Ethically based medical decision making in the intensive care unit: residency teaching strategies.

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

authors： Conway-Morris A,Wilson J,Shankar-Hari M

更新日期：2018-01-01 00:00:00

abstract：:For well over a decade, intensive care unit (ICU) telemedicine programs have been providing care to patients and families and an invaluable service to many receiving sites that are otherwise outside the traditional reach of high-quality critical care. It will be important that during this growth, outcomes regarding th...

journal_title：Critical care clinics

authors： Johnson AB

更新日期：2019-07-01 00:00:00

abstract：:The years that have passed since the introduction of the pulmonary artery catheter have been marked by radical changes in the practice of general and critical care medicine. There has been an increase in the application of physiologic principles to the management of shock states, myocardial infarction, and respiratory...

journal_title：Critical care clinics

authors： Ginosar Y,Sprung CL

更新日期：1996-10-01 00:00:00

abstract：:Positive-pressure ventilation may improve gas exchange, decrease the work-cost of breathing, and rest respiratory muscles, but it also will alter cardiac output and may modify blood flow distribution. Ventilation may induce these hemodynamic changes by altering systemic venous return to the RV (RV preload), pulmonary ...

journal_title：Critical care clinics

authors： Pinsky MR

更新日期：1990-07-01 00:00:00

abstract：:Cardiogenic shock remains the most dreaded complication of acute myocardial infarction. Mortality rates remain high despite modern interventional therapy. Patients with a variety of other cardiovascular entities may also develop cardiogenic shock. Management consists of rapid stabilization of systemic arterial blood p...

journal_title：Critical care clinics

authors： Alpert JS,Becker RC

更新日期：1993-04-01 00:00:00

abstract：:The leukotrienes are a group of biologically active products of arachidonic acid metabolism that have been demonstrated to possess the capability to alter vascular reactivity as well as vascular permeability when applied topically to tissues or infused into the vascular bed of various organs. These biologic effects of...

journal_title：Critical care clinics

authors： Sprague RS,Stephenson AH,Dahms TE,Lonigro AJ

更新日期：1989-04-01 00:00:00

abstract：:Cardiopulmonary arrest during pregnancy is a rare event that critical care clinicians must be prepared to manage. The causes of cardiopulmonary arrest during pregnancy, recommended modifications to cardiopulmonary resuscitation protocols that are specific to pregnancy, indications for and timing of perimortem cesarean...

journal_title：Critical care clinics

authors： Mallampalli A,Powner DJ,Gardner MO

更新日期：2004-10-01 00:00:00

abstract：:Blunt thoracic trauma can result in significant morbidity in injured patients. Both chest wall and the intrathoracic visceral injuries can lead to life-threatening complications if not anticipated and treated. Pain control, aggressive pulmonary toilet, and mechanical ventilation when necessary are the mainstays of sup...

journal_title：Critical care clinics

authors： Wanek S,Mayberry JC

更新日期：2004-01-01 00:00:00

abstract：:The proliferation of methicillin-resistant Staphylococcus aureus (MRSA) and the severity of nosocomial critical care infections necessitate the development of viable alternative therapies. An increase in the tolerance of MRSA to the activity of vancomycin and to the associated suboptimal therapeutic measures is of par...

journal_title：Critical care clinics

authors： Alder J

更新日期：2008-04-01 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

authors： Campbell ML

更新日期：2004-07-01 00:00:00

abstract：:Hemorrhage is the leading cause of preventable death in trauma. Damage control resuscitation relies on permissive hypotension, minimizing crystalloid use, and early implementation of massive transfusion protocols with established blood component ratios. These protocols improve the survival of the severely injured pati...

journal_title：Critical care clinics

authors： Cantle PM,Cotton BA

更新日期：2017-01-01 00:00:00

abstract：:Chemical agents of warfare are divided into lung agents, blood agents, vesicants, and nerve agents. Intensivists must familiarize themselves with the clinical presentation and management principles in the event of a chemical attack. Key principles in management include aggressive supportive care and early administrati...

