Articles: critical-care.
-
The aim of this study was to determine the cause of death of those patients who died on general hospital wards after discharge from an intensive care unit. Of 1700 patients admitted over a 5-year period, 341 (20%) died in intensive care but a further 153 (9%) died on general wards. ⋯ The main causes of death were pneumonia, hypoxic or structural brain damage, cerebrovascular accident, malignancy, myocardial infarction, renal or multi-organ failure and sepsis. Some of these may have been preventable with further intensive care or improved care on the wards.
-
Ann Fr Anesth Reanim · Jan 1997
[Anesthesia and intensive care of craniostenosis and craniofacial dysmorphism in children].
Craniosynostosis occurs in one out of 2,000 births. It results in primary skull deformations requiring surgical repair, in infants with a body weight of less than 10 kg. Pure craniosynostosis is the most frequent situation, where the risk for cerebral compression during brain development is the lowest. ⋯ With experienced teams, this high-risk surgery carries a low peroperative mortality (less than 1%) and morbidity rate. The latter includes essentially transient peroperative hypotension. The excellent final cosmetic and functional results justify the practice of this surgery in children with a bodyweight of less than 10 kg.
-
Langenbecks Arch Chir Suppl Kongressbd · Jan 1997
[Shock room management in severe craniocerebral trauma].
Early clinical management of severe head injury should take place in an emergency resuscitation room and be conducted according to the guidelines of the treatment of severely injured patients with attention given to time. The first phase (with a maximum duration of 30 min) comprises physical examination, stabilisation of vital functions and basic technical diagnostics. With pulmonary and circulatory functions stabilized, the second phase begins with a craniol computed tomography examination followed by adequate therapeutic measures, including, if necessary, the CT-controlled implantation of an intracranial pressure catheter.
-
Ann Fr Anesth Reanim · Jan 1997
[Decision to limit or practise maximum therapeutic support in a neurosurgical intensive care unit].
To assess the respective rates of intensive care maximalization, limitation and withdrawal practice in a neurosurgical intensive care unit. ⋯ This prospective study confirmed the results of several previous surveys. The medical decision to limit or to discontinue treatments is rather frequent in intensive care units. This is an illegal practice in French legislation and code of professional ethics. Recommendations by representative French medical associations on the modalities of decision making on limitation of therapy would be welcome.
-
In a cooperative effort involving each medical society the joint study group of the medical research societies in Germany (AWMF) has established guidelines for the diagnosis and treatment of various diseases. Special guidelines which pertain specifically to operative intensive care medicine do not exist. However, official recommendations have been made for intensive care management in general. ⋯ Also yet the value of those guidelines cannot be assessed. It is beyond doubt that besides being of benefit, they do present some dangers. One must point out that these guide lines are recommendations and not rules upon which medical liability may be based.