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Mayo Clinic Critical and Neurocritical Care Board Review最新文献

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Essentials of Multimodal Brain Monitoring 多模式脑监测要点
Mayo Clinic Critical and Neurocritical Care Board Review Pub Date : 2019-09-01 DOI: 10.1093/MED/9780190862923.003.0131
J. Fugate
{"title":"Essentials of Multimodal Brain Monitoring","authors":"J. Fugate","doi":"10.1093/MED/9780190862923.003.0131","DOIUrl":"https://doi.org/10.1093/MED/9780190862923.003.0131","url":null,"abstract":"Intensive care unit (ICU) clinicians spend a substantial amount of time monitoring patients and their organ systems. Staples of systemic monitoring include continuous electrocardiography, pulse oximetry, serum laboratory values of liver and kidney function, urinary output, and ventilator parameters. Monitoring methods for the brain have lagged somewhat in technologic advances. Neuroimaging is essential to supplementing the clinical examination, and the technology has become increasingly sophisticated.","PeriodicalId":308040,"journal":{"name":"Mayo Clinic Critical and Neurocritical Care Board Review","volume":"40 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2019-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"127517135","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Intraventricular Drug Administration 脑室内给药
Mayo Clinic Critical and Neurocritical Care Board Review Pub Date : 2019-09-01 DOI: 10.1093/MED/9780190862923.003.0128
W. Horn, Benjamin Brown
{"title":"Intraventricular Drug Administration","authors":"W. Horn, Benjamin Brown","doi":"10.1093/MED/9780190862923.003.0128","DOIUrl":"https://doi.org/10.1093/MED/9780190862923.003.0128","url":null,"abstract":"The blood-brain barrier prevents many medications from reaching brain tissue, and the intraventricular (IVT) route can be a useful alternative in appropriate situations. The administration of medications through extraventricular drains requires expertise. Permanently placed catheters such as Ommaya reservoirs can also be used for medication administration. These devices should be handled according to the manufacturer’s recommendations to avoid damaging them. Many hospitals have practice protocols.Herein we provide some guidelines.","PeriodicalId":308040,"journal":{"name":"Mayo Clinic Critical and Neurocritical Care Board Review","volume":"17 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2019-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"116945526","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Unstable Spinal Fractures 不稳定脊柱骨折
Mayo Clinic Critical and Neurocritical Care Board Review Pub Date : 2019-09-01 DOI: 10.1093/MED/9780190862923.003.0089
W. Clifton, Mark A. Pichelmann
{"title":"Unstable Spinal Fractures","authors":"W. Clifton, Mark A. Pichelmann","doi":"10.1093/MED/9780190862923.003.0089","DOIUrl":"https://doi.org/10.1093/MED/9780190862923.003.0089","url":null,"abstract":"Traumatic spinal injuries occur relatively frequently, with an annual incidence of about 12,000 patients per year in the United States. Modern advances in critical care management of patients with spinal injuries and spinal cord injuries have greatly decreased mortality. Therefore, the prevalence in the United States is more than 200,000 patients per year. The importance of early diagnosis and proper management of acute spinal fractures cannot be understated. This chapter reviews the different types of bony and ligamentous disruption in the cervical, thoracic, lumbar, and sacral spine that can lead to new or worsened neurologic injury if left untreated.","PeriodicalId":308040,"journal":{"name":"Mayo Clinic Critical and Neurocritical Care Board Review","volume":"97 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2019-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"116671553","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Clinical Management of Liver Transplant Recipients 肝移植受者的临床管理
Mayo Clinic Critical and Neurocritical Care Board Review Pub Date : 2019-09-01 DOI: 10.1093/MED/9780190862923.003.0072
B. Gali
{"title":"Clinical Management of Liver Transplant Recipients","authors":"B. Gali","doi":"10.1093/MED/9780190862923.003.0072","DOIUrl":"https://doi.org/10.1093/MED/9780190862923.003.0072","url":null,"abstract":"Improvements in surgical, anesthetic, and critical care management since the 1990s have led to better outcomes for liver transplant (LT) recipients. Estimated 1-year survival after LT increased from 64% in 1989 to 89% in 2014. Of all transplants performed in the United States, 23% are LTs, and more than 7,000 LTs were performed in 2015. In most medical centers, LT recipients are initially cared for in an intensive care unit (ICU). With changes in the intraoperative surgical and anesthetic management, the typical time and resources required for immediate postoperative care have decreased, allowing for rapid recovery protocols to be instituted in some centers for patients without clinical complications.","PeriodicalId":308040,"journal":{"name":"Mayo Clinic Critical and Neurocritical Care Board Review","volume":"202 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2019-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"123052609","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Initial Approach to the Management of Multisystem Trauma 多系统创伤处理的初步方法
Mayo Clinic Critical and Neurocritical Care Board Review Pub Date : 2019-09-01 DOI: 10.1093/MED/9780190862923.003.0062
D. S. Morris
{"title":"Initial Approach to the Management of Multisystem Trauma","authors":"D. S. Morris","doi":"10.1093/MED/9780190862923.003.0062","DOIUrl":"https://doi.org/10.1093/MED/9780190862923.003.0062","url":null,"abstract":"Nearly 200,000 people die of injury-related causes in the United States each year, and injury is the leading cause of death for all patients aged 1 to 44 years. Approximately 30 million people sustain nonfatal injuries each year, which results in about 29 million emergency department visits and 3 million hospital admissions. Management of severely injured patients, typically defined as having an Injury Severity Score greater than 15 is best managed in a level I or level II trauma center. Any physician who provides care for critically ill patients should have a basic familiarity with the fundamentals of trauma care.","PeriodicalId":308040,"journal":{"name":"Mayo Clinic Critical and Neurocritical Care Board Review","volume":"80 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2019-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"125018217","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Intracerebral and Intraventricular Hemorrhage 脑内和脑室内出血
