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The Journal of critical illness最新文献

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The technique of percutaneous tracheostomy. Using serial dilation to secure an airway with minimal risk. 经皮气管切开术技术。以最小的风险使用连续扩张来保护气道。
The Journal of critical illness Pub Date : 1993-02-01
Y Friedman, C Franklin
{"title":"The technique of percutaneous tracheostomy. Using serial dilation to secure an airway with minimal risk.","authors":"Y Friedman,&nbsp;C Franklin","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Percutaneous tracheostomy is the procedure of choice for most patients who require prolonged use of an artificial airway; it can be performed rapidly at the bedside and is associated with fewer complications than is the standard procedure. The serial dilational technique involves the insertion of prelubricated dilators that gradually enlarge the diameter of a tract made by a guidewire and guiding catheter, facilitating placement of a standard double-cannula tracheostomy tube. The most dangerous complication, paratracheal insertion, occurs only rarely. The small skin incision and resulting tight fit of the tracheostomy tube in the stoma help prevent bleeding and infection.</p>","PeriodicalId":80210,"journal":{"name":"The Journal of critical illness","volume":"8 2","pages":"289-97"},"PeriodicalIF":0.0,"publicationDate":"1993-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"21020477","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 weaning a patient from mechanical ventilation; when to begin, what method to use, and how to predict outcome. 使患者脱离机械通气的技术;什么时候开始，用什么方法，如何预测结果。
The Journal of critical illness Pub Date : 1993-01-01
E Gluck, D H Eubanks, R C Bone
{"title":"Techniques for weaning a patient from mechanical ventilation; when to begin, what method to use, and how to predict outcome.","authors":"E Gluck,&nbsp;D H Eubanks,&nbsp;R C Bone","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>A variety of methods have been employed to help wean patients from prolonged ventilatory support. Although synchronized intermittent mandatory ventilation is probably the most widely used, it has not been shown to be clearly superior to T piece or pressure support weaning. Regardless of the method you choose, begin weaning before the patient's lung function has returned to normal or baseline levels and end when the patient shows the minimum capacity necessary to sustain himself off the ventilator. The patient's response to the change in the level of ventilatory support governs the rapidity of weaning. The rapid shallow breathing index can be useful in predicting weaning outcome, as is the patient's ability to tolerate a weaning trial.</p>","PeriodicalId":80210,"journal":{"name":"The Journal of critical illness","volume":"8 1","pages":"121-9"},"PeriodicalIF":0.0,"publicationDate":"1993-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"21019298","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
A case for nonionic contrast media--despite the high cost. 非离子造影剂的案例——尽管成本很高。
The Journal of critical illness Pub Date : 1992-12-01
E B Lieberman, T M Bashore
{"title":"A case for nonionic contrast media--despite the high cost.","authors":"E B Lieberman,&nbsp;T M Bashore","doi":"","DOIUrl":"","url":null,"abstract":"","PeriodicalId":80210,"journal":{"name":"The Journal of critical illness","volume":"7 12","pages":"1853-4, 1860"},"PeriodicalIF":0.0,"publicationDate":"1992-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"21019289","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 technique of bronchoalveolar lavage. A guide to sampling the terminal airways and alveolar space. 支气管肺泡灌洗技术。末梢气道和肺泡间隙取样指南。
The Journal of critical illness Pub Date : 1992-11-01
A Anzueto, S M Levine, S G Jenkinson
{"title":"The technique of bronchoalveolar lavage. A guide to sampling the terminal airways and alveolar space.","authors":"A Anzueto,&nbsp;S M Levine,&nbsp;S G Jenkinson","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Bronchoalveolar lavage (BAL) provides a means of recovering cells and biochemical substances directly from the alveoli in patients with numerous pulmonary diseases. It is also useful in diagnosing opportunistic infections in immunocompromised patients. Upper airway contamination of BAL specimens is the chief liability. In diffuse lung disease, the bronchoscope is usually positioned in the middle lobe; when focal lung disease is present, the bronchoscope is placed in the area of greatest roentgenographic involvement. Sterile saline is instilled and recovered for analysis. Most side effects are related to endoscopic technique, location and extent of lavaged lung area, and the volume and temperature of instilled fluid.</p>","PeriodicalId":80210,"journal":{"name":"The Journal of critical illness","volume":"7 11","pages":"1817-24"},"PeriodicalIF":0.0,"publicationDate":"1992-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"21020634","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 technique of fiberoptic bronchoscopy. Diagnostic and therapeutic uses in intubated, ventilated patients. 纤维支气管镜检查技术。在插管、通气患者中的诊断和治疗用途。
