神经外科重症NICU重症概念知识.ppt

神经科需要了解的重症知识对重症的了解可以让一个脑外科医生把手术做的更好

Rock?Leaf?Ro神经重症SSnake?ear2

神经重症我们在做什么1.阵痛镇静(应激必要性)2.感染感控(防胜于治)3.多模态监测(不是装备的展示)4.生命体征的支持与管理(体温-TTM呼吸-VAP循环-容量血压-灌注压)5.重症超声(实例)从重症医学的角度去看待疾病和患者

part1:为什么要镇痛镇静·与传统理念的冲突·镇痛镇静利大于弊 弊大于利·从理论到实践●

NCBIResources?HowTo?PublMedgovPubMedUSNationalLibraryofAdvancedMedicineNationalInstitutesofHealthFormatAbstract▼Sendto▼CritCareMed.2002Jan;30(1):119-41.Clinicalpracticeguidelinesforthesustaineduseofsedativesandanalgesicsinthecriticallyilladult.JacobiJ,FraserGL.CoursinDE,RikerRR.FontaineD.WittbrodtET,ChalinDE,MasicaMF,BierkeHS.CoplinWM.CrippenDW,FuchsBD.KelleherRMMarikPE.NasrawaySAJr,MurrayMJ.PeruziWT.LumbPD:TaskForceoftheAmericanCollegeofCrticalCareMedicine(ACCM)oftheSocietyofCrticaCareMedicine(SCCM).AmericanSocietyofHealth-SystemPharmacists(ASHP).AmericanColleqeofChestPhysicians.ErratuminCritCareMed2002Mar;30(3):726.CommentinLessagreementisnotedbetweenthevisualanalogscaleandthefacesscaleforpatientswithmoderatepainthanforthosewithseverepain.[CritCareMed.2003]Rotationofpropofolandmidazolamforlong-termsedation.[CritCareMed.2004]Neurolepticmalignantsyndromeinthecriticalcareunit.[CritCareMed.2002]Haloperidolshouldbeusedsparingly.[CritCareMed.2002]Propyleneglycoltoxicityoccursduringlow-doseinfusionsoflorazepam.[CritCareMed.2003]PMIDIndexedforMEDLINE]f对SearchSimilararticlesClinicalpracticeguidelinesforthesustaineduseofsedativesand[AmJHealthSystPharm.2002]ReviewImprovingsedationandanalgesiainthecriticallyill[MinervaAnest