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The Journal of critical illness最新文献

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Tips for monitoring the position of a central venous catheter. How placement can go awry--even when the anatomy is normal. 监测中心静脉导管位置的提示。即使解剖结构正常，放置位置也会出错。
The Journal of critical illness Pub Date : 1993-06-01
P G Polos, S A Sahn
{"title":"Tips for monitoring the position of a central venous catheter. How placement can go awry--even when the anatomy is normal.","authors":"P G Polos,&nbsp;S A Sahn","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Malpositioning of a central venous catheter can cause potentially life-threatening complications. Knowledge of thoracic anatomy and close attention to proper insertion technique increase the likelihood of, but do not ensure, proper placement. Selection of a right-sided venous entry site reduces the risk of malpositioning. The return of nonpulsatile, dark-colored blood is a strong, but not infallible, indication of venous placement. Do not assume that venous system valves preclude malpositioning. Use chest films to confirm accurate insertion. When these are equivocal, take simultaneous blood samples from a peripheral artery and the central line; the samples will have markedly different blood gas levels if the catheter is in a vein.</p>","PeriodicalId":80210,"journal":{"name":"The Journal of critical illness","volume":"8 6","pages":"660-74"},"PeriodicalIF":0.0,"publicationDate":"1993-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"21043043","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
Managing complications in heart transplant recipients. Improved techniques and medications increase survival rates. 心脏移植受者并发症的处理。改进的技术和药物提高了生存率。
The Journal of critical illness Pub Date : 1993-06-01
J A Kobashigawa, L W Stevenson
{"title":"Managing complications in heart transplant recipients. Improved techniques and medications increase survival rates.","authors":"J A Kobashigawa,&nbsp;L W Stevenson","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Major problems facing cardiac transplant recipients include rejection, infection, and transplant coronary artery disease. Commonly used antirejection drugs are high-dose corticosteroids and cytolytic agents. Bacterial infections, such as those caused by staphylococci, occur early in the postoperative period, while opportunistic infections, including viral, fungal, and parasitic diseases, occur several weeks after transplant surgery. Coronary angiography is used to detect transplant coronary artery disease, the only definitive treatment for which is retransplantation. A number of promising new immunosuppressive agents and techniques may prevent some complications and further improve the care cardiac transplant recipients receive.</p>","PeriodicalId":80210,"journal":{"name":"The Journal of critical illness","volume":"8 6","pages":"678-89"},"PeriodicalIF":0.0,"publicationDate":"1993-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"21019927","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
Techniques for chest tube insertion and pleurodesis. An updated look at two common procedures. 胸管插入及胸膜切除术技术。对两个常见过程的最新介绍。
The Journal of critical illness Pub Date : 1993-05-01
M Silver, R C Bone
{"title":"Techniques for chest tube insertion and pleurodesis. An updated look at two common procedures.","authors":"M Silver,&nbsp;R C Bone","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Chest tube insertion is warranted for drainage of large exudative pleural effusions, empyemas, hemothoraces, or chylothoraces, and for some pneumothoraces or parapneumonic effusions. Chest tubes may also be used to instill sclerosing agents to prevent recurrent malignant effusions or pneumothorax. There are no absolute contraindications to tube thoracostomy; however, if time allows, effort should be made to correct any coexisting hemorrhagic disorders before the procedure is performed. Pleurodesis may be contraindicated in patients who are expected to undergo lung surgery. The incisional method is safest for chest tube insertion and pleurodesis; bear in mind, however, that some patients with pneumothorax may be better treated with small-caliber drainage.</p>","PeriodicalId":80210,"journal":{"name":"The Journal of critical illness","volume":"8 5","pages":"631-7"},"PeriodicalIF":0.0,"publicationDate":"1993-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"21019906","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 MI in the elderly: choosing the best revascularization method. Risks and benefits of thrombolysis, angioplasty, and bypass surgery. 老年人急性心肌梗死:选择最佳血运重建方法。溶栓、血管成形术和搭桥手术的风险和益处。
