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Percutaneous tracheostomy. 经皮气管造口术。
Clinical intensive care : international journal of critical & coronary care medicine Pub Date : 2019-03-01 DOI: 10.1093/med/9780198749080.003.0029
M. W. Bennett, A. Bodenham
{"title":"Percutaneous tracheostomy.","authors":"M. W. Bennett, A. Bodenham","doi":"10.1093/med/9780198749080.003.0029","DOIUrl":"https://doi.org/10.1093/med/9780198749080.003.0029","url":null,"abstract":"Percutaneous dilational tracheostomy (PDT) originated in the USA and now an increasing number of UK centres are adopting the technique. It compares favourably with traditional surgical tracheostomy; PDT can be performed more satisfactorily at the bedside, avoiding the transport of critically ill patients to the operating theatre. It is a more rapid and convenient technique and evidence increasingly suggests that it is associated with significantly fewer and less severe complications. If early reports are confirmed by larger, carefully controlled trials, it is likely that PDT will largely replace conventional surgical techniques for the provision of tracheostomy in the critically ill. An improved risk-benefit ratio of PDT may favour earlier conversion of translaryngeal intubation to tracheostomy.","PeriodicalId":79828,"journal":{"name":"Clinical intensive care : international journal of critical & coronary care medicine","volume":"42 1","pages":"270-5"},"PeriodicalIF":0.0,"publicationDate":"2019-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"77564068","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
Risk factors for fat embolism syndrome in multiple trauma patients 多发创伤患者脂肪栓塞综合征的危险因素
Clinical intensive care : international journal of critical & coronary care medicine Pub Date : 2006-09-01 DOI: 10.3109/09563070701704051
K. Mjahed, A. Bouhouri, Y. Alaoui, I. Tazi, A. Adib, L. Barrou
{"title":"Risk factors for fat embolism syndrome in multiple trauma patients","authors":"K. Mjahed, A. Bouhouri, Y. Alaoui, I. Tazi, A. Adib, L. Barrou","doi":"10.3109/09563070701704051","DOIUrl":"https://doi.org/10.3109/09563070701704051","url":null,"abstract":"Abstract Objective. To evaluate risk factors for fat embolism syndrome (FES) in patients with multiple trauma. Design. Case–control study. Setting. Tertiary care university hospital, surgical intensive care unit. Patients. Sixty adults with multiple trauma, 30 of them with FES. Interventions. None. Measurements and main results. Patients were matched by gender, age (±5 years), injury severity score and date. Thirty patients were considered as the control group. Mortality was significantly higher in the FES group (p<0.001). FES was linked to anaemia (p<0.03), thrombocytopenia (p<0.01) and hypocholesterolaemia (p<0.05). Some characteristics of fracture were associated with a high risk of occurrence of FES: right side (p<0.02), displaced (p<0.05) and closed fracture (p<0.05). The timing of fixation did not statistically differ between the two groups, but orthopaedic treatment was linked with the occurrence of FES (p<0.005). In multivariate analysis, the Acute Physiology and Chronic Health Evaluation System I...","PeriodicalId":79828,"journal":{"name":"Clinical intensive care : international journal of critical & coronary care medicine","volume":"17 1","pages":"75-79"},"PeriodicalIF":0.0,"publicationDate":"2006-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.3109/09563070701704051","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"69373205","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
The use of trans-oesophageal echocardiography to guide therapy in a case of massive pulmonary embolus masquerading as inferior myocardial infarction 应用经食管超声心动图指导治疗大面积肺栓塞伪装为下壁心肌梗死1例
Clinical intensive care : international journal of critical & coronary care medicine Pub Date : 2006-03-01 DOI: 10.3109/17402520600619543
Sherif Awad, Somnath Kumar, J. Rogers
{"title":"The use of trans-oesophageal echocardiography to guide therapy in a case of massive pulmonary embolus masquerading as inferior myocardial infarction","authors":"Sherif Awad, Somnath Kumar, J. Rogers","doi":"10.3109/17402520600619543","DOIUrl":"https://doi.org/10.3109/17402520600619543","url":null,"abstract":"AbstractPulmonary embolism is a life-threatening condition which has a number of clinical manifestations. We report a case of a 68-year old female who presented in cardiac arrest following an episode of chest pain. Admission electrocardiogram (ECG) demonstrated inferior ST elevation suggestive of acute myocardial infarction but prompt resolution of these changes cast doubt over the diagnosis. This was resolved by the use of urgent bedside trans-oesophageal echocardiography (TOE) which demonstrated multiple mobile costs in the right atrium and ventricle. A review of the literature on this condition and the use of TOE as an early diagnostic modality is discussed.","PeriodicalId":79828,"journal":{"name":"Clinical intensive care : international journal of critical & coronary care medicine","volume":"17 1","pages":"55-57"},"PeriodicalIF":0.0,"publicationDate":"2006-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"69448430","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
