Articles: critical-care.
-
Pulmonary hypertension may be primary, of unknown etiology, or secondary to existing cardiorespiratory disease. In general, the prognosis is poor, but the superimposed physiologic changes of pregnancy, labor, and delivery may produce a lethal condition. ⋯ If the choice is to continue the pregnancy, a well-coordinated intensive management plan is necessary. This plan should include midsecond trimester hospital admission of the patient, continuous hemodynamic monitoring during the intrapartum period and immediately after delivery, and preferably elective induction with hemodynamically stable epidural anesthesia for labor and delivery.
-
Neurologic emergencies during pregnancy are not encountered often but contribute significantly to maternal mortality. This chapter reviews neurologic emergencies with an emphasis on pathophysiology and related nursing care for patients with epilepsy, status epilepticus, eclampsia, intracranial hemorrhage, increased intracranial pressure, ischemic stroke, myasthenia gravis, autonomic hyperreflexia, Wernicke's encephalopathy, and chorea gravidarum.
-
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.
-
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.
-
Critical care medicine · Dec 1991
Multicenter Study Clinical Trial Controlled Clinical TrialAcute physiology and chronic health evaluation (APACHE II) and Glasgow coma scores as predictors of outcome from intensive care after cardiac arrest.
a) To examine the accuracy of the Acute Physiology and Chronic Health Evaluation (APACHE II) and the Glasgow Coma Scores as predictors of the outcome of patients following resuscitation from cardiac arrest; b) to study the impact of the components of APACHE II on the prediction. ⋯ The APACHE II scoring system cannot be recommended as a prognostic tool to support clinical judgement in cardiac arrest patients, but by modifying it, a more accurate prediction of poor outcome could be achieved. The Glasgow Coma Score explained to a great extent the predictive power of the APACHE II.