2,833 publications from this institution
Society Of Critical Care Medicine 29Th Educational And Scientific Symposium; Orlando, Florida, Usa; February 11-15, 2000: Poster Presentations
Just imagine this possible scenario: it is summer 2020 and our intensive care unit (ICU) is full of patients with COVID-19 and severe respiratory failure as a result of the newly described coronavirus, SARS-CoV-2 [1-3]. We have decreased virtually all the other activities in the hospital, so that there are not many critically ill patients with other problems. We have cancelled all non-urgent (and in fact some urgent) surgical cases, including cardiac surgery and neurosurgery cases that usually come through our Department.
Sepsis results from the activation of a complex cascade of mediators, an appropriate and necessary body response to infection or insult which can, however, become excessive and detrimental to the host. When the immunological host response is not well controlled, it may lead to multiple organ failure and death. This manuscript reviews the epidemiology and the major factors involved in the development of sepsis, and considers a number of therapeutic interventions that may help to better control the septic process and the related development of multiple organ failure.
Cerebral autoregulation was altered in half of the patients with sepsis and was associated with the development of SABD. These findings support the concept that cerebral hypoxia could contribute to the development of SABD.
Intensive care units (ICUs) around the world have been hugely impacted by the SARS-CoV-2 pandemic and the vast numbers of patients admitted with COVID-19, requiring respiratory support and prolonged stays. This pressure, with resulting shortages of ICU beds, equipment, and staff has raised ethical dilemmas as physicians have had to determine how best to allocate the sparse resources. Here, we reflect on some of the major ethical aspects of the COVID-19 pandemic, including resource allocation and rationing, end-of-life decision-making, and communication and staff support. Importantly, these issues are regularly faced in non-pandemic ICU patient management and useful lessons can be learned from the discussions that have occurred as a result of the COVID-19 situation.
info:eu-repo/semantics/published
Various invasive, minimally invasive, and noninvasive methods to assess CO are available. A profound understanding of the different CO monitoring methods is key to define indications for CO monitoring in the individual critically ill or surgical patient.
Even though patients with a history of insulin-treated diabetes are more severely ill and more likely to have renal failure, insulin-treated diabetes is not associated with increased mortality in ICU patients.
