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An Acute Respiratory Distress Syndrome Patient Successfully Treated with Noninvasive Mechanical Ventilation 无创机械通气成功治疗急性呼吸窘迫综合征1例
Pub Date : 2015-04-01 DOI: 10.4274/TYBDD.83803
Y. Savran, Tuğba Başoğlu, Güntuğ Güngör, S. Öztürk
E-pos ta: yusuf.savran@deu.edu.tr Tel.: +90 505 658 60 40 ÖZET Halen tartışmalı olması ve literatürde sık rastlanmaması nedeniyle noninvaziv mekanik ventilasyon ile başarılı bir şekilde tedavi ettiğimiz Akut respiratuvar distress sendromu (ARDS) olgumuz ile ilgili tecrübelerimizi paylaşmak istiyoruz. Yirmi altı yaşındaki Burkitt lenfoma tanılı erkek hasta kemoterapi sonrası nötropenik ateş ve sepsis ilişkili ARDS tanılarıyla yoğun bakıma yatırıldı. Hastanın bilincinin ve kooperasyonunun iyi olması sebebiyle PO2/FiO2=114,2 olmasına rağmen noninvaziv mekanik ventilasyon başlandı. Noninvaziv mekanik ventilasyon destek basınçları ve spontan solunum denemeleri, aralıklı arteriyel kan gazı sonuçlarına göre başarılı bir şekilde yönetilerek 72 saat sonunda noninvaziv mekanik ventilasyon ihtiyacı kalmadı. Özellikle erken dönem ARDS ve uygun seçilmiş olgularda entübasyondan önce noninvaziv mekanik ventilasyon denenmelidir ancak noninvaziv mekanik ventilasyon ile hasta iyileşmiyor, kötüleşiyorsa invaziv mekanik ventilasyon uygulaması geciktirilmemelidir. Anahtar Kelimeler: Akut respiratuar distress sendromu, noninvaziv ventilasyon, bağışıklığı baskılanmış hasta, akut solunum yetmezliği
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引用次数: 0
Right Tracheobronchial Injury Due to Endotracheal Tube Malpositioning: A Case Presentation 气管内管错位致右气管支气管损伤1例
Pub Date : 2014-12-05 DOI: 10.4274/tybdd.70188
S. Uçkun, T. Kuzucuoğlu
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引用次数: 0
Hyperglycemia in the Intensive Care Unit 重症监护病房的高血糖症
Pub Date : 2014-12-05 DOI: 10.4274/TYBDD.03521
R. Lenhardt, O. Akça
E-mail: rainer.lenhardt@louisville.edu Phone: +90 001 502-852-5851 SUMMARY Hyperglycemia is frequently encountered in the intensive care unit. In this disease, after severe injury and during diabetes mellitus homeostasis is impaired; hyperglycemia, hypoglycemia and glycemic variability may ensue. These three states have been shown to independently increase mortality and morbidity. Patients with diabetics admitted to the intensive care unit tolerate higher blood glucose values without increase of mortality. Stress hyperglycemia may occur in patients with or without diabetes and has a strong association with increased mortality in the intensive care unit patients. Insulin is the drug of choice to treat hyperglycemia in the intensive care unit. In patients with moderate hyperglycemia a basal–bolus insulin concept can be used. Close glucose monitoring is of paramount importance throughout the intensive care unit stay of the patient. In the guidelines for glycemic control based on meta-analyses it was shown that a tight glycemic control does not have a significant mortality advantage over conventional treatment. Given the controversy about optimal blood glucose goals in the intensive care unit setting, it seems reasonable to target a blood glucose level around 140 mg/dL to avoid episodes of hypoglycemia and minimize glycemic variability. The closed loop system with continuous glucose monitoring and algorithm based insulin application by an infusion pump is a promising new concept with the potential to further reduce mortality and morbidity due to hyperglycemia, hypoglycemia and glycemic variability. The goal of this review was to give a brief overview about pathophysiology of hyperglycemia and to summarize current guidelines for glycemic control in critically ill patients.
