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Chronic Critical Illness
Chronic critical illness is a disease state which affects intensive care patients who have survived an initial insult but remain dependent on intensive care for a protracted period, neither dying nor recovering.Girard K, Raffin TA. The chronically critically ill: to save or let die? ''Respir Care''. 1985; 30: 339-47. The most characteristic clinical feature is a prolonged requirement for mechanical ventilation.Nelson JE, Cox CE, Hope AA, Carson SS. Chronic critical illness. ''Am J Respir Crit Care Med''. 2010; 182(4): 446-54. Other features include profound weakness associated with critical illness polyneuropathy and myopathy, increased susceptibility to infection, metabolic changes and hormonal changes. There may be protracted or permanent delirium, or other marked cognitive impairment. The physical and psychological symptoms of the disease are very severe, including a propensity to develop post traumatic stress syndrome.Nelson JE, Meier DE, Litke A, Natale DA, Siegel RE, Morriso ...
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Respiratory Therapist
A respiratory therapist is a specialized healthcare practitioner trained in critical care and cardio-pulmonary medicine in order to work therapeutically with people who have acute critical conditions, cardiac and pulmonary disease. Respiratory therapists graduate from a college or university with a degree in respiratory therapy and have passed a national board certifying examination. The NBRC (National Board for Respiratory Care) is responsible for credentialing as a CRT (certified respiratory therapist), or RRT (registered respiratory therapist), The specialty certifications of respiratory therapy include: CPFT and RPFT (Certified or Registered Pulmonary Function Technologist), ACCS (Adult Critical Care Specialist), NPS (Neonatal/Pediatric Specialist), and SDS (Sleep Disorder Specialist). Respiratory therapists work in hospitals in the intensive care units (Adult, Pediatric, and Neonatal), on hospital floors, in emergency departments, in pulmonary functioning laboratories (P ...
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Intensive Care
Intensive care medicine, also called critical care medicine, is a medical specialty that deals with seriously or critically ill patients who have, are at risk of, or are recovering from conditions that may be life-threatening. It includes providing life support, invasive monitoring techniques, resuscitation, and end-of-life care. Doctors in this specialty are often called intensive care physicians, critical care physicians or intensivists. Intensive care relies on multidisciplinary teams composed of many different health professionals. Such teams often include doctors, nurses, physical therapists, respiratory therapists, and pharmacists, among others. They usually work together in intensive care units (ICUs) within a hospital. Scope Patients are admitted to the intensive care unit if their medical needs are greater than what the general hospital ward can provide. Indications for the ICU include blood pressure support for cardiovascular instability (hypertension/hypotension ...
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Mechanical Ventilation
Mechanical ventilation, assisted ventilation or intermittent mandatory ventilation (IMV), is the medical term for using a machine called a ventilator to fully or partially provide artificial ventilation. Mechanical ventilation helps move air into and out of the lungs, with the main goal of helping the delivery of oxygen and removal of carbon dioxide. Mechanical ventilation is used for many reasons, including to protect the airway due to mechanical or neurologic cause, to ensure adequate oxygenation, or to remove excess carbon dioxide from the lungs. Various healthcare providers are involved with the use of mechanical ventilation and people who require ventilators are typically monitored in an intensive care unit. Mechanical ventilation is termed invasive if it involves an instrument to create an airway that is placed inside the trachea. This is done through an endotracheal tube or nasotracheal tube. For non-invasive ventilation in people who are conscious, face or nasal mask ...
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Critical Illness Polyneuropathy
Critical illness polyneuropathy (CIP) and critical illness myopathy (CIM) are overlapping syndromes of diffuse, symmetric, flaccid muscle weakness occurring in critically ill patients and involving all extremities and the diaphragm with relative sparing of the cranial nerves. CIP and CIM have similar symptoms and presentations and are often distinguished largely on the basis of specialized electrophysiologic testing or muscle and nerve biopsy. The causes of CIP and CIM are unknown, though they are thought to be a possible neurological manifestation of systemic inflammatory response syndrome. Corticosteroids and neuromuscular blocking agents, which are widely used in intensive care, may contribute to the development of CIP and CIM, as may elevations in blood sugar, which frequently occur in critically ill patients. CIP was first described by Charles F. Bolton in a series of five patients. Combined CIP and CIM was first described by Nicola Latronico in a series of 24 patients. ...
