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 sedatives: propofol, the benzodiazepines, opioids, and alpha(2)-adrenoceptor agonists. Benzodiazepines, opioids, and possibly even propofol worsen outcome in animal models of infection, whereas preliminary evidence suggests that the alpha(2)-adrenoceptor agonist, dexmedetomidine, may improve outcomes in the setting of infection. Given the burden of sepsis and secondary infections in critical care, choice of sedation may need to be carefully considered to preserve immune responses in critically ill patients.
journal_name
Crit Care Clinjournal_title
Critical care clinicsauthors
Sanders RD,Hussell T,Maze Mdoi
10.1016/j.ccc.2009.05.001subject
Has Abstractpub_date
2009-07-01 00:00:00pages
551-70, ixissue
3eissn
0749-0704issn
1557-8232pii
S0749-0704(09)00040-2journal_volume
25pub_type
杂志文章,评审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
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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 proliferation of methicillin-resistant Staphylococcus aureus (MRSA) and the severity of nosocomial critical care infections necessitate the development of viable alternative therapies. An increase in the tolerance of MRSA to the activity of vancomycin and to the associated suboptimal therapeutic measures is of par...
journal_title:Critical care clinics
pub_type: 杂志文章,评审
doi:10.1016/j.ccc.2007.12.010
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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::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
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更新日期:2003-07-01 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::This article provides a background so that the intensivist can appreciate the social and cultural context in which the AIDS epidemic developed. The upheaval that AIDS has caused in the gay community is described along with some of the economic effects AIDS has had on that population and on the practice of medicine, bo...
journal_title:Critical care clinics
pub_type: 杂志文章,评审
doi:
更新日期:1993-01-01 00:00:00
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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
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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
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journal_title:Critical care clinics
pub_type: 杂志文章,评审
doi:
更新日期:1991-04-01 00:00:00
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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 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
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journal_title:Critical care clinics
pub_type: 杂志文章,评审
doi:10.1016/j.ccc.2005.05.004
更新日期:2005-07-01 00:00:00
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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::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 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
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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::Assessment of oxygenation is an integral part of monitoring critically ill patients. Current available modalities including pulse oximetry, transcutaneous and transconjunctival oxygen measurements are reviewed. In addition, future modalities to assess oxygen delivery and utilization at the level of the intact end-orga...
journal_title:Critical care clinics
pub_type: 杂志文章,评审
doi:
更新日期:1988-07-01 00:00:00
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journal_title:Critical care clinics
pub_type: 杂志文章,评审
doi:
更新日期:1993-04-01 00:00:00
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journal_title:Critical care clinics
pub_type: 杂志文章,评审
doi:
更新日期:1992-10-01 00:00:00
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journal_title:Critical care clinics
pub_type: 杂志文章,评审
doi:10.1016/s0749-0704(03)00098-8
更新日期:2004-01-01 00:00:00
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journal_title:Critical care clinics
pub_type: 杂志文章,评审
doi:10.1016/j.ccc.2005.01.006
更新日期:2005-04-01 00:00:00
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journal_title:Critical care clinics
pub_type: 杂志文章,评审
doi:
更新日期:1995-07-01 00:00:00
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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::Telestroke and teleneurologic intensive care units (teleneuro-ICUs) optimize the diagnosis and treatment of neurologic emergencies. Establishment of a telestroke or teleneuro-ICU program relies on investment in experienced stroke and neurocritical care personnel as well as advanced telecommunications technologies. Tel...
journal_title:Critical care clinics
pub_type: 杂志文章,评审
doi:10.1016/j.ccc.2014.12.002
更新日期:2015-04-01 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::The role of extracorporeal membrane oxygenation (ECMO) in supporting adult refractory respiratory failure continues to evolve. Technical advances and the clinical challenges of H1N1 associated severe ARDS have spurred a resurgence of interest in ECMO. Published systematic review and pooled analyses point out the limit...
journal_title:Critical care clinics
pub_type: 杂志文章,评审
doi:10.1016/j.ccc.2011.05.009
更新日期:2011-07-01 00:00:00
abstract::In summary, advances in critical care and mechanical ventilation have resulted in an increased salvage of critically ill patients, a number of whom require long-term ventilation as a means of life support. In addition, the total number of patients receiving long-term ventilation has increased dramatically over the pas...
journal_title:Critical care clinics
pub_type: 杂志文章,评审
doi:
更新日期:1994-10-01 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::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