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 with associated CHF, sodium nitroprusside is still an excellent agent. It has a rapid onset of action and blood pressure can be easily titrated. Nitroglycerin is also another agent that can be used in this situation. (2) In the treatment of malignant hypertension with associated aortic dissection, trimethophan camsylate is the preferred agent. An alternative choice is the combination of nitroprusside and labetalol. (3) In the treatment of malignant hypertension with associated myocardial ischemia, an excellent choice is nitroglycerin. Labetalol also should be considered in this situation. (4) In the treatment of hypertension during pregnancy, hydralazine is still a good choice. Labetalol has also been shown to be efficacious. (5) In the treatment of malignant hypertension with associated cerebral ischemia, the following drugs should be considered: nitroprusside, nitroglycerin, and labetalol. The most important attribute of these agents is that they are nonsedating and rapid in onset. (6) In the treatment of postoperative hypertension the choices best suited are labetalol, enalapril, nitroprusside, and nitroglycerin. These agents are rapid in onset and all can be administered intravenously.
journal_name
Crit Care Clinjournal_title
Critical care clinicsauthors
Rubenstein EB,Escalante Csubject
Has Abstractpub_date
1989-07-01 00:00:00pages
477-95issue
3eissn
0749-0704issn
1557-8232journal_volume
5pub_type
杂志文章,评审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::Multiplane (TEE) transducer imaging is the most highly evolved TEE technology at present. New clinical applications of this technology will be realized as echocardiographers gain experience with it. Current limitations of TEE are likely to be surmounted as its use increases, and continuous improvements and miniaturiza...
journal_title:Critical care clinics
pub_type: 杂志文章,评审
doi:10.1016/s0749-0704(05)70246-3
更新日期:1996-04-01 00:00:00
abstract::Measuring cardiac output without knowledge of the oxygen extraction by the tissues is of limited value. Instead of calculating oxygen consumption and oxygen delivery, a diagram relating cardiac index to the oxygen extraction ratio is proposed to interpret hemodynamic data at the bedside. This diagram is particularly h...
journal_title:Critical care clinics
pub_type: 杂志文章,评审
doi:10.1016/s0749-0704(05)70288-8
更新日期:1996-10-01 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::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
pub_type: 杂志文章,评审
doi:10.1016/j.ccc.2004.03.015
更新日期:2004-07-01 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::Prolonged intubation and mechanical ventilation following cardiac surgery have been associated with increased hospital and intensive care unit length of stays; higher health care costs; and morbidity resulting from atelectasis, intrapulmonary shunting, and pneumonia. Early extubation was developed as a strategy in the...
journal_title:Critical care clinics
pub_type: 杂志文章,评审
doi:10.1016/j.ccc.2020.06.005
更新日期:2020-10-01 00:00:00
abstract::Although much has been accomplished in HTx and LTx in the past few decades, much remains to be conquered. It is an ever-changing, always fascinating field. Though science and technology know no limits, the primary limitation of HTx and LTx continues to be the availability of donor organs. One can only hope that furthe...
journal_title:Critical care clinics
pub_type: 杂志文章,评审
doi:10.1016/s0749-0704(02)00054-4
更新日期:2003-04-01 00:00:00
abstract::The burned child requires a management that is different from that employed in the burned adult because of physiologic and psychological dissimilarities, although basic principles of management are the same. Particular problems and treatment of the burned child are highlighted. ...
journal_title:Critical care clinics
pub_type: 杂志文章
doi:
更新日期:1985-03-01 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::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
pub_type: 杂志文章,评审
doi:
更新日期:1989-04-01 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::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::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::The proportion of hospitalized patients with pulmonary embolism (PE) is increasing. Whether this represents more admissions with PE or more diagnoses made in hospitalized patients is uncertain. The proportion of hospitalized patients with deep venous thrombosis has decreased precipitously as a result of home treatment...
journal_title:Critical care clinics
pub_type: 杂志文章,评审
doi:10.1016/j.ccc.2011.09.006
更新日期:2011-10-01 00:00:00
abstract::Functional hemodynamic monitoring is the assessment of the dynamic interactions of hemodynamic variables in response to a defined perturbation. Recent interest in functional hemodynamic monitoring for the bedside assessment of cardiovascular insufficiency has heightened with the documentation of its accuracy in predic...
