Articles: critical-care.
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Critically ill patients with intracerebral hemorrhage require immediate treatment in an intensive care unit. In the acute phase of the disease the patients are endangered from increased intracerebral pressure, respiratory disorders (aspiration!) and hypertension. An adequate intensive care management consisting of sedation, analgesia, intubation and mechanical ventilation, correct body positioning and treatment of hypertension is of decisive importance for the prognosis of these patients. The aim of this report is to discuss the most important therapeutic strategies and arising problems in the course of intracerebral hemorrhage.
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Adult respiratory distress syndrome (ARDS) is an acute form of noncardiogenic respiratory failure that often occurs in previously healthy individuals who have sustained severe physiologic insult that is pulmonary or nonpulmonary in origin. The perinatal nurse can help increase the survival of the maternal-fetal dyad by prompt recognition of the syndrome and early institution of therapeutic measures.
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Sedation and analgesia are commonly practised in critically ill patients. The drugs and techniques used vary widely, however. Many reports have emphasized that analgesia has to be the primary goal in every therapeutic intervention in critically ill patients. ⋯ In a dose range of 0.75-1.0 micrograms.kg bw-1.h-1 this drug can safely be given to patients undergoing controlled mechanical ventilation. Caution is necessary in hypovolaemic patients, in whom hypotension can occur if sufentanil is administered in the recommended dose. Sufentanil in a dose range between 0.25-0.35 micrograms.kg bw-1.h-1 is safe when given to patients during the weaning period.