Medical errors and adverse events: Focus on the Intensive Care Unit 医疗差错和不良事件:重点关注重症监护病房
Clinical intensive care : international journal of critical & coronary care medicine Pub Date : 2006-03-01 DOI: 10.3109/09563070600576196
M. Al-Ansari, M. Hijazi
{"title":"Medical errors and adverse events: Focus on the Intensive Care Unit","authors":"M. Al-Ansari, M. Hijazi","doi":"10.3109/09563070600576196","DOIUrl":"https://doi.org/10.3109/09563070600576196","url":null,"abstract":"AbstractErrors in intensive care units indicate a breakdown in the system or wrong decision-making. They must be recognized, their causes analyzed and preventive measures taken. We should try to understand the causes of errors, to install an informative reporting system of adverse events as an essential prerequisite, to measure them, and to choose the best approaches for minimizing the harm to the patients. Patient care, safety and quality must continue to be our highest priority. It is to be improved by our collective effort.","PeriodicalId":79828,"journal":{"name":"Clinical intensive care : international journal of critical & coronary care medicine","volume":"17 1","pages":"9-17"},"PeriodicalIF":0.0,"publicationDate":"2006-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.3109/09563070600576196","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"69373175","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: 1
Delivery of nitric oxide by high-frequency percussive ventilation: System design and evaluation 高频冲击式通风输送一氧化氮:系统设计与评价
Clinical intensive care : international journal of critical & coronary care medicine Pub Date : 2006-03-01 DOI: 10.3109/09563070600619368
L. Cancio, Eleuterio Galvez, B. Jordan, W. Allies
{"title":"Delivery of nitric oxide by high-frequency percussive ventilation: System design and evaluation","authors":"L. Cancio, Eleuterio Galvez, B. Jordan, W. Allies","doi":"10.3109/09563070600619368","DOIUrl":"https://doi.org/10.3109/09563070600619368","url":null,"abstract":"Abstract Background: Inhaled nitric oxide (NO) improves oxygenation in patients with acute respiratory distress syndrome (ARDS), and may act synergistically with high-frequency ventilation. High-frequency percussive ventilation (HFPV) has improved outcome in patients with inhalation injury. Thus, a system for NO delivery via HFPV would be desirable, but has not yet been described. Methods: A mechanical test lung was used for this evaluation. HFPV was delivered by means of a Volumetric Diffusive Respiration ventilator (VDR-4®). Spontaneous breaths were simulated by means of a lever arm attached to the bellows of the test lung. NO was instilled continuously at a constant rate into a side port between the sliding venturi of the VDR-4® and the endotracheal tube. Nitrogen dioxide (NO2) and NO levels were measured electrochemically via ports located at the front and back of the test lung. Expired gas was scavenged, and environmental NO2 levels were monitored. The ability of the system to provide constant NO lev...","PeriodicalId":79828,"journal":{"name":"Clinical intensive care : international journal of critical & coronary care medicine","volume":"17 1","pages":"41-48"},"PeriodicalIF":0.0,"publicationDate":"2006-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.3109/09563070600619368","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"69373184","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
Antimicrobial-impregnated catheters for reducing nosocomial catheter-associated blood stream infections in the pediatric intensive care unit 用于减少儿科重症监护病房内导管相关血流感染的抗菌浸渍导管
Clinical intensive care : international journal of critical & coronary care medicine Pub Date : 2006-03-01 DOI: 10.1080/09563070600692902
F. Odetola, R. Dechert, K. VanderElzen, C. Chenoweth, F. Moler
