Search results for "Critical Care and Intensive Care Medicine"
showing 10 items of 682 documents
Hemodynamic monitoring and management in patients undergoing high risk surgery: a survey among North American and European anesthesiologists
2011
Abstract Introduction Several studies have demonstrated that perioperative hemodynamic optimization has the ability to improve postoperative outcome in high-risk surgical patients. All of these studies aimed at optimizing cardiac output and/or oxygen delivery in the perioperative period. We conducted a survey with the American Society of Anesthesiologists (ASA) and the European Society of Anaesthesiology (ESA) to assess current hemodynamic management practices in patients undergoing high-risk surgery in Europe and in the United States. Methods A survey including 33 specific questions was emailed to 2,500 randomly selected active members of the ASA and to active ESA members. Results Overall,…
A systematic approach to ultrasound-guided central venous catheter placement—desirable modifications
2017
Infraclavicular access to the axillary vein-new possibilities for the catheterization of the central veins in the intensive care unit
2016
Central vein cannulation is one of the most commonly performed procedures in intensive care. Traditionally, the jugular and subclavian vein are recommended as the first choice option. Nevertheless, these attempts are not always obtainable for critically ill patients. For this reason, the axillary vein seems to be a rational alternative approach. In this narrative review, we evaluate the usefulness of the infraclavicular access to the axillary vein. The existing evidence suggests that infraclavicular approach to the axillary vein is a reliable method of central vein catheterization, especially when performed with ultrasound guidance.
In-hospital outcomes of catheter-directed thrombolysis in patients with pulmonary embolism.
2020
AbstractAimsCatheter-directed treatment of acute pulmonary embolism (PE) is technically advancing. Recent guidelines acknowledge this treatment option for patients with overt or imminent haemodynamic decompensation, particularly when systemic thrombolysis is contraindicated. We investigated patients with PE who underwent catheter-directed thrombolysis (CDT) in the German nationwide inpatient cohort.Methods and resultsData from hospitalizations with PE (International Classification of Disease code I26) between 2005 and 2016 were collected by the Federal Office of Statistics in Germany. Patients with PE who underwent CDT (OPS 8-838.60 or OPS code 8-83b.j) were compared with patients receiving…
A systematic review on the efficacy and safety of chloroquine for the treatment of COVID-19
2020
Purpose COVID-19 (coronavirus disease 2019) is a public health emergency of international concern. As of this time, there is no known effective pharmaceutical treatment, although it is much needed for patient contracting the severe form of the disease. The aim of this systematic review was to summarize the evidence regarding chloroquine for the treatment of COVID-19. Methods PubMed, EMBASE, and three trial Registries were searched for studies on the use of chloroquine in patients with COVID-19. Results We included six articles (one narrative letter, one in-vitro study, one editorial, expert consensus paper, two national guideline documents) and 23 ongoing clinical trials in China. Chloroqui…
Prehospital diagnosis in stroke patients-differentiation between cerebral ischemic events and cerebral hemorrhage
1996
A large number of stroke patients is treated by the Mainz-EMS during the first hours after the onset of symptoms. A combination of anamnestic and clinical variables included in the score prehospitally leads to the tentative diagnosis confirmed by CT-scan in the majority of cases. It should therefore be possible in the future to initiate specific therapy for stroke patients prehospitally.
Akutschmerztherapie in Pädiatrie und Geriatrie – Akutschmerztherapie im Alter –ein ganzheitlicher Ansatz
2011
Post-operative pain management of elderly patients requires special attention. In addition to the organic functional impairments, age-related changes in psychological and social factors play an important role. Also life experiences, painful medical history and a range of different complaints of old age influence the expectations to the treatment of pain. Several factors have to be considered, so 1) age-appropriate preoperative assessment of organic, psychological and social factors, 2) a selection of regularly administered non-opioid, or combination of two different effective non-opioids, notably on the contra-indications and dose limits, 3) if necessary careful titration of the strong opio…
Recomendaciones prácticas para el manejo del paciente con dolor crónico durante la pandemia de COVID-19
2021
Resumen La infeccion por SARS-CoV-2 ha evolucionado hasta convertirse progresivamente en una pandemia y en una emergencia de salud publica de importancia internacional que ha obligado a las organizaciones de salud a nivel mundial, regional y local a adoptar una serie de medidas para hacer frente a la COVID-19 e intentar disminuir su impacto, no solo en el ambito social sino tambien en el ambito sanitario, modificandose las pautas de actuacion en los servicios de salud. Dentro de estas recomendaciones, que incluyen las unidades de tratamiento del dolor, los pacientes con sospecha o infeccion confirmada por SARS-CoV-2 pueden encontrase en situacion de espera para consulta medica o tecnicas in…
Association between increased arterial stiffness and clinical outcomes in patients with early sepsis: a prospective observational cohort study.
2019
Background Conduit arteries, especially the aorta, play a major role in ensuring efficient cardiac function and optimal microvascular flow due to their viscoelastic properties. Studies in animals and on isolated arteries show that acute systemic inflammation can cause aortic stiffening which affects hemodynamic efficiency. Carotid-femoral pulse wave velocity, a measure of aortic stiffness, may be useful as a bedside investigational method in patients with early sepsis admitted to intensive care, as circulatory changes can lead to multiple organ failure and increased mortality. This study aims to investigate arterial stiffness in early sepsis and its association with clinical outcomes. Metho…
Blood alcohol concentration for monitoring ethanol treatment to prevent alcohol withdrawal in the intensive care unit.
2001
Abstract Objective. Alcohol withdrawal syndrome (AWS) is a serious complication during postoperative treatment in chronic alcoholics. Despite prophylactic treatment, AWS occurs in at least 25% of these patients after elective surgery. An established protocol for the prevention of AWS is ethanol administration. The aim of this study was to evaluate possible differences in ethanol dose and levels between successfully treated patients and those who developed AWS. Design. Prospective, observational study with retrospective post hoc analysis. Setting. Intensive care unit (ICU). Patients. Thirty-two alcohol-dependent patients undergoing elective or emergency surgery after trauma with postoperativ…