Medizinische Klinik, Intensivmedizin und Notfallmedizin
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Med Klin Intensivmed Notfmed · Sep 2011
Review[Medical geriatric aspects in intensive care therapy of elderly patients].
For elderly patients specific medical problems, such as the consequences of aging organs, comorbidities or geriatric syndromes must be considered in the intensive care treatment of acute diseases. Under these circumstances special instruments for geriatric assessment are particularly useful. Up to now geriatrics and intensive care medicine have made complementary contributions in the treatment of severely ill elderly patients. A closer interdisciplinary cooperation of the two disciplines could be of substantial beneficial value in the care of the sick and elderly to overcome the many open questions and pressing problems.
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Med Klin Intensivmed Notfmed · Sep 2011
Review[Volume replacement therapy options for critically ill patients].
For critically ill patients with hypovolemia, volume replacement therapy is important to maintain sufficient tissue perfusion and oxygenation. Nearly all patients receive crystalloids and often additionally colloids. The advantages of the former are low costs, immediate availability, the ability to fill both the intravascular and extravascular fluid spaces and a non-allergenic potential. ⋯ Colloids are more efficient volume expanders and tissue edema can be avoided. The disadvantages compared to crystalloids are the higher costs and the risk of rare but potentially severe anaphylactic reactions. Artificial colloids (hydroxyethyl starch) are cheaper than the natural colloid albumin but the safety profile is less favorable.
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Med Klin Intensivmed Notfmed · Sep 2011
Review[Scientific acquisition of knowledge in operative medicine. The importance of intensive care medicine].
The forms of treatment in intensive care medicine and the medicinal and instrumental equipment for maintaining the circulation, pulmonary and renal functions as well as surveillance for recognition of life-threatening arrhythmias or multiorgan failure have experienced an enormous development in recent decades. Survival of traumatized or critically ill patients has been substantially improved. Due to these developments surgeons are confronted with new patterns of diseases which necessitate the development of new operative measures. This article gives a review of the most important changes in operative medicine (e.g. traumatology and vascular surgery) which can essentially be attributed to experience and success in intensive care medicine.
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Med Klin Intensivmed Notfmed · Sep 2011
Review[Long-term outcome of elderly patients after intensive care treatment].
In general, elderly patients have poorer outcomes than younger patients after intensive care treatment. Diagnosis at admission and high age mainly influence short-term mortality within the first few months after intensive care, while comorbitities and functional status are more pivotal regarding long-term mortality. ⋯ Due to the constant improvement of intensive care treatment during recent decades, increasingly more patients survive their acute critical disease. Now it is time to focus on translational research to discover causal relationships between intensive care treatment and morbidity during follow-up to improve the quality of survival.