Tidsskrift for den Norske lægeforening : tidsskrift for praktisk medicin, ny række
-
Tidsskr. Nor. Laegeforen. · Jan 2010
Review[Acute respiratory failure concomitant with serious disease or injury].
Acute respiratory failure has an annual incidence of 20-75/100,000 and is the most common reason for admittance to an intensive care unit. A common cause is acute inflammatory changes in lung tissue. The article reviews clinical, etiological, pathophysiological and therapeutic aspects of acute respiratory failure, with an emphasis on failure secondary to proinflammatory processes. ⋯ No specific treatment is available for secondary tissue inflammation; it usually resolves when the precipitating injuries or disease processes are healed. Positive pressure ventilation can prevent serious hypoxemia from causing additional damage to affected tissue. With modern treatment in an intensive care unit only 10-15 % of the deaths are caused by the respiratory failure per se, most deaths are caused by failure of several additional organs (multiorgan failure).
-
Neutropenic enterocolitis is a life-threatening complication that usually occurs in connection with chemotherapy for acute leukemias. Our experience with diagnosis and treatment of these patients is presented. ⋯ Neutropenic enterocolitis is a heterogeneous condition and the treatment is mainly conservative. Surgical intervention is mandatory in patients with free intraabdominal air, ileus and intractable intestinal bleeding. The prognosis seems to worsen when aplasia develops after a short time and when there is a large number of affected bowel segments.
-
Intensive care is medical care for critically ill patients. Over the last 20 years more attention has been drawn to studying long-term outcome after intensive care. ⋯ Many ICU patients have rehabilitation potential despite critical illness and comorbidity and most of the long-term survivors achieve acceptable quality of life. ICU patients are a heterogeneous group with great variation in short and long-term outcome. Organization of intensive care should include follow-up after hospital discharge.
-
A 20-year-old woman presented with dyspnoea in the Emergency department and subsequently suffered a cardiac arrest. The initial rhythm was PEA (pulseless electrical activity). She had intermittent return of spontaneous circulation. ⋯ The remaining hospital stay was uneventful and ten days after the presentation she was transferred to her local hospital. At this point she was without neurological sequelae. The patient had used oral contraceptives (ethinyl estradiol/ drospirenone).