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 not without risk, including misleading results, iatrogenic anemia, and therapeutic actions of uncertain benefit. Laboratory testing should be conducted as part of a therapeutic approach to a clinical problem, mindful of pretest probability of disease, the performance of the selected test, and the relative benefits and risks of testing. Considering the indication for a particular test can lead to a more rational approach to laboratory testing and better use of available tests.
journal_name
Crit Care Clinjournal_title
Critical care clinicsauthors
Ezzie ME,Aberegg SK,O'Brien JM Jrdoi
10.1016/j.ccc.2007.07.005subject
Has Abstractpub_date
2007-07-01 00:00:00pages
435-65issue
3eissn
0749-0704issn
1557-8232pii
S0749-0704(07)00045-0journal_volume
23pub_type
杂志文章,评审abstract::It is often necessary to transfuse blood products in shock. Use of these products can be life-saving, but they also carry considerable risk. It is important, therefore, that the physician be aware of the indications as well as possible complications, so that a proper decision can be made weighing the risk versus the b...
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::Patients with CCI have continuing profound medical needs, poor prognosis for significant functional recovery, and a high mortality rate. Nonetheless, some survive for months or years, but unfortunately, often with functional skills and quality of life lower than need be. Careful evaluation of each patient's medical co...
journal_title:Critical care clinics
pub_type: 杂志文章,评审
doi:10.1016/s0749-0704(02)00011-8
更新日期:2002-07-01 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::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::Caring for the new quadriplegic is an immense undertaking involving multiple health care professionals who must function as a team. The physician in charge must understand rehabilitation principles and be able to communicate with all members of the team caring for the patient. Rehabilitation principles, if considered ...
journal_title:Critical care clinics
pub_type: 杂志文章
doi:
更新日期:1987-07-01 00:00:00
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::The years that have passed since the introduction of the pulmonary artery catheter have been marked by radical changes in the practice of general and critical care medicine. There has been an increase in the application of physiologic principles to the management of shock states, myocardial infarction, and respiratory...
journal_title:Critical care clinics
pub_type: 历史文章,杂志文章
doi:10.1016/s0749-0704(05)70278-5
更新日期:1996-10-01 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
doi:10.1016/s0749-0704(03)00005-8
更新日期:2003-07-01 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::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 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::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::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
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::In summary, interventional techniques are well-established and offer safe and effective alternatives for management of patients in the intensive care unit or other setting. It is likely that the radiologist will become more involved in the management of ill children and adults. It is hoped that this will reduce the ne...
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::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::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::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::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::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::Bioterrorism is not only a reality of the times in which we live but bioweapons have been used for centuries. Critical care physicians play a major role in the recognition of and response to a bioterrorism attack. Critical care clinicians must be familiar with the diagnosis and management of the most likely bioterrori...
journal_title:Critical care clinics
pub_type: 杂志文章,评审
doi:10.1016/j.ccc.2013.03.015
更新日期:2013-07-01 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::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::Acute coronary syndrome is a major health problem affecting approximately 1.5 million individuals a year. Early diagnosis and appropriate evidence-based therapies improve clinical outcomes significantly. Current data suggest that an early invasive therapy may improve intermediate-term and long-term outcomes, particula...
journal_title:Critical care clinics
pub_type: 杂志文章,评审
doi:10.1016/j.ccc.2007.07.003
更新日期:2007-10-01 00:00:00
abstract::The pathophysiology of the burn injury and treatment factors that influence burn depth are explained. Details of burn wound care, including indications for early excision, topical antimicrobials, and the most recent advances in skin substitutes, are described. Burn wound sepsis, the most common and serious complicatio...
journal_title:Critical care clinics
pub_type: 杂志文章
doi:
更新日期:1985-03-01 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::Obesity has been recognized as an increasing problem not only in North America but globally. With a significant rise in the prevalence of obesity amongst children and adolescents over the past 20 years, the comorbidities associated with obesity are also now emerging at an earlier age. These comorbidities cause specifi...
journal_title:Critical care clinics
pub_type: 杂志文章,评审
doi:10.1016/j.ccc.2010.06.009
更新日期:2010-10-01 00:00:00
abstract::This article identifies the key challenges facing critical care practitioners in Africa. As a continent with a large proportion of the poorest countries and a plethora of unique diseases that place large demands for critical resources, the provision of care is largely in the context of severely constrained human and m...
journal_title:Critical care clinics
pub_type: 杂志文章,评审
doi:10.1016/j.ccc.2006.03.008
更新日期:2006-07-01 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::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