Articles: critical-care.
-
Critical care clinics · Jan 1994
ReviewPredictors of outcome from critical illness. Shock and cardiopulmonary resuscitation.
Many of our patients in ICUs suffer from shock, be it due to sepsis, trauma, arrest, or other causes. These patients continue to have a very high mortality rate in spite of very labor intensive and expensive treatment. The ability to identify patients who are likely to succumb to their illness is of utmost importance. ⋯ These indicators serve as useful monitors to evaluate treatment and guide clinical management. Understanding the underlying pathophysiologic mechanisms responsible for the wide variety of illnesses associated with circulatory failure is crucial in our concerted effort to reduce mortality in these patients. As knowledge is gained, we hopefully will be able to develop more accurate and specific predictors of outcome to prudently select patients most likely to benefit.
-
Sedation in the intensive care unit (ICU) aims to improve patient comfort and facilitate treatment procedures. Most units still rely on a combination of opioid and benzodiazepines with the addition of other drugs for specific requirements. However, the effect of sedative agents in critically ill patients is often unpredictable, so frequent assessment of the depth of sedation is essential to match the depth to patient requirements. ⋯ The technique may not be suitable for a large number of patients, particularly early in their ICU stay but, for long-term sedation and in the weaning phase--of sedation as well as ventilation--the utility of a drug delivery system truly controlled by the patient should be further explored. The ICU has been succinctly described as an environment in which 'anxiety is prevalent, pain frequent, rest difficult and sleep impossible'. Sedation in the ICU has the double objective of relieving patient distress as well as facilitating treatment procedures.(ABSTRACT TRUNCATED AT 250 WORDS)