Critical care clinics
-
Critical care clinics · Oct 1997
ReviewGastrointestinal decontamination after poisoning. Where is the science?
The approach to the use of gastrointestinal decontamination procedures in the treatment of ingested toxins has changed in recent years. Many toxicologists and physicians have taken strong positions either for or against the use of emesis, gastric lavage, activated charcoal, or other procedures. What is the scientific basis for these positions? This article reviews and comments on the published studies comparing the effectiveness of these widely used procedures.
-
Drug-related causes of hyperthermia can often be overlooked in the setting of elevated body temperature. This article reviews the pathophysiology, presentation, and treatment of several drug-induced hyperthermia syndromes: malignant hyperthermia, neuroleptic malignant syndrome, sympathomimetic poisoning, and anticholinergic toxicity. Although the general approach is similar, specific management strategies may be required for each syndrome.
-
Drowning and near drowning remain a common cause of childhood death and disability. Toddlers aged one through four drown in private swimming pools. ⋯ Management of respiratory failure without neurologic impairment has the most successful outcome. Prevention of drowning morbidity is dependent on constant parental supervision, and immediate and expert CPR.
-
Critical care clinics · Jul 1997
ReviewEtiology and treatment of acquired coagulopathies in the critically ill adult and child.
Excessive bleeding frequently complicates the care of critically ill patients. Except in the case of trauma or inpatients with known coagulopathies, the bleeding is generally not directly related to the illness that results in admission to the intensive care unit. In general, the causes of the bleeding can be divided into three categories: consumptive coagulopathies, bleeding related to "hepatic issues," and iatrogenic causes. ⋯ However, some differences do exist in regards to the clinical manifestations and management of some consumptive coagulopathies. This article reviews the more common causes of bleeding in the critically ill patient and outlines diagnostic and treatment approaches for these patients. Particular emphasis will be placed on the differences in presentation and management where differences exist.
-
Critical care clinics · Jul 1997
ReviewCommon nutritional issues in pediatric and adult critical care medicine.
This article discusses many of the nutritional topics important to the intensivist. Nutritional assessment, substrate immunonutrition, and disease specific issues are presented. Early introduction of enteral feeds and the use of nutritional modulation are emphasized.