Ugeskrift for laeger
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Critical illness is characterized by one or more failing organs. Hormonal regulation of metabolism changes during the course of critical illness and is related to the severity of disease. ⋯ Recent large scale insulin infusion studies have demonstrated beneficial effects on both the immune response and coagulation systems. Future research will show whether further hormonal substitution can reveal similar results.
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Acute renal failure (ARF) is characterized by a sudden increase in plasma creatinine and a decrease in urine flow. ARF is caused by multiple factors of which the most important are hypovolemia, hypotension, septic mediators and nephrotoxic agents. ARF is observed in 10-23% of critically ill patients. ⋯ If the patient survives, the recovery of renal function is 90-95%. Non-dialytic therapy is early volume resuscitation whereas furosemid may worsen ARF. At the present time the dialytic therapy of choice in ICU patients with ARF is continuous renal replacement therapy (CRRT).
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Ugeskrift for laeger · Feb 2007
Comparative Study[Capacity problems in Danish intensive care units?].
There are documented capacity problems in Danish ICUs. The indications for intensive care have increased in the last decade without any increase in the number of ICU beds. ⋯ Possible solutions: 1) an increase in the number of ICU beds, 2) re-organization of Danish ICUs into larger units and 3) creation of "step-down"-units. Intensive care is a costly area in the healthcare system, where there must be distinct guidelines for visitation and use of expensive medicine and advanced technology.
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Ugeskrift for laeger · Feb 2007
[What is intensive care medicine? Multidisciplinary intensive care units].
Intensive care medicine is described from a multidisciplinary point of view. The term "multidisciplinary" is used, although "multispeciality" may be more appropriate. ⋯ Intensive care medicine is conducted in the high-technology environment of intensive care units. These are further classified according to their own competency base as well as the level of the hospital in which they are situated.
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Ugeskrift for laeger · Feb 2007
Comparative Study[Post-specialty training program in intensive care medicine. Nordic and European aspects].
Intensive care medicine has become technically and conceptually more demanding in recent years and this has created a need for improved training and education in this field. In Scandinavia a successful post-specialty training program in intensive care medicine was established in 1998 and so far about 200 physicians have passed the two-year program. This program has contributed to an increased interest in and a development of intensive care medicine - both clinically and scientifically - in the five Scandinavian countries (Denmark, Norway, Sweden, Iceland and Finland).