Extracorporeal life support in critical care medicine

1990 ◽  
Vol 5 (4) ◽  
pp. 265-278 ◽  
Author(s):  
J.M. Sinard ◽  
R.H. Bartlett

Pediatric Intensive Care offers providers of critical care to children, from trainees to experienced clinicians, a concise, easy-to-carry resource on pediatric critical care medicine. It is designed for frequent and quick reference at the bedside, providing solutions to questions and situations encountered in practice. The 20 chapters are written by authorities in the field and include citations of some of the most essential references for further reading on each topic. The chapters cover key elements of the practice of pediatric critical care medicine, from cardiopulmonary resuscitation, monitoring, and procedures to extracorporeal life support, sedation and analgesia, and end of life care. Etiology and treatment of all types of organ failure are presented, as are chapters on toxicological emergencies/poisoning, critical care pharmacology, trauma, and burns. The book is sized to fit in a pocket, includes access to electronic, web-based content, and contains focused text, bulleted lists, tables, and figures. The book facilitates the delivery of critical care by residents, fellows, generalists in settings where critical care expertise is not readily available, and practicing intensivists.


Author(s):  
Otis B. Rickman

Critical care medicine is a multidisciplinary branch of medicine encompassing the provision of organ support to patients who are severely ill. All areas of medicine may have relevance for critically ill patients; however, this review focuses only on aspects of cardiopulmonary monitoring, life support, technologic interventions, and disease states typically managed in the intensive care unit (ICU). Airway management, venous access, respiratory failure, mechanical ventilation, acute respiratory distress syndrome, shock, and sepsis are reviewed.


2021 ◽  
Author(s):  
Jun Ho Lee ◽  
Joo Yeon Kim ◽  
Ilkun Park ◽  
Kiick Sung ◽  
Wook Sung Kim ◽  
...  

Abstract Although a multidisciplinary team (MDT) approach is recommended in advanced heart failure and heart transplantation (HTx), no studies have discussed the impact of the team approach on the clinical outcomes of HTx. In 2014, we established an MDT approach in our HTx program with active involvement of teams for critical care and extracorporeal life support (ECLS) using a real-time online information sharing system. We hypothesized that this MDT approach improved the survival of patients who have undergone HTx. In this study, we enrolled 250 adult patients who underwent HTx between December 2003 and June 2018; they were divided into non-MDT (n = 120; before 2014) and MDT (n = 130; since 2014) groups, with the primary outcome being overall mortality. The mean age of HTx recipients was 51.0 ± 13.7 years, and 77 recipients (30.8%) were female. The MDT group had more high-risk patients in terms of age of donors, diabetes, dialysis, ECLS, and waiting time. Various multivariable analytic methods, including inverse-probability-of-treatment-weighting analysis, revealed that the MDT approach was an independent predictor of overall survival. Therefore, collaboration of an HF team, a critical care team, and an ECLS team may improve survival after HTx.


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