Articles: critical-illness.
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Acta Anaesthesiol Scand Suppl · Jan 1995
ReviewEffects of catecholamines on regional perfusion and oxygenation in critically ill patients.
Multiple organ failure is the major cause of death in patients with sepsis. Bacterial translocation from the gut is considered to induce and maintain sepsis. Therefore, the splanchnic region plays an important role in the pathogenesis and treatment of sepsis. ⋯ Catecholamines with beta mimetic effects are often used to increase DO2. The question as to whether dobutamine or dopamine should be used first in treatment of septic shock cannot be answered yet. Whether treatment with low dose dopamine or dopexamine actually improves renal function and splanchnic oxygenation is the purpose of ongoing studies.
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American family physician · Jan 1995
ReviewAnalgesia, sedation and paralysis in the intensive care unit.
Patients admitted to the intensive care unit often experience some degree of pain and frequently are anxious, confused or delirious. Relief of pain, anxiety and agitation is important for effective patient care. ⋯ Opioids are the cornerstone of analgesia, while benzodiazepines and haloperidol are commonly used for sedation and relief of agitation. When sedative agents fail to control agitation and effective ventilation of the patient is compromised, it may be appropriate to pharmacologically paralyze the patient.
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Clin Intensive Care · Jan 1995
Subjective psychological status of severely ill patients discharged from mechanical ventilation.
To evaluate psychological status in consecutive survivors of ICU who needed mechanical ventilation (MV). ⋯ These results showed that psychological status is poor in ventilated ICU patients, which should be considered in their care.
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Comparative Study
Comparison of APACHE II and III scoring systems for mortality prediction in critical surgical illness.
To determine whether the Acute Physiology and Chronic Health Evaluation III (APACHE III), an updated version of APACHE II that contains a larger number of postoperative patients in the normative database, offers better prediction in critical surgical illness. ⋯ In institutions or groups of patients where APACHE II underestimates mortality, APACHE III may be corrective. However, the differences are subtle and may be difficult to detect in smaller studies.
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Critical illness creates stress in patients and their families. However, families' reactions vary and suggest that having a loved one in an intensive care unit (ICU) may not be a crisis for all families. The purpose of this study was to explore and describe the meanings that families ascribe to an ICU experience. ⋯ Interviews were analyzed qualitatively and revealed five categories of meanings that the ICU experience had for families: "it could go either way," "everything is good," "going upstairs," "like living on a roller-coaster," and "there is no hope." All eight families described an initial period of uncertainty during which they were unsure whether the patient would survive. The subsequent trajectory of critical illness followed one of two paths: positive or negative. The results of this study are of interest to nurses who seek to broaden their understanding of the impact of critical illness on the family.