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Category: Intensive Care Medicine

Posted in: ATOTW > Intensive Care Medicine 2019 Language: english

Pre-hospital emergency anaesthesia refers to induction of anaesthesia and securing the airway in the pre-hospital environment. It is high risk due to patient factors and the pre-hospital environment. Many factors should be addressed to minimise risks. This tutorial explores some of these factors and discusses recent changes in practice.

Posted in: ATOTW > Intensive Care Medicine 2019 Language: portuguese

Este tutorial apresenta um resumo das evidências sobre a cetamina e seus diversos usos. Inclui uma discussão sobre o seu papel enquanto droga anestésica e analgésica em cuidados pré-hospitalares, serviços de emergência, salas de cirurgia e unidades de cuidados críticos.

Posted in: ATOTW > Intensive Care Medicine 2019 Language: portuguese

A pneumonia associada à ventilação mecânica é uma causa significativa de morbidade e mortalidade em pacientes gravemente doentes que passam por ventilação mecânica invasiva via tubo endotraqueal ou traqueostomia. Neste artigo, discutiremos a incidência, sistemas de pontuação, patofisiologia, prevenção, fatores de risco, diagnóstico e tratamento desta condição.

Posted in: ATOTW > Intensive Care Medicine 2018 Language: chinese

对于经气管插管或气管切开行有创机械通气的危重患者,呼吸机相关性肺炎是发病和死亡的一个重要原因。本文旨在讨论VAP的发病率、评分系统、病理生理学、预防、危险因素、诊断和治疗。

Posted in: ATOTW > Intensive Care Medicine 2018 Language: chinese

腹腔内高温化疗是术中将浓缩、高温的化疗药物直接灌注入腹腔的治疗方式,是针对腹腔脏器表面恶性肿瘤的择期手术病人的有效符合治疗方法之一。本教程主要探讨该治疗过程对于麻醉和生理的影响。

Posted in: ATOTW > Intensive Care Medicine 2018 Language: spanish

La neumonía asociada al ventilador es una causa significativa de morbilidad y mortalidad en pacientes críticamente enfermos quienes sufren ventilación mecánica invasiva a través de un tubo endotraqueal o traqueostomía. A lo largo de este artículo discutiremos la incidencia, sistemas de puntuación, fisiopatología, prevención, factores de riesgo, diagnóstico y tratamiento de esta condición.

Posted in: ATOTW > Intensive Care Medicine 2018 Language: english

Ventilator-associated pneumonia is a significant cause of morbidity and mortality in critically unwell patients who undergo invasive mechanical ventilation via an endotracheal tube or tracheostomy. Throughout this article we will discuss the incidence, scoring systems, pathophysiology, prevention, risk factors, diagnosis and treatment of this condition.

Posted in: ATOTW > Intensive Care Medicine 2018 Language: english

Hyperthermic intraperitoneal chemotherapy (HIPEC) is a highly concentrated, heated chemotherapy treatment that is delivered directly to the abdomen during surgery as an effective multimodality treatment option for selected patients with peritoneal surface malignancies. This tutorial discusses the anaesthetic considerations and physiological impacts of the procedure.

Posted in: ATOTW > General Topics & Intensive Care Medicine 2018 Language: english

This tutorial aims to provide the reader with a framework for approaching the complex physiologic changes and challenges of liver transplant anesthesiology. After reading this article the reader should be able to understand the common perioperative issues surrounding the patient with liver failure and recognize that outcomes are dependent on a multidisciplinary approach to management.

Posted in: ATOTW > Intensive Care Medicine 2018 Language: portuguese

A retirada do paciente da ventilação mecânica e do suporte das vias aéreas na UTI é um grande desafio. O sucesso depende de uma perfeita mistura de arte e ciência. A combinação de abordagem por algoritmos e perspicácia clínica é provavelmente a melhor receita para o sucesso. Este tutorial faz um resumo das atuais recomendações na área.

Posted in: ATOTW > Intensive Care Medicine 2018 Language: spanish

La liberación de la ventilación mecánica y el soporte de la vía aérea artificial en la unidad de cuidados intensivos es difícil y desafiante. El éxito depende de la combinación perfecta de arte y ciencia. Un algoritmo con enfoque basado en la evidencia junto con una perspicacia clínica muy fuerte es posiblemente la mejor receta para el éxito. Este tutorial intenta resumir las guías actualmente aceptadas en esta área.

Il ne peut avoir de scénarios plus difficiles pour les équipes de soins intensifs non pédiatriques que la gestion initiale et la stabilisation d'un nouveau-né en détresse. Cet article est la partie 2 de la série de tutoriels et développe la gestion spécifique de chacune des quatre étiologies les plus communes responsables de causer la détresse du nouveau-né.