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Myopathy
In medicine, myopathy is a disease of the muscle in which the muscle fibers do not function properly. This results in muscular weakness. ''Myopathy'' means muscle disease (Greek : myo- ''muscle'' + patheia '' -pathy'' : ''suffering''). This meaning implies that the primary defect is within the muscle, as opposed to the nerves ("neuropathies" or "neurogenic" disorders) or elsewhere (e.g., the brain). Muscle cramps, stiffness, and spasm can also be associated with myopathy. Capture myopathy can occur in wild or captive animals, such as deer and kangaroos, and leads to morbidity and mortality. It usually occurs as a result of stress and physical exertion during capture and restraint. Muscular disease can be classified as neuromuscular or musculoskeletal in nature. Some conditions, such as myositis, can be considered both neuromuscular and musculoskeletal. Signs and symptoms Common symptoms include muscle weakness, cramps, stiffness, and tetany. Systemic diseases Myopathies i ...
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Metabolic
Metabolism (, from el, μεταβολή ''metabolē'', "change") is the set of life-sustaining chemical reactions in organisms. The three main functions of metabolism are: the conversion of the energy in food to energy available to run cellular processes; the conversion of food to building blocks for proteins, lipids, nucleic acids, and some carbohydrates; and the elimination of metabolic wastes. These enzyme-catalyzed reactions allow organisms to grow and reproduce, maintain their structures, and respond to their environments. The word metabolism can also refer to the sum of all chemical reactions that occur in living organisms, including digestion and the transportation of substances into and between different cells, in which case the above described set of reactions within the cells is called intermediary (or intermediate) metabolism. Metabolic reactions may be categorized as ''catabolic'' – the ''breaking down'' of compounds (for example, of glucose to pyruvate by cel ...
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Hormonal
A hormone (from the Greek participle , "setting in motion") is a class of signaling molecules in multicellular organisms that are sent to distant organs by complex biological processes to regulate physiology and behavior. Hormones are required for the correct development of animals, plants and fungi. Due to the broad definition of a hormone (as a signaling molecule that exerts its effects far from its site of production), numerous kinds of molecules can be classified as hormones. Among the substances that can be considered hormones, are eicosanoids (e.g. prostaglandins and thromboxanes), steroids (e.g. oestrogen and brassinosteroid), amino acid derivatives (e.g. epinephrine and auxin), protein or peptides (e.g. insulin and CLE peptides), and gases (e.g. ethylene and nitric oxide). Hormones are used to communicate between organs and tissues. In vertebrates, hormones are responsible for regulating a variety of physiological processes and behavioral activities such as digestion, met ...
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Delirium
Delirium (also known as acute confusional state) is an organically caused decline from a previous baseline of mental function that develops over a short period of time, typically hours to days. Delirium is a syndrome encompassing disturbances in attention, consciousness, and cognition. It may also involve other neurological deficits, such as psychomotor disturbances (e.g. hyperactive, hypoactive, or mixed), impaired sleep-wake cycle, emotional disturbances, and perceptual disturbances (e.g. hallucinations and delusions), although these features are not required for diagnosis. Delirium is caused by an acute organic process, which is a physically identifiable structural, functional, or chemical problem in the brain that may arise from a disease process ''outside'' the brain that nonetheless affects the brain. It may result from an underlying disease process (e.g. infection, hypoxia), side effect of a medication, withdrawal from drugs, over-consumption of alcohol, usage of hall ...
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Post Traumatic Stress Syndrome
Post or POST commonly refers to: *Mail, the postal system, especially in Commonwealth of Nations countries **An Post, the Irish national postal service **Canada Post, Canadian postal service **Deutsche Post, German postal service ** Iraqi Post, Iraqi postal service **Russian Post, Russian postal service ** Hotel post, a service formerly offered by remote Swiss hotels for the carriage of mail to the nearest official post office **United States Postal Service or USPS **Parcel post, a postal service for mail that is heavier than ordinary letters *Post, a job or occupation Post, POST, or posting may also refer to: Architecture and structures *Lamppost, a raised source of light on the edge of a road *Post (structural), timber framing *Post and lintel, a building system * Steel fence post *Trading post *Utility pole or utility post Military *Military base, an assigned station or a guard post **Outpost (military), a military outpost **Guardpost, or guardhouse Geography *Post, Iran, a ...
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Post-intensive Care Syndrome
Post-intensive care syndrome (PICS) describes a collection of health disorders that are common among patients who survive critical illness and intensive care. Generally, PICS is considered distinct from the impairments experienced by those who survive critical illness and intensive care following traumatic brain injury and stroke. The range of symptoms that PICS describes falls under three broad categories: physical impairment, cognitive impairment, and psychiatric impairment. A person with PICS may have symptoms from one or multiple of these categories. Improvements in survival after a critical illness have led to research focused on long-term outcomes for these patients. This improved survival has also led to the discovery of significant functional disabilities that many survivors of critical illness experience. Because the majority of literature in critical care medicine is focused on short-term outcomes (e.g. survival), the current understanding of PICS is relatively limited. Re ...
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