Abstract:
:Approximately 20% of all mechanically ventilated patients fail their first attempt to wean. Prolonged mechanical ventilation increases morbidity, mortality, and costs. No single weaning parameter predicts patient ability to wean. Weaning studies suggest that daily trials of spontaneous breathing for appropriate patients assured by standing protocol and driven by respiratory care practitioners and/or nurses improve the weaning process and patient outcome.
journal_name
Crit Care Clinjournal_title
Critical care clinicsauthors
Eskandar N,Apostolakos MJdoi
10.1016/j.ccc.2006.12.002subject
Has Abstractpub_date
2007-04-01 00:00:00pages
263-74, xissue
2eissn
0749-0704issn
1557-8232pii
S0749-0704(06)00082-0journal_volume
23pub_type
杂志文章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::Total parenteral nutrition was developed in the 1960s and has since been implemented commonly in the intensive care unit (ICU). Studies published in the 1980s and early 1990s indicate that the use of total parenteral nutrition is associated with increased mortality and infectious morbidity. These detrimental effects w...
journal_title:Critical care clinics
pub_type: 杂志文章
doi:10.1016/j.ccc.2010.04.002
更新日期:2010-07-01 00:00:00
abstract::Cerebral injury is a frequent complication of cardiac surgery, and it has been associated with high mortality, morbidity, hospital costs; an increased likelihood of admission to a secondary care facility after hospital discharge; and impaired quality of life. This article examines postulated mechanisms for cerebral in...
journal_title:Critical care clinics
pub_type: 杂志文章,评审
doi:10.1016/j.ccc.2007.09.004
更新日期:2008-01-01 00:00:00
abstract::Brain injury represents the major cause of long-term disability and mortality among patients resuscitated from cardiac arrest. Brain-directed therapies include maintenance of normal oxygenation, hemodynamic support to optimize cerebral perfusion, glycemic control, and targeted temperature management. Pertinent guideli...
journal_title:Critical care clinics
pub_type: 杂志文章,评审
doi:10.1016/j.ccc.2014.06.007
更新日期:2014-10-01 00:00:00
abstract::Optimal airway management requires an experienced caregiver, attention to detail, and knowledge of the patient's physiology. A variety of pharmacologic agents have proved useful in obtaining a secure airway and minimizing risk to the patient. Depending on the skills of the caregiver, oral intubation has become the pre...
journal_title:Critical care clinics
pub_type: 杂志文章,评审
doi:10.1016/s0749-0704(05)70119-6
更新日期:2000-07-01 00:00:00
abstract::Chemical agents of warfare are divided into lung agents, blood agents, vesicants, and nerve agents. Intensivists must familiarize themselves with the clinical presentation and management principles in the event of a chemical attack. Key principles in management include aggressive supportive care and early administrati...
journal_title:Critical care clinics
pub_type: 杂志文章,评审
doi:10.1016/j.ccc.2019.05.002
更新日期:2019-10-01 00:00:00
abstract::It is important that educators in the intensive care unit (ICU) provide physicians in training with the guidance and experience requisite in developing foundational skills in value-based medical practice. This article discusses the underlying philosophy of ethically based medical decision making and describes the comp...
journal_title:Critical care clinics
pub_type: 杂志文章,评审
doi:10.1016/s0749-0704(05)70215-3
更新日期:1996-01-01 00:00:00
abstract::Infections caused by Candida species are now endemic and entrenched in the intensive care unit setting. Candida infections continue to provide a major diagnostic and therapeutic challenge to clinicians. The increased prevalence of Candida infections represent the high price clinicians and patients must pay for the adv...
journal_title:Critical care clinics
pub_type: 杂志文章,评审
doi:
更新日期:1988-04-01 00:00:00
abstract::The appropriate starting point for a history of neurocritical care is a matter of debate, and the organization of facts and conjectures about it must be somewhat arbitrary. Intensive care for neurosurgical patients dates back to the work of Walter Dandy at the Johns Hopkins Hospital in the 1930s; many consider his cre...
journal_title:Critical care clinics
pub_type: 历史文章,杂志文章
doi:10.1016/j.ccc.2008.12.004
更新日期:2009-01-01 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::The metabolic response to injury can induce a state of hypermetabolism that results in the rapid loss of the body nitrogen, so that a critical reduction in lean body mass that affects morbidity and mortality can occur in a short period of time. The process also induces a redistribution of the body nitrogen away from t...
