Abstract:
:Vasodilators that affect the pulmonary vasculature are appealing adjuncts in many cardiopulmonary conditions that require mechanical ventilation such as ARDS, COPD, PPHN, and cardiothoracic surgery. The adverse systemic effects of parenteral PGE1 and parenteral prostacyclin limit their usefulness in critically ill patients. Liposomal PGE1 has few systemic effects, but thus far has not resulted in a significant clinical benefit in patients with ARDS. Inhaled NO and aerosolized prostacyclin offer the advantage of selective pulmonary vasodilation with minimal systemic effects. Both agents decrease PAP and in many clinical situations improve oxygenation; however, the physiologic effects of inhaled NO and aerosolized prostacyclin have not convincingly led to improved clinical outcomes. Currently, use of vasodilators in mechanically ventilated patients remains investigational.
journal_name
Crit Care Clinjournal_title
Critical care clinicsauthors
Zimmerman JL,Hanania NAdoi
10.1016/s0749-0704(05)70023-3subject
Has Abstractpub_date
1998-10-01 00:00:00pages
611-27issue
4eissn
0749-0704issn
1557-8232pii
S0749-0704(05)70023-3journal_volume
14pub_type
杂志文章,评审abstract::Prolonged intubation and mechanical ventilation following cardiac surgery have been associated with increased hospital and intensive care unit length of stays; higher health care costs; and morbidity resulting from atelectasis, intrapulmonary shunting, and pneumonia. Early extubation was developed as a strategy in the...
journal_title:Critical care clinics
pub_type: 杂志文章,评审
doi:10.1016/j.ccc.2020.06.005
更新日期:2020-10-01 00:00:00
abstract::Acute respiratory failure is common in critically ill children, who are at increased risk of respiratory embarrassment because of the developmental variations in the respiratory system. Although multiple etiologies exist, pneumonia and bronchiolitis are most common. Respiratory system monitoring has evolved, with the ...
journal_title:Critical care clinics
pub_type: 杂志文章,评审
doi:10.1016/j.ccc.2012.12.004
更新日期:2013-04-01 00:00:00
abstract::Patients with CCI have continuing profound medical needs, poor prognosis for significant functional recovery, and a high mortality rate. Nonetheless, some survive for months or years, but unfortunately, often with functional skills and quality of life lower than need be. Careful evaluation of each patient's medical co...
journal_title:Critical care clinics
pub_type: 杂志文章,评审
doi:10.1016/s0749-0704(02)00011-8
更新日期:2002-07-01 00:00:00
abstract::Providing nutritional support has become a standard component of managing critically ill patients. While many studies have documented that providing nutritional support can change nutritional outcomes (e.g., amino acid profile, weight gain, nitrogen balance), data are lacking that demonstrate that nutrition actually i...
journal_title:Critical care clinics
pub_type: 杂志文章,meta分析
doi:10.1016/s0749-0704(05)70009-9
更新日期:1998-07-01 00:00:00
abstract::The epidemiology, biomechanics, physiopathology, emergency medical systems, diagnostic criteria, and therapy related to acute cervical spinal cord injury are discussed in this article. ...
journal_title:Critical care clinics
pub_type: 杂志文章,评审
doi:
更新日期:1985-07-01 00:00:00
abstract::Hypocalcemia and hypophosphatemia have recently been recognized as common metabolic complications in acutely ill patients. The diagnostic and therapeutic approaches to these abnormalities are described in this article. ...
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::Summarizing the mission of the ICU, the institution directive board and the unit director must generate a structure, proceedings criteria, management, and analysis of results capable of providing satisfactory care. Furthermore, they must take into account each organizational aspect that is necessary to offer an approp...
journal_title:Critical care clinics
pub_type: 杂志文章,评审
doi:10.1016/j.ccc.2006.04.002
更新日期:2006-07-01 00:00:00
abstract::Brain injury represents the major cause of long-term disability and mortality among patients resuscitated from cardiac arrest. Brain-directed therapies include maintenance of normal oxygenation, hemodynamic support to optimize cerebral perfusion, glycemic control, and targeted temperature management. Pertinent guideli...
journal_title:Critical care clinics
pub_type: 杂志文章,评审
doi:10.1016/j.ccc.2014.06.007
更新日期:2014-10-01 00:00:00
abstract::Given time, the brain can tolerate extraordinarily severe hyponatremia, but it does not take well to sudden changes; both rapid onset and rapid correction of hyponatremia can be injurious. Emergency treatment of hyponatremia should be reserved for the patient who has not had time to fully adapt to the disturbance. Whe...
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::Anemia is common in critically ill patients, but treatment with red blood cell transfusions can have unwanted effects. Limiting the occurrence and severity of anemia by using erythropoietic agents (iron and/or recombinant erythropoietin), therefore, remains an attractive option during the intensive care unit stay but ...
journal_title:Critical care clinics
pub_type: 杂志文章,评审
doi:10.1016/j.ccc.2012.04.003
更新日期:2012-07-01 00:00:00
abstract::Optimal airway management requires an experienced caregiver, attention to detail, and knowledge of the patient's physiology. A variety of pharmacologic agents have proved useful in obtaining a secure airway and minimizing risk to the patient. Depending on the skills of the caregiver, oral intubation has become the pre...
journal_title:Critical care clinics
pub_type: 杂志文章,评审
doi:10.1016/s0749-0704(05)70119-6
更新日期:2000-07-01 00:00:00
abstract::The patient with advanced cirrhosis presents unique challenges to the critical care physician, in great measure because of the protean functions attributable to the liver and the multiplicity of derangements that may occur. Portal hypertension, once it develops, is the source of potentially devastating complications t...
