Critical care clinics
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Critical care clinics · Jan 2009
Historical ArticleEvolution of the intensive care unit as a clinical center and critical care medicine as a discipline.
This article discusses the history of the ICU and critical care medicine (CCM). It also discusses the certification of critical care nurses and allied health professionals, as well as CCM societies and congresses, education and board certification, evidence-based CCM, research and publications, and future challenges to the field.
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Infectious disease has been a leading cause of death in humans since the first recorded tabulations. From Hippocrates and Galen, to Lister, Fleming and Semmelweiss, this article reviews the notable historical figures of sepsis research. The early descriptions and theories about the etiology (microbial pathogens), pathogenesis (toxins and mediators), and treatment of sepsis-associated disease are also discussed.
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This article reviews the development of early ideas regarding the origins and pathogenesis of shock. The early history of shock is related primarily to traumatic shock. More recent history centers on differentiation of clinical syndromes and individual characteristics. ⋯ Progress has been aided by constant development of improved assessment technologies. Today, shock is not a single syndrome and the definition of shock no longer is descriptive in nature. The most accepted current definition involves an oxygen supply/demand imbalance that can have various causes-hypovolemia, cardiac dysfunction, vascular failure, or obstructive processes.
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Critical care clinics · Jan 2009
Historical ArticleBattlefield trauma, traumatic shock and consequences: war-related advances in critical care.
Over the course of history, while the underlying causes for wars have remained few, mechanisms of inflicting injury and our ability to treat the consequent wounds have dramatically changed. Success rates in treating war-related injuries have improved greatly, although the course of progress has not proceeded linearly. From Homer's Iliad to the Civil War to Vietnam, there have been significant improvements in mortality, despite a concurrent increase in the lethality of weapons. These improvements have occurred primarily as a result of progress in three key areas: management of wounds, treatment of shock, and systems of organization.
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Critical care clinics · Oct 2008
ReviewPsychiatric aspects of organ transplantation in critical care.
Intensive care unit teams are a critical part of the solid organ transplant process. The psychosocial issues involved during critical periods of transplantation are important for intensive care physicians and clinicians to understand to provide comprehensive care to transplant patients. ⋯ Considered are the pretransplant evaluation phase, psychiatric disorders in transplant patients, and cognitive impairments and delirium with additional issues specific to particular organs. Also covered are the side effects of immunosuppressive medications and special issues arising with living donors.