Biliary Disease: Calculous and Acalculous Cholecystitis

2020 ◽  
Author(s):  
Kimberly A Davis ◽  
Lucy Ruangvoravat
Keyword(s):  
United States ◽  
Critically Ill Patients ◽  
Acalculous Cholecystitis ◽  
The United States ◽  
Biliary Disease ◽  
Significant Morbidity ◽  
Emphysematous Cholecystitis ◽  
Secondary Insult ◽  
Hemodynamic Compromise ◽  
Elective Cholecystectomy

Cholelithiasis is extremely common in the United States, affecting approximately 10 to 15% of the population. The vast majority of patients remain asymptomatic. Elective cholecystectomy for symptomatic cholelithiasis is a well-established procedure with excellent outcomes. The diagnosis in critically ill patients may not be straightforward. Inflammation and infection of the gallbladder can lead to significant morbidity and mortality. Whether the gallbladder is the primary etiology of hemodynamic compromise (as in emphysematous or gangrenous cholecystitis) or is the victim of secondary insult (as in ischemia-related acalculous cholecystitis), the intensivist must consider cholecystitis in the differential of clinical deterioration. This review contains 6 figures, 5 tables, and 59 references. Key words: acalculous, biliary disease, cholangitis, cholecystitis, emphysematous cholecystitis

Biliary Disease: Calculous and Acalculous Cholecystitis

2020 ◽  
Author(s):  
Kimberly A Davis ◽  
Lucy Ruangvoravat
Keyword(s):  
United States ◽  
Critically Ill Patients ◽  
Acalculous Cholecystitis ◽  
The United States ◽  
Biliary Disease ◽  
Significant Morbidity ◽  
Emphysematous Cholecystitis ◽  
Secondary Insult ◽  
Hemodynamic Compromise ◽  
Elective Cholecystectomy

Cholelithiasis is extremely common in the United States, affecting approximately 10 to 15% of the population. The vast majority of patients remain asymptomatic. Elective cholecystectomy for symptomatic cholelithiasis is a well-established procedure with excellent outcomes. The diagnosis in critically ill patients may not be straightforward. Inflammation and infection of the gallbladder can lead to significant morbidity and mortality. Whether the gallbladder is the primary etiology of hemodynamic compromise (as in emphysematous or gangrenous cholecystitis) or is the victim of secondary insult (as in ischemia-related acalculous cholecystitis), the intensivist must consider cholecystitis in the differential of clinical deterioration. This review contains 6 figures, 5 tables, and 59 references. Key words: acalculous, biliary disease, cholangitis, cholecystitis, emphysematous cholecystitis

Smallpox Vaccination

PEDIATRICS ◽  
1972 ◽  
Vol 49 (6) ◽  
pp. 922-923
Author(s):  
Edward B. Shaw
Keyword(s):  
United States ◽  
Herd Immunity ◽  
The United States ◽  
Morbidity And Mortality ◽  
Routine Immunization ◽  
Smallpox Vaccination ◽  
Significant Morbidity

The zero incidence of smallpox in the United States for so many years, and the significant morbidity and mortality from vaccination, has led to the acceptable and desirable recommendation that routine immunization against smallpox be discontinued. However appropriate this step may seem, it will pose a number of new problems which will involve the pediatrician especially. (1) For many years, smallpox vaccination has been an almost sacred tenet, an immunologic gospel to the population, and has been credited with the conquest of this disease in this country—even though herd immunity could hardly be said to have existed here. Public reeducation is a hazardous matter.

Tracheostomy

2019 ◽  
pp. 850-854
Author(s):  
Saba Ghorab ◽  
David G. Lott
Keyword(s):  
United States ◽  
Mechanical Ventilation ◽  
Critical Care ◽  
Critically Ill ◽  
Critically Ill Patients ◽  
Prolonged Mechanical Ventilation ◽  
The United States ◽  
Critical Care Patients

Tracheostomy is a procedure where a conduit is created between the skin and the trachea. Tracheostomy is one of the most frequent procedures undertaken in critically ill patients. Each year, approximately 10% of critical care patients in the United States require a tracheostomy, most often for prolonged mechanical ventilation.

