Báo cáo y học: "Clinical review: The impact of noise on patients’ sleep and the effectiveness of noise reduction strategies in intensive care units" ppsx
... expertise, and invasive hemodynamic
monitoring). Currently, the provision of critical care in the ED
is increasing (in terms of both frequency and duration), largely
because of ED overcrowding [5,7].
This ... watchful eye of the intensivists who are
ultimately responsible for their care. All of these factors could
potentially lead to delays in recognizing deteriora...
... Conclusion
Based on a number of original papers, the impact of noise on
patients’ sleep and the effectiveness of noise reduction
strategies in ICUs have been reviewed. These have shown:
noise ... sleep
observation together with the continuous recordings of noise
and light level enabled Cureton-Lane and Fontaine to
determine that noise was the...
... is the decoupling of
oxygenation and CO
2
elimination. Ventilation is determined by
changes in power (a surrogate for V
t
) and in frequency.
Simply increasing the power will often result in ... CO
2
elimination is propor-
tional to the V
t
and the frequency, but increases in the V
t
achieved by lowering the frequency are thought to more than
compensate for the...
... for the treatment of severe sepsis. APC has anti-
coagulant activity by limiting thrombin formation and by inhibition
of factors VIIIa and Va, and it promotes fibrinolysis by inhibiting
plasminogen ... required chronic
dialysis were excluded from the PROWESS study because
of the need for intensive heparin therapy and limited informa-
tion on the medication half-life...
... trigger-
ing factor superimposed on pre-existing hypertension. The
risks for developing malignant hypertension are related to
the severity of the underlying hypertension, and therefore
the role of ... kidney has long been
postulated to play a central role in the pathophysiology of
malignant hypertension [42]. Activation of the
renin–angiotensin system has been strong...
... clarified the
physical chemistry principles that describe the independent
determinants of proton concentration and pH, allowing the
clinician to precisely and accurately determine the pH and to
understand ... when combined with a traumatic brain injury; it
is unknown whether this is true for other injuries in isolation or
combination. The interpretation of SBE must there...
... actions in one area having a significant impact on
the other.
Implications for controlling the cost of critical
care
The paucity of data regarding the impact of ED care of
critically patients on ... delay in nurse
implementation of orders for critically ill patients, both in the
ED and upon arrival in the ICU [35].
Finally, in the UK study condu...
... 3 consecutive days. In that
study NIV was effective in shortening the duration of invasive
ventilation, and decreasing the incidence of nosocomial
infections, mortality, and length of ICU and ... the increase in intrathoracic pressure. These
benefits include increases in functional residual capacity and
oxygenation, reduction in the work of breathing, and...
... to the more fulminant presentations of these conditions
and the role of the critical care physician in their diagnosis and management.
Keywords antineutrophil cytoplasmic antibody, critical care, ... particularly in PAN. Urinalysis must be
performed. Is the patient being treated for urinary sepsis on
the basis of blood and protein on the urine dipstick in...
... avoiding unnecessary immunosuppressive therapy. In this
second part of the review we consider the role played by the
ICU in their treatment and look at the prognosis of the fulminant
presentations. ... to the ICU patients with fulminant vasculitis may
be hypotensive because of a combination of dehydration,
haemorrhage and systemic inflammatory response syndrome.
As...