The Journal of critical illness Pub Date : 1992-10-01
A Anzueto, S M Levine, S G Jenkinson
{"title":"The technique of fiberoptic bronchoscopy. Diagnostic and therapeutic uses in intubated, ventilated patients.","authors":"A Anzueto,&nbsp;S M Levine,&nbsp;S G Jenkinson","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Fiberoptic bronchoscopy has a variety of applications in the intensive care unit. This procedure, which can be done at the patient's bedside, can be used to clear excess secretions; check the position of, or replace, an endotracheal tube; identify areas of active bleeding; diagnose opportunistic infections; and evaluate obstructive airway lesions. Before the bronchoscope is inserted, antisialagogues, anxiolytics, and topical anesthetics are administered along with supplemental oxygen. In intubated, ventilated patients, a fiberoptic bronchoscope may be passed through a swivel adapter to prevent loss of the delivered oxygen and tidal volume. Cardiac arrhythmias and hypoxemia are among the most common complications.</p>","PeriodicalId":80210,"journal":{"name":"The Journal of critical illness","volume":"7 10","pages":"1657-64"},"PeriodicalIF":0.0,"publicationDate":"1992-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"21020633","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
New treatment strategies for cardiogenic shock in acute MI. Management options depend on the availability of a cath lab. 急性心肌梗死心源性休克的新治疗策略。管理选择取决于导管实验室的可用性。
The Journal of critical illness Pub Date : 1992-08-01
H Feld
{"title":"New treatment strategies for cardiogenic shock in acute MI. Management options depend on the availability of a cath lab.","authors":"H Feld","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Aggressive treatment strategies that include early revascularization may significantly improve survival from acute MI complicated by cardiogenic shock. Symptoms of impending cardiogenic shock include tachycardia, cool extremities, pallor, cyanosis, and a normal or low blood pressure. When possible, the right and left sides of the heart are catheterized immediately. For patients who need to be transferred to a hospital with a catheterization laboratory, use temporary support measures--intubation, administration of positive inotropic agents, and placement of an intra-aortic balloon pump. Coronary angiography can reveal whether direct PTCA or bypass surgery is appropriate. Thrombolysis is limited to patients for whom transfer is delayed and those in whom cardiogenic shock is ruled out.</p>","PeriodicalId":80210,"journal":{"name":"The Journal of critical illness","volume":"7 8","pages":"1277-84; 1293-4"},"PeriodicalIF":0.0,"publicationDate":"1992-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"21020635","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 technique of instituting mechanical ventilation. Patient preparation; endotracheal intubation; monitoring. 机械通气:实行机械通气的技术病人准备;气管插管;监控。
The Journal of critical illness Pub Date : 1992-08-01
E Gluck, R C Bone, D H Eubanks
{"title":"The technique of instituting mechanical ventilation. Patient preparation; endotracheal intubation; monitoring.","authors":"E Gluck,&nbsp;R C Bone,&nbsp;D H Eubanks","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Potential indications for mechanical ventilation include hypoxemia unresponsive to oxygen administration, hypercapnia resulting in acidemia, and an unstable chest wall. For best results, carefully prepare the patient (both physically and emotionally) before instituting ventilation. Sedatives and local anesthesia can facilitate intubation; avoid paralytic agents unless you are experienced at intubation. The oral route is most commonly used. Once the patient circuit is attached to the endotracheal tube, reexamine the patient and double-check the inspiratory flow and I:E ratio; adjust the ventilator's settings as necessary. Monitor the patient frequently to ascertain the adequacy of alveolar ventilation and arterial oxygen.</p>","PeriodicalId":80210,"journal":{"name":"The Journal of critical illness","volume":"7 8","pages":"1319-28"},"PeriodicalIF":0.0,"publicationDate":"1992-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"21020636","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
