Lijec̆nic̆ki vjesnik
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Monitoring of vital functions is one of the most important and essential tools in the management of critically ill patients in the ICU. Today it is possible to detect and analyze a great variety of physiological signals by various noninvasive and invasive techniques. ⋯ It enables monitoring of pressures, flow and saturation, pressures in the systemic and pulmonary circulation, estimation of cardiac performance and judgment of the adequacy of the cardiocirculatory system. Carefully and correctly obtained information are basis for proper hemodynamic assessment which usually effects the therapeutic decisions.
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Lijec̆nic̆ki vjesnik · Jun 1995
Case Reports[Accidental hypothermia with cardiorespiratory arrest. Case report].
A case of an effective cardiopulmonary resuscitation in a 71-year-old woman following drowning in a cold water and cardiopulmonary arrest for at least 20 minutes is presented. Intubation, ventilation with 100% oxygen, external cardiac massage and administration of adrenaline, 1 mg intravenously, were implemented. Ventricular fibrillation, which occurred after adrenaline therapy, responded to electrical defibrillation with 200 J and converted into a sinus rhythm. ⋯ The patient became gradually conscious, and she was weaned from mechanical respiration after 12 hours. Subsequently, the patient was extubated. There were no neurological deficits.
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238 patients with multiple trauma hospitalized in the Intensive Care Unit of the Zagreb General Hospital during 1993 and 1994 were analyzed. They were grouped with respect to the type of their injury. The first group was composed of patients with isolated head injury. ⋯ Assisted ventilation over 24 hours needed 180 patients (average of 11,4 days). The most common complications were respiratory: pneumonia developed 60 and ARDS five patients. The rate of mortality was 35,9% (65 patients died.
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A significant improvement has been noticed over the last 20 years in children in whom shock syndrome has developed. This has been attained through the application of technological advances in respiratory, cardiovascular, renal, nutritional support and improved antibacterial and antifungal therapy, but mostly through a better understanding of the physiology of shock. Newer concepts of the pathophysiology of sepsis and septic shock are presented, with clinical definitions referring to the pediatric patient. Innovative therapeutic modalities designed to modulate the systemic inflammatory response triggered by bacterial infection are discussed.