Post Myocardial Infarction Cardiogenic Shock: A Review of Current Therapies
Cardiogenic shock is often a devastating consequence of acute myocardial infarction (MI) and portends to significant mortality and morbidity. Despite improvements in expediting the time to treatment and enhancements in available medical therapy and reperfusion techniques, cardiogenic shock remains the most common cause of mortality following MI. Post-MI cardiogenic shock most commonly occurs as a consequence of severe left ventricular dysfunction. Right ventricular (RV) MI must also be considered. Mechanical complications including acute mitral regurgitation, ventricular septal rupture, and ventricular free-wall rupture ca...
Source: Journal of Intensive Care Medicine - May 13, 2013 Category: Intensive Care Authors: Ng, R., Yeghiazarians, Y. Tags: Analytic Review Source Type: research
Pain in the ICU: A Psychiatric Perspective
Pain is abundant in the intensive care unit (ICU). Successful analgesia demands a comprehensive appreciation for the etiologies of pain, vigilant clinical assessment, and personalized treatments. For the critically ill, frequent threats to mental and bodily integrity magnify the experience of pain, challenging clinicians to respond swiftly and thoughtfully. Because pain is difficult to predict and physiologic correlates are not specific, self-report remains the gold standard assessment. When communication is limited by intubation or cognitive deficits, behavioral pain scales prove useful. Patient-tailored analgesia aspires...
Source: Journal of Intensive Care Medicine - May 13, 2013 Category: Intensive Care Authors: Azzam, P. N., Alam, A. Tags: Analytic Review Source Type: research
Extreme Obesity in the Intensive Care Unit: The Malignant Obesity Hypoventilation Syndrome
(Source: Journal of Intensive Care Medicine)
Source: Journal of Intensive Care Medicine - February 20, 2013 Category: Intensive Care Authors: Munoz, S., Nowzaradan, Y., Varon, J. Tags: Editorial Source Type: research
Splenic Artery Aneurysm Rupture: A Rare but Fatal Cause for Peripartum Collapse
Splenic artery aneurysm (SAA) is the most common (60%) of all visceral artery aneurysms. The majority of these cases are asymptomatic, but the presentation of their rupture can vary from abdominal/chest pain to cardiovascular collapse (Sadat U, Dar O, Walsh S, Varty K. Splenic artery aneurysms in pregnancy—a systematic review. Int J Surg. 2008;6(3):261-265.). Although rare, the mortality associated with the rupture is as high as 25% (De Vries JE, Schattenkerk ME, Malt RA. Complications of splenic artery aneurysm other than intraperitoneal rupture. Surgery. 1982;91(2):200-204; Caillouette JC, Merchant EB: Ruptured spl...
Source: Journal of Intensive Care Medicine - February 20, 2013 Category: Intensive Care Authors: Khurana, J., Spinello, I. M. Tags: Case Report Source Type: research
Characteristics of Patients With the "Malignant Obesity Hypoventilation Syndrome" Admitted to an ICU
Conclusions:
MOHS is a serious multisystem disorder with a high mortality that appears to be relatively common, frequently misdiagnosed, and inadequately treated. (Source: Journal of Intensive Care Medicine)
Source: Journal of Intensive Care Medicine - February 20, 2013 Category: Intensive Care Authors: Marik, P. E., Desai, H. Tags: Original Research Source Type: research
Predictors and Outcomes of Pneumonia in Patients With Spontaneous Intracerebral Hemorrhage
Conclusion.
Mechanical ventilation, tube feeding, dysphagia, and tracheostomy are exposures associated with increased risk of the development of pneumonia in patients with sICH. Pneumonia is associated with an increase in morbidity, length of stay, and mortality among patients with sICH. (Source: Journal of Intensive Care Medicine)
Source: Journal of Intensive Care Medicine - February 20, 2013 Category: Intensive Care Authors: Alsumrain, M., Melillo, N., DeBari, V. A., Kirmani, J., Moussavi, M., Doraiswamy, V., Katapally, R., Korya, D., Adelman, M., Miller, R. Tags: Review of a Large Clinical Series Source Type: research
Early Diagnosis and Evidence-Based Care of Surgical Sepsis
Sepsis continues to be a common and serious problem among surgical patients. It is a leading cause of both morbidity and mortality in the perioperative period. The early identification of sepsis and the early implementation of evidence-based care can improve outcomes. This focused review will identify ways to improve the early identification of sepsis and discuss the current evidence-based guidelines for the early management of sepsis, severe sepsis, and septic shock in the surgical patients. (Source: Journal of Intensive Care Medicine)
Source: Journal of Intensive Care Medicine - February 20, 2013 Category: Intensive Care Authors: Moore, L. J., Moore, F. A. Tags: Analytic Reviews Source Type: research
The Management of the Critically Ill Obstetric Patient
Hypertensive disorders, postpartum hemorrhage, and sepsis are the most common indications for intensive care unit admission among obstetric patients. In general, ICU mortality is low, and better than would be predicted using available mortality prediction tools. Provision of care to this special population requires an intimate understanding of physiologic changes that occur during pregnancy. Clinicians must be aware of the way various diagnostic and treatment choices can affect the mother and fetus. Most clinically necessary radiographic tests can be safely performed and fall under the maternal radiation exposure limit of ...
