Articles: critical-care.
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Review Case Reports
Movement disorders associated with withdrawal from high-dose intravenous haloperidol therapy in delirious ICU patients.
Intravenous haloperidol is recommended as the drug of choice to treat delirium in ICU patients. Movement disorders and other adverse events commonly occur with oral haloperidol use but are rarely seen with IV haloperidol use, and withdrawal symptoms have not been reported with short-term ICU use. We describe self-limited dyskinesia during withdrawal of high-dose continuous IV haloperidol therapy in five ICU patients.
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Acute respiratory distress syndrome (ADRS) is a severe, life-threatening consequence of certain pulmonary and systemic insults. It is thought to result from a dramatic change in the permeability of the alveolar-capillary membrane, allowing the movement of fluid and proteins into alveolar air spaces. ⋯ However, the poor compliance of the ARDS-affected lung can greatly increase the risk of ventilator induced lung injury. This has led to a concern that traditional ventilation strategies may in fact be perpetuating the very conditions they attempt to compensate for.
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Intensive Crit Care Nurs · Jun 1997
ReviewFocus of nursing in critical and acute care settings: prevention or cure?
The fluidity of the boundaries of critical and acute care can lead to challenges for nurses working on acute general wards when caring for post-critical care patients and for those in whom a critical care situation arises during a period of acute care. The development and use of critical care skills pose special difficulties for acute care nurses, because of the acuteness and infrequency of such incidents and the diversity of skills the nurses need to possess. Nonetheless, critical care is an important component of an acute ward nurse's repertoire, particularly in relation to preventing episodes of critical illness. ⋯ They may, in addition, lead to an over-reliance on the use of such facilities and must be implemented carefully in order to bridge, rather than widen, the gap between acute and critical care. Critical care is used in this paper as a global term, to encompass all settings where patients are usually more highly dependent and critically ill than patients on general wards. It includes intensive therapy, high-dependency, coronary care and other specialist critical care units.
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Intensive care medicine · Jun 1997
A new method of accurately identifying costs of individual patients in intensive care: the initial results.
To analyse the patient-related and non-patient-related costs of intensive care using an activity-based costing methodology. ⋯ The use of average costs or scoring systems to cost intensive care is limited, as these methods cannot determine actual resource usage in individual patients. The methodology described here allows all the resources used by an individual patient or group of patients to be identified and thus provides a valuable tool for economic evaluations of different treatment modalities.
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The use of inhaled nitric oxide in the critically ill has increased significantly over the past few years but little published information exists on standards for current practice. Sixty-four intensive therapy units in the UK were surveyed by questionnaire from which 54 (84.4%) satisfactory replies were received. We present the survey results and put forward recommendations based on current literature and our own clinical experience for the safe use of inhaled nitric oxide.