Critical care clinics
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Critical care clinics · Jan 1986
Comparative StudyEthical decision making and the critical care team.
This article studies the process of decision making used to arrive at decisions to withdraw treatment in the adult and neonatal intensive care unit. The emerging role of team decision making is described as a cumulative process of dialogue between the health care team and the patient's family (including the patient in some cases).
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This article reviews the cardiac sequelae of blunt chest injury. Major cardiac injuries of blunt chest trauma involve damage to the myocardium, although pericardial disease, valvular heart disease, and coronary artery disease may result. Recognition of the various syndromes associated is discussed, and a synthesis of diagnostic and management strategies for speculation is provided.
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Hypovolemic shock is the most common form of shock seen clinically and has attracted the greatest laboratory interest. It is caused by a sudden decrease in the intravascular blood volume relative to the vascular capacity, to the extent that effective tissue perfusion cannot be maintained. The authors of this article discuss the pathophysiology of hypovolemic shock, the assessment of the patient in shock, the immunologic consequences of shock, impairment of cardiac function in hypovolemic shock, and the management of hypovolemic shock.
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Critical care clinics · Nov 1985
ReviewThe systemic septic response: multiple systems organ failure.
Sepsis, which is the host response to one or more microorganisms, is probably best understood within the concept of activator-mediator-responder. The various forms of metabolic support work in all three areas. ⋯ Appropriate nutritional support seems to have been an important factor in this reduction in mortality. There are many new areas of research that need to be evaluated, and many of these areas are now directed at regulatory aspects of the metabolic response.