... reflects cutting edges of science and the wisdom of experts in all aspects ofcritical care. …’ The Congress provided a forum in which researchers and clinicians could come together and look at the questions ... assist the development of further trials of transfusion and appropriate use of blood products in ICU patients Most of the sessions on sepsis focused on the role of coagulation and the factors affecting ... CriticalCare February 2002 Vol No Ramakrishnan of hyperglycaemia in critically ill patients A total of 1548 medical and surgical patients were randomised on admission...
... influence of controlled mandatory ventilation (CMV), intermittent mandatory ventilation (IMV) and biphasic intermittent positive airway pressure (BIPAP) on duration of intubation and consumption of ... Comparison of oxygen cost of breathing with pressure-support ventilation and biphasic intermittent positive airway pressure ventilation Crit Care Med 1998, 26:1518-1522 Steinhoff H, Falke K, Schwarzhoff ... lower consumption of analgesics and sedatives as compared with the initial use of CMV followed by weaning with partial ventilatory support Clearly, the higher doses of analgesics and sedatives used...
... Page i Textbook of Neuroanaesthesia andCriticalCare Page ii DEDICATION To our patients Page iii Textbook of Neuroanaesthesia andCriticalCare Edited by Basil F Matta MB BCh ... at increased risk of stroke Sensory Nerves and Head Pain The anatomy of the sensory innervation to the cranium is important for an understanding of the basis of certain types of headache Furthermore, ... doses (3 mg/kg) of morphine and moderate doses of fentanyl (15 μg/kg) have little effect on CBF and CMR, high doses of fentanyl (50–100 μg/kg)89 and sufentanil90 depress CMR and CBF Results with...
... out of 76 patients in one study of head-injured patients and 11 of the 18 died.39 Tindall et al40 showed that a transient rise in PaCO2 often preceded the development of an A wave and Lassen and ... prolonged and reversible increase in the rate of CSF production in the dog Anesthesiology 1982; 57: 255–260 74 Artru AA Effects of enflurane and isoflurane on resistance to reabsorption of cerebrospinal ... mitochondria and cause efflux of Ca2+ and K+ into the cytosol and increases in levels of arachidonic acid, which is the rate-limiting substrate for prostanoid synthesis Increase of arachidonic...
... (ml) of blood and indicator, λb and λi the specific heat of blood and indicator, and ρb and ρi the density of blood and indicator If time is brought into the equation, the volumes become flows and: ... radiographic confirmation of catheter tip position (at the level ofand just medial to the mastoid bone), withdrawal of blood at a rate < ml/min and careful attention to head position are mandatory Jugular ... venous flow, and hence CBF, are then calculated using the equation: where Tb, Ti and Tm are the temperature of blood, indicator and mixture of blood and indicator respectively, Vb and Vi the volumes...
... increase the level of the injury Careful handling of patients and the prevention of hypoxaemia and hypovolaemia are very important Large doses of methylprednisolone (30 mg/kg within h of injury followed ... example in spinal surgery and craniofacial operations Systolic blood pressures of 50 mmHg and above are well tolerated by children under the age of 10 andof 70 mmHg and above in children over ... Evidence of cardiac disease should be sought by careful history and thorough examination, noting the presence of angina and its severity, previous myocardial infarction and symptoms and signs of cardiac...
... areas of the gland and inhibit the production of, in ascending order of occurrence: gonadotrophins, prolactin, ACTH and, rarely, TSH This results in secondary inhibition of the peripheral glands ... macroglossia and decreased mobility of the neck and temporomandibular joints Hypertrophy of pharyngeal and laryngeal soft tissue obscures the glottis Thyroid enlargement may distort the airway and cause ... thin and very fragile with loss of connective tissue Osteoporosis and bone fractures are common andcare is needed when gaining vascular access and positioning the patient Wound healing is slow and...
... Great Britain and Ireland Recommendations for the transfer of patients with acute head injuries to neurosurgical units AAGBI, London, 1996 75 Royal College of Surgeons of England Report of the working ... infusion of propofol must be taken into account in the calculation of daily caloric intake In our hands, the use of 200 μg/kg/min propofol to produce burst suppression for long periods has often ... DK Survey of intensive careof severely head injured patients in the United Kingdom BMJ 1996; 312: 944–947 19 Ghajar J, Hariri RJ, Narayan RK et al Survey ofcriticalcare management of comatose,...
... intensive careof acute stroke? • If so what should be offered in terms of monitoring and therapy? • In the light of the prevalence of stroke, these questions are of major importance to health -care ... index of left ventricular preload and intravascular volume status in the critically ill patient and the use of thermodilution catheters allows the measurement of cardiac output and calculation of ... management of certain parameters may be indicated The neurocritical care management of acute stroke and the benefit of specific monitoring modalities and interventions remain the subject of debate...
