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 anti-inflammatory responses in innate and adaptive immunity, skews toward a proinflammatory state. This leads to endothelial dysfunction and activation of the hemostatic response, which may lead to disseminated intravascular coagulation. This article reviews the pathogenesis of sepsis, in particular the inflammatory and hemostatic response in meningococcal sepsis.
journal_name
Crit Care Clinjournal_title
Critical care clinicsauthors
Boeddha NP,Bycroft T,Nadel S,Hazelzet JAdoi
10.1016/j.ccc.2019.12.005subject
Has Abstractpub_date
2020-04-01 00:00:00pages
391-399issue
2eissn
0749-0704issn
1557-8232pii
S0749-0704(19)30100-9journal_volume
36pub_type
杂志文章,评审abstract::A substantial proportion of patients admitted to intensive care units (ICUs) are elderly patients. Based upon population growth, patient preference, and current physician practice, the number of elderly patients who receive critical care services is likely to increase substantially over the next 10 to 20 years. Numero...
journal_title:Critical care clinics
pub_type: 杂志文章
doi:10.1016/s0749-0704(03)00051-4
更新日期:2003-10-01 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::This article presents the health effects of some of the more important acute natural disasters and outlines requirements for effective medical response to these events (table 7). In summary, although all disasters are unique in that they affect regions of the world with differing social, economic, and health backgroun...
journal_title:Critical care clinics
pub_type: 杂志文章,评审
doi:
更新日期:1991-04-01 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::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::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::Intoxications frequently perturb acid-base and electrolyte status, intravascular volume, and renal function. In selected cases, extracorporeal techniques effectively restore homeostasis and augment intoxicant removal. The use of 4-methylpyrazole, an inhibitor of alcohol dehydrogenase, is a new and effective treatment ...
journal_title:Critical care clinics
pub_type: 杂志文章,评审
doi:10.1016/s0749-0704(01)00011-2
更新日期:2002-04-01 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::Invasive fungal infections (IFI) and fungal sepsis in the intensive care unit are increasing and are associated with considerable morbidity and mortality. In this setting, IFI are predominantly caused by Candida species. Outcomes continue to be suboptimal; however, there are a few key clinician modifiable factors. PK-...
journal_title:Critical care clinics
pub_type: 杂志文章,评审
doi:10.1016/j.ccc.2010.11.001
更新日期:2011-01-01 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::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
pub_type: 杂志文章,评审
doi:10.1016/j.ccc.2016.08.002
更新日期:2017-01-01 00:00:00
abstract::Significant advances have been made in the management of cardiac arrhythmias. New technology has enhanced the ability to understand and treat a variety of tachycardias. Excitement and caution surround ablative approaches for atrial fibrillation. The role of ICDs and class III antiarrhythmic drugs in the management of ...
journal_title:Critical care clinics
pub_type: 杂志文章,评审
doi:10.1016/s0749-0704(05)70171-8
更新日期:2001-04-01 00:00:00
abstract::An estimated 14 million patients survive sepsis hospitalization each year. However, survivors commonly experience new functional disability, cognitive impairment, and a high rate of further medical setbacks, including hospital readmission and late death. One in 5 older survivors has a potentially preventable hospital ...
journal_title:Critical care clinics
pub_type: 杂志文章,评审
doi:10.1016/j.ccc.2018.06.002
更新日期:2018-10-01 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 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::In general, coma portends a very poor outcome in ICU patients except when a drug overdose is the cause. Interactions with concurrent diseases and the cause of the comatose state are important variables that modify mortality rates. Recent studies have made it possible to predict irreversibility with a high degree of sp...
journal_title:Critical care clinics
pub_type: 杂志文章,评审
doi:
更新日期:1994-01-01 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::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::It is as important to monitor the passage of time in the resuscitation effort as it is to follow the physiologic parameters. The goals in resuscitation are based on restoring cellular metabolism to a level consistent with optimum survival. The level of invasiveness of monitoring is dictated by the extent to which the ...
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::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::Both limb muscle weakness and respiratory muscle weakness are exceedingly common in critically ill patients. Respiratory muscle weakness prolongs ventilator dependence, predisposing to nosocomial complications and death. Limb muscle weakness persists for months after discharge from intensive care and results in poor l...
journal_title:Critical care clinics
pub_type: 杂志文章,评审
doi:10.1016/j.ccc.2018.03.005
更新日期:2018-07-01 00:00:00
abstract::Timely performance and accurate interpretation of portable chest radiographs in the ICU setting are fundamental components of quality care. Teamwork between intensive care clinicians and radiologists is necessary to assure that the appropriate studies, of high technical quality, are obtained. By working together to in...
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::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::The known metabolic abnormalities and nutritional requirements of the brain injury, spinal cord injury, and acute stroke patient have been presented. Further investigations are required in all these conditions to identify specific nutritional requirements and metabolic abnormalities. The specific role of nutritional s...
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::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::Critical illness predisposes individuals to highly variable metabolic and immune responses, leading to muscle mass loss, impaired healing, immobility, and susceptibility to infections and cognitive impairment. Recommendations for nutrition in critically ill patients are supported by observational studies, small random...
journal_title:Critical care clinics
pub_type: 杂志文章,评审
doi:10.1016/j.ccc.2015.11.002
更新日期:2016-04-01 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::The management of critically ill patients necessitates the use of sedatives and analgesics to provide patient comfort and cooperation. These drugs exert profound effects on all organ systems, not only the central nervous system, and this article describes the immunologic effects of the commonly used critical care seda...
journal_title:Critical care clinics
pub_type: 杂志文章,评审
doi:10.1016/j.ccc.2009.05.001
更新日期:2009-07-01 00:00:00
abstract::N-6 and n-3 PUFAs from the diet are absorbed and reach the cell where they interact with fatty acid binding proteins within cell membranes and cytoplasm. They are processed in the endoplasmic reticulum (desaturation-elongation reactions, lipid synthesis, eicosanoid and epoxide production) and in peroxisomes (beta-oxid...
journal_title:Critical care clinics
pub_type: 杂志文章,评审
doi:10.1016/s0749-0704(05)70160-3
更新日期:2001-01-01 00:00:00
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 pat...
journal_title:Critical care clinics
pub_type: 杂志文章,评审
doi:10.1016/s0749-0704(05)70023-3
更新日期:1998-10-01 00:00:00