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 operative measures. Trauma and critical care physicians must have insight into ways to improve the detection, resuscitation, and management of trauma patients with acute substance intoxication or chronic abuse history. The need for prophylaxis of withdrawal syndrome differs with drug type. The major difficulty is proper identification of individuals at risk, which is complicated by patients' unconsciousness, reluctance, or medical inability to give detailed history of substance use. Failure to recognize withdrawal symptoms may both confuse the diagnosis of traumatic injury and be life-threatening. The goal in treating the trauma patient who is also a substance abuser is both to fully assess that person's injuries and achieve physiologic stability and use the hospitalization as an opportunity to educate and counsel the patient to abandon his or her destructive behavior.
journal_name
Crit Care Clinjournal_title
Critical care clinicsauthors
Milzman DP,Soderstrom CAsubject
Has Abstractpub_date
1994-07-01 00:00:00pages
595-612issue
3eissn
0749-0704issn
1557-8232journal_volume
10pub_type
杂志文章,评审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
pub_type： 历史文章,杂志文章
doi：10.1016/s0749-0704(05)70278-5
更新日期：1996-10-01 00:00:00
abstract：:Approximately 12,000 Americans suffer traumatic spinal cord injuries each year. This article discusses the management of their neurologic, respiratory, cardiovascular, gastroenterologic, and genitourinary complications in the critical care setting. ...
journal_title：Critical care clinics
pub_type： 杂志文章,评审
doi：
更新日期：1986-10-01 00:00:00
abstract：:Recent increase in both the elderly population and associated incidence of dementia are of critical importance to patient care in ICUs in the United States. Identification of pre-existing cognitive impairment, such as mild cognitive impairment and dementia, could prevent delirium and associated morbidity and mortality...
journal_title：Critical care clinics
pub_type： 杂志文章,评审
doi：10.1016/j.ccc.2008.05.006
更新日期：2008-10-01 00:00:00
abstract：:The critically ill patient presents a pharmaceutical dilemma, with the clinical condition often necessitating the administration of potent medications. The underlying disease process often includes or produces multi-system failure, which will subsequently alter the response to drugs, with the potential to further comp...
journal_title：Critical care clinics
pub_type： 杂志文章,评审
doi：
更新日期：1985-11-01 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：: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
pub_type： 杂志文章,评审
doi：
更新日期：1987-04-01 00:00:00
abstract：:Management of the cardiac transplant recipient includes careful titration of inotropes and vasopressors. Recipient pulmonary hypertension and ventilatory status must be optimized to prevent allograft right ventricular failure. Vasoplegia, coagulopathy, arrhythmias, and renal dysfunction also require careful management...
journal_title：Critical care clinics
pub_type： 杂志文章,评审
doi：10.1016/j.ccc.2018.08.008
更新日期：2019-01-01 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
pub_type： 杂志文章,评审
doi：
更新日期：1989-01-01 00:00:00
abstract：:The future of cardiopulmonary resuscitation lies in new technologies for monitoring and generating vital organ perfusion during cardiac arrest and the post-resuscitation phase and in pharmacologic agents that will enhance ROSC and reverse ischemia-reperfusion injury. ROSC is the first step toward survival, so interven...
journal_title：Critical care clinics
pub_type： 杂志文章,评审
doi：10.1016/s0749-0704(05)70139-1
更新日期：2000-10-01 00:00:00
abstract：:The pathophysiology of the burn injury and treatment factors that influence burn depth are explained. Details of burn wound care, including indications for early excision, topical antimicrobials, and the most recent advances in skin substitutes, are described. Burn wound sepsis, the most common and serious complicatio...
journal_title：Critical care clinics
pub_type： 杂志文章
doi：
更新日期：1985-03-01 00:00:00
abstract：:The availability, portability, safety, and other features of ultrasound have ushered this relatively new imaging modality into the everyday clinical practice of multiple disciplines. Features unique to ultrasound lend this imaging modality the opportunity for extensive use in the ICU. A review of its uses in this capa...
journal_title：Critical care clinics
pub_type： 杂志文章,评审
doi：10.1016/s0749-0704(05)70097-x
更新日期：2000-01-01 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：:The recent development of valid and reliable assessment tools to monitor agitation, sedation, analgesia, and delirium in the ICU represents an essential first step in the provision of patient comfort and the development of preferred treatment strategies. To make the ICU a more humane healing environment, these assessm...