电子邮件:rainer.lenhardt@louisville.edu电话:+90 001 502-852-5851总结:高血糖是重症监护病房的常见疾病。在这种疾病中,在严重损伤后和糖尿病期间,体内平衡受损;可能出现高血糖、低血糖和血糖变异性。这三种状态分别增加了死亡率和发病率。入住重症监护病房的糖尿病患者可以忍受较高的血糖值而不增加死亡率。应激性高血糖可能发生在患有或不患有糖尿病的患者身上,并与重症监护病房患者的死亡率增加密切相关。胰岛素是重症监护病房治疗高血糖的首选药物。对于中度高血糖患者,可以采用基础剂量胰岛素的概念。严密的血糖监测是至关重要的整个重症监护病房的住院病人。在基于荟萃分析的血糖控制指南中显示,严格的血糖控制与常规治疗相比并没有显著的死亡率优势。鉴于在重症监护病房设置的最佳血糖目标存在争议,似乎合理的目标是将血糖水平控制在140 mg/dL左右,以避免低血糖发作并将血糖变异性降至最低。连续血糖监测闭环系统和基于算法的胰岛素注射泵应用是一个很有前途的新概念,具有进一步降低高血糖、低血糖和血糖变异性引起的死亡率和发病率的潜力。这篇综述的目的是简要概述高血糖的病理生理学,并总结当前危重患者血糖控制的指南。
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引用次数: 2
Neuroleptic Malignant Syndrome Requiring Neurological Intensive Care Unit Follow-up: Review with Nine Cases 需要神经重症监护病房随访的抗精神病药恶性综合征:回顾9例
Pub Date : 2014-12-05 DOI: 10.4274/TYBDD.18189
N. Bülbül, Y. Seçil, Y. Beckmann, T. Incesu, G. Akhan
Nöroleptik malign sendrom (NMS) nöroloji pratiğimizde rastladığımız, antipsikotikler (AP) ve dopaminerjik sistemi etkileyen diğer ilaçların kullanımına bağlı olarak ortaya çıkabilen, ve ciddi komplikasyonlarla seyretmesi nedeniyle yoğun bakım izlemi gerektiren bir tablodur (1-4). Hem nöroloji hekimlerinin, hem acil servis hekimlerinin hem de bu hastaları karşılama potansiyeli olan diğer branşlardaki hekimlerin hastalık hakkında bilgilenmesi tanıyı kolaylaştıracak ve yaşamsal önem taşıyan acil müdahale durumunu hızlandıracaktır. Bu amaçlardan yola çıkarak son üç yıl içinde Nöroloji Yoğun Bakım Ünitemizde (NYBÜ) NMS tanısıyla izlenen dokuz olgu retrospektif olarak değerlendirilmiş, tüm nörolojik ve diğer muayene, laboratuvar bulguları ile birlikte literatür eşliğinde tartışılmıştır.
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引用次数: 0
The Effect of Lactate, Albumin, C-reactive Protein, PaO2/FiO2 and Glucose Levels of Trauma Patients at the Time of Administration to Intensive Care 重症监护时创伤患者乳酸、白蛋白、c反应蛋白、PaO2/FiO2和葡萄糖水平的影响
Pub Date : 2014-12-05 DOI: 10.4274/tybdd.02411
E. Yilmaz, C. Bor, M. Uyar, K. Demirag, Ilkin Cankayalı
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引用次数: 5
The Effect of Care Bundles Based on Guidelines Over the Central Venous Catheter Infections in an Intensive Care Unit 基于指南的护理包对重症监护病房中心静脉导管感染的影响
Pub Date : 2014-12-01 DOI: 10.4274/TYBDD.19483
F. Polat, Ali Haydar Şahinoğlu, A. Dilek, E. Köksal, Yasemin Üstün, C. Kaya, Fatma Ülger, Ş. Esen
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引用次数: 1
Fast Hugs with Intensive Care Unit 重症监护病房的快速拥抱
Pub Date : 2014-12-01 DOI: 10.4274/tybdd.69885
N. Şenoğlu, Işıl Köse, Ç. Zincircioğlu, R. H. Erbay
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引用次数: 1
Early Diagnosis in Acute Kidney Failure: Neutrophil Gelatinase Associated Lipocain (NGAL), Kidney Injury Molecule-1 (KIM-1), Interleukine-18 (IL-18), Cystatin C 急性肾衰竭的早期诊断:中性粒细胞明胶酶相关脂素(NGAL)、肾损伤分子-1 (KIM-1)、白细胞介素-18 (IL-18)、胱抑素C
Pub Date : 2014-12-01 DOI: 10.4274/TYBDD.29494
M. Büget, Elif Özkilitçi, C. Kucukgergin, Ş. Seçkin, S. Kuçukay, Yılmaz Yenigün, G. Orhun, İbrahim Özkan Özakıncı, P. E. Özcan
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引用次数: 2
Yapı ve Fonksiyon: İdeal Hasta Bakımında Yoğun Bakım Ünitesi Planlanması
Pub Date : 2014-08-05 DOI: 10.4274/TYBDD.77487
Jozef Kesecioğlu
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引用次数: 0
Atropine Bağlı Gelişen Anafilaktoid Reaksiyon
Pub Date : 2014-08-05 DOI: 10.4274/TYBDD.25744
Melike Korkmaz Toker, Ayşegül Karabay, Aykan Gülleroğlu, G. Gündoğdu, Ilhan Guney Bicer, M. Aldemir
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引用次数: 0
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Türk Yoğun Bakim Derneği Dergisi
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