... complications of BSD are highlighted in Tables 27.6 and 27.7 and Figure 27.1 and 27.2 Diagnosis of Brain Death The criteria for the diagnosis of brain death published by the Honorary Secretary of the ... Group of Conference of Medical Royal Colleges and their Faculties in the United Kingdom Diagnosis of death BMJ 1976; ii: 1187–1188 Working Group of Conference of Medical Royal Colleges and their ... transplantation A code of practice including the diagnosis of brainstem death HMSO, London, 1998 37 Working Group of the Royal College of Physicians and the Conference of Medical Royal Colleges and their...
... length of stay, increased economic burden, and an almost twofold increased risk of death Two other examples: in women younger than 65, influenza was shown to increase mortality substantially [6], and ... excess mortality In critically ill HIV patients, Tumbarello and colleagues [13] assessed a crude mortality of 43%, with an infection-associated excess mortality of 27% A similar rate of bloodstream ... described by Smith and colleagues [14] in non-HIV patients Probably one of the largest investigations was presented by Pittet and colleagues [15], who found a crude mortality of 50% in critically ill...
... result of the decision to withhold or withdraw care, so there is a need for objective measurements of standard ofcare The needs of the patient, their family, and those of the nurses and physicians ... Outcome at the end of life: J Randell Curtis J Randell Curtis drew attention to the difficulties of assessing the quality ofcare that occurs at the end of life In the USA, the majority of ICU patients ... get any patient assessment of the standard of their care The question then is whether the tools used to measure quality ofcare are measuring it from the point of view of supplement How we measure...
... Federation of Societies of Intensive andCriticalCareMedicine (WFSICCM) References Lipman J, Lichtman AR: International perspectives on critical care: criticalcare in Africa CriticalCare Clin ... a faculty ofCriticalCareMedicine was established in the College ofMedicineof South Africa With effect from September 2001, the criticalcare specialist trainees have to write and pass an ... criticalcaremedicine in South Africa Criticalcare healthworkers have to put forth strong motivations to the country’s health policy-makers of the important part they play in the delivery of...
... terms of morbidity and mortality, provided that the optimization protocol is well defined and standardized In this context, the study conducted by Sandham and coworkers [2] was commented on and ... demonstration of the beneficial effects of tight control of glucose levels by high doses of insulin, andof enhancing adrenal function in relative adrenal insufficiency by administering low doses of hydrocortisone ... understanding of how mechanical stress can injure the lung, both by altering barrier properties of the pulmonary endothelium and epithelium and by stimulating proinflammatory responses of macrophages...
... intensive care unit (ICU) and up to week afterwards [6-9] Former ICU patients may have more short-term sleep disturbances caused by both the period ofcriticalcareand the high prevalence of concurrent ... in sleep quality after a criticalcare period Difficulties in falling asleep and the quality of sleep were affected and remained altered at 12 months in 38% and 20% of former ICU patients, respectively ... disturbances caused by both the period ofcriticalcareand the presence of concurrent diseases Chronic diseases are known to affect sleeping patterns, and the prevalence of sleep disturbances in such...
... influences ofcriticalcare or criticalcare medical conditions Regardless, the results raise concerns about the accuracy of administrative coding, and particularly about the accuracy of post hoc ... Reliability of diagnostic coding in intensive care patients Crit Care 2008, 12:R95 Martin GS: Epidemiology studies in criticalcare Crit Care 2006, 10:136-137 US National Registry of Cardiopulmonary ... on specific medical conditions) or in breadth of data collected As a criticalcare community, for purposes inclusive of healthcare quality, research and education, we must develop comprehensive...
... CriticalCare Vol 13 No Collinson occurs in a range of other clinical conditions other than cardiac dysfunction, including sepsis [11] Values are frequently raised in the intensive care ... the death hormone The routine measurement of NTproBNP is certainly extremely valuable as part of the initial assessment of a patient admitted to intensive care as a rule-out test for cardiac dysfunction ... Performance of N-terminal-pro-Btype natriuretic peptide in critically ill patients: a prospective observational cohort study Crit Care 2008, 12:R137 Maisel AS, Krishnaswamy P, Nowak RM, McCord J, Hollander...
... of Intensive Care Medicine, St George’s Healthcare NHS Trust, Blackshaw Road, London, SW17 0QT, UK Interdepartmental Division ofCriticalCare Medicine, and Department of Medicine, Division of ... 5Division of Pulmonary, Sleep andCriticalCare Medicine, Rhode Island Hospital/ Brown University, 593 Eddy Street, Providence, RI 02903, USA 6Cardiovascular Research Institute and Departments ofMedicine ... Page of Intensiva], and ASDI [Austrian Center for Documentation and Quality Assurance in Intensive Care Medicine] ) or for purposes of research (for example, ANZICS [Australian and New Zealand...
... design of future trials and the practice ofcriticalcaremedicine Our results accord with the findings of a recent report that found low rates of efficacy in trials in criticalcare medicine, ... a search of the tables of contents of five high-impact medical journals (BMJ, New England Journal of Medicine, Journal of the American Medical Association, Lancet, Annals of Internal Medicine) ... 2Department of Family Medicine, University of Virginia Health System, 1215 Lee Street, Charlottesville, Virginia, 22908, USA and 3Department of Internal Medicine, The Ohio State University College of Medicine, ...