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-PD studies with the approved antifungal agents have provided guidance on the dosing strategy that predicts improved outcome. In addition, time to therapy is a critical element. Therefore early recognition through improved risk factor analysis and diagnostics will be key developments. Source control for infected devices and endophthalmitis must be considered.
journal_name
Crit Care Clinjournal_title
Critical care clinicsauthors
Lepak A,Andes Ddoi
10.1016/j.ccc.2010.11.001subject
Has Abstractpub_date
2011-01-01 00:00:00pages
123-47issue
1eissn
0749-0704issn
1557-8232pii
S0749-0704(10)00098-9journal_volume
27pub_type
杂志文章,评审abstract::As the geriatric population in the United States increases and better management of chronic diseases improves survival, more elderly will become critically ill and potentially require treatment in an intensive care unit (ICU). Dan Callahan has written, "... we will live longer lives, be better sustained by medical car...
journal_title:Critical care clinics
pub_type: 杂志文章
doi:10.1016/s0749-0704(03)00056-3
更新日期:2003-10-01 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
pub_type: 杂志文章,评审
doi:10.1016/s0749-0704(05)70262-1
更新日期:1996-07-01 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::Hypocalcemia and hypophosphatemia have recently been recognized as common metabolic complications in acutely ill patients. The diagnostic and therapeutic approaches to these abnormalities are described in this article. ...
journal_title:Critical care clinics
pub_type: 杂志文章,评审
doi:
更新日期:1987-10-01 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::In July 2001, the United States Joint Commission on Accreditation of Health care Organizations adopted a new leadership standard that requires department heads in health care organizations to perform at least one Failure Mode and Effects Analysis (FMEA) every year. This proactive approach to error prevention has prove...
journal_title:Critical care clinics
pub_type: 杂志文章,评审
doi:10.1016/j.ccc.2004.07.005
更新日期:2005-01-01 00:00:00
abstract::Improving the course and outcome of patients with ARDS presents a considerable challenge. An important component of meeting this challenge is a more comprehensive understanding of the heterogeneous pathophysiology of ARDS and the biologic response of the individual patient. This understanding may be developed through ...
journal_title:Critical care clinics
pub_type: 杂志文章,评审
doi:10.1016/s0749-0704(03)00072-1
更新日期:2002-01-01 00:00:00
abstract::The overlap syndrome defines the relationship between obstructive sleep apnea (OSA) and chronic obstructive pulmonary disease (COPD), and is a commonly noted but poorly studied disorder. Individuals who have the overlap syndrome have been recognized to have greater risk for pulmonary hypertension, right heart failure,...
journal_title:Critical care clinics
pub_type: 杂志文章,评审
doi:10.1016/j.ccc.2008.02.005
更新日期:2008-07-01 00:00:00
abstract::Good airway management depends on a system that emphasizes teamwork to expedite care and minimize errors. By understanding the accreditation and licensing requirements, appropriate personnel and equipment can be allocated along cost effective guidelines. Newer techniques for management of the difficult airway, such as...
journal_title:Critical care clinics
pub_type: 杂志文章,评审
doi:10.1016/s0749-0704(05)70129-9
更新日期:2000-07-01 00:00:00
abstract::Access to critical care is rapidly growing in areas of the world where it was previously nonexistent and where infectious diseases often comprise the largest disease burden. Additionally, with crowding, mass migrations, and air travel, infectious diseases previously geographically confined are quickly spread across th...
journal_title:Critical care clinics
pub_type: 杂志文章,评审
doi:10.1016/j.ccc.2013.03.005
更新日期:2013-07-01 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::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::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::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::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::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::Advances in the area of pediatric medicine during the past few years have presented ethical dilemmas for the physician to consider. This article discusses the ethical principles upon which clinical reasoning and judgments can be made. ...
journal_title:Critical care clinics
pub_type: 杂志文章
doi:
更新日期:1992-01-01 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
pub_type: 杂志文章,评审
doi:10.1016/j.ccc.2019.02.006
更新日期:2019-07-01 00:00:00
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 operativ...
journal_title:Critical care clinics
pub_type: 杂志文章,评审
doi:
更新日期:1994-07-01 00:00:00
abstract::Decisions to admit and discharge patients to and from the intensive care unit (ICU) when resources are scarce should be made according to the triage principle--that is, resources should be allocated based on the patient's ability to benefit from critical care. The ICU organizational structure and the constraints on de...
journal_title:Critical care clinics
pub_type: 杂志文章,评审
doi:
更新日期:1993-07-01 00:00:00
abstract::Cardiogenic shock remains a leading cause of mortality despite advances in the treatment of myocardial infarction and advanced heart failure. Medical therapy can be inadequate, and patients may need mechanical circulatory support (MCS). The proper application of MCS requires knowledge of the underlying cause of acute ...
journal_title:Critical care clinics
pub_type: 杂志文章,评审
doi:10.1016/j.ccc.2014.04.002
更新日期:2014-07-01 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 primary uses of FFB in the intensive care unit are in the diagnosis of opportunistic infection and for airway management. In addition, use of PTC brush or BAL with quantitative cultures may allow identification of the specific cause of bacterial pneumonia. Determination of the location and cause of pulmonary hemor...
journal_title:Critical care clinics
pub_type: 杂志文章,评审
doi:
更新日期:1992-10-01 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::Traumatic brain injury is a common occurrence in the United States, leading to approximately 190,000 deaths or long-term disabilities. Following the primary insult, secondary disturbances in cerebral blood flow (CBF) and metabolism may have deleterious effects on potentially viable neurons. Recent studies evaluating C...
journal_title:Critical care clinics
pub_type: 杂志文章,评审
doi:10.1016/s0749-0704(05)70300-6
更新日期:1997-01-01 00:00:00
abstract::Anemia is common in critically ill patients, but treatment with red blood cell transfusions can have unwanted effects. Limiting the occurrence and severity of anemia by using erythropoietic agents (iron and/or recombinant erythropoietin), therefore, remains an attractive option during the intensive care unit stay but ...
journal_title:Critical care clinics
pub_type: 杂志文章,评审
doi:10.1016/j.ccc.2012.04.003
更新日期:2012-07-01 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::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
abstract::The thermal-dye technique for the measurement of ELW is available for clinical and experimental use. This method is safe and can be performed serially in an individual patient. Although it is invasive, it requires only a central venous catheter and an arterial catheter, which are often already in place for routine hem...
journal_title:Critical care clinics
pub_type: 杂志文章,评审
doi:
更新日期:1986-07-01 00:00:00
abstract::More than one-half million patients are hospitalized annually for traumatic brain injury (TBI). One-quarter demonstrate sleep-disordered breathing, up to 50% experience insomnia, and half have hypersomnia. Sleep disturbances after TBI may result from injury to sleep-regulating brain tissue, nonspecific neurohormonal r...
journal_title:Critical care clinics
pub_type: 杂志文章,评审
doi:10.1016/j.ccc.2015.03.012
更新日期:2015-07-01 00:00:00