Endotracheal Tube Cuff Pressure Monitoring: A Review of the Evidence

2011 ◽  
Vol 21 (11) ◽  
pp. 379-386 ◽  
Author(s):  
Pervez Sultan ◽  
Brendan Carvalho ◽  
Bernd Oliver Rose ◽  
Roman Cregg
Keyword(s):  
United States ◽  
Tracheal Intubation ◽  
Endotracheal Tube ◽  
Critically Ill Patients ◽  
Cuff Pressure ◽  
The United States ◽  
Endotracheal Tube Cuff ◽  
Pressure Monitoring ◽  
Tube Cuff ◽  
Endotracheal Tube Cuff Pressure

Tracheal intubation constitutes a routine part of anaesthetic practice both in the operating theatre as well as in the care of critically ill patients. The procedure is estimated to be performed 13–20 million times annually in the United States alone. There has been a recent renewal of interest in the morbidity associated with endotracheal tube cuff overinflation, particularly regarding the rationale and requirement for endotracheal tube cuff monitoring intra-operatively.

Status Epilepticus: Work-Up and Management in Adults

2020 ◽  
Vol 40 (06) ◽  
pp. 652-660
Author(s):  
Assia Meziane-Tani ◽  
Brandon Foreman ◽  
Moshe A. Mizrahi
Keyword(s):  
United States ◽  
Status Epilepticus ◽  
Drug Administration ◽  
Baby Boomer ◽  
The United States ◽  
Morbidity And Mortality ◽  
Significant Morbidity ◽  
Neurological Emergencies ◽  
Work Up

AbstractStatus epilepticus is one of the most common neurological emergencies and is likely to have increasing prevalence in coming years given an aging “baby boomer” population in the United States. Because status epilepticus is associated with significant morbidity and mortality, identification and treatment are paramount. Care should be taken to exclude nonorganic mimics and infectious and metabolic causes. Status epilepticus can be classified into stages with associated recommendations for escalation in therapy, increasing from push-dose benzodiazepines to continuous anesthetic infusions and other nontraditional therapies. Concurrent electroencephalogram monitoring helps to identify, localize, and assess resolution of ictal patterns alongside antiseizure drug administration. A protocol is proposed for the management of status epilepticus in a step-wise fashion.

scholarly journals The Potential Influence of Common Viral Infections Diagnosed during Hospitalization among Critically Ill Patients in the United States

PLoS ONE ◽  
2011 ◽  
Vol 6 (4) ◽  
pp. e18890 ◽  
Author(s):  
Makesha Miggins ◽  
Anjum Hasan ◽  
Samuel Hohmann ◽  
Frederick Southwick ◽  
George Casella ◽  
...  
Keyword(s):  
United States ◽  
Critically Ill ◽  
Critically Ill Patients ◽  
Viral Infections ◽  
The United States ◽  
Potential Influence

scholarly journals Acinetobacterinfections: a growing threat for critically ill patients

2007 ◽  
Vol 136 (8) ◽  
pp. 1009-1019 ◽  
Author(s):  
M. E. FALAGAS ◽  
E. A. KARVELI ◽  
I. I. SIEMPOS ◽  
K. Z. VARDAKAS
Keyword(s):  
United States ◽  
Intensive Care Unit ◽  
Intensive Care ◽  
Critically Ill ◽  
Critically Ill Patients ◽  
Relative Frequency ◽  
The United States ◽  
Considerable Proportion ◽  
Southern Europe ◽  
Icu Patients

SUMMARYThere has been increasing concern regarding the rise ofAcinetobacterinfections in critically ill patients. We extracted information regarding the relative frequency ofAcinetobacterpneumonia and bacteraemia in intensive-care-unit (ICU) patients and the antimicrobial resistance ofAcinetobacterisolates from studies identified in electronic databases.Acinetobacterinfections most frequently involve the respiratory tract of intubated patients andAcinetobacterpneumonia has been more common in critically ill patients in Asian (range 4–44%) and European (0–35%) hospitals than in United States hospitals (6–11%). There is also a gradient in Europe regarding the proportion of ICU-acquired pneumonias caused byAcinetobacterwith low numbers in Scandinavia, and gradually rising in Central and Southern Europe. A higher proportion ofAcinetobacterisolates were resistant to aminoglycosides and piperacillin/tazobactam in Asian and European countries than in the United States. The data suggest thatAcinetobacterinfections are a growing threat affecting a considerable proportion of critically ill patients, especially in Asia and Europe.

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