International journal of critical illness and injury science
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Int J Crit Illn Inj Sci · Jul 2015
Regional anesthesia for management of acute pain in the intensive care unit.
Pain is a major problem for Intensive Care Unit (ICU) patients. Despite numerous improvements it is estimated that as many as 70% of the patients experience moderate-to-severe postoperative pain during their stay in the ICU. Effective pain management means not only decreasing pain intensity, but also reducing the opioids' side effects. ⋯ Furthermore, recent studies suggest that effective acute pain management may be helpful in reducing the development of chronic pain. When used appropriately, and in combination with other treatment modalities, regional analgesia techniques (neuraxial and peripheral nerve blocks) have the potential to reduce or eliminate the physiological stress response to surgery and trauma, decreasing the possibility of surgical complications and improving the outcomes. Also they may reduce the total amount of opioid analgesics necessary to achieve adequate pain control and the development of potentially dangerous side effects.
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Flexible and rigid bronchoscopes are used in diagnosis, therapeutics, and palliation. While their use is widespread, effective, and generally safe; there are numerous potential complications that can occur. ⋯ Attributable mortality rates remain low at < 0.1% for fiberoptic and rigid bronchoscopy. Here we review the complications (classified as mechanical or systemic) of both rigid and flexible bronchoscopy in hope of making practitioners who are operators of these tools, and those who consult others for interventions, aware of potential problems, and pitfalls in order to enhance patient safety and comfort.
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Int J Crit Illn Inj Sci · Jul 2015
Prognosis of critical surgical patients depending on the duration of stay in the ICU.
To analyze the epidemiological and prognostic differences between critical surgical patients admitted to intensive care unit (ICU) according to length of stay in the ICU. ⋯ Surgical patients who survive in the ICU, regardless of the length of their stay in it, have the same odds of hospital survival. Found as predictors of mortality in ICU APACHE II, age, admission in a coma state, and application of invasive techniques.