Articles: critical-care.
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Critical care consumes a significant portion of health care costs. Although there are currently increasing pressures to limit expenditures, data are not always available to allow physicians and patients to make informed therapeutic or triage decisions regarding prolonged intensive care unit (ICU) stays. The purpose of this study was to evaluate long-term outcome, quality of life, and charges in surgical patients requiring prolonged ICU stays (> 14 days). ⋯ In this population, prolonged ICU stays resulted in acceptable quality of life and a relatively high survival rate despite significant economic investment. This study does not support withdrawal of therapy or triage decisions based solely or primarily on age or length of ICU stay.
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To characterize the population pharmacokinetics of amikacin in intensive care unit (ICU) patients and to analyse whether these patients show different kinetic behaviour on the basis of their clinical diagnoses. ⋯ The amikacin pharmacokinetic parameters obtained should allow Bayesian individualization of amikacin doses in patients admitted to medical ICUs, on the basis of their clinical diagnoses.
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Intensive care after lung, and heart-lung transplantation may have simple post operative course specially after preventive procedures of reperfusion injury, nosocomial infections during mechanical ventilation and immunosuppression risks. Nevertheless a severe mediastinal shift may occurred after single lung transplantation in emphysema. Rapid changes in ventilation/perfusion ratio during lung infection or rejection specially in pulmonary hypertension are responsible of dramatic respiratory failure. Knowledge of multiorgan dysfunction and multidisciplinary experience encourage to future development.
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Dimens Crit Care Nurs · Nov 1996
ReviewReversal agents to counteract muscle relaxation: nursing considerations.
Advances in pharmacology and technology over the last decade have fostered expanded use of muscle relaxants in critical care units and emergency departments. The neuromuscular blockade facilitated by these agents may be reversed pharmacologically, or may be spontaneously reversed endogenously. To ensure appropriate patient management, the critical care nurse, clinical nurse specialist, and acute care nurse practitioner must have a comprehensive understanding of the pathophysiology of neuromuscular blockade and reversal, the medications involved in this process, and the critical patient assessment and management skills necessary to assure a positive patient outcome.