journal_title：Critical care clinics

authors： Mishra R,Geiling J

更新日期：2019-10-01 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

authors： Sterns RH

更新日期：1991-01-01 00:00:00

abstract：:This article describes the history of critical care medicine's cooperation with ethics, relates some lessons learned from this cooperation, identifies implications for other chronic and acute settings, and gives some suggestions for governmental and social input into the solution of the difficult ethical questions fac...

journal_title：Critical care clinics

authors： Kanoti GA,Orlowski JP,Vinicky J

更新日期：1986-01-01 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

authors： Weaver LK

更新日期：1999-04-01 00:00:00

abstract：:Laboratory testing is ubiquitous among hospitalized patients and is more common among patients in the intensive care unit (ICU). Despite its high cost and prevalence, there are few data to support the current practice of laboratory testing in most ICUs. Although testing offers considerable potential benefits, it is no...

journal_title：Critical care clinics

authors： Ezzie ME,Aberegg SK,O'Brien JM Jr

更新日期：2007-07-01 00:00:00

abstract：:Intrahospital transport of critically ill patients must be considered as part of the critical care continuum. The level of care provided must be commensurate with the severity of illness. These transfers are intensive in terms of utilization of personnel and resources. Advance preparation and optimal coordination of t...

journal_title：Critical care clinics

authors： Venkataraman ST,Orr RA

更新日期：1992-07-01 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

authors： Kane-Gill S,Weber RJ

更新日期：2006-04-01 00:00:00

abstract：:Infections caused by Candida species are now endemic and entrenched in the intensive care unit setting. Candida infections continue to provide a major diagnostic and therapeutic challenge to clinicians. The increased prevalence of Candida infections represent the high price clinicians and patients must pay for the adv...

journal_title：Critical care clinics

authors： Sobel JD

更新日期：1988-04-01 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

authors： Hall ED

更新日期：1989-10-01 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

authors： Avramov MN,White PF

更新日期：1995-10-01 00:00:00

abstract：:There are numerous mechanisms of hypoxemia and hypercapnia during the perioperative period. Mechanisms of hypoxemia include oxygen delivery problems, decreased FAC-CC relationship, hypoventilation, decreased cardiac output, increased oxygen consumption, decreased hypoxic pulmonary vasoconstriction, and increased nonal...

journal_title：Critical care clinics

authors： Foltz BD,Benumof JL

更新日期：1987-04-01 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

authors： Elliott K,Foley KM

更新日期：1990-04-01 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

authors： Weise KL

更新日期：1988-10-01 00:00:00

abstract：:Ethically charged situations are common in pediatric critical care. Most situations can be managed with minimal controversy within the medical team or between the team and patients/families. Familiarity with institutional resources, such as hospital ethics committees, and national guidelines, such as publications from...

journal_title：Critical care clinics

authors： Orioles A,Morrison WE

更新日期：2013-04-01 00:00:00

abstract：:Septic shock is a common clinical problem in the intensive care setting. The high mortality rate associated with septic shock, regardless of age, reflects the inadequacy of available therapeutic approaches. The purpose of this article is to review the current pharmacologic approaches to the treatment of septic shock w...

journal_title：Critical care clinics

authors： Boyd JL 3rd,Stanford GG,Chernow B

更新日期：1989-01-01 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

authors： Saffle JR

更新日期：2016-10-01 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

authors： Kumar A

更新日期：2009-10-01 00:00:00

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

authors： Cunha BA

更新日期：1998-04-01 00:00:00

abstract：:The PAC has allowed physicians to obtain information that was unavailable prior to its introduction into clinical medicine. There are numerous pitfalls, however, in obtaining and interpreting this information. Even if these pitfalls are avoided, changing therapy to the patient's benefit based on PAC data is not guaran...

journal_title：Critical care clinics

authors： Leibowitz AB

更新日期：1996-07-01 00:00:00