The Mount Sinai journal of medicine, New York
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Historical Article
The surgical intensive care unit of The Mount Sinai Hospital: a brief history focusing on contributions to academic critical care medicine and excellence in patient care.
The Mount Sinai Hospital Surgical Intensive Care Unit (SICU) was founded in 1969. Drs. ⋯ Since it was founded, the SICU has been an integral part of the Mount Sinai Medical Center, providing a wide variety of clinical services including critical care, central line placement, and nutritional consultation. As one of the largest training programs in the United States and a frequent contributor to the medical literature, the SICU has also played a vital role in academic critical care medicine.
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Approximately two-thirds of all women in the United States receive analgesia for labor and delivery. The ideal labor analgesic technique would confer complete pain relief without side effects to either the mother or the neonate. ⋯ Modern obstetric analgesia techniques and medications come close to achieving these goals. The following article will review current labor analgesia techniques and medications used during labor and delivery.
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Airway management is a critical component of modern anesthetic care. Advances in airway management, as well as the recent history of airway management teaching at The Mount Sinai Hospital, are reviewed.
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Selected orthopedic surgical procedures, such as total joint arthroplasty and spinal instrumentation, have some of the highest perioperative transfusion rates of all surgical procedures. Blood transfusions carry the risk of complications, including the transmission of disease, immunomodulation, and hemolytic and non-hemolytic reactions. Strategies that reduce or remove the risk of allogeneic transfusion include preoperative autologous donation, acute normovolemic hemodilution, perioperative cell salvage techniques, deliberate hypotension, and pharmacologic interventions. This paper will review the current status of these therapies in the orthopedic surgical patient.
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Serious neurological complications after spinal anesthesia are rare, but do occur. The most common are postdural puncture headache and hypotension. Hypotension after spinal anesthesia is a physiological consequence of sympathetic blockade. The diagnoses and management of these sequelae are discussed.