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Inadvertent Hyperventilation During Intraoperative Anesthetic Care in the Pediatric Population 小儿术中麻醉护理中无意过度通气
ICU director Pub Date : 2012-07-01 DOI: 10.1177/1944451612449182
Andrew J Rozmiarek, Thomas A. Taghon, J. Tobias
{"title":"Inadvertent Hyperventilation During Intraoperative Anesthetic Care in the Pediatric Population","authors":"Andrew J Rozmiarek, Thomas A. Taghon, J. Tobias","doi":"10.1177/1944451612449182","DOIUrl":"https://doi.org/10.1177/1944451612449182","url":null,"abstract":"Background. Recent clinical data suggest that inadvertent intraoperative hyperventilation may have long-lasting deleterious effects during the postoperative period with the potential for exaggerating the respiratory depressant effect of opioids. The current study identified the incidence of inadvertent hyperventilation during intraoperative anesthetic care in a cohort of pediatric patients. Methods. A retrospective review of the electronic medical record system was performed on patients undergoing posterior spinal fusion. These patients were chosen as arterial blood gas (ABG) analysis is routinely performed for such cases. ABG data were analyzed for the occurrence of hyperventilation, defined as alkalosis (pH ≥ 7.45) concurrent with hypocarbia (PaCo2 ≤ 35 mm Hg). Results. The study cohort included 166 patients who ranged in age from 22 months to 21 years. There were a total of 452 ABG samples obtained. Hyperventilation with the combination of alkalosis and hypocarbia was noted in 40 of the 452 (9%) ABG sa...","PeriodicalId":89772,"journal":{"name":"ICU director","volume":"3 1","pages":"172-175"},"PeriodicalIF":0.0,"publicationDate":"2012-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1177/1944451612449182","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"65896417","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: 6
Communication Breakdowns in the Academic Intensive Care Unit 学术重症监护室的沟通障碍
ICU director Pub Date : 2012-07-01 DOI: 10.1177/1944451612446222
Omar B. Lateef, E. Chen, M. Darin
{"title":"Communication Breakdowns in the Academic Intensive Care Unit","authors":"Omar B. Lateef, E. Chen, M. Darin","doi":"10.1177/1944451612446222","DOIUrl":"https://doi.org/10.1177/1944451612446222","url":null,"abstract":"The current work flow within a large urban intensive care unit is prone to communication errors that can result in less than optimal patient care. This article discusses several cases that highligh...","PeriodicalId":89772,"journal":{"name":"ICU director","volume":"3 1","pages":"194-198"},"PeriodicalIF":0.0,"publicationDate":"2012-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1177/1944451612446222","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"65896561","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
Applying National Critical Care Pharmacy Recommendations to Practice 将国家重症监护药房建议应用于实践
ICU director Pub Date : 2012-07-01 DOI: 10.1177/1944451612452304
D. Horner, Fanny Li, Cindy A Loffler, Ashley Thompson, A. K. Gross
{"title":"Applying National Critical Care Pharmacy Recommendations to Practice","authors":"D. Horner, Fanny Li, Cindy A Loffler, Ashley Thompson, A. K. Gross","doi":"10.1177/1944451612452304","DOIUrl":"https://doi.org/10.1177/1944451612452304","url":null,"abstract":"The aim of the article is to share how a pharmacist with postgraduate pharmacy residency training in critical care and work-related experience can be incorporated into an academic medical center intensive care unit. In the model described herein, a pharmacist working in the interdisciplinary environment can participate in roles far beyond that of the traditional dispensing pharmacist. The practice model is compared with the critical care pharmacy recommendations from a national pharmacy task force.","PeriodicalId":89772,"journal":{"name":"ICU director","volume":"3 1","pages":"189-193"},"PeriodicalIF":0.0,"publicationDate":"2012-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1177/1944451612452304","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"65896721","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
Management of the Potential Organ Donor in the ICU ICU潜在器官供体的管理
ICU director Pub Date : 2012-07-01 DOI: 10.1177/1944451612450912
Meagan Lansdale, M. Gropper
