Abstract:
:The recent development of valid and reliable assessment tools to monitor agitation, sedation, analgesia, and delirium in the ICU represents an essential first step in the provision of patient comfort and the development of preferred treatment strategies. To make the ICU a more humane healing environment, these assessment tools must be used as part of a comprehensive evaluation of interventional and preventive treatments, pharmacologic and nonpharmacologic. In the spirit of the JCAHO, it may be time to add the evaluation of sedation, agitation, and delirium to that of pain assessment, making all aspects of patient comfort the fifth vital sign for the critically ill.
journal_name
Crit Care Clinjournal_title
Critical care clinicsauthors
Fraser GL,Riker RRdoi
10.1016/s0749-0704(05)70189-5subject
Has Abstractpub_date
2001-10-01 00:00:00pages
967-87issue
4eissn
0749-0704issn
1557-8232pii
S0749-0704(05)70189-5journal_volume
17pub_type
杂志文章,评审abstract::This article reviews two important innovations in echocardiography resulting from the recent advances in the capabilities of microprocessors. The first, automatic endocardial border detection, has been implemented on computers contained entirely within echocardiograph machines and is gaining wide clinical use. The sec...
journal_title:Critical care clinics
pub_type: 杂志文章,评审
doi:10.1016/s0749-0704(05)70256-6
更新日期:1996-04-01 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::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::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
更新日期:2016-10-01 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::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:
更新日期:1988-01-01 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::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::Given time, the brain can tolerate extraordinarily severe hyponatremia, but it does not take well to sudden changes; both rapid onset and rapid correction of hyponatremia can be injurious. Emergency treatment of hyponatremia should be reserved for the patient who has not had time to fully adapt to the disturbance. Whe...
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::Renal failure continues to cause a major burden of morbidity and mortality in both its acute and chronic forms, regardless of advances in current renal replacement therapies. A bioartificial kidney that includes a conventional dialysis filter and a renal tubule assist device containing approximately 10(8) renal proxim...
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
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::Vancomycin-resistant enterococci (VRE) consist mainly of Enterococcus faecalis and E faecium, the latter mostly hospital-acquired. In addition, E gallinarum and E casseliflavus are intrinsically vancomycin-resistant and are community-acquired. VRE have become common in many hospitals throughout the world and, once est...
journal_title:Critical care clinics
pub_type: 杂志文章,评审
doi:10.1016/j.ccc.2013.06.006
更新日期:2013-10-01 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::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::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::Timely performance and accurate interpretation of portable chest radiographs in the ICU setting are fundamental components of quality care. Teamwork between intensive care clinicians and radiologists is necessary to assure that the appropriate studies, of high technical quality, are obtained. By working together to in...
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::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::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
abstract::Measuring cardiac output without knowledge of the oxygen extraction by the tissues is of limited value. Instead of calculating oxygen consumption and oxygen delivery, a diagram relating cardiac index to the oxygen extraction ratio is proposed to interpret hemodynamic data at the bedside. This diagram is particularly h...
journal_title:Critical care clinics
pub_type: 杂志文章,评审
doi:10.1016/s0749-0704(05)70288-8
更新日期:1996-10-01 00:00:00
abstract::Acute respiratory failure can be the result of a variety of clinical conditions, such as congestive heart failure, pneumonia, pulmonary embolism, exacerbation of obstructive lung diseases, and acute respiratory distress syndrome (ARDS). This article focuses on developments related to acute lung injury and ARDS and rev...
journal_title:Critical care clinics
pub_type: 杂志文章,评审
doi:10.1016/j.ccc.2004.05.010
更新日期:2004-10-01 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::Traumatic brain injury (TBI) is an alteration in brain function, or other evidence of brain pathology, caused by an external force. TBI is a major cause of disability and mortality worldwide. Post-traumatic amnesia, or the interval from injury until the patient is oriented and able to form and later recall new memorie...
journal_title:Critical care clinics
pub_type: 杂志文章,评审
doi:10.1016/j.ccc.2017.03.011
更新日期:2017-07-01 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
abstract::The burned child requires a management that is different from that employed in the burned adult because of physiologic and psychological dissimilarities, although basic principles of management are the same. Particular problems and treatment of the burned child are highlighted. ...
journal_title:Critical care clinics
pub_type: 杂志文章
doi:
更新日期:1985-03-01 00:00:00
abstract::Supraventricular and ventricular arrhythmias remain relatively commonplace in the ICU. Proper pharmacologic treatment requires that the clinician recognize accompanying disease states that may alter the pharmacokinetics and pharmacodynamics of antiarrhythmic drugs. In addition, knowledge of cardiovascular toxicity, no...
journal_title:Critical care clinics
pub_type: 杂志文章,评审
doi:
更新日期:1991-07-01 00:00:00
abstract::Severe viral pneumonia is an increasing problem among adults. The incidence and number of viruses known to cause pneumonia and respiratory failure have also expanded in recent years. This article provides an overview of severe respiratory disease caused by coronavirus, respiratory syncytial virus, adenovirus, and hant...
journal_title:Critical care clinics
pub_type: 杂志文章,评审
doi:10.1016/j.ccc.2013.07.003
更新日期:2013-10-01 00:00:00
abstract::Carbon monoxide (CO) poisoning is the leading cause of death as a result of unintentional poisoning in the United States. CO toxicity is the result of a combination of tissue hypoxia-ischemia secondary to carboxyhemoglobin formation and direct CO-mediated damage at a cellular level. Presenting symptoms are mostly nons...
journal_title:Critical care clinics
pub_type: 杂志文章,评审
doi:10.1016/j.ccc.2012.07.007
更新日期:2012-10-01 00:00:00
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
更新日期:2020-07-01 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 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