journal_title:Critical care clinics
pub_type: 杂志文章,评审
doi:10.1016/j.ccc.2014.08.005
更新日期:2015-01-01 00:00:00
abstract::As health care expenditures increase, payers, including the Centers for Medicare and Medicaid Services, are moving away from reimbursement based on types and volume of services to an emphasis on quality of provided care, an approach called value-based purchasing (VBP). Because it is tied to reimbursement, VBP creates ...
journal_title:Critical care clinics
pub_type: 杂志文章,评审
doi:10.1016/j.ccc.2012.10.002
更新日期:2013-01-01 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
pub_type: 杂志文章,评审
doi:10.1016/j.ccc.2007.07.005
更新日期:2007-07-01 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::The EMR in the ICU has the utility of providing the necessary information to make sound clinical decisions for critically ill patients. For it to be optimized, the EMR must be more than just what is being replicated in the written record or merely a documentation tool; it must add value that supports and enhances clin...
journal_title:Critical care clinics
pub_type: 杂志文章,评审
doi:10.1016/s0749-0704(05)70068-3
更新日期:1999-07-01 00:00:00
abstract::The field of neuroendovascular therapy is rapidly growing. New technology and operators' expertise is developing at a pace that will make this discipline progressively more available and successful. For the intensive care of patients who have acute brain ischemia, new techniques of recanalizing occluded arteries are p...
journal_title:Critical care clinics
pub_type: 杂志文章,评审
doi:10.1016/s0749-0704(05)70086-5
更新日期:1999-10-01 00:00:00
abstract::Ethical issues that arise in the care of pregnant women are challenging to physicians, especially in critical care situations. By familiarizing themselves with the concepts of medical ethics in obstetrics, physicians will become more capable of approaching complex ethical situations with a clear and structured framewo...
journal_title:Critical care clinics
pub_type: 杂志文章,评审
doi:10.1016/j.ccc.2015.08.007
更新日期:2016-01-01 00:00:00
abstract::Nutritional support of the burn patient is essential to optimize host immune defenses and to promote prompt wound healing. The interdependent relationship between metabolism, nutrition, and infection is discussed, followed by an extensive description of the various means of determining the appropriate type, form, and ...
journal_title:Critical care clinics
pub_type: 杂志文章,评审
doi:
更新日期:1995-07-01 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::The endothelial glycocalyx (EG) is the most luminal layer of the blood vessel, growing on and within the vascular wall. Shedding of the EG plays a central role in many critical illnesses. Degradation of the EG is associated with increased morbidity and mortality. Certain illnesses and iatrogenic interventions can caus...
journal_title:Critical care clinics
pub_type: 杂志文章,评审
doi:10.1016/j.ccc.2019.12.007
更新日期:2020-04-01 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::This article is intended to inform the reader of the current state of the art of pneumatically powered artificial hearts, including animal experiments and information available on 11 recipients of orthotopically placed devices. ...
journal_title:Critical care clinics
pub_type: 杂志文章,评审
doi:
更新日期:1986-04-01 00:00:00
abstract::Summarizing the mission of the ICU, the institution directive board and the unit director must generate a structure, proceedings criteria, management, and analysis of results capable of providing satisfactory care. Furthermore, they must take into account each organizational aspect that is necessary to offer an approp...
journal_title:Critical care clinics
pub_type: 杂志文章,评审
doi:10.1016/j.ccc.2006.04.002
更新日期:2006-07-01 00:00:00
abstract::The Surviving Sepsis Campaign targets central venous pressure, mean arterial pressure, and central venous oxygen saturation as guides for resuscitation. Fluid resuscitation and the use of vasopressors are paramount to the success of the campaign's end points. Although the achievement of supranormal physiologic paramet...
journal_title:Critical care clinics
pub_type: 杂志文章
doi:10.1016/j.ccc.2009.12.005
更新日期:2010-04-01 00:00:00
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 hig...
journal_title:Critical care clinics
pub_type: 杂志文章,评审
doi:10.1016/s0749-0704(05)70328-6
更新日期:1997-07-01 00:00:00