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::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::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::Meningococcemia is notorious for evasion of the host immune system and its rapid progression to fulminant disease, and serves as a unique model for pediatric sepsis. Illness severity is determined by complex interplays among host, pathogen, and environment. The inflammatory host response, including proinflammatory and...
journal_title:Critical care clinics
pub_type: 杂志文章,评审
doi:10.1016/j.ccc.2019.12.005
更新日期:2020-04-01 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::Approximately 12,000 Americans suffer traumatic spinal cord injuries each year. This article discusses the management of their neurologic, respiratory, cardiovascular, gastroenterologic, and genitourinary complications in the critical care setting. ...
journal_title:Critical care clinics
pub_type: 杂志文章,评审
doi:
更新日期:1986-10-01 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::The most important adaptive responses from a physiological stance involved the cardiovascular system, consisting in particular of elevation of the cardiac output and its redistribution to favor the coronary and cerebral circulations, at the expense of the splanchnic vascular beds. The evidence regarding these physiolo...
journal_title:Critical care clinics
pub_type: 杂志文章,评审
doi:10.1016/j.ccc.2004.01.001
更新日期:2004-04-01 00:00:00
abstract::Venous thromboembolic disease is a very common complication in the ICU. This article reviews incidence, prevention, and therapy related to venous thromboembolism, including both deep venous thrombosis and pulmonary embolism. Special diagnostic and treatment considerations in the ICU setting are highlighted. The increa...
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
abstract::Intoxications frequently perturb acid-base and electrolyte status, intravascular volume, and renal function. In selected cases, extracorporeal techniques effectively restore homeostasis and augment intoxicant removal. The use of 4-methylpyrazole, an inhibitor of alcohol dehydrogenase, is a new and effective treatment ...
journal_title:Critical care clinics
pub_type: 杂志文章,评审
doi:10.1016/s0749-0704(01)00011-2
更新日期:2002-04-01 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::Carbon monoxide (CO) poisoning is common and frequently unrecognized since the signs and symptoms are relatively nonspecific. CO poisoning causes tissue hypoxia. Additionally, various animal studies have demonstrated that CO interferes with myoglobin, P450, and other enzyme function; causes lipid peroxidation through ...
journal_title:Critical care clinics
pub_type: 杂志文章,评审
doi:10.1016/s0749-0704(05)70056-7
更新日期:1999-04-01 00:00:00
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::Management of the cardiac transplant recipient includes careful titration of inotropes and vasopressors. Recipient pulmonary hypertension and ventilatory status must be optimized to prevent allograft right ventricular failure. Vasoplegia, coagulopathy, arrhythmias, and renal dysfunction also require careful management...
journal_title:Critical care clinics
pub_type: 杂志文章,评审
doi:10.1016/j.ccc.2018.08.008
更新日期:2019-01-01 00:00:00
abstract::Venous thromboembolic disease continues to be a major source of morbidity and mortality, with obese patients who are critically ill presenting some of the most at-risk patients. As the literature evolves, it has become clear that there is a complex relationship between obesity and thrombosis and atherogenesis. It is t...
journal_title:Critical care clinics
pub_type: 杂志文章,评审
doi:10.1016/j.ccc.2010.06.011
更新日期:2010-10-01 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::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::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::The provision of care to the CCI patient is complex, challenging, and unique. The advanced practice nursing model at Mount Sinai Hospital is one successful care delivery model that fills the needs of both CCI patients and the nurses who work with them. The following transferable aspects of the RCU add to the unit's su...
journal_title:Critical care clinics
pub_type: 杂志文章,评审
doi:10.1016/s0749-0704(02)00008-8
更新日期:2002-07-01 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