{"title":"Management of the Potential Organ Donor in the ICU","authors":"Meagan Lansdale, M. Gropper","doi":"10.1177/1944451612450912","DOIUrl":"https://doi.org/10.1177/1944451612450912","url":null,"abstract":"There is a major gap between supply and demand of organs for transplantation. Organ donation after neurological death is increasing in the United States, and there is potential for this gap to be minimized by focused medical management of the potential donor in the ICU. Increasing organ yield requires early potential donor identification and early referral to organ procurement organizations, and understanding the medical issues specific to the brain-dead patient, such as hemodynamic instability requiring vasopressors, coagulopathy, diabetes insipidus, renal failure, and acute lung injury/acute respiratory distress syndrome. Intensive care with treatment focused on these issues has the potential to increase both the number of potential donors and the number of organs transplanted per donor.","PeriodicalId":89772,"journal":{"name":"ICU director","volume":"3 1","pages":"185-188"},"PeriodicalIF":0.0,"publicationDate":"2012-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1177/1944451612450912","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"65896522","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: 11
Preclinical Studies: Stem Cells for Treatment of Sepsis 临床前研究:干细胞治疗败血症
ICU director Pub Date : 2012-07-01 DOI: 10.1177/1944451612452303
Ying-gang Zhu, Xiao‐mei Feng, Jae-Woo Lee
{"title":"Preclinical Studies: Stem Cells for Treatment of Sepsis","authors":"Ying-gang Zhu, Xiao‐mei Feng, Jae-Woo Lee","doi":"10.1177/1944451612452303","DOIUrl":"https://doi.org/10.1177/1944451612452303","url":null,"abstract":"Sepsis remains a major cause of morbidity and mortality in hospitalized patients. The pathophysiology of sepsis involves complex interactions between microbial pathogens and the host immune system....","PeriodicalId":89772,"journal":{"name":"ICU director","volume":"3 1","pages":"166-171"},"PeriodicalIF":0.0,"publicationDate":"2012-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1177/1944451612452303","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"65896649","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
An Algorithm for the Practical Management of the New Onset of Atrial Fibrillation in Patients Admitted to the ICU ICU患者新发房颤的实用管理算法
ICU director Pub Date : 2012-05-31 DOI: 10.1177/1944451612449649
W. Shapiro, K. Schulze
{"title":"An Algorithm for the Practical Management of the New Onset of Atrial Fibrillation in Patients Admitted to the ICU","authors":"W. Shapiro, K. Schulze","doi":"10.1177/1944451612449649","DOIUrl":"https://doi.org/10.1177/1944451612449649","url":null,"abstract":"Currently, there are no ICU specific management guidelines for the new onset of atrial fibrillation (AF). This article provides a proposed treatment algorithm for paroxysmal AF that is based on recent separate consensus guidelines for the management of AF and for throbophrophylaxis. The AF treatment algorithm provides the intensivist with a decision tree approach based on the patients clinical findings at the time of ICU admission.","PeriodicalId":89772,"journal":{"name":"ICU director","volume":"3 1","pages":"179-184"},"PeriodicalIF":0.0,"publicationDate":"2012-05-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1177/1944451612449649","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"65896484","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
Minocycline-Induced Drug Reaction With Eosinophilia and Systemic Symptoms Syndrome Myocarditis and Multiple Organ Failure 二甲胺四环素诱导的药物反应与嗜酸性粒细胞增多和全身症状综合征心肌炎和多器官衰竭
ICU director Pub Date : 2012-05-17 DOI: 10.1177/1944451612442687
Jamie L. Taylor, M. S. Kulkarni, E. Behringer, Taizoon Yusufali, A. Trento, N. D'attellis
{"title":"Minocycline-Induced Drug Reaction With Eosinophilia and Systemic Symptoms Syndrome Myocarditis and Multiple Organ Failure","authors":"Jamie L. Taylor, M. S. Kulkarni, E. Behringer, Taizoon Yusufali, A. Trento, N. D'attellis","doi":"10.1177/1944451612442687","DOIUrl":"https://doi.org/10.1177/1944451612442687","url":null,"abstract":"This article reports a case of minocycline- induced drug reaction with eosinophilia and systemic symp- toms syndrome in a 16-year-old female who presented with acute myocarditis and severe heart failure. Drug reac- tion with eosinophilia and systemic symptoms syndrome is a severe, multisystem reaction. It is usually manifested by cutaneous, lymphatic, and solid organ involvement with progression to multisystem organ failure, following the use of several medications. There are 3 previous docu- mented reports of drug reaction with eosinophilia and systemic symptoms syndrome - induced myo- carditis. This is a case report and a review of the literature.","PeriodicalId":89772,"journal":{"name":"ICU director","volume":"3 1","pages":"139-143"},"PeriodicalIF":0.0,"publicationDate":"2012-05-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1177/1944451612442687","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"65895834","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
Care of the Organ Donor in the ICU: Perspective of the Procurement Organization 重症监护病房器官捐献者的护理:采购机构的视角
ICU director Pub Date : 2012-05-01 DOI: 10.1177/1944451612443985
S. Swain, B. Sardella
