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 respiratory support and venoarterial for cardiac support. "Awake" ECMO is the trend with extubation and tracheostomy on the rise. Fluid overload is common and managed with diuretics or hemofiltration. Nutrition is important and provided enterally or via total parenteral nutrition. Overall survival for pediatric cardiac and respiratory ECMO has remained at approximately 50% to 60%.
journal_name
Crit Care Clinjournal_title
Critical care clinicsauthors
Jenks CL,Raman L,Dalton HJdoi
10.1016/j.ccc.2017.06.005subject
Has Abstractpub_date
2017-10-01 00:00:00pages
825-841issue
4eissn
0749-0704issn
1557-8232pii
S0749-0704(17)30047-7journal_volume
33pub_type
杂志文章,评审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::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::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
pub_type: 杂志文章,评审
doi:
更新日期:1992-07-01 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
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::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::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::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::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::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::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::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::Glycated hemoglobin A1c can be used to assess intensive care unit patients' level of chronic glycemic control. Compared with patients with normal glycated hemoglobin A1c, patients with elevated glycated hemoglobin A1c seem to better tolerate hyperglycemia and large glucose fluctuations during critical illness. The ris...
journal_title:Critical care clinics
pub_type: 杂志文章,评审
doi:10.1016/j.ccc.2018.11.010
更新日期:2019-04-01 00:00:00
abstract::The use of ultrasonography in medical practice has evolved dramatically over the last few decades and will continue to improve as technological advances are incorporated into daily medical practice. Although ultrasound machine size and equipment have evolved, the basic principles and fundamental functions have remaine...
journal_title:Critical care clinics
pub_type: 杂志文章,评审
doi:10.1016/j.ccc.2013.08.006
更新日期:2014-01-01 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::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::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::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::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::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::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::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::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
pub_type: 杂志文章
doi:
更新日期:1986-01-01 00:00:00
abstract::Hypertensive crisis is an acute emergency requiring aggressive management. Its incidence has decreased in recent years but still is prevalent in the medical community. From review of past and present treatment regimens, the following recommendations can be considered. (1) In the treatment of malignant hypertension wit...
journal_title:Critical care clinics
pub_type: 杂志文章,评审
doi:
更新日期:1989-07-01 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::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::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::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::The pregnant patient with normal cardiac function can accommodate many significant alterations in the cardiovascular system without difficulty. Pregnancy in a patient with significant cardiac disease, however, can be extremely hazardous, resulting in decompensation and even death. these conditions account for up to 30...
journal_title:Critical care clinics
pub_type: 杂志文章,评审
doi:
更新日期:1991-10-01 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::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