The Journal of critical illness Pub Date : 1993-05-01
S C Ajluni, C L Grines
{"title":"Acute MI in the elderly: choosing the best revascularization method. Risks and benefits of thrombolysis, angioplasty, and bypass surgery.","authors":"S C Ajluni,&nbsp;C L Grines","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>MI is often recognized less promptly in elderly patients than in younger patients; thus, the best opportunity for reperfusion is often missed. If infarction is diagnosed in less than 12 hours and there are no strong contraindications, thrombolytic therapy is appropriate for the elderly. Coronary angioplasty is a suitable alternative if performed promptly, especially because elderly patients are more likely to have contraindications to, or higher mortality from, thrombolysis. Predictors of unfavorable outcome following angioplasty for acute MI in the elderly include multivessel disease, occlusion of the infarcted artery, and cardiogenic shock. CABG surgery (performed during infarction or in the peri-infarct setting) is also an option for those elderly patients who are hemodynamically stable.</p>","PeriodicalId":80210,"journal":{"name":"The Journal of critical illness","volume":"8 5","pages":"569-76"},"PeriodicalIF":0.0,"publicationDate":"1993-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"21019905","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
Update on PTCA: what are its limitations? Can they be overcome by new devices? A look at atherectomy, intra-arterial stents, and laser catheters. PTCA的最新进展:它的局限性是什么?它们能被新设备克服吗?动脉粥样硬化切除术，动脉内支架和激光导管。
The Journal of critical illness Pub Date : 1993-04-01
T Feldman, M Moscucci
{"title":"Update on PTCA: what are its limitations? Can they be overcome by new devices? A look at atherectomy, intra-arterial stents, and laser catheters.","authors":"T Feldman,&nbsp;M Moscucci","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Complications limiting the use of percutaneous transluminal coronary angioplasty (PTCA) include abrupt vessel closure and restenosis. Certain coronary lesions, such as chronic total occlusions and diffuse or long stenoses, pose serious technical difficulties. New devices may overcome some of these limitations. For example, atherectomy may prove useful for thrombotic vessels or diffusely diseased vein grafts, and it may lower restenosis rates in larger vessels. Stents are currently used as a bailout measure when acute dissection occurs. Although lasers produce smoother margins than does conventional PTCA and effectively ablate atherosclerotic plaque material, the restenosis rate associated with use of these devices may be similar to that of conventional PTCA.</p>","PeriodicalId":80210,"journal":{"name":"The Journal of critical illness","volume":"8 4","pages":"461-78"},"PeriodicalIF":0.0,"publicationDate":"1993-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"21020025","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
Techniques for vascular access when venous entry is impossible. Route depends on urgency and the agent to be administered. 静脉无法进入时的血管通路技术。路由取决于紧急情况和要管理的代理。
The Journal of critical illness Pub Date : 1993-04-01
J J Vyskocil, J A Kruse, R F Wilson
{"title":"Techniques for vascular access when venous entry is impossible. Route depends on urgency and the agent to be administered.","authors":"J J Vyskocil,&nbsp;J A Kruse,&nbsp;R F Wilson","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>When a patient requires parenteral fluid or drug administration and venous cannulation cannot be performed, consider less typical routes. Intraosseus infusions are usually more effective in children than adults, but intraosseus cannulation failure may occur in as many as 20% of patients. Intra-arterial infusions are possible if pump pressures are kept high. Hypodermoclysis (infusion into the subcutaneous tissues) can correct moderate dehydration. Administering resuscitative drugs endobronchially is usually safe and effective, although pulmonary function may be somewhat compromised. A number of drugs may be given sublingually, either by injection or topical application. Finally, the corpora cavernosa of the penis may be used for short-term, large-volume fluid administration.</p>","PeriodicalId":80210,"journal":{"name":"The Journal of critical illness","volume":"8 4","pages":"539-45"},"PeriodicalIF":0.0,"publicationDate":"1993-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"21020026","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
Alternative techniques for gaining venous access. What to do when peripheral intravenous catheterization is not possible. 获得静脉通路的替代技术。不能外周静脉置管时该怎么办?
