Articles: critical-illness.
-
Critical care medicine · Jun 1995
Enteral nutrition in the critically ill patient: a prospective survey.
To describe current enteral nutrition-prescribing practices for critically ill patients, and to identify factors associated with initiation of, and tolerance to, enteral nutrition. ⋯ Enteral nutrition is not started in all eligible ICU patients. Approximately half of those patients receiving enteral nutrition achieved tolerance of the regimen. Gastrointestinal dysfunction causing intolerance to enteral nutrition is a common reason for not starting, or discontinuing, feedings.
-
Monitoring of vital functions is one of the most important and essential tools in the management of critically ill patients in the ICU. Today it is possible to detect and analyze a great variety of physiological signals by various noninvasive and invasive techniques. ⋯ It enables monitoring of pressures, flow and saturation, pressures in the systemic and pulmonary circulation, estimation of cardiac performance and judgment of the adequacy of the cardiocirculatory system. Carefully and correctly obtained information are basis for proper hemodynamic assessment which usually effects the therapeutic decisions.
-
AACN clinical issues · May 1995
ReviewEarly administration of enteral nutrients in critically ill patients.
Aggressive nutrition intervention has become an essential component in the therapy of critically ill patients. Early provision of enteral nutrients within 24 hours of injury or surgery appears optimal and is associated with benefits such as a reduction in septic complications, a decrease in the hypermetabolic response to severe burn injury, and improved wound healing. Early enteral nutrient administration has a significant impact on preserving gastrointestinal integrity and barrier function and maintaining intestinal immunologic defenses, which may have a role in decreasing infectious outcomes in critically ill patients. ⋯ Small intestine feeding usually is preferred to gastric nutrient administration, yet some declare biologic superiority with intragastric feedings. The optimal enteral product for use in critically ill patients remains unknown. Key nutrients, such as glutamine, arginine, fiber, and alternative lipids, may have potential benefits and need to be considered when formulating an enteral regimen in this patient population.
-
Critical care medicine · May 1995
Comparative StudyEvaluation of a new continuous thermodilution cardiac output monitor in critically ill patients: a prospective criterion standard study.
To evaluate the accuracy of a new continuous cardiac output monitor (one based on the thermodilution principle) in critically ill patients. ⋯ Continuous cardiac output measurement using the thermodilution technique is reasonably accurate and is reliable and applicable in routine clinical practice, and therefore may add to patient safety. However, the response time is too slow for the immediate detection of acute changes in cardiac output. Some clinical conditions such as the rapid infusion of cold solutions can interfere with the continuous cardiac output measurement. Conventional bolus thermodilution and indocyanine green dye dilution methods showed good agreement and can be used interchangeably.
-
Disease-a-month : DM · May 1995
Review Case ReportsRecognition, assessment, and treatment of anxiety in the critical care patient.
A multidisciplinary group of experts involved in the treatment of critically ill patients participated in a workshop conference designed to develop practice recommendations for the recognition, assessment, and treatment of anxiety in the critical care environment. Anxiety was identified as a ubiquitous problem in critical care that may interfere with healing and recovery. The faculty agreed that clinicians should be familiar with the signs and symptoms of anxiety and should be able to determine when interventions are necessary. ⋯ Protocols for determining the best agents to be used in a given setting and their most appropriate method of administration should be established. Pharmacologic and nonpharmacologic treatments are not mutually exclusive but should be complementary. Finally, procedures for obtaining psychiatric consultation, when necessary, should be in place.