{"title":"Antimicrobial-impregnated catheters for reducing nosocomial catheter-associated blood stream infections in the pediatric intensive care unit","authors":"F. Odetola, R. Dechert, K. VanderElzen, C. Chenoweth, F. Moler","doi":"10.1080/09563070600692902","DOIUrl":"https://doi.org/10.1080/09563070600692902","url":null,"abstract":"AbstractObjective. Over 250,000 cases of central venous catheter-associated bloodstream infections (CVC-BSI) occur annually in the US leading to increased morbidity, costs, and mortality. While found to decrease the incidence of CVC-BSI in adult patients, no recommendations exist on the use of antimicrobial-impregnated catheters (AIC) in pediatric patients. This study was conducted to assess the effectiveness of AIC in reducing the incidence rates of CVC-BSI in a pediatric intensive care unit (PICU). Design. Retrospective cohort study. Setting. A 16-bed PICU in a tertiary children's hospital. Interventions and measurements. All PICU admissions requiring placement of a central venous catheter (CVC) from January 1999 through June 2003 were assessed for CVC-BSI, 21 months before, and 30 months after, introduction of AICs. Results. Of 5005 admissions during the 51-month study period, 1656 (33%) required CVC placement. Of these, 1441 (87%) admissions were initially assessed. Of these, 612 admissions (3057 CVC ...","PeriodicalId":79828,"journal":{"name":"Clinical intensive care : international journal of critical & coronary care medicine","volume":"17 1","pages":"33-40"},"PeriodicalIF":0.0,"publicationDate":"2006-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1080/09563070600692902","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"59534736","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: 1
Acute cholestasis as a side effect of intravenous levomepromazine in ICU-patients 重症监护病房患者静脉注射左旋丙嗪的副作用:急性胆汁淤积
Clinical intensive care : international journal of critical & coronary care medicine Pub Date : 2006-03-01 DOI: 10.3109/09563070500492312
P. T. Horst, N. Foudraine
{"title":"Acute cholestasis as a side effect of intravenous levomepromazine in ICU-patients","authors":"P. T. Horst, N. Foudraine","doi":"10.3109/09563070500492312","DOIUrl":"https://doi.org/10.3109/09563070500492312","url":null,"abstract":"AbstractLevomepromazine has been used as an adjunct to standard sedative therapies in mechanically ventilated ICU patients, despite a relative lack of safety data. This addition could increase the risk of cholestasis, a side effect common among phenothiazines. The aim of our study was to assess whether the addition of an infusion of levomepromazine to midazolam increases the risk of cholestasis. The index group was retrospectively defined by patients with an infusion of levomepromazine in addition to infusion of midazolam. The control group was retrospectively defined by patients with infusion of midazolam alone. Liver function tests were retrieved from patient data records. Exclusion criteria were serum AP, GGT, ALAT levels more than a 2-fold increase of the upper limit of normal value (ULN), on the first day of therapy. Drug-induced cholestatic liver injury was defined as more than a 2-fold increase from baseline of the ULN of alkaline phosphatase. No statistically significant differences were found for...","PeriodicalId":79828,"journal":{"name":"Clinical intensive care : international journal of critical & coronary care medicine","volume":"17 1","pages":"27-32"},"PeriodicalIF":0.0,"publicationDate":"2006-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.3109/09563070500492312","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"69373144","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: 3
A national survey of management of patients aged over 75 years undergoing elective and emergency laparotomy 75岁以上择期和急诊剖腹手术患者管理的全国调查
Clinical intensive care : international journal of critical & coronary care medicine Pub Date : 2006-01-01 DOI: 10.3109/09563070701704119
T. Cook, C. Farrow, B. Walton
{"title":"A national survey of management of patients aged over 75 years undergoing elective and emergency laparotomy","authors":"T. Cook, C. Farrow, B. Walton","doi":"10.3109/09563070701704119","DOIUrl":"https://doi.org/10.3109/09563070701704119","url":null,"abstract":"Abstract Objectives. Laparotomy in the elderly population is a frequently performed operation with high mortality. Little is published about the anaesthetic management of these patients. In view of this high mortality, such data would be useful prior to designing studies where the effect of interventions in peri-operative practice might be studied. Design. A postal survey of the proposed management of two hypothetical 75 year olds. Patient A: ASA 2, requiring elective anterior resection. Patient B: ASA 3 requiring emergency laparotomy for bowel obstruction. Setting. The survey was sent to the anaesthetic college tutor in 251 acute National Health Service hospitals in the UK, who was asked to pass it to the anaesthetist working in the emergency theatre on that day. Interventions and measurements. If no reply was received within 6 weeks, the survey was resent. Replies were analysed and the data summarized. Main results. Replies were received from 163 (65%) anaesthetists. Nineteen per cent of emergency lists...","PeriodicalId":79828,"journal":{"name":"Clinical intensive care : international journal of critical & coronary care medicine","volume":"17 1","pages":"85-93"},"PeriodicalIF":0.0,"publicationDate":"2006-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.3109/09563070701704119","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"69373218","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: 1
