Articles: intensive-care-units.
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Case Reports
Intensive care unit psychosis revisited: understanding and managing delirium in the critical care setting.
Delirium occurs frequently in critically ill patients, yet this syndrome is often unrecognized and poorly understood. Health professionals must recognize delirium and patients at risk because delirium can lead to higher morbidity rates and longer lengths of stay. Various disease states and pathophysiologic disorders cause delirium, as do many commonly used drugs. ⋯ Treatment of delirium focuses on finding the cause and managing the symptoms, often with the use of pharmacologic agents. Critical care nurses need to perform cognitive assessments so that deficits can be recognized and specific interventions for prevention of cognitive impairment can be used. Appropriate nursing care can lessen the severity of delirium, shorten its course, and decrease the morbidity associated with the syndrome.
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Critical care medicine · May 1994
Admissions to a pediatric intensive care unit for status epilepticus: a 10-year experience.
To characterize the etiology, course, and prognosis in children admitted to a pediatric intensive care unit (ICU) for status epilepticus. ⋯ Most cases of status epilepticus were caused by epilepsy, atypical febrile seizure, encephalitis, meningitis, or metabolic disease. The mortality rate during the ICU stay was 6%. The prognosis was good in most surviving cases, more so if the neurologic development of the child was normal before the status epilepticus.
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Growth of > or = 10(5) colonies of bacteria per milliliter obtained at bronchoscopy in children and adults correlates with bacterial pneumonia. To determine whether quantitative tracheal aspirate cultures aid in diagnosis of pneumonia in the neonatal intensive care unit setting, tracheal aspirates were obtained from 25 infants who had recently undergone endotracheal intubation; 15 of the infants had suspected pneumonia and 10 control infants had undergone intubation for suspected apnea of prematurity (4 infants) or elective surgery (6 infants). Studies also were performed to detect Mycoplasma, Ureaplasma, viruses, and Pneumocystis. ⋯ In 12 infants whose tracheal aspirates grew < 10(5) bacteria, respiratory decompensation later was explained by other causes in 11 infants, and there was one false-negative culture. There were three false-positive tracheal aspirates in the control group. We conclude that tracheal aspirates of infants who have recently had an endotracheal tube placed may be useful for diagnosing pneumonia and for identifying the causative agent.