5. Intensive Care Flashcards
when did intensive care units start
latter third of the 20th century
what is sepsis
the body’s overwhelming and life-threatening response to infection which can lead to tissue damage, organ failure and death
intensive care medicine focuses on
- diagnosis and treatment of the underlying cause of critical illness
- monitoring and support of organ systems’ function
challenges in Intensive care
- staffing (expertise, teamwork, caring)
- Quality assurance and improvement
- budget
- education and support of patients and families
what was the randomized trial carried out that resulted in getting people of ventilators quicker
everyday waking up the patients by turning off the sedation.
if everyday it was quicker to wake them up
they then turned down the sedation and got them off the ventilators quicker
Acute Kidney Injury
defined as an abrupt decline in renal function over days-wks
occurs in 5-7% of hospitilized patients and 50% or more of ICU patients
Frequency of AKI is increasing
Acute Kidney Injury Supportive Care
- maintain adequate perfusion
- dietary restrictions
- dose medications for GFR (Glomerular Filtration Rate)
- monitor the uraemic complications
Renal Replacement Therapy
dialysis catheters
use of a machine to filter waste products, toxins and excess fluid from the blood when the kidneys are no longer able to.
what is a common consequence of the resuscitation process
sodium and water overload
septic patients in the ICU gain as much as 12.5L of body water during the first two days of resuscitation
it may take up to 3 weeks for the patients to excrete this excess load
standard indications for RTT in AKI
uraemia
volume overload
hyperkalemia
metabolic acidosis
severe hyperphosphatemia
intoxications
what does optimal support for families include
early and repeated discussion of prognosis, goals of care and choices
