End-of-life care in the critically ill geriatric population.

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 care, in return for which our deaths in old age are more likely to be drawn out and wild." Although no health care provider hopes for a drawn out and wild death for elderly patients, many geriatric persons will succumb to disease and die after having chosen and received ICU care. Recent data suggest that, on average, 11% of Medicare recipients spend more that 7 days in the ICU within 6 months before death.

journal_name

Crit Care Clin

journal_title

Critical care clinics

authors

Mularski RA,Osborne ML

doi

10.1016/s0749-0704(03)00056-3

subject

Has Abstract

pub_date

2003-10-01 00:00:00

pages

789-810, viii

issue

4

eissn

0749-0704

issn

1557-8232

pii

S0749-0704(03)00056-3

journal_volume

19

pub_type

杂志文章
  • Ethically based medical decision making in the intensive care unit: residency teaching strategies.

    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

    authors: Crausman RS,Armstrong JD 2nd

    更新日期:1996-01-01 00:00:00

  • Improving quality in the intensive care unit setting.

    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

    authors: Gallesio AO,Ceraso D,Palizas F

    更新日期:2006-07-01 00:00:00

  • Arterial catheterization.

    abstract::Arterial catheterization is used frequently in the management of critically ill patients, both for continuous blood pressure monitoring and access to the arterial circulation to obtain frequent blood gas measurements. The procedure is usually easily accomplished at the bedside using percutaneous methods such as the Se...

    journal_title:Critical care clinics

    pub_type: 杂志文章,评审

    doi:

    authors: Clark VL,Kruse JA

    更新日期:1992-10-01 00:00:00

  • Satisfaction in Intensive Care Unit Telemedicine Programs.

    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

    authors: Johnson AB

    更新日期:2019-07-01 00:00:00

  • Detection and management of pre-existing cognitive impairment and associated behavioral symptoms in the Intensive Care Unit.

    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

    authors: Lee HB,DeLoatch CJ,Cho S,Rosenberg P,Mears SC,Sieber FE

    更新日期:2008-10-01 00:00:00

  • Airway management: considerations in the trauma patient.

    abstract::The five components integral to modern, sophisticated airway management in trauma patients include equipment, pharmacologic adjuncts, manual techniques, physical circumstances, and patient profile. Although there is a finite number of pieces and types of equipment, pharmacologic adjuncts, and manual techniques, the la...

    journal_title:Critical care clinics

    pub_type: 杂志文章,评审

    doi:

    authors: Grande CM,Stene JK,Bernhard WN

    更新日期:1990-01-01 00:00:00

  • Dementia and the Critically Ill Older Adult.

    abstract::Dementia is a terminal illness that leads to progressive cognitive and functional decline. As the elderly population grows, the incidence of dementia in hospitalized older adults increases and is associated with poor short-term and long-term outcomes. Delirium is associated with an accelerated cognitive decline in hos...

    journal_title:Critical care clinics

    pub_type: 杂志文章,评审

    doi:10.1016/j.ccc.2020.08.010

    authors: Ghneim M,Diaz JJ Jr

    更新日期:2021-01-01 00:00:00

  • Physiology of mechanical ventilation.

    abstract::Mechanical ventilation, although essential in taking care of acute lung injury and widely used during surgical procedures worldwide, remains a highly debated field. Clinical trials in the last decade have shown convincingly that mechanical ventilation can result in additional mortality in patients with acute lung inju...

    journal_title:Critical care clinics

    pub_type: 杂志文章,评审

    doi:10.1016/j.ccc.2006.11.016

    authors: Haitsma JJ

    更新日期:2007-04-01 00:00:00

  • Noninvasive oxygen monitoring.

    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:

    authors: Brown M,Vender JS

    更新日期:1988-07-01 00:00:00

  • Mean arterial pressure: therapeutic goals and pharmacologic support.

    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

    authors: Shapiro DS,Loiacono LA

    更新日期:2010-04-01 00:00:00

  • Methods for monitoring the level of sedation.

    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:

    authors: Avramov MN,White PF

    更新日期:1995-10-01 00:00:00

  • Extracorporeal therapies for acute intoxications.

    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

    authors: Borkan SC

    更新日期:2002-04-01 00:00:00

  • Hypertensive crisis.

    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 wit...

    journal_title:Critical care clinics

    pub_type: 杂志文章,评审

    doi:

    authors: Rubenstein EB,Escalante C

    更新日期:1989-07-01 00:00:00

  • Risk Stratification of Pulmonary Embolism.

    abstract::Given the broad treatment options, risk stratification of pulmonary embolism is a highly desirable component of management. The ideal tool identifies patients at risk of death from the original or recurrent pulmonary embolism. Using all-cause death in the first 30-days after pulmonary embolism diagnosis as a surrogate...

    journal_title:Critical care clinics

    pub_type: 杂志文章,评审

    doi:10.1016/j.ccc.2020.02.002

    authors: Moumneh T,Wells PS,Miranda S

    更新日期:2020-07-01 00:00:00

  • Serotonin syndrome. A clinical update.

