Báo cáo y học: "Advanced directives and treatment decisions in the intensive care unit" potx

... ofillness/injury they will suffer and what types of medicalinterventions they must consider [5]. Because medicine is notstatic, making a prospective determination regarding the types of treatment ... or against specifictypes of treatment; it typically becomes effective only when the patient is incompetent and either terminally ill orpermanently unconscious. A durable power of attorney is ... the issue. We oughtnot to be overly concerned with the execution and applicationof advanced directives but with the motivation behind them and the dialogue they engender over time [4]. In the...

Báo cáo y học: "Recently published papers: Heavyweight problems in the intensive care unit" potx

... recently in Intensive Care Medicine add moreweight to the arguments against such views [2,3]. In the study by Sakr and colleagues, the European obser-vational Sepsis Occurrence in Acutely Ill ... reading. There was noassociation between increased mortality and obesity. Therewas, however, an increase in morbidity with a trend towardslonger length of stay, both in the ICU and in the hospital,between ... fare worse, not the obese patients – a thought-provoking point made in the accompanying editorial [4,5].CommentaryRecently published papers: Heavyweight problems in the intensive care unit?Lui...

Báo cáo y học: "Is succinylcholine appropriate or obsolete in the intensive care unit" docx

... mortalityrate than cardiac arrest in succinylcholine-inducedhyperkalaemia alone [8].Unpredictable activity In intensive care patients there is large variability in the activity of plasma cholinesterase, ... an enzyme that metabolizesCommentaryIs succinylcholine appropriate or obsolete in the intensive care unit?Leo HDJ BooijInstitute for Anaesthesiology, University Hospital Nijmegen, Sint Radboud, ... breathingpossible if intubation fails. The situation in the ICU isdifferent, however. During anaesthesia, intubation and artificial ventilation are only indicated to facilitate surgery byensuring...

Báo cáo y học: " Rational use of computerized protocols in the intensive care unit" ppt

... nursing, and respiratory therapy staffs of the Intermountain Respiratory Intensive Care Unit and of the Shock-Trauma/Intermountain Respiratory ICU, and to the Respiratory Care Department of the ... Whileour understanding of underlying mechanisms of injury and inflammation in sepsis and ARDS has blossomed, our under-standing of clinical management of sepsis and ARDS has not.Several clinical trials ... D, Olin M, Badihi Y, Cohen G, Donchin Y, Sieski M,Cotev S: The nature and causes of human errors in a medical intensive care unit. In Proceedings of the Human Factors and Ergonomics Society Annual...

Báo cáo y học: "Clinical review: Acid–base abnormalities in the intensive care unit" doc

... events are probablyinsignificant for the young and otherwise physiologicallysound patients, they may be significantly physiologicallychallenging for the elderly or for those with physiologicdecompensation ... strongly consider including each of these variables in theirmethodology. Further evaluation of these and potentially othermarkers of morbidity and resource utilization is appropriate.Competing interests The ... for other injuries in isolation orcombination. The interpretation of SBE must thereforeincorporate the injury complex into decision-making, perhapslimiting its utility. A recent study of salvageable...

Báo cáo y học: " A stronger approach to weakness in the intensive care unit" doc

... sensory loss, and absent reflexes distally in the Figure 1A flow chart giving an approach to generalized weakness and/ or ventilatory failure in the intensive care unit. CK, creatine kinase; ... creatinekinase may help to identify CIM, but the peak may be missed in the membranopathy/necrotizing varieties or creatine kinasemay not be significantly elevated in cases with loss of myosinfilaments. ... histology and rapidrecovery. Presumably, the muscle membrane becomesdysfunctional, inexcitable and leaky, allowing myoglobin toleave the muscle. Some cases behave like disuse atrophy withselective...

Báo cáo khoa học: "Elevated troponin and myocardial infarction in the intensive care unit: a prospective study" potx

... obtained at the direction of the ICU team asclinically indicated. ECGs were performed by a technologistduring the day, and by the ICU bedside nurse in emergencies and during the evenings and ... should determine the prognostic importance of ele-vated troponin in the ICU by more comprehensively examiningother diagnoses and their consequences, and by evaluating the role of other modalities ... of damage. The diagnosis of MI has thus evolved follow-ing the introduction of routine troponin testing, resulting in the redefinition of MI by the joint European Society of Cardiology(ESC)/American...

Báo cáo y học: " Cost effectiveness of antimicrobial catheters in the intensive care unit: addressing uncertainty in the decision" doc

... chlorhexidine silver sulfadiazine; ICER, incremental cost effectiveness ratio; ICU, intensive care unit; int/ext, internally and externally coated; QALY, quality-adjusted life year; MR, minocycline and ... catheters; CH/SSD, chlorhexidine silver sulfadiazine; CR-BSI, catheter related bloodstream infection; ICU, intensive care unit; int/ext, internally and externally coated; MR, minocycline and ... uncertainty indicate that minocycline and rifampicin catheters generate the greatest health benefits (1.6 quality-adjusted life years) and opportunity cost savings (AUD $130,289 per 1,000 catheters...

Báo cáo y học: "Acute kidney injury on admission to the intensive care unit: where to go from here" docx

... numerous pub-lications and research projects in the past 5 years [1-4],including the study by Kolhe and colleagues [1] in Critical Care. Interestingly, as facts about AKI and its impact on prog-nosis ... kidney injury (AKI) is a common problem, especially in critically ill patients. In Critical Care, Kolhe and colleagues reportthat 6.3% of 276,731 patients in 170 intensive care units (ICUs) in the ... areas in the field of AKI remainuncertain, the issue of RRT being a particularly controversialone [5]. There is wide variation in clinical practice regardingmode, indication, timing, dose and...

Báo cáo y học: "Risk stratification of early admission to the intensive care unit of patients with no major criteria of severe community-acquired pneumonia: development of an international prediction rule" potx

... E, Fine MJ: Investigation of the ability of the Pneumonia Severity Index to accurately predictclinically relevant outcomes: a European study. Clin MicrobiolInfect 2007, 13:923-931.9. Yealy DM, ... of the attending physicians and missing values were assumed to be normal. This strategy iswidely used in the clinical application of prediction rules and reflects the methods used in the original ... requiring IRVS [19]. Indeed, ICU care has been demonstrated to improve outcome in severely ill and unstable patients, and these patients require intensive moni-toring and may potentially need...

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