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 car...

journal_title：Critical care clinics

authors： Mularski RA,Osborne ML

更新日期：2003-10-01 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

authors： Carson SS

更新日期：2003-10-01 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

authors： Garcia VF,Brown RL

更新日期：2003-07-01 00:00:00

abstract：:The evolving understanding of pathophysiologic events during and after pediatric cardiac arrest has not yet resulted in significantly improved outcome. Exciting breakthroughs in basic and applied science laboratories are, however, on the immediate horizon for study in specific subpopulations of cardiac arrest victims....

journal_title：Critical care clinics

authors： Morris MC,Nadkarni VM

更新日期：2003-07-01 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

authors： Goudarzi BM,Bonvino S

更新日期：2003-04-01 00:00:00

abstract：:Providing effective critical care to vascular surgical patients is challenging to the intensivist. These patients often have multiple significant concurrent diseases that need to be adequately managed. A selective policy for identifying patients that need ICU is recommended. Early and smooth restoration to their preop...

journal_title：Critical care clinics

authors： Gopalan PD,Burrows RC

更新日期：2003-01-01 00:00:00

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

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

更新日期：2002-10-01 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

authors： Thomas DC,Kreizman IJ,Melchiorre P,Ragnarsson KT

更新日期：2002-07-01 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

authors： Carasa M,Nespoli G

更新日期：2002-07-01 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

authors： Borkan SC

更新日期：2002-04-01 00:00:00

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

authors： Wong HR

更新日期：2002-01-01 00:00:00

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 assessm...

journal_title：Critical care clinics

authors： Fraser GL,Riker RR

更新日期：2001-10-01 00:00:00

abstract：:Alterations in hemostasis are common in patients with cancer admitted to the ICU. Depending on the underlying disease and specific hemostatic abnormality, the patient with cancer may develop bleeding, thrombosis, or both, such as DIC. Bleeding complications usually result from abnormalities in platelets or deficiency ...

journal_title：Critical care clinics

authors： DeSancho MT,Rand JH

更新日期：2001-07-01 00:00:00

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

authors： Fei L,Trohman RG

更新日期：2001-04-01 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

authors： Zaloga GP,Marik P

更新日期：2001-01-01 00:00:00

abstract：:The future of cardiopulmonary resuscitation lies in new technologies for monitoring and generating vital organ perfusion during cardiac arrest and the post-resuscitation phase and in pharmacologic agents that will enhance ROSC and reverse ischemia-reperfusion injury. ROSC is the first step toward survival, so interven...

journal_title：Critical care clinics

authors： Manning JE,Katz LM

更新日期：2000-10-01 00:00:00

abstract：:Good airway management depends on a system that emphasizes teamwork to expedite care and minimize errors. By understanding the accreditation and licensing requirements, appropriate personnel and equipment can be allocated along cost effective guidelines. Newer techniques for management of the difficult airway, such as...

journal_title：Critical care clinics

authors： Showan AM,Sestito JA

更新日期：2000-07-01 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

authors： Rodricks MB,Deutschman CS

更新日期：2000-07-01 00:00:00

abstract：:Early recognition of the sepsis syndrome, prompt administration of broad-spectrum antibiotics, surgical intervention when indicated, and aggressive supportive care in intensive care units remain the therapeutic strategies for patients with sepsis. Antibiotic selection is based on many factors including the most probab...

journal_title：Critical care clinics

authors： Simon D,Trenholme G

更新日期：2000-04-01 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

authors： Beagle GL

更新日期：2000-01-01 00:00:00

abstract：:The field of neuroendovascular therapy is rapidly growing. New technology and operators' expertise is developing at a pace that will make this discipline progressively more available and successful. For the intensive care of patients who have acute brain ischemia, new techniques of recanalizing occluded arteries are p...

journal_title：Critical care clinics

authors： Gomez CR,Wadlington VR,Terry JB,Tulyapronchote R

更新日期：1999-10-01 00:00:00

abstract：:The EMR in the ICU has the utility of providing the necessary information to make sound clinical decisions for critically ill patients. For it to be optimized, the EMR must be more than just what is being replicated in the written record or merely a documentation tool; it must add value that supports and enhances clin...

