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 high. The major similarities, as well as the minor differences, between pediatric and adult septic shock are reviewed in this article, with an emphasis on current clinical practice and recent clinical investigations of novel therapies.
journal_name
Crit Care Clinjournal_title
Critical care clinicsauthors
Carcillo JA,Cunnion REdoi
10.1016/s0749-0704(05)70328-6subject
Has Abstractpub_date
1997-07-01 00:00:00pages
553-74issue
3eissn
0749-0704issn
1557-8232pii
S0749-0704(05)70328-6journal_volume
13pub_type
杂志文章,评审abstract::Nosocomial diarrheas are an important problem in hospitals, and in critical care units in particular. Hospital-acquired diarrhea may be on an infectious or noninfectious basis. Common noninfectious causes of nosocomial diarrhea include medication-induced changes in the fecal flora or changes secondary to enteral hyper...
journal_title:Critical care clinics
pub_type: 杂志文章,评审
doi:10.1016/s0749-0704(05)70398-5
更新日期:1998-04-01 00:00:00
abstract::Acute respiratory distress syndrome (ARDS) and acute lung injury (ALI) are distinctly modern clinical entities. Recent epidemiologic research has taken advantage of large cohorts in efforts to better describe these highly lethal syndromes with a focus on differentiation of clinically meaningful subtypes and early pred...
journal_title:Critical care clinics
pub_type: 杂志文章,评审
doi:10.1016/j.ccc.2011.05.005
更新日期:2011-07-01 00:00:00
abstract::Transplant patients face challenging medical journeys, with many detours to the intensive care unit. Before and after transplantation, they have significant psychological and cognitive comorbidities, which decrease their quality of life and potentially compromise their medical outcomes. Critical care staff are essenti...
journal_title:Critical care clinics
pub_type: 杂志文章,评审
doi:10.1016/j.ccc.2017.03.009
更新日期:2017-07-01 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::Severe viral pneumonia is an increasing problem among adults. The incidence and number of viruses known to cause pneumonia and respiratory failure have also expanded in recent years. This article provides an overview of severe respiratory disease caused by coronavirus, respiratory syncytial virus, adenovirus, and hant...
journal_title:Critical care clinics
pub_type: 杂志文章,评审
doi:10.1016/j.ccc.2013.07.003
更新日期:2013-10-01 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::Venous thromboembolic disease continues to be a major source of morbidity and mortality, with obese patients who are critically ill presenting some of the most at-risk patients. As the literature evolves, it has become clear that there is a complex relationship between obesity and thrombosis and atherogenesis. It is t...
journal_title:Critical care clinics
pub_type: 杂志文章,评审
doi:10.1016/j.ccc.2010.06.011
更新日期:2010-10-01 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::The energy expenditure of the critically ill patient is influenced by many factors, thus making it difficult to predict. Measurement of energy expenditure in mechanically ventilated patients receiving elevated oxygen concentrations requires a good understanding of the measurement technique and its limitations, whether...
journal_title:Critical care clinics
pub_type: 杂志文章,评审
doi:
更新日期:1987-01-01 00:00:00
abstract::Bioterrorism is not only a reality of the times in which we live but bioweapons have been used for centuries. Critical care physicians play a major role in the recognition of and response to a bioterrorism attack. Critical care clinicians must be familiar with the diagnosis and management of the most likely bioterrori...
journal_title:Critical care clinics
pub_type: 杂志文章,评审
doi:10.1016/j.ccc.2013.03.015
更新日期:2013-07-01 00:00:00
abstract::Fluid creep is the term applied to a burn resuscitation, which requires more fluid than predicted by standard formulas. Fluid creep is common today and is linked to several serious edema-related complications. Increased fluid requirements may accompany the appropriate resuscitation of massive injuries but dangerous fl...
journal_title:Critical care clinics
pub_type: 杂志文章,评审
doi:10.1016/j.ccc.2016.06.007
更新日期:2016-10-01 00:00:00
abstract::Decisions to admit and discharge patients to and from the intensive care unit (ICU) when resources are scarce should be made according to the triage principle--that is, resources should be allocated based on the patient's ability to benefit from critical care. The ICU organizational structure and the constraints on de...
