Journal of intensive care medicine
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J Intensive Care Med · Nov 2008
Case ReportsManagement of the obstetric patient with status asthmaticus.
Status asthmaticus requiring mechanical ventilation is an uncommon, life-threatening disorder in obstetric patients. The unique physiologic changes of pregnancy, impact of the fetus on the maternal condition, and concerns for fetal and maternal health and survival are particular concerns in critical illness. ⋯ There is abundant literature on the management of asthma during pregnancy; however the literature is very limited in those with status asthmaticus who require intensive care unit admission. We report our intensive care unit experience in the management of status asthmaticus in 5 pregnant patients and review the literature on management of status asthmaticus during pregnancy.
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As of August 2007, 96 900 people are awaiting organ transplantation in the United States, while only 28 930 transplants were performed in 2006. With such a large gap between organ need and organ availability, it is inevitable that many will die while awaiting transplantation. ⋯ The use of these standardized and aggressive donor management protocols has been shown to increase the number of transplanted organs and prevent the number of donors lost due to medical failures. A protocol-driven approach by a dedicated organ donor management team should be considered a key component of any program designed to bridge the gap between organ supply and demand.
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J Intensive Care Med · Nov 2008
Review of a large clinical series: sedation and analgesia usage with airway pressure release and assist-control ventilation for acute lung injury.
Our objective was to compare sedative and analgesic doses, agents, and sedation status in patients with airway pressure release ventilation (APRV) versus assist-control (AC) ventilation on the first day after acute lung injury diagnosis. ⋯ APRV may be associated with decreased sedation and analgesia medications and improved sedation status. Differences in the patients receiving APRV versus AC ventilation may have contributed to this conclusion. Further investigation is needed.
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J Intensive Care Med · Nov 2008
Clinical TrialCerebral oximetry monitoring with near infrared spectroscopy detects alterations in oxygenation before pulse oximetry.
The monitoring of oxygenation may be imperative to ensure patient safety and optimal outcome. We anecdotally noted that monitoring cerebral oxygenation (rSO2) using near infrared spectroscopy may provide an earlier warning of changes in oxygenation than pulse oximetry. ⋯ Cerebral oxygenation monitoring using near infrared spectroscopy detects changes in oxygenation earlier than standard pulse oximetry.