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Harrison's Principles of Internal Medicine, 18e
| Part 12. Critical Care Medicine > Section 1. Respiratory Critical Care > |
Chapter 267. Approach to the Patient with Critical Illness
Sections: Approach to the Patient with Critical Illness: Introduction, Shock, Respiratory Failure, Care of the Mechanically Ventilated Patient, Multiorgan System Failure, Monitoring in the ICU, Prevention of Complications of Critical Illness, Neurologic Dysfunction in Critically Ill Patients, Withholding and Withdrawing Care, Further Readings.
Topics Discussed: care of intensive care unit patient.
Excerpt:"The care of critically ill patients requires a thorough understanding of pathophysiology and is centered initially on resuscitation of patients at extremes of physiologic deterioration. This resuscitation is often fast-paced and occurs early without a detailed awareness of the patients chronic medical problems. While physiologic stabilization is taking place, intensivists attempt to gather important background medical information to supplement the real-time assessment of the patients current physiologic conditions. Numerous tools are available to assist intensivists in the accurate assessment of pathophysiology and management to incipient organ failure, offering a window of opportunity for diagnosing and treating underlying disease(s) in a stabilized patient. Indeed, the use of invasive interventions such as mechanical ventilation and renal replacement therapy is commonplace in the intensive care unit. An appreciation of the risks and benefits of such aggressive and often invasive interventions is vital to assure an optimal patient outcome. Nonetheless, intensivists must recognize when patients chances for recovery are remote or impossible and counsel and comfort dying patients and their significant others. Critical care physicians often must redirect the goals of care from resuscitation..."
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