Search results for "Critical"

Current state of critically ill patients sedation with volatile anesthetics. Its role in renal and hepatic toxicity

2013

Summary The anesthetic-conserving device (AnaConDa™) facilitated, from a technical viewpoint, the routine use of volatile anesthetics in intensive care patients using ICU ventilators. To date, its use is currently time-limited by clinicians due to the potential renal and hepatic toxicity associated with the production of plasma fluoride after its metabolism, despite its advantages. We reviewed the available human and animal studies literature examining the use of volatile anesthetics as sedative agents and its role in renal and/or hepatic toxicity. We have very few studies concerning the prolonged administration of sevoflurane through the AnaConDa™ and its effect on renal and hepatic functi…

Optimizing ceftolozane-tazobactam dosage during continuous renal replacement therapy: some nuances

2020

Heterogeneous Oxygenation of Rectal Carcinomas in Humans: A Critical Parameter for Preoperative Irradiation?

1984

The surgical treatment of rectal carcinoma in humans is often combined with irradiation. However, the efficacy of this latter treatment modality is crucially influenced by the oxygenation status of the tumor tissue to be treated. Therefore, the knowledge of the O2 supply to the tumor tissue is a decisive prerequisite for the assessment of the efficiency of radiotherapy.

Stroke--a medical emergency.

1999

Stroke is the third leading cause of death and number one cause of disability in industrialised countries. A number of new therapeutic approaches are currently in development for use in the acute phase of ischaemic stroke and all trials have, to date, demonstrated the importance of early diagnosis and subsequent initiation of treatment. It is well known that, for most patients, there is a long delay between the onset of symptoms and the start of treatment. A number of factors are responsible for this time delay: signs and symptoms often go unrecognised by patients, relatives, and bystanders and, unlike trauma or myocardial infarction, stroke is not given a high priority by medical staff. St…

Delirium Assessment in Older People in Emergency Departments. A Literature Review.

2018

Delirium is a neuropsychiatric syndrome often manifesting in acute disease conditions, and with a greater prevalence in the older generation. Delirium in the Emergency Department (ED) is a highly prevalent problem that typically goes unnoticed by healthcare providers. The onset of a delirium episode in the ED is associated with an increase in morbidity and mortality. Because delirium is a preventable syndrome, these statistics are unacceptable. Emergency Department staff therefore should strive to perform systematic screening in order to detect delirium. Different tools have been developed for the assessment of delirium by healthcare professionals other than psychiatrists or geriatricians. …

Dressings and Securement Devices of Peripheral Arterial Catheters in Intensive Care Units and Operating Theaters

2020

Background: Hemodynamic monitoring, implemented by the placement of peripheral arterial catheters (PACs), is a characterizing aspect of the intensive care units. Peripheral arterial catheters can continually detect blood pressure and quickly conduct blood sampling. The use of PACs is generally considered safe, without serious complications. Currently, only 25% of the implanted catheters are actually subject to complications, including accidental removal, dislocation, occlusion, and infection. All of these complications arise from inadequate catheter stabilization at the level of the skin. This study aimed to summarize and describe the effectiveness and characteristics of dressings and secur…

Delirium: From the Operating Room to the ICU

2020

Delirium is a transitory and reversible syndrome which is potentially avoidable; nevertheless represents the most common acute encephalic dysfunction in critically ill patients. Despite this population being daily treated by anesthesiologists in the operating rooms and by critical care physicians in the Intensive care unit, delirium remains an underdiagnosed condition that is associated with a significative increase in morbidity and mortality. Furthermore, it is associated with higher costs and length of stay.

Emergency department performances during overcrowding: the experience of the health protection agency of Brianza.

2018

Background: Hospital emergency departments (ED) can contribute to improve health outcomes and reduce costs of health care system. This study evaluated ED admissions during a twelve months period, analyzing characteristics of patients who underwent to emergency care in order to understand factors involved in ED overcrowding and promote adequate management. Methods: This retrospective study analyzed a twelve months window, with in-depth focus on December/January when almost all EDs reported overcrowding. All ED admissions were recorded in electronic schedules including: demographic characteristics, time/date of the access, incoming triage code, diagnosis, performed procedures, discharge, time…

Cardiac arrest in older adult patients

2021

Purpose of review To describe the epidemiology, prognostication, and treatment of out- and in-hospital cardiac arrest (OHCA and IHCA) in elderly patients. Recent findings Elderly patients undergoing cardiac arrest (CA) challenge the appropriateness of attempting cardiopulmonary resuscitation (CPR). Current literature suggests that factors traditionally associated with survival to hospital discharge and neurologically intact survival after CA cardiac arrest in general (e.g. presenting ryhthm, bystander CPR, targeted temperature management) may not be similarly favorable in elderly patients. Alternative factors meaningful for outcome in this special population include prearrest functional sta…

Heart rate variability as predictor of mortality in sepsis: A systematic review.

2018

Background Autonomic dysregulation is one of the recognized pathophysiological mechanisms in sepsis, generating the hypothesis that heart rate variability (HRV) can be used to predict mortality in sepsis. Methods This was a systematic review of studies evaluating HRV as a predictor of death in patients with sepsis. The search was performed by independent researchers in PubMed, LILACS and Cochrane, including papers in English, Portuguese or Spanish, indexed until August 20th, 2017 with at least 10 patients. Study quality was assessed by Newcastle-Ottawa Scale. To analyze the results, we divided the articles between those who measured HRV for short-term recordings ( 1 hour), and those who did…