    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

    authors: Mills KC

    更新日期:1997-10-01 00:00:00

  • Blood pressure management in acute stroke.

    abstract::The optimal management of arterial blood pressure in the setting of acute stroke has not been firmly defined. The different types of stroke--ischemic, intracerebral hemorrhage, and subarachnoid hemorrhage--have different pathophysiologies and require different approaches in terms of blood pressure management in the ac...

    journal_title:Critical care clinics

    pub_type: 杂志文章,评审

    doi:10.1016/j.ccc.2006.08.002

    authors: Urrutia VC,Wityk RJ

    更新日期:2006-10-01 00:00:00

  • ARDS. The future.

    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

    authors: Wong HR

    更新日期:2002-01-01 00:00:00

  • Optimizing antimicrobial therapy in sepsis and septic shock.

    abstract::This article reviews principles in the rational use of antibiotics in sepsis and septic shock and presents evidence-based recommendations for optimal antibiotic therapy. Every patient with sepsis and septic shock must be evaluated at presentation before the initiation of antibiotic therapy. However, in most situations...

    journal_title:Critical care clinics

    pub_type: 杂志文章,评审

    doi:10.1016/j.ccc.2009.08.004

    authors: Kumar A

    更新日期:2009-10-01 00:00:00

  • Complications of chronic liver disease.

    abstract::The patient with advanced cirrhosis presents unique challenges to the critical care physician, in great measure because of the protean functions attributable to the liver and the multiplicity of derangements that may occur. Portal hypertension, once it develops, is the source of potentially devastating complications t...

    journal_title:Critical care clinics

    pub_type: 杂志文章,评审

    doi:

    authors: Chung RT,Jaffe DL,Friedman LS

    更新日期:1995-04-01 00:00:00

  • Lipid modulation and systemic inflammation.

    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

    authors: Zaloga GP,Marik P

    更新日期:2001-01-01 00:00:00

  • Mechanical circulatory devices in acute heart failure.

    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

    authors: Teuteberg JJ,Chou JC

    更新日期:2014-07-01 00:00:00

  • Arthritis in the intensive care unit.

    abstract::Acute arthritis in critically ill patients may be caused by local or systemic infection, by a flare of chronic joint disease such as rheumatoid or crystal-associated arthritis, or by less common entities such as hemarthrosis. Diagnosis requires analysis of synovial fluid, and appropriate treatment is based on its find...

    journal_title:Critical care clinics

    pub_type: 杂志文章,评审

    doi:10.1016/s0749-0704(02)00021-0

    authors: Raj JM,Sudhakar S,Sems K,Carlson RW

    更新日期:2002-10-01 00:00:00

  • An introduction to ultrasound equipment and knobology.

    abstract::The use of ultrasonography in medical practice has evolved dramatically over the last few decades and will continue to improve as technological advances are incorporated into daily medical practice. Although ultrasound machine size and equipment have evolved, the basic principles and fundamental functions have remaine...

    journal_title:Critical care clinics

    pub_type: 杂志文章,评审

    doi:10.1016/j.ccc.2013.08.006

    authors: Enriquez JL,Wu TS

    更新日期:2014-01-01 00:00:00

  • Cardiopulmonary resuscitation and somatic support of the pregnant patient.

    abstract::Cardiopulmonary arrest during pregnancy is a rare event that critical care clinicians must be prepared to manage. The causes of cardiopulmonary arrest during pregnancy, recommended modifications to cardiopulmonary resuscitation protocols that are specific to pregnancy, indications for and timing of perimortem cesarean...

    journal_title:Critical care clinics

    pub_type: 杂志文章,评审

    doi:10.1016/j.ccc.2004.05.005

    authors: Mallampalli A,Powner DJ,Gardner MO

    更新日期:2004-10-01 00:00:00

  • Acute renal failure and dialysis in cancer patients.

    abstract::Acute renal failure continues to be a common occurrence in critically ill cancer patients. It frequently results from a combination of risk factors, which include the following: hemodynamic alterations associated with renal ischemia; exposure to nephrotoxic drugs; urinary tract obstruction; and specific abnormalities ...

    journal_title:Critical care clinics

    pub_type: 杂志文章,评审

    doi:

    authors: Flombaum CD

    更新日期:1988-01-01 00:00:00

  • Sleep in traumatic brain injury.

    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

    authors: Vermaelen J,Greiffenstein P,deBoisblanc BP

    更新日期:2015-07-01 00:00:00

  • The economics of cardiovascular disease in the United States.

    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

    authors: Chen J,Rizzo JA

    更新日期:2012-01-01 00:00:00

  • Fluid Creep and Over-resuscitation.

    abstract::Fluid creep is the term applied to a burn resuscitation, which requires more fluid than predicted by standard formulas. Fluid creep is common today and is linked to several serious edema-related complications. Increased fluid requirements may accompany the appropriate resuscitation of massive injuries but dangerous fl...

    journal_title:Critical care clinics

    pub_type: 杂志文章,评审

    doi:10.1016/j.ccc.2016.06.007

    authors: Saffle JR

    更新日期:2016-10-01 00:00:00

  • Cardiac disease in pregnancy.

    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:

    authors: Clark SL

    更新日期:1991-10-01 00:00:00

  • Rehabilitation in spinal cord injury.

    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:

    authors: Keppler JP

    更新日期:1987-07-01 00:00:00