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::In summary, interventional techniques are well-established and offer safe and effective alternatives for management of patients in the intensive care unit or other setting. It is likely that the radiologist will become more involved in the management of ill children and adults. It is hoped that this will reduce the ne...
journal_title:Critical care clinics
pub_type: 杂志文章,评审
doi:
更新日期:1994-04-01 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::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::This article documents the role of hypothalamic hypothyroidism and decreased T4-->T3 conversion as the cause of low T4 and T3 in non-thyroidal illness syndrome (NTIS). This article also presents the arguments for administration of replacement triiodothyronine (T3) and thyroxine (T4) hormone in patients who have NTIS. ...
journal_title:Critical care clinics
pub_type: 杂志文章,评审
doi:10.1016/j.ccc.2005.10.001
更新日期:2006-01-01 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 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::Acute renal failure continues to be a common occurrence in critically ill cancer patients. It frequently results from a combination of risk factors, which include the following: hemodynamic alterations associated with renal ischemia; exposure to nephrotoxic drugs; urinary tract obstruction; and specific abnormalities ...
journal_title:Critical care clinics
pub_type: 杂志文章,评审
doi:
更新日期:1988-01-01 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::The role of the fiberscope in the management of difficult and failed intubations has been well established and the importance of learning this valuable skill has been emphasized. Nonetheless, the fiberscope is underutilized in anesthesia and critical care practices because of a high rate of intubation failure. The mai...
journal_title:Critical care clinics
pub_type: 杂志文章,评审
doi:
更新日期:1995-01-01 00:00:00
abstract::Given the broad treatment options, risk stratification of pulmonary embolism is a highly desirable component of management. The ideal tool identifies patients at risk of death from the original or recurrent pulmonary embolism. Using all-cause death in the first 30-days after pulmonary embolism diagnosis as a surrogate...
journal_title:Critical care clinics
pub_type: 杂志文章,评审
doi:10.1016/j.ccc.2020.02.002
更新日期:2020-07-01 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::The optimal management of arterial blood pressure in the setting of acute stroke has not been firmly defined. The different types of stroke--ischemic, intracerebral hemorrhage, and subarachnoid hemorrhage--have different pathophysiologies and require different approaches in terms of blood pressure management in the ac...
journal_title:Critical care clinics
pub_type: 杂志文章,评审
doi:10.1016/j.ccc.2006.08.002
更新日期:2006-10-01 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::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::The intensive care unit (ICU) environment is not propitious for restoring sleep and many studies have reported that critically ill patients have severe sleep disruptions. However, sleep alterations in critically ill patients are specific and differ significantly from those in ambulatory patients. Polysomnographic patt...
journal_title:Critical care clinics
pub_type: 杂志文章,评审
doi:10.1016/j.ccc.2015.03.001
更新日期:2015-07-01 00:00:00
abstract::This article reviews principles in the rational use of antibiotics in sepsis and septic shock and presents evidence-based recommendations for optimal antibiotic therapy. Every patient with sepsis and septic shock must be evaluated at presentation before the initiation of antibiotic therapy. However, in most situations...
journal_title:Critical care clinics
pub_type: 杂志文章,评审
doi:10.1016/j.ccc.2009.08.004
更新日期:2009-10-01 00:00:00
abstract::Sedative drugs commonly are titrated to effect in critically ill patients. Subjective clinical assessment tools are used to determine the patient's level of sedation, and there clearly is a need for improved quantitative methods of monitoring sedation. This article describes the current methods for assessing the level...
journal_title:Critical care clinics
pub_type: 杂志文章,评审
doi:
更新日期:1995-10-01 00:00:00
abstract::Meningococcemia is notorious for evasion of the host immune system and its rapid progression to fulminant disease, and serves as a unique model for pediatric sepsis. Illness severity is determined by complex interplays among host, pathogen, and environment. The inflammatory host response, including proinflammatory and...
journal_title:Critical care clinics
pub_type: 杂志文章,评审
doi:10.1016/j.ccc.2019.12.005
更新日期:2020-04-01 00:00:00