Mayo Clinic Critical and Neurocritical Care Board Review Pub Date : 2019-09-01 DOI: 10.1093/MED/9780190862923.003.0082
O. Dumitrascu, M. Aguilar
{"title":"Intracerebral and Intraventricular Hemorrhage","authors":"O. Dumitrascu, M. Aguilar","doi":"10.1093/MED/9780190862923.003.0082","DOIUrl":"https://doi.org/10.1093/MED/9780190862923.003.0082","url":null,"abstract":"Intraparenchymal cerebral hemorrhage and intraventricular hemorrhage are common cerebrovascular emergencies with various causes and prognoses. Rapid triage and individualized management are required because appropriate critical care management improves morbidity and mortality. A multidisciplinary approach for diagnosis and treatment is recommended.","PeriodicalId":308040,"journal":{"name":"Mayo Clinic Critical and Neurocritical Care Board Review","volume":"BME-33 3","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2019-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"121000276","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Mechanical Ventilation: Basic Modes 机械通风:基本模式
Mayo Clinic Critical and Neurocritical Care Board Review Pub Date : 2019-09-01 DOI: 10.1093/MED/9780190862923.003.0002
Amelia Lowell
{"title":"Mechanical Ventilation: Basic Modes","authors":"Amelia Lowell","doi":"10.1093/MED/9780190862923.003.0002","DOIUrl":"https://doi.org/10.1093/MED/9780190862923.003.0002","url":null,"abstract":"The main goal of mechanical ventilation is to unload the respiratory muscles to facilitate oxygenation and ventilation. This is accomplished by providing a minute ventilation (VE) (respiratory rate × tidal volume [VT]) that will result in adequate alveolar ventilation coupled with supplemental oxygen and a mean airway pressure that will result in adequate arterial oxygenation.","PeriodicalId":308040,"journal":{"name":"Mayo Clinic Critical and Neurocritical Care Board Review","volume":"25 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2019-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"116402800","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Acute Vascular Disorders of the Intestine 急性肠血管疾病
Mayo Clinic Critical and Neurocritical Care Board Review Pub Date : 2019-09-01 DOI: 10.1093/MED/9780190862923.003.0043
O. Mousa, S. Pungpapong
{"title":"Acute Vascular Disorders of the Intestine","authors":"O. Mousa, S. Pungpapong","doi":"10.1093/MED/9780190862923.003.0043","DOIUrl":"https://doi.org/10.1093/MED/9780190862923.003.0043","url":null,"abstract":"Mesenteric ischemia is caused by insufficient blood supply to the foregut and intestines. When the blood supply does not meet the metabolic requirements of these organs, catastrophic complications may result. Death is imminent in the setting of acute mesenteric ischemia if diagnosis is delayed; associated mortality rates are as high as 60% to 80%. The severity and extent of this disease depend on the nature of the vascular obstruction and the type of occluded vessel.","PeriodicalId":308040,"journal":{"name":"Mayo Clinic Critical and Neurocritical Care Board Review","volume":"15 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2019-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"122394730","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 2
Consequences of Anoxia and Ischemia to the Brain 缺氧和缺血对大脑的影响
Mayo Clinic Critical and Neurocritical Care Board Review Pub Date : 2019-09-01 DOI: 10.1093/MED/9780190862923.003.0011
J. Fugate
{"title":"Consequences of Anoxia and Ischemia to the Brain","authors":"J. Fugate","doi":"10.1093/MED/9780190862923.003.0011","DOIUrl":"https://doi.org/10.1093/MED/9780190862923.003.0011","url":null,"abstract":"Systemic illness can have an abrupt and sometimes profound effect on the central nervous system. Organ failure and acute electrolyte disturbances may cause neurologic manifestations that are often accompanied by a decline in consciousness. Secondary injury is characterized by demyelination, cerebral edema, and anoxic-ischemic brain injury.","PeriodicalId":308040,"journal":{"name":"Mayo Clinic Critical and Neurocritical Care Board Review","volume":"188 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2019-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"123757960","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Essentials of Cranial Neuroimaging 颅神经影像学要点
Mayo Clinic Critical and Neurocritical Care Board Review Pub Date : 2019-09-01 DOI: 10.1093/MED/9780190862923.003.0132
E. Lindell
{"title":"Essentials of Cranial Neuroimaging","authors":"E. Lindell","doi":"10.1093/MED/9780190862923.003.0132","DOIUrl":"https://doi.org/10.1093/MED/9780190862923.003.0132","url":null,"abstract":"Critically ill patients may have a wide array of neuroimaging abnormalities, including ischemic stroke, intracranial hemorrhage (ICH), and anoxic or hypoxic brain injury. Recognition of common and life-threatening patterns is essential to proper treatment. Critically ill patients are in an unstable condition, so moving them to a computed tomographic (CT) or magnetic resonance imaging (MRI) suite presents logistic and safety challenges that involve nursing care, transport of the ventilator and other intravenous tubing, and vasopressor medications. CT has a faster acquisition time than MRI and is more commonly used to obtain emergent neuroimaging data, such as massive stroke or intracranial structural information.","PeriodicalId":308040,"journal":{"name":"Mayo Clinic Critical and Neurocritical Care Board Review","volume":"18 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2019-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"126177982","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
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