journal_title:Critical care clinics
pub_type: 杂志文章,评审
doi:
更新日期:1995-04-01 00:00:00
abstract::Medication errors are a significant public health problem in United States hospitals. Patients in the ICU are at particular risk for medication errors because of the characteristics of an ICU and the nature of its patients. This article reviews the principles of medication safety and applies these principles to the IC...
journal_title:Critical care clinics
pub_type: 杂志文章,评审
doi:10.1016/j.ccc.2006.02.005
更新日期:2006-04-01 00:00:00
abstract::The overlap syndrome defines the relationship between obstructive sleep apnea (OSA) and chronic obstructive pulmonary disease (COPD), and is a commonly noted but poorly studied disorder. Individuals who have the overlap syndrome have been recognized to have greater risk for pulmonary hypertension, right heart failure,...
journal_title:Critical care clinics
pub_type: 杂志文章,评审
doi:10.1016/j.ccc.2008.02.005
更新日期:2008-07-01 00:00:00
abstract::The evolving understanding of pathophysiologic events during and after pediatric cardiac arrest has not yet resulted in significantly improved outcome. Exciting breakthroughs in basic and applied science laboratories are, however, on the immediate horizon for study in specific subpopulations of cardiac arrest victims....
journal_title:Critical care clinics
pub_type: 杂志文章,评审
doi:10.1016/s0749-0704(03)00003-4
更新日期:2003-07-01 00:00:00
abstract::Dementia is a terminal illness that leads to progressive cognitive and functional decline. As the elderly population grows, the incidence of dementia in hospitalized older adults increases and is associated with poor short-term and long-term outcomes. Delirium is associated with an accelerated cognitive decline in hos...
journal_title:Critical care clinics
pub_type: 杂志文章,评审
doi:10.1016/j.ccc.2020.08.010
更新日期:2021-01-01 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::India is a vast democracy of nearly one billion people. Before the British rule ended in 1947, the life span of an Indian was a mere 21 years. Within a short span of 50 years, it increased to an impressive 63 years, largely due to public health measures initiated by the government. This created a pool of more than 300...
journal_title:Critical care clinics
pub_type: 历史文章,杂志文章,评审
doi:10.1016/s0749-0704(05)70312-2
更新日期:1997-04-01 00:00:00
abstract::Venous thromboembolic disease is a very common complication in the ICU. This article reviews incidence, prevention, and therapy related to venous thromboembolism, including both deep venous thrombosis and pulmonary embolism. Special diagnostic and treatment considerations in the ICU setting are highlighted. The increa...
journal_title:Critical care clinics
pub_type: 杂志文章,评审
doi:10.1016/j.ccc.2005.05.004
更新日期:2005-07-01 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::Carbon monoxide (CO) poisoning is common and frequently unrecognized since the signs and symptoms are relatively nonspecific. CO poisoning causes tissue hypoxia. Additionally, various animal studies have demonstrated that CO interferes with myoglobin, P450, and other enzyme function; causes lipid peroxidation through ...
journal_title:Critical care clinics
pub_type: 杂志文章,评审
doi:10.1016/s0749-0704(05)70056-7
更新日期:1999-04-01 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::Despite great improvement in patient and graft survival, the long-term morbidity and mortality in renal transplant recipients are still significant. Cardiovascular disease accounts for much of the mortality in long-term survivors; screening before the transplant procedure and adequate control of hypertension should he...
journal_title:Critical care clinics
pub_type: 杂志文章,评审
doi:
更新日期:1990-10-01 00:00:00
abstract::Infectious complications are common occurrences in end-stage liver disease (ESLD). Frequent infections precipitate decompensation of liver disease leading to acute or chronic liver failure, organ dysfunction, de-listing from transplant, and major morbidity and mortality. The spectrum of microorganisms has shifted with...
journal_title:Critical care clinics
pub_type: 杂志文章,评审
doi:10.1016/j.ccc.2016.03.006
更新日期:2016-07-01 00:00:00
abstract::As scientists and physicians have gained sophistication in understanding and treating illness, our view of disease has changed in scope. We appreciate more fully the diverse and wide-ranging effects of stress on the ability of the organism to maintain homeostasis. As our study of the failure of homeostasis has advance...
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::It is often necessary to transfuse blood products in shock. Use of these products can be life-saving, but they also carry considerable risk. It is important, therefore, that the physician be aware of the indications as well as possible complications, so that a proper decision can be made weighing the risk versus the b...
journal_title:Critical care clinics
pub_type: 杂志文章,评审
doi:
更新日期:1992-04-01 00:00:00
abstract::Improving the course and outcome of patients with ARDS presents a considerable challenge. An important component of meeting this challenge is a more comprehensive understanding of the heterogeneous pathophysiology of ARDS and the biologic response of the individual patient. This understanding may be developed through ...
journal_title:Critical care clinics
pub_type: 杂志文章,评审
doi:10.1016/s0749-0704(03)00072-1
更新日期:2002-01-01 00:00:00
abstract::Serotonin syndrome is characterized by varied degrees of cognitive, autonomic, and neuromuscular dysfunction and can only be produced by drug therapy that increases central nervous system serotonin neurotransmission. Information gained from a retrospective review of 127 cases of serotonin syndrome is presented. It is ...
journal_title:Critical care clinics
pub_type: 杂志文章,评审
doi:10.1016/s0749-0704(05)70368-7
更新日期:1997-10-01 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::Although much has been accomplished in HTx and LTx in the past few decades, much remains to be conquered. It is an ever-changing, always fascinating field. Though science and technology know no limits, the primary limitation of HTx and LTx continues to be the availability of donor organs. One can only hope that furthe...
journal_title:Critical care clinics
pub_type: 杂志文章,评审
doi:10.1016/s0749-0704(02)00054-4
更新日期:2003-04-01 00:00:00