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[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.
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Med Klin Intensivmed Notfmed · Sep 2011
Review[Geriatric patients in intensive care medicine. Ethical aspects].
Due to demographic change and progress in medicine, the percentage of geriatric patients treated in intensive care is continuously increasing. In addition to the acute disease, many of these patients may also have chronic illnesses, multimorbidity, and cognitive limitations. ⋯ The denial of access to intensive care, however, cannot be justified by the advanced age of the patient alone. This would display an ethically problematic form of discrimination (ageism).