Ventilation for Life : Keeping post - ICU patients out of the ICU

Author(s): Laher , D . S .
ISSUE: 2008 ; VOL 32 ; PART 2

Journal Title:Access
AARC Times ( Formerly : AAR Times ) AARC Times ( Formerly : AAR Times )

Page: 18-25
ISSN: Print: 0893-8520
BL Shelfmark: 0537.535500
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ICU management of severe acute respiratory syndrome.

Intensive Care Med. 2003 Jun;29(6):870-5. Epub 2003 May 9.
Related Articles,
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Comment in: Intensive Care Med. 2003 Jun;29(6):861-2. Lapinsky SE, Hawryluck L.
Mount Sinai Hospital, Interdepartmental Division of Critical Care, University of Toronto, 600 University Ave, M5G 1X5, Toronto, Canada. Stephen.lapinsky@utoronto.ca

BACKGROUND: Severe acute respiratory syndrome (SARS) is a contagious viral illness first recognized in late 2002. It has now been documented in 26 countries worldwide, with significant outbreaks in China, Hong Kong, Singapore, and Toronto. Research into identifying the etiological agent, evaluating modes of disease transmission, and treatment options is currently ongoing.

DISCUSSION: The disease can produce a severe bilateral pneumonia, with progressive hypoxemia. Up to 20% of patients require mechanical ventilatory support, with a fatal outcome occurring in about 5% of cases.

CONCLUSIONS: We review the current knowledge about this disease, with particular emphasis on ICU management and infection control precautions to prevent disease transmission.PMID: 12739014 [PubMed - indexed for MEDLINE]


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Principles of Critical Care, 3rd Ed.
Part IV. Pulmonary Disorders >EquipmentSections: Pharmacologic Preparation and Use, Muscle Relaxants and Airway Management in the Intensive Care Unit.
Topics Discussed: airway maintenance; endotracheal intubation; muscle relaxants.

Excerpt: "In spite of the vast array of available equipment, most tracheal intubation can be accomplished using a very small subset of the equipment and a very simple checklist (Table 35-5) A cart that is fully stocked with all of the equipment required to manage a difficult airway should be available to airway managers, but need not be brought to the bedside of every patient in crisis.
6) The goals of pharmacologic preparation of the patient include creating conditions that allow safe intubation, providing relief from the discomfort and hemodynamic consequences associated with airway manipulation and tracheal intubation, and decreasing the hormonal and neurologic consequences of the procedure. The spectrum of pharmacologic preparation ranges from topical to intravenous general anesthesia. In the hands of experienced operators, most airway manipulations can be accomplished with topical anesthesia alone. Intravenous general anesthesia is indicated in the setting of elevated ICP and favorable airway anatomy (Table 35-6). There are many institutions where an intravenous general anesthetic is routinely administered for tracheal intubation, but..."

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