prompt administration of broad-spectrum antibiotics, surgical intervention when indicated, and aggressive supportive care in intensive care units remain the therapeutic strategies for patients with sepsis. Antibiotic selection is based on many factors including the most probab...
journal_title:Critical care clinics
pub_type: 杂志文章,评审
doi:10.1016/s0749-0704(05)70108-1
更新日期:2000-04-01 00:00:00
abstract::Total parenteral nutrition was developed in the 1960s and has since been implemented commonly in the intensive care unit (ICU). Studies published in the 1980s and early 1990s indicate that the use of total parenteral nutrition is associated with increased mortality and infectious morbidity. These detrimental effects w...
journal_title:Critical care clinics
pub_type: 杂志文章
doi:10.1016/j.ccc.2010.04.002
更新日期:2010-07-01 00:00:00
abstract::Dyspnea is a subjective experience that can be reported by the patient. Respiratory distress is an observable corollary, and represents the physical or emotional suffering that results from the experience of dyspnea. Recognizing and understanding this subjective phenomenon poses a challenge to intensive care unit (ICU...
journal_title:Critical care clinics
pub_type: 杂志文章,评审
doi:10.1016/j.ccc.2004.03.015
更新日期:2004-07-01 00:00:00
abstract::The provision of care to the CCI patient is complex, challenging, and unique. The advanced practice nursing model at Mount Sinai Hospital is one successful care delivery model that fills the needs of both CCI patients and the nurses who work with them. The following transferable aspects of the RCU add to the unit's su...
journal_title:Critical care clinics
pub_type: 杂志文章,评审
doi:10.1016/s0749-0704(02)00008-8
更新日期:2002-07-01 00:00:00
abstract::Advances in the area of pediatric medicine during the past few years have presented ethical dilemmas for the physician to consider. This article discusses the ethical principles upon which clinical reasoning and judgments can be made. ...
journal_title:Critical care clinics
pub_type: 杂志文章
doi:
更新日期:1992-01-01 00:00:00
abstract::One third of cancer patients in active therapy and two thirds of patients with far-advanced disease have significant pain. A series of specific neurologic pain syndromes occur in this population and are unique to this pain population. Early diagnosis and treatment are critical to prevent irreversible neurologic damage...
journal_title:Critical care clinics
pub_type: 杂志文章,评审
doi:
更新日期:1990-04-01 00:00:00
abstract::Clinicians are confronted with a complex challenge when a patient is admitted to a critical care unit (CCU) with a significant chest roentgenography (CXR) abnormality. The etiology of a new infiltrate seen on CXR in a patient already in the CCU is more difficult to establish, but is of equal concern. ...
journal_title:Critical care clinics
pub_type: 杂志文章,评审
doi:10.1016/s0749-0704(05)70383-3
更新日期:1998-01-01 00:00:00
abstract::The consequences of acute and chronic drug abuse pose significant problems for physicians managing the trauma victim in the resuscitative, perioperative, intensive care, and hospitalization periods. Substance abuse, whether acute or chronic, modifies the physiologic response to injury and to resuscitative and operativ...
journal_title:Critical care clinics
pub_type: 杂志文章,评审
doi:
更新日期:1994-07-01 00:00:00
abstract::In pediatric trauma care, many long-held tenets of management have been revised. This article reviews the latest advances in pediatric trauma care, particularly in the areas of resuscitation and management of thoracic and abdominal injuries. The final topic is a discussion of what the intensivist and surgeon must know...
journal_title:Critical care clinics
pub_type: 杂志文章,评审
doi:10.1016/s0749-0704(03)00005-8
更新日期:2003-07-01 00:00:00
abstract::Although our understanding of molecular events in septic shock is growing exponentially, bedside management has changed only incrementally over the last 20 years. In pediatric and adult patients alike, treatment continues to be largely supportive. Morbidity and mortality, though gradually improving, continue to be hig...
journal_title:Critical care clinics
pub_type: 杂志文章,评审
doi:10.1016/s0749-0704(05)70328-6
更新日期:1997-07-01 00:00:00
abstract::The five components integral to modern, sophisticated airway management in trauma patients include equipment, pharmacologic adjuncts, manual techniques, physical circumstances, and patient profile. Although there is a finite number of pieces and types of equipment, pharmacologic adjuncts, and manual techniques, the la...
journal_title:Critical care clinics
pub_type: 杂志文章,评审
doi:
更新日期:1990-01-01 00:00:00
abstract::The EMR in the ICU has the utility of providing the necessary information to make sound clinical decisions for critically ill patients. For it to be optimized, the EMR must be more than just what is being replicated in the written record or merely a documentation tool; it must add value that supports and enhances clin...
journal_title:Critical care clinics
pub_type: 杂志文章,评审
doi:10.1016/s0749-0704(05)70068-3
更新日期:1999-07-01 00:00:00
abstract::Acute hypoxemic respiratory failure is a pulmonary capillary leak state that occurs in many different clinical settings. The resultant edema causes refractory hypoxemia due to intrapulmonary shunting and loss of lung compliance. Mechanical ventilation with PEEP and high concentrations of supplemental oxygen are freque...
journal_title:Critical care clinics
pub_type: 杂志文章,评审
doi:
更新日期:1988-10-01 00:00:00
abstract::There have been many recent advances in the management of traumatic brain injury (TBI). Research regarding established and novel therapies is ongoing. Future research must not only focus on development of new strategies but determine the long-term benefits or disadvantages of current strategies. In addition, the impac...