Ways to improve outcome after cardiopulmonary resuscitation. How to monitor patients, correct dysrhythmias. 提高心肺复苏后预后的方法。如何监测患者，纠正心律失常。
The Journal of critical illness Pub Date : 1992-08-01
C L Bryan, J D Rossrucker
{"title":"Ways to improve outcome after cardiopulmonary resuscitation. How to monitor patients, correct dysrhythmias.","authors":"C L Bryan,&nbsp;J D Rossrucker","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Noninvasive monitoring techniques for assessing circulation during CPR include thoracic electrical bioimpedance and measurement of end-tidal carbon dioxide. Many dysrhythmias can be corrected with portable devices, such as automatic external defibrillation pacers, or with automatic implantable cardioverter-defibrillators or external transcutaneous cardiac pacers. Bradycardia is treated, however, only if it is accompanied by hemodynamically significant hypotension or ventricular ectopy. Adenosine may be preferable to verapamil for the management of paroxysmal supraventricular tachycardia. Three consecutive energy discharges are now recommended for the management of ventricular fibrillation.</p>","PeriodicalId":80210,"journal":{"name":"The Journal of critical illness","volume":"7 8","pages":"1330-47"},"PeriodicalIF":0.0,"publicationDate":"1992-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"21020637","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 technique of occlusive-cuff impedance plethysmography. How to use this sensitive, noninvasive tool to detect proximal DVT. 闭塞袖带阻抗脉搏波描记技术。如何使用这种灵敏、无创的工具来检测近端深静脉血栓。
The Journal of critical illness Pub Date : 1992-07-01
D K Payne
{"title":"The technique of occlusive-cuff impedance plethysmography. How to use this sensitive, noninvasive tool to detect proximal DVT.","authors":"D K Payne","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Occlusive-cuff impedance plethysmography (IPG) is a rapid, reliable, and noninvasive method of diagnosing proximal deep venous thrombosis (DVT) in the lower extremities. The test is relatively easy to perform and carries an overall accuracy of greater than 90% when compared with venography. IPG is useful in detecting acute, symptomatic DVT and in determining the presence of recurrent DVT. In certain patients with nondiagnostic lung scans in whom pulmonary embolism is suspected, IPG may be helpful in determining appropriate therapy without use of pulmonary angiography.</p>","PeriodicalId":80210,"journal":{"name":"The Journal of critical illness","volume":"7 7","pages":"1135-43"},"PeriodicalIF":0.0,"publicationDate":"1992-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"21020638","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
Guidelines for judicious use of electrocardiography. A summary of recommendations from the ACC/AHA Task Force Report. 明智使用心电图的指南。行政协调会/美国心脏协会工作组报告的建议摘要。
The Journal of critical illness Pub Date : 1992-06-01
H J Swan
{"title":"Guidelines for judicious use of electrocardiography. A summary of recommendations from the ACC/AHA Task Force Report.","authors":"H J Swan","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Electrocardiography continues to be a cornerstone in the management of an array of cardiac and noncardiac disorders. However, the ease with which an electrocardiogram can be obtained, as well as its low cost, has led to widespread use--and possible overuse--of this technology. A joint committee of the American College of Cardiology and the American Heart Association recently published guidelines for appropriate use of electrocardiography in patients with known heart disease; in persons suspected of having, or who are at risk for, heart disease; and in persons with no apparent or suspected cardiac disease. These guidelines can help clinicians determine when, and for which patients in the intensive care unit, an electrocardiogram is warranted.</p>","PeriodicalId":80210,"journal":{"name":"The Journal of critical illness","volume":"7 6","pages":"861-70"},"PeriodicalIF":0.0,"publicationDate":"1992-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"21020530","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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