The Surgical clinics of North America
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Sepsis in the surgical patient continues to be a common and potentially lethal problem. Early identification of patients and timely implementation of evidence-based therapies continue to represent significant clinical challenges for care providers. The implementation of a sepsis screening program in conjunction with protocol for the delivery of evidence-based care and rapid source control can improve patient outcomes. The article provides definitions and guidelines for the screening and management of sepsis and septic shock.
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Pain management in the intensive care unit (ICU) is a complex process. Both the experience of pain as well as its treatment can have consequences relating to the overall outcome of the patient. Further, lack of the ability of many patients in the ICU to communicate their distress makes it even more critical for the ICU practitioner to understand the typical causes of pain in this setting and the applicability of many pain management regimens.
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Surg. Clin. North Am. · Dec 2012
ReviewRemoving the critically ill patient from mechanical ventilation.
Weaning from mechanical ventilation is usually straightforward but is occasionally challenging. Sedation must be used at the appropriate times and with appropriate dosing. ⋯ Early tracheostomy is beneficial in traumatic brain injury patients. Noninvasive ventilation is most useful in patients with baseline obstructive sleep apnea and chronic obstructive pulmonary disease.
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Surg. Clin. North Am. · Dec 2012
ReviewOptimizing drug therapy in the surgical intensive care unit.
This article provides a review of commonly prescribed medications in the surgical ICU, focusing on sedatives, antipsychotics, neuromuscular blocking agents, cardiovascular agents, anticoagulants, and antibiotics. A brief overview of pharmacology is followed by practical considerations to aid prescribers in selecting the best therapy within a given category of drugs to optimize patient outcomes.