The Journal of critical illness Pub Date : 1993-03-01
J J Vyskocil, J A Kruse, R F Wilson
{"title":"Alternative techniques for gaining venous access. What to do when peripheral intravenous catheterization is not possible.","authors":"J J Vyskocil,&nbsp;J A Kruse,&nbsp;R F Wilson","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>There are a number of therapeutic options for fluid administration in patients who lack usual venous access. Ways to establish this access include limb elevation and wrapping, the application of nitroglycerin ointment to dilate veins, and blood pressure cuff inflation. Ultrasonography can also be used to delineate vascular structures. Cutdown procedures are the oldest, most direct method to reach uncommon venous sites, such as the inferior epigastric, intercostal, iliac, and lateral thoracic veins. Today, cutdown procedures are regarded as the method of last resort, and they should be performed in operating suites or similar settings. Possible complications include inadvertent arterial puncture and hemorrhage.</p>","PeriodicalId":80210,"journal":{"name":"The Journal of critical illness","volume":"8 3","pages":"435-42"},"PeriodicalIF":0.0,"publicationDate":"1993-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"21022253","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 need for vascular access: a bell-shaped curve of progress. 对血管通路的需求:进展的钟形曲线。
The Journal of critical illness Pub Date : 1993-03-01
J G Smith, R B George
{"title":"The need for vascular access: a bell-shaped curve of progress.","authors":"J G Smith,&nbsp;R B George","doi":"","DOIUrl":"","url":null,"abstract":"","PeriodicalId":80210,"journal":{"name":"The Journal of critical illness","volume":"8 3","pages":"313, 330"},"PeriodicalIF":0.0,"publicationDate":"1993-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"21022376","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
Intracranial monitoring as a management option for patients with liver failure. 颅内监测作为肝衰竭患者的管理选择。
The Journal of critical illness Pub Date : 1993-03-01
W Couldwell, M H Weiss
{"title":"Intracranial monitoring as a management option for patients with liver failure.","authors":"W Couldwell,&nbsp;M H Weiss","doi":"","DOIUrl":"","url":null,"abstract":"","PeriodicalId":80210,"journal":{"name":"The Journal of critical illness","volume":"8 3","pages":"329-30"},"PeriodicalIF":0.0,"publicationDate":"1993-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"21020240","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
Today's approach to PTCA: how it is performed, who might benefit. When can angioplasty replace medical therapy or bypass surgery? 今天的PTCA方法:如何执行，谁可能受益。什么时候血管成形术可以取代药物治疗或搭桥手术?
The Journal of critical illness Pub Date : 1993-02-01
M Moscucci, T Feldman
{"title":"Today's approach to PTCA: how it is performed, who might benefit. When can angioplasty replace medical therapy or bypass surgery?","authors":"M Moscucci,&nbsp;T Feldman","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>The use of percutaneous transluminal coronary angioplasty has expanded tremendously over the past decade. Because equipment has improved and physicians' experience has increased, the procedure is often appropriate for patients with complex lesions or difficult coronary anatomies. Currently, stenoses are successfully opened in more than 90% of patients. Angioplasty is an alternative to medical therapy for patients with one- or two-vessel disease; in some patients with multivessel disease, it is an alternative to coronary artery bypass graft surgery. Among elderly patients, those who are poor candidates for bypass surgery, those who have had previous bypass surgery, and those with acute myocardial infarction or cardiogenic shock, coronary angioplasty may be particularly useful.</p>","PeriodicalId":80210,"journal":{"name":"The Journal of critical illness","volume":"8 2","pages":"185-8; 191-3; 197-208"},"PeriodicalIF":0.0,"publicationDate":"1993-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"21020476","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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