Posted in: ATOTW > Intensive Care Medicine 2018 Language: chinese

重症监护病房机械通气和人工气道支持的脱离是困难且具有挑战性的。成功取决于艺术和科学的完美结合。 一种有规有矩的循证方法,加上非常强的临床洞察力,可能是成功的最佳方法。 本文试图总结当前在这一领域被接受的指导方针。

Il peut y avoir quelques scénarios plus difficiles pour les équipes de soins intensifs non pédiatriques que la gestion initiale et la stabilisation d'un nouveau-né malade. Les deux articles de cette série fourniront des conseils pratiques d'anesthésie, de pédiatrie et de médecine d'urgence aux médecins et aux infirmières des milieux de soins intensifs pour adultes. La première partie de la série se concentre sur la reconnaissance et la prise en charge initiale d’une détresse néonatale.

The management of perioperative bleeding involves multiple assessments and strategies to ensure appropriate patient care. Initially, it is important to identify those patients with an increased risk of perioperative bleeding. Next, strategies should be employed to correct preoperative anaemia and to stabilise macrocirculation and microcirculation to optimise the patient's tolerance to bleeding. Finally, targeted interventions should be used to reduce intraoperative and postoperative bleeding, and so prevent subsequent morbidity and mortality. The objective of these updated guidelines is to provide healthcare professionals with an overview of the most recent evidence to help ensure improved clinical management of patients.

Posted in: ATOTW > Intensive Care Medicine 2018 Language: english

Liberation from mechanical ventilation and the artificial airway support in the intensive care unit is difficult and challenging. Success hinges on the perfect blend of art and science. An algorithmic evidence based approach along with a very strong clinical acumen is possibly the best recipe for success. This tutorial attempts to summarise the currently accepted guidelines in this area.

Existem poucos cenários mais desafiadores para equipes de intensivistas não-pediátricos que o manejo inicial e estabilização de um recém-nascido doente. Este artigo é a segunda parte de uma série de tutoriais e expande o manejo específico de cada uma das quarto condições mais comuns responsáveis pelo colapso neonatal.

Posted in: ATOTW > Intensive Care Medicine 2017 Language: portuguese

Pode haver poucos cenários mais desafiadores para equipes de cuidados intensivos não pediátricos que o manuseio inicial e estabilização de um neonato doente. Os dois artigos desta serie proverão recomendações práticas para médicos e enfermeiros com formação em cuidados intensivos de adultos, anestesia, pediatria e medicina de emergência. A primeira parte da série centra-se no reconhecimento e no gerenciamento inicial do colapso neonatal.

This article presents case studies related to cerebral challenge.

This article defines standards and makes recommendations to help guide maternity and critical care providers in establishing and managing a maternal critical care service. Originally published as Anaesthesia Tutorial of the Week #310, 27 October 2014, edited by Matt Rucklidge.

Posted in: UIA > Intensive Care Medicine & Basic Sciences 2017 Language: english

Appropriate management of hyponatraemia is often challenging because of both numerous pathophysiological mechanisms and multiple underlying pathological conditions. After revising the normal control of sodium balance this article will review the causes, classification, diagnosis and management of hyponatraemia. An algorithm for investigations and treatment is provided at the end of this article. Originally published as Anaesthesia Tutorial of the Week #314, 2 April 2015, edited by William English.

The aim of this article is to provide the reader with an overview of the current guidelines and evidence for the management of sepsis in children. Sepsis is a major cause of morbidity and mortality in children and, although mortality rates are lower in children than in adults, they are estimated at about 10% in severe sepsis. Originally published as Anaesthesia Tutorial of the Week #278, 28 January 2013

Puede haber pocos escenarios más desafiantes para los equipos de cuidados intensivos no pediátricos que el manejo inicial y la estabilización de un neonato enfermo. Este artículo es la parte 2 de la serie tutorial y se expande sobre el manejo específico de cada una de las cuatro condiciones más comunes responsables de causar colapso neonatal.

对于非儿科重症监护组来说,常可见到比危重新生儿的早期管理和稳定更棘手的情况。该文章是系列教程的第2部分,就新生儿衰竭最常见的四种病因(先天性心脏病、感染、先天性代谢异常和非意外伤害)的管理进行分别介绍。

Posted in: ATOTW > Intensive Care Medicine 2017 Language: chinese

对于非儿科重症监护团队来说,实施新生儿初步管理及维持疾病状态新生儿稳定最具有挑战意义的。这个系列的两篇文章将从成人重症监护、麻醉、儿科和急诊医学背景等方面为医生护士提供实用性建议。本系列的第一部分着重新生儿衰竭的专家指南与初期管理。

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