Polymyxin B-immobilized fibre haemoperfusion reduces urinary 8-hydroxy-2?-deoxyguanosine levels in patients with septic shock 多粘菌素b固定化纤维血液灌注减少尿8-羟基-2?脓毒性休克患者-脱氧鸟苷水平
Clinical intensive care : international journal of critical & coronary care medicine Pub Date : 2006-01-01 DOI: 10.3109/09563070701704135
T. Nakamura, Y. Kawagoe, Y. Ueda, K. Node, H. Koide
{"title":"Polymyxin B-immobilized fibre haemoperfusion reduces urinary 8-hydroxy-2?-deoxyguanosine levels in patients with septic shock","authors":"T. Nakamura, Y. Kawagoe, Y. Ueda, K. Node, H. Koide","doi":"10.3109/09563070701704135","DOIUrl":"https://doi.org/10.3109/09563070701704135","url":null,"abstract":"Abstract Objective. To determine whether urinary 8-hydroxy-2′-deoxyguanosine (8-OHdG) levels are altered in patients with septic shock and whether polymyxin B-immobilized fibre (PMX-F) haemoperfusion reduces the 8-OHdG level in these patients. Design and subjects. Twenty patients with septic shock and 20 age-matched healthy volunteers were included in the study. The septic shock patients were divided into two treatment groups: a PMX-F treatment group (n =12) and a non-PMX-F treatment group (n =8). Standard supportive care was continued without change during PMX-F haemoperfusion. Clinical markers, including plasma endotoxin, were measured before and after the first and the second PMX-F treatment and the following day. Urinary 8-OHdG levels were also examined before and after the first and the second PMX-F treatment (24 h pooled urine) and the following day. Results. Urinary 8-OHdG levels were significantly higher in septic shock patients (median 38.0 ng/mg creatinine; range 16.0–52.0 ng/mg creatinine) than...","PeriodicalId":79828,"journal":{"name":"Clinical intensive care : international journal of critical & coronary care medicine","volume":"17 1","pages":"95-100"},"PeriodicalIF":0.0,"publicationDate":"2006-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.3109/09563070701704135","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"69373224","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: 3
The difficulties that exist putting ethical theory into practice in critical care 伦理学理论在重症监护中应用的困难
Clinical intensive care : international journal of critical & coronary care medicine Pub Date : 2006-01-01 DOI: 10.3109/09563070500246239
A. Tillyard, M. Kuper, S. Brett
{"title":"The difficulties that exist putting ethical theory into practice in critical care","authors":"A. Tillyard, M. Kuper, S. Brett","doi":"10.3109/09563070500246239","DOIUrl":"https://doi.org/10.3109/09563070500246239","url":null,"abstract":"AbstractAt a recent General Medical Council conference it was suggested by Dame Janet Smith, author of the Shipman inquiry report, that medical students should be assessed on their understanding of ethical principles (GMC Education Conference, May 9, 2005). Indeed, issues of medical ethics have recently made headline news around the world. In England, the right of a patient with progressive cerebellar ataxia to compel doctors to continued feeding for so long as he wishes is under appeal (Dyer, C. The Guardian, London, May 16th, 2005). In America, the recent death following withdrawal of feeding from Terri Schiavo, who was in a persistent vegetative state since 1990, taxed doctors, legislators and politicians up to the White House (Stolberg, SG, The New York Times, April 1, 2005). While such high profile cases arise exceptionally, critical care routinely involves ethical considerations, either implicitly or explicitly. This review describes various ethical principles commonly employed in relation to critic...","PeriodicalId":79828,"journal":{"name":"Clinical intensive care : international journal of critical & coronary care medicine","volume":"17 1","pages":"1-7"},"PeriodicalIF":0.0,"publicationDate":"2006-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.3109/09563070500246239","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"69372957","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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