journal_title:Critical care clinics
pub_type: 杂志文章,评审
doi:10.1016/j.ccc.2016.08.008
更新日期:2017-01-01 00:00:00
abstract::Acute kidney injury (AKI) is a common complication among critically ill patents, and 5% of intensive care unit (ICU) patients require initiation of renal replacement therapy (RRT). In recent years, clinical trials have provided evidence-based guidance for some important aspects of RRT management in patients with AKI, ...
journal_title:Critical care clinics
pub_type: 杂志文章,评审
doi:10.1016/j.ccc.2016.12.003
更新日期:2017-04-01 00:00:00
abstract::Glycated hemoglobin A1c can be used to assess intensive care unit patients' level of chronic glycemic control. Compared with patients with normal glycated hemoglobin A1c, patients with elevated glycated hemoglobin A1c seem to better tolerate hyperglycemia and large glucose fluctuations during critical illness. The ris...
journal_title:Critical care clinics
pub_type: 杂志文章,评审
doi:10.1016/j.ccc.2018.11.010
更新日期:2019-04-01 00:00:00
abstract::Hypertension is a pervasive and growing health concern. The occurrence of hypertension due to systemic vasoconstriction in patients before, during, and after surgery is not uncommon and can have serious consequences with regard to outcomes. Careful evaluation prior to surgery to identify the underlying cause of hypert...
journal_title:Critical care clinics
pub_type: 杂志文章,评审
doi:
更新日期:2007-10-01 00:00:00
abstract::The thyrotoxic patient offers a considerable challenge to the critical care physician because the "obvious" diagnosis often will be a cardiac (or other nonthyroidal) problem, but the "correct" diagnosis will be an endocrinologic one. The importance of considering the diagnosis of thyrotoxicosis in any patient with tac...
journal_title:Critical care clinics
pub_type: 杂志文章,评审
doi:
更新日期:1991-01-01 00:00:00
abstract::The thermal-dye technique for the measurement of ELW is available for clinical and experimental use. This method is safe and can be performed serially in an individual patient. Although it is invasive, it requires only a central venous catheter and an arterial catheter, which are often already in place for routine hem...
journal_title:Critical care clinics
pub_type: 杂志文章,评审
doi:
更新日期:1986-07-01 00:00:00
abstract::Functional hemodynamic monitoring is the assessment of the dynamic interactions of hemodynamic variables in response to a defined perturbation. Recent interest in functional hemodynamic monitoring for the bedside assessment of cardiovascular insufficiency has heightened with the documentation of its accuracy in predic...
journal_title:Critical care clinics
pub_type: 杂志文章,评审
doi:10.1016/j.ccc.2014.08.005
更新日期:2015-01-01 00:00:00
abstract::Cardiogenic shock remains a leading cause of mortality despite advances in the treatment of myocardial infarction and advanced heart failure. Medical therapy can be inadequate, and patients may need mechanical circulatory support (MCS). The proper application of MCS requires knowledge of the underlying cause of acute ...
journal_title:Critical care clinics
pub_type: 杂志文章,评审
doi:10.1016/j.ccc.2014.04.002
更新日期:2014-07-01 00:00:00
abstract::Renal failure continues to cause a major burden of morbidity and mortality in both its acute and chronic forms, regardless of advances in current renal replacement therapies. A bioartificial kidney that includes a conventional dialysis filter and a renal tubule assist device containing approximately 10(8) renal proxim...
journal_title:Critical care clinics
pub_type: 杂志文章,评审
doi:10.1016/j.ccc.2005.01.006
更新日期:2005-04-01 00:00:00
abstract::This article is intended to inform the reader of the current state of the art of pneumatically powered artificial hearts, including animal experiments and information available on 11 recipients of orthotopically placed devices. ...
journal_title:Critical care clinics
pub_type: 杂志文章,评审
doi:
更新日期:1986-04-01 00:00:00
abstract::Metabolic acid-base disturbances commonly and predictably complicate the course of many intensive care unit patients and plague the intensivists, surgeons, and anesthesiologists beset with the task of caring for them. In this article, we offer a systematic approach to the patient with the metabolic acid-base disorders...
journal_title:Critical care clinics
pub_type: 杂志文章,评审
doi:
更新日期:1987-10-01 00:00:00
abstract::This article has reviewed the current knowledge regarding the occurrence and possible role of oxygen radical generation and lipid peroxidation in acute CNS injury. Although much work remains, three criteria required to establish the pathophysiologic importance of oxygen radical reactions in post-traumatic events have ...
journal_title:Critical care clinics
pub_type: 杂志文章,评审
doi:
更新日期:1989-10-01 00:00:00
abstract::Sepsis is caused by a dysregulated host response to infection. Immune responses determine the characteristics of sepsis. The body's protection against infection involves danger signal surveillance and recognition from nonself, effector functions in response to sensing danger signals, homeostatic regulation, and genera...
journal_title:Critical care clinics
pub_type: 杂志文章,评审
doi:10.1016/j.ccc.2017.08.002
更新日期:2018-01-01 00:00:00
abstract::Multiplane (TEE) transducer imaging is the most highly evolved TEE technology at present. New clinical applications of this technology will be realized as echocardiographers gain experience with it. Current limitations of TEE are likely to be surmounted as its use increases, and continuous improvements and miniaturiza...
journal_title:Critical care clinics
pub_type: 杂志文章,评审
doi:10.1016/s0749-0704(05)70246-3
更新日期:1996-04-01 00:00:00
abstract::Acute coronary syndrome is a major health problem affecting approximately 1.5 million individuals a year. Early diagnosis and appropriate evidence-based therapies improve clinical outcomes significantly. Current data suggest that an early invasive therapy may improve intermediate-term and long-term outcomes, particula...
journal_title:Critical care clinics
pub_type: 杂志文章,评审
doi:10.1016/j.ccc.2007.07.003
更新日期:2007-10-01 00:00:00