Critical care clinics
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The five components integral to modern, sophisticated airway management in trauma patients include equipment, pharmacologic adjuncts, manual techniques, physical circumstances, and patient profile. Although there is a finite number of pieces and types of equipment, pharmacologic adjuncts, and manual techniques, the last two components are variable. ⋯ We believe that the commonly used airway management algorithms are a poor substitute for a conceptual understanding of the basic principles of the five components of airway management, although these decision trees may be useful as learning tools. The construction of a truly complete decision tree is virtually impossible because of the high number of individual patient profiles.
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Critical care clinics · Jan 1990
ReviewPerioperative anesthetic management of the pediatric trauma patient.
The object of this article is to provide the anesthesiologist with an approach to the perioperative management of pediatric trauma. The initial focus is on planning and initial stabilization and transport. ⋯ The anesthetic management of the head-injured patient is focused upon the control of intracranial pressure, and the major method for control is hyperventilation to reduce the CO2. Head trauma patients often have injuries to other body systems, which may account for both their ventilatory and their circulatory problems.
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Acute traumatic brain injury is a leading cause of morbidity and mortality. Intensive management is aimed at early evacuation of intracranial mass lesions, control of intracranial hypertension, and prevention of medical complications.
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Critical care clinics · Jul 1989
ReviewMultiple systems organ failure (MSOF): lessons learned from the adult respiratory distress syndrome (ARDS).
The relationship between ARDS and MSOF is explored. Models include that ARDS represents only one organ failing in MSOF, or that MSOF is a complication of ARDS owing to the development of infection and sepsis syndrome in these patients. Data are reviewed suggesting an important role of infection and sepsis syndrome in both models.
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Critical care clinics · Jul 1989
ReviewPericarditis, pericardial effusion, cardiac tamponade, and constriction.
Critical care aspects of pericardial disease are covered, including diagnosis and differential diagnosis of acute pericarditis, pericardial effusion with and without cardiac tamponade, constrictive pericarditis and effusive-constrictive pericarditis. Emphasis is placed on clinical signs and the important invasive and noninvasive diagnostic procedures, particularly various imaging methods (emphasis on echocardiography), electrocardiography, and cardiac catheterization. Medical and surgical therapies are reviewed, and the technique of pericardiocentesis is presented.