journal_title：Critical care clinics

authors： Sado AS

更新日期：1999-07-01 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

authors： Weaver LK

更新日期：1999-04-01 00:00:00

abstract：:This article provides an overview of some of the current issues involved in sedation and anxiolysis in the intensive care unit. The problems involved in trying to monitor sedation levels are discussed, as are some of the newer options available for physiologic monitoring of the central nervous system. The problem of a...

journal_title：Critical care clinics

authors： Lowson SM,Sawh S

更新日期：1999-01-01 00:00:00

abstract：:Vasodilators that affect the pulmonary vasculature are appealing adjuncts in many cardiopulmonary conditions that require mechanical ventilation such as ARDS, COPD, PPHN, and cardiothoracic surgery. The adverse systemic effects of parenteral PGE1 and parenteral prostacyclin limit their usefulness in critically ill pat...

journal_title：Critical care clinics

authors： Zimmerman JL,Hanania NA

更新日期：1998-10-01 00:00:00

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

authors： Heyland DK

更新日期：1998-07-01 00:00:00

abstract：:Nosocomial diarrheas are an important problem in hospitals, and in critical care units in particular. Hospital-acquired diarrhea may be on an infectious or noninfectious basis. Common noninfectious causes of nosocomial diarrhea include medication-induced changes in the fecal flora or changes secondary to enteral hyper...

journal_title：Critical care clinics

authors： Cunha BA

更新日期：1998-04-01 00:00:00

abstract：:Clinicians are confronted with a complex challenge when a patient is admitted to a critical care unit (CCU) with a significant chest roentgenography (CXR) abnormality. The etiology of a new infiltrate seen on CXR in a patient already in the CCU is more difficult to establish, but is of equal concern. ...

journal_title：Critical care clinics

authors： Santos E,Talusan A,Brandstetter RD

更新日期：1998-01-01 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

authors： Mills KC

更新日期：1997-10-01 00:00:00

abstract：:Although our understanding of molecular events in septic shock is growing exponentially, bedside management has changed only incrementally over the last 20 years. In pediatric and adult patients alike, treatment continues to be largely supportive. Morbidity and mortality, though gradually improving, continue to be hig...

journal_title：Critical care clinics

authors： Carcillo JA,Cunnion RE

更新日期：1997-07-01 00:00:00

abstract：:India is a vast democracy of nearly one billion people. Before the British rule ended in 1947, the life span of an Indian was a mere 21 years. Within a short span of 50 years, it increased to an impressive 63 years, largely due to public health measures initiated by the government. This created a pool of more than 300...

journal_title：Critical care clinics

authors： Udwadia FE,Guntupalli KK,Vidyasagar D

更新日期：1997-04-01 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

authors： Yundt KD,Diringer MN

更新日期：1997-01-01 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

authors： Vincent JL

更新日期：1996-10-01 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

authors： Ginosar Y,Sprung CL

更新日期：1996-10-01 00:00:00

abstract：:This article argues that dopamine infused in low doses has not been shown to avert the onset of or ameliorate the course of acute renal failure in critically ill patients. The inotropic and diuretic effects of dopamine are discussed, and its adverse effects are described. An attempt is made to offer an evidence-based ...

journal_title：Critical care clinics

authors： Cottee DB,Saul WP

更新日期：1996-07-01 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

authors： Leibowitz AB

更新日期：1996-07-01 00:00:00

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

authors： Legget ME,Bashein G

更新日期：1996-04-01 00:00:00

abstract：:Multiplane (TEE) transducer imaging is the most highly evolved TEE technology at present. New clinical applications of this technology will be realized as echocardiographers gain experience with it. Current limitations of TEE are likely to be surmounted as its use increases, and continuous improvements and miniaturiza...

journal_title：Critical care clinics

authors： Khandheria BK,Tajik AJ,Seward JB

更新日期：1996-04-01 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

authors： Crausman RS,Armstrong JD 2nd

更新日期：1996-01-01 00:00:00

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

authors： Avramov MN,White PF

更新日期：1995-10-01 00:00:00