ISSN:1070-5295    

出版商:OVID    

年代:1996

数据来源: OVID

ISSN:1070-5295    

出版商:OVID    

年代:1996

数据来源: OVID

摘要:

In the National Institutes of Health rt-PA Stroke Study, treatment of ischemic stroke within 3 hours of onset with intravenous tissue plasminogen activator resulted in improved neurologic outcome, without increased mortality from intracerebral hemorrhage. Experimental neuroprotective therapies may soon provide the opportunity to further limit ischemic damage, either alone or in combination with thrombolysis. New imaging techniques, such as diffusion-weighted magnetic resonance imaging, have been shown to detect acute ischemia before infarction develops and may eventually revolutionize the diagnosis of acute stroke. At the present time, however, ICU care for victims of severe stroke remains primarily supportive, and survivors are often left with profound neurologic deficits. Outcomes research is required to determine which patients are most likely to benefit from heroic supportive care for lifethreatening stroke.

ISSN:1070-5295    

出版商:OVID    

年代:1996

数据来源: OVID

摘要:

The management of central nervous system infections is continuously changing. There is increasing evidence that the timehonored practice of fluid restriction in children with acute bacterial meningitis may contribute to a poor outcome. The emergence of penicillin- and cephalosporin-resistant pneumo-cocci have increased the urgency for the development of new antimicrobial agents to treat central nervous system infections. Steady progress continues to be made in the diagnosis and management of the neurologic complications of AIDS.

ISSN:1070-5295    

出版商:OVID    

年代:1996

数据来源: OVID

摘要:

Head injury remains a cause of severe morbidity and mortality, although recent advances have helped in the development of new treatment strategies. Appropriate fluid management and maintenance of cerebral perfusion, particularly in cases of multiple trauma, is critical. Jugular venous oxygen saturation is a new way to assess the patient with head injury, and to test the effect of treatments on cerebral blood flow. Electrophysiologic testing may help prognosticate in cases of severe head injury. This article reviews the current data on epidemiology, therapy, prognosis, and outcome of patients with traumatic brain injury.

ISSN:1070-5295    

出版商:OVID    

年代:1996

数据来源: OVID

摘要:

The management of seizures and status epilepticus are important in critical care neurology. Seizures are a common manifestation of either a primary nervous system disorder or dysfunction in other organ systems. Status epilepticus represents a medical emergency, and its treatment requires a systematic, coordinated approach. Clinical studies have improved our knowledge of the etiology, prognosis, and electroencephalographic features of status epilepticus, and further understanding of the pathophysiologic mechanisms of epilepsy has led to advances in its treatment. New medications have been introduced for the treatment of seizures, status epilepticus, and refractory status epilepticus.

ISSN:1070-5295    

出版商:OVID    

年代:1996

数据来源: OVID

摘要:

Autonomic dysfunction is common in critically ill patients, but it often remains unrecognized due to the elusive nature of the physiological alterations and their multifactorial influences. This review focuses on autonomic dysfunction encountered in patients with acute illness secondary to primary neurologic disorders and with non-neurologic acute systemic diseases. Our goal is to enhance the reader clinician's appreciation of autonomic disorders in a practical manner that enhances diagnostic understanding, anticipatory planning, and prognostication, in contrast to the usual phenomenological approach to the topic.

ISSN:1070-5295    

出版商:OVID    

年代:1996

数据来源: OVID

摘要:

The proven efficacy of interventions in preventing clinically significant bleeding from stress ulcers has lead to their widespread use. Unfortunately, such therapy has not been proven to alter morbidity or mortality and is associated with complications such as nosocomial pneumonia. A declining incidence of stress ulcers, an improved understanding of their pathogenesis, and studies involving those patients at greatest risk has allowed us to more appropriately apply such therapy. Future use of stress ulcer prophylaxis will ideally be based on outcome analysis studies using relevant endpoints such as transfusion requirement, duration of ICU stay, and mortality. The benefits and role of therapies such as proton pump inhibitors and gastrointestinal decontamination must also be examined more closely.

ISSN:1070-5295    

出版商:OVID    

年代:1996

数据来源: OVID

摘要:

Patients with acute liver failure are critically ill and their survival depends not only on the capacity of the liver to regenerate but also on intensive supportive medical management. There is no effective therapy for any of the major known causes of acute liver failure. Most cases of non-A, non-B hepatitis-related acute liver failure are also non-C, non-E hepatitis-related. The role of the newly described hepatitis viruses in the etiology of acute liver failure is unknown. Cerebral edema is a common complication of acute liver failure, and its pathophysiology and treatment have been recently explored. Selection of patients likely to survive is important in order to determine which patients require liver transplantation. Increased effort has been placed in developing prognostic factors or criteria that predict a need for liver transplantation. Due to the shortage of donor organs, alternatives to orthotopic liver transplantations continue to be explored.

ISSN:1070-5295    

出版商:OVID    

年代:1996

数据来源: OVID

摘要:

Diarrhea is a common problem for patients admitted to ICUs. This article reviews the common causes of diarrhea in this setting, including medication-induced diarrhea and antibioticassociated diarrhea from bothClostridium difficileinfection and due to decreased colonic salvage of carbohydrate. Diarrhea as a result of intolerance for enteral feedings is discussed, including the role of hypoalbuminemia and fiber. Intestinal ischemia and fecal impaction are also reviewed. In addition, recent findings as they relate to diarrhea caused byEscherichia coli0157:H7 andVibrio choleraeare discussed. An approach to management and therapy of diarrhea in the critically ill is also presented.

ISSN:1070-5295    

出版商:OVID    

年代:1996

数据来源: OVID