{"title":"Care of the Organ Donor in the ICU: Perspective of the Procurement Organization","authors":"S. Swain, B. Sardella","doi":"10.1177/1944451612443985","DOIUrl":"https://doi.org/10.1177/1944451612443985","url":null,"abstract":"The number of patients awaiting a solid organ transplant in the United States continues to grow each year despite efforts to increase the donor pool. Because only 1% of all deaths in the United States may become eligible as organ donors, the preservation of donors and the maximum number of organs from each donor is essential. Optimal organ procurement rests on the principles of early identification of potential donors, timely family- and patient-centric discussion of the option for organ donation and then careful donor management up to and through the procurement process. Health care practitioners in the ICU play important roles at each step of this process. This article outlines the basic considerations for optimizing organ quality during the donation process.","PeriodicalId":89772,"journal":{"name":"ICU director","volume":"3 1","pages":"125-127"},"PeriodicalIF":0.0,"publicationDate":"2012-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1177/1944451612443985","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"65896738","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
Acute Liver Failure: Current Evidence-Based Management for ICU Care 急性肝衰竭:当前ICU护理的循证管理
ICU director Pub Date : 2012-05-01 DOI: 10.1177/1944451612444444
Tania C. Yarema, C. Marshall, Amy Salgado Cucina, Heather S Dodge, Barbara Imhoff, Jonathan A. Judy, J. Peterson
{"title":"Acute Liver Failure: Current Evidence-Based Management for ICU Care","authors":"Tania C. Yarema, C. Marshall, Amy Salgado Cucina, Heather S Dodge, Barbara Imhoff, Jonathan A. Judy, J. Peterson","doi":"10.1177/1944451612444444","DOIUrl":"https://doi.org/10.1177/1944451612444444","url":null,"abstract":"Acute liver failure (ALF) is a rare and potentially life-threatening condition; the mortality rate for ALF remains high because of the rapid progression of the syndrome. A large number of etiologies such as drugs (acetaminophen being most common), viruses (hepatitis A and B), and autoimmune and metabolic causes can lead to ALF, but in a significant percentage of cases no exact etiology is determined. As the disease progresses to the life- threatening stage, management of these critically ill patients requires meticulous attention to their hemodynamic and neurologic condition and to other complications that can arise. This review describes the typical presentation of ALF and discusses its diagnosis and etiologies. The laboratory and radiologic hallmarks of the diagnosis are also described. The authors also evaluate the evidence for a variety of therapeutic maneuvers that have been put forward to ameliorate the course of ALF. Ultimately, given its often inexorable course, orthotopic liver transplant may bec...","PeriodicalId":89772,"journal":{"name":"ICU director","volume":"3 1","pages":"116-124"},"PeriodicalIF":0.0,"publicationDate":"2012-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1177/1944451612444444","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"65896448","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
Pain Management for the Obese Sleep Apnea Patient Insights for ICU Practitioners 肥胖睡眠呼吸暂停患者的疼痛管理对ICU从业人员的启示
ICU director Pub Date : 2012-04-17 DOI: 10.1177/1944451612438918
M. Schumacher
{"title":"Pain Management for the Obese Sleep Apnea Patient Insights for ICU Practitioners","authors":"M. Schumacher","doi":"10.1177/1944451612438918","DOIUrl":"https://doi.org/10.1177/1944451612438918","url":null,"abstract":"Currently, one third of the US adult population is considered obese. As such, obese patients are a rapidly growing population of patients being admitted to ICU. The problems in managing pain for these patients, primarily perioperative and hospital-associated respiratory depression, are becoming increasingly apparent. New approaches for pain management are intended to minimize the life-threatening side effects of traditional pain control drugs (opioids) and to increase the therapeutic options with nonopioid agents. This article (a) reviews the pathophysiology of obstructive sleep apnea and other related sleep apnea syndromes, (b) describes risk factors for perioperative and hospital-associated respiratory depression, (c) reviews other significant side effects of opioid analgesic agents, and finally (d) summarizes the emerging consensus for the use of multimodal analgesia for managing pain in obese patients with obstructive sleep apnea.","PeriodicalId":89772,"journal":{"name":"ICU director","volume":"3 1","pages":"80-84"},"PeriodicalIF":0.0,"publicationDate":"2012-04-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1177/1944451612438918","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"65896218","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
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