journal_title：Critical care clinics
pub_type： 杂志文章,评审
doi：10.1016/s0749-0704(05)70189-5
更新日期：2001-10-01 00:00:00
abstract：:Vesicants (or blister agents) are cytotoxic alkylating compounds, which are chemical agents sometimes collectively known as mustard gas or simply as mustard. Other blister agents are nitrogen mustard; sulfur mustard; lewisite, a vesicant that contains arsenic; and phosgene oxime, a halogenated oxime that possesses dif...
journal_title：Critical care clinics
pub_type： 杂志文章,评审
doi：10.1016/j.ccc.2005.06.005
更新日期：2005-10-01 00:00:00
abstract：:Obesity has been recognized as an increasing problem not only in North America but globally. With a significant rise in the prevalence of obesity amongst children and adolescents over the past 20 years, the comorbidities associated with obesity are also now emerging at an earlier age. These comorbidities cause specifi...
journal_title：Critical care clinics
pub_type： 杂志文章,评审
doi：10.1016/j.ccc.2010.06.009
更新日期：2010-10-01 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：:Infection and/or sepsis biomarkers should help to make the diagnosis and thus initiate therapy earlier, help to differentiate between infectious and sterile inflammation, allow the use of more-specific antimicrobials, shorten the time of antimicrobial use, and ideally identify distinct phenotypes that may benefit from...
journal_title：Critical care clinics
pub_type： 杂志文章,评审
doi：10.1016/j.ccc.2011.01.002
更新日期：2011-04-01 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：:Extracorporeal life support is a modified form of cardiopulmonary bypass. Experience in extracorporeal membrane oxygenation (ECMO) has come largely from the neonatal population. Most centers have transitioned the ECMO pumps from roller pumps to centrifugal technology. Modes of support include venovenous for respirator...
journal_title：Critical care clinics
pub_type： 杂志文章,评审
doi：10.1016/j.ccc.2017.06.005
更新日期：2017-10-01 00:00:00
abstract：:Procalcitonin is a biomarker that is generally elevated in bacterial infections. This review describes a conceptual framework for biomarkers using lessons from the history of troponin, applies this framework to procalcitonin with a review of observational studies and randomized trials in and out of the intensive care ...
journal_title：Critical care clinics
pub_type： 杂志文章,评审
doi：10.1016/j.ccc.2019.08.003
更新日期：2020-01-01 00:00:00
abstract：:Cardiovascular disease is the leading cause of death in the United States,and thus its clinical and economic implications are enormous. In an increasingly cost-conscious economic environment, it is important to understand not only the effectiveness of treatments and technologies but also their cost-effectiveness. The ...
journal_title：Critical care clinics
pub_type： 杂志文章,评审
doi：10.1016/j.ccc.2011.10.007
更新日期：2012-01-01 00:00:00
abstract：:Alterations in hemostasis are common in patients with cancer admitted to the ICU. Depending on the underlying disease and specific hemostatic abnormality, the patient with cancer may develop bleeding, thrombosis, or both, such as DIC. Bleeding complications usually result from abnormalities in platelets or deficiency ...
journal_title：Critical care clinics
pub_type： 杂志文章,评审
doi：10.1016/s0749-0704(05)70200-1
更新日期：2001-07-01 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：: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：:Approximately 20% of all mechanically ventilated patients fail their first attempt to wean. Prolonged mechanical ventilation increases morbidity, mortality, and costs. No single weaning parameter predicts patient ability to wean. Weaning studies suggest that daily trials of spontaneous breathing for appropriate patien...
journal_title：Critical care clinics
pub_type： 杂志文章
doi：10.1016/j.ccc.2006.12.002
更新日期：2007-04-01 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：:Contrast-associated acute kidney injury (CAAKI) is a common iatrogenic condition. The principal risk factors for CAAKI are underlying renal impairment; diabetes in the setting of kidney disease; and intravascular volume depletion, effective or absolute. CAAKI is associated with serious adverse short-term and long-term...
journal_title：Critical care clinics
pub_type： 杂志文章,评审
doi：10.1016/j.ccc.2015.06.008
更新日期：2015-10-01 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：: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：: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