Source: Journal of Intensive Care Medicine - February 20, 2013 Category: Intensive Care Authors: Honiden, S., Abdel-Razeq, S. S., Siegel, M. D. Tags: Analytic Reviews Source Type: research
Hepatorenal Syndrome in the Intensive Care Unit
Hepatorenal syndrome (HRS) is a functional form of acute kidney injury (AKI) associated with advanced liver cirrhosis or fulminant hepatic failure. Various new concepts have emerged since the initial diagnostic criteria and definition of HRS was initially published. These include better understanding of the pathophysiological mechanisms involved in HRS, identification of bacterial infection (especially spontaneous bacterial peritonitis) as the most important HRS-precipitating event, recognition that insufficient cardiac output plays a role in the occurrence of HRS, and evidence that renal failure reverses with pharmacother...
Source: Journal of Intensive Care Medicine - February 20, 2013 Category: Intensive Care Authors: Wadei, H. M., Gonwa, T. A. Tags: Analytic Reviews Source Type: research
The Authors' Response
(Source: Journal of Intensive Care Medicine)
Source: Journal of Intensive Care Medicine - January 15, 2013 Category: Intensive Care Authors: Yeong, E.-K., Lee, C.-H., Hu, F.-C. Tags: The Authors ' Response Source Type: research
Emerging New Markers of Toxic Epidermal Necrolysis
(Source: Journal of Intensive Care Medicine)
Source: Journal of Intensive Care Medicine - January 15, 2013 Category: Intensive Care Authors: Kapoor, S. Tags: Letter To The Editor Source Type: research
Use of Video Laryngoscopy and Camera Phones to Communicate Progression of Laryngeal Edema in Assessing for Extubation: A Case Series
Video laryngoscopy has demonstrated utility in airway management. For the present case series, we report the use of video laryngoscopy to evaluate the airway of critically ill, mechanically ventilated patients, as a means to reduce the risk of immediate postextubation stridor by assessing the degree of laryngeal edema. We also describe the use of cellular phone cameras to document and communicate airway edema in using video laryngoscopy for the patients’ medical records. We found video laryngoscopy to be an effective method of assessing airway edema, and cellular phone cameras were useful for recording and documentin...
Source: Journal of Intensive Care Medicine - January 15, 2013 Category: Intensive Care Authors: Newmark, J. L., Ahn, Y. K., Adams, M. C., Bittner, E. A., Wilcox, S. R. Tags: Case Report Source Type: research
The Cumulative Effect of Multiple Critical Care Protocols on Length of Stay in a Geriatric Trauma Population
The elderly individuals are the most rapidly growing cohort within the US population, and a corresponding increase is being seen in elderly trauma patients. Elderly patients are more likely to have a hospital length of stay (LOS) in excess of 10 days. They account for 60% of total ICU days. Length of stay is frequently used as a proxy measure for improvement in injury outcomes, changes in quality of care, and hospital outcomes. Patient care protocols are typically created from evidence-based guidelines that serve to reduce variation in care from patient to patient. Patient care protocols have been found to positively impac...
Source: Journal of Intensive Care Medicine - January 15, 2013 Category: Intensive Care Authors: Frederickson, T. A., Renner, C. H., Swegle, J. R., Sahr, S. M. Tags: Review of a Large Clinical Series Source Type: research
Update and New Developments in the Management of the Exsanguinating Patient
Definitive management of the exsanguinating patient continues to challenge providers in multiple specialties. Significant hemorrhage may be encountered in a variety of patient care circumstances. Over the past two decades, the vast majority of data and evidence regarding transfusion in the exsanguinating patient has been based upon the trauma literature, and a large amount of recent research has investigated this subject area. In addition to the care of trauma patients, the data which have emerged can also be extrapolated to the treatment of nontrauma patients undergoing transfusion for major hemorrhage. The concept of mas...
Source: Journal of Intensive Care Medicine - January 15, 2013 Category: Intensive Care Authors: Riha, G. M., Schreiber, M. A. Tags: Analytic Reviews Source Type: research
Hypernatremic Disorders in the Intensive Care Unit
Hypernatremia, defined as plasma sodium concentration >145 mEq/L, is frequently encountered in critically ill patients admitted to the intensive care unit (ICU). Hypernatremia indicates a decrease in total body water relative to sodium and is invariably associated with plasma hyperosmolality though total body sodium content may be normal, decreased, or increased. Hypernatremia usually occurs as a result of impaired thirst or access to water, with or without increased water losses from renal and extrarenal sources. Critically ill patients in ICU are at high risk of hypernatremia because of their inability to control free...
Source: Journal of Intensive Care Medicine - January 15, 2013 Category: Intensive Care Authors: Arora, S. K. Tags: Analytic Reviews Source Type: research
