Surgical Intensive Care Unit

  • Philip S. Barie
  • David T. Harrington
  • William G. Cioffi
  • Bashar Fahoum
  • Charles A. AdamsJr.
  • Edwin A. Deitch
  • Avery B. Nathens
  • Larry M. Gentilello
Chapter

Abstract

“Less is more” characterizes the trends in ventilation strategies. The minimalist approach is to avoid intubating the airway at all. Noninvasive positive pressure ventilation (NPPV) uses a gas-tight facemask to deliver volume- or pressure-controlled mechanical ventilator breaths, bi-level positive airway pressure (BIPAP), or continuous positive airway pressure (CPAP) [1]. Several studies suggest that NPPV may avoid intubation and decrease the risk of nosocomial pneumonia in patients with acute exacerbations of chronic obstructive pulmonary disease (COPD), and limited data suggest that NPPV may be used for other causes of acute respiratory failure [2], and as an adjunct to weaning [3].

Keywords

Continuous Positive Airway Pressure Acute Respiratory Distress Syndrome Enteral Nutrition Atrial Natriuretic Peptide Pulmonary Artery Catheter 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.
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References

  1. 1.
    Rabatin JT, Gay PC (1999) Noninvasive ventilation. Mayo Clin Proc 74:817–820PubMedGoogle Scholar
  2. 2.
    Martin TJ, Hovis JD, Costantino JP, et al. (2000) A randomized, prospective evaluation of noninvasive ventilation for acute respiratory failure. Am J Respir Crit Care Med 161:807–813PubMedGoogle Scholar
  3. 3.
    Nava S, Ambrosino N, Clini E, et al. (1988) Noninvasive mechanical ventilation in the weaning of patients with respiratory failure due to chronic obstructive pulmonary disease. A randomized controlled trial. Ann Intern Med 128:721–728Google Scholar
  4. 4.
    Jolliet P, Tassaux D, Thouret JM, Chevrolet JC (1999) Beneficial effects of helium:oxygen versus air:oxygen noninvasive pressure support in patients with decompensated chronic obstructive pulmonary disease. Crit Care Med 27:2422–2429PubMedGoogle Scholar
  5. 5.
    Sandur S, Stoller JK (1999) Pulmonary complications of mechanical ventilation. Clin Chest Med 20:223–247PubMedGoogle Scholar
  6. 6.
    The Acute Respiratory Distress Syndrome Network. (2000) Ventilation with lower tidal volumes as compared with traditional tidal volumes for acute lung injury and the acute respiratory distress syndrome. N Engl J Med 342:1301–1308Google Scholar
  7. 7.
    Hirvela ER (2000) Advances in the management of acute respiratory distress syndrome. Protective ventilation. Arch Surg 135:126–135PubMedGoogle Scholar
  8. 8.
    Szabo C (1996) The pathophysiological role of peroxynitrite in shock, inflammation, and ischemia-reperfusion injury. Shock 6:79–88PubMedGoogle Scholar
  9. 9.
    Steudel W, Hurford WE, Zapol WM (1999) Inhaled nitric oxide. Basic biology and clinical applications. Anesthesiology 91:1090–1121PubMedGoogle Scholar
  10. 10.
    Dellinger EP, Zimmerman JL, Taylor RW, et al. (1998) Effects of inhaled nitric oxide in patients with acute respiratory distress syndrome: results of a randomized Phase II trial. Crit Care Med 26:15–23PubMedGoogle Scholar
  11. 11.
    Gerlach H, Rossaint R, Pappert D, Falke KJ (1993) Time-course and dose-response of nitric oxide inhalation for systemic oxygenation and pulmonary hypertension in patients with adult respiratory distress syndrome. Eur J Clin Invest 23:499–502PubMedGoogle Scholar
  12. 12.
    Troncy E, Collet JP, Shapiro S, et al. (1998) Inhaled nitric oxide in acute respiratory distress syndrome. Crit Care Med 157:1483–1488Google Scholar
  13. 13.
    Manthous CA, Schmidt GA, Hall JB (1998) Liberation from mechanical ventilation. A decade of progress. Chest 114:886–901PubMedGoogle Scholar
  14. 14.
    Jacob B, Chatila W, Manthous CA (1996) The unassisted respiratory rate:tidal volume ratio accurately predicts weaning outcome. Crit Care Med 101:61–67Google Scholar
  15. 15.
    Yang KL, Tobin MJ (1991) A prospective study of indexes predicting the outcome of trials of weaning from mechanical ventilation. N Engl J Med 324:1445–1450PubMedGoogle Scholar
  16. 16.
    Epstein SK, Ciubotaru RL (1996) Influence of gender and endotracheal tube size on preextubation breathing pattern. Am J Respir Crit Care Med 154:1647–1652PubMedGoogle Scholar
  17. 17.
    Johannigman JA, Davis K Jr, Campbell RS, et al. (1997) Use of the rapid shallow breathing index as an indicator of patient work of breathing during pressure support ventilation. Surgery 122:737–740PubMedGoogle Scholar
  18. 18.
    Dekel B, Segal E, Perel A (1996) Pressure support ventilation. Arch Intern Med 156:369–373PubMedGoogle Scholar
  19. 19.
    Esteban A, Alia A, Gardo F, et al. (1997) Extubation outcome after spontaneous breathing trials with T-tube or pressure support ventilation. Am J Respir Crit Care Med 156:459–465PubMedGoogle Scholar
  20. 20.
    Dries DJ (1997) Weaning from mechanical ventilation. J Trauma 43:372–384PubMedGoogle Scholar
  21. 21.
    Kollef MH, Shapiro SD, Silver P, et al. (1997) A randomized, controlled trial of protocol-directed versus physician-directed weaning from mechanical ventilation. Crit Care Med 25:567–574PubMedGoogle Scholar
  22. 22.
    Horst HM, Mouro D, Hall-Jenssens RA, Pamukov N (1998) Decrease in ventilation time with a standardized weaning process. Arch Surg 133:483–488PubMedGoogle Scholar
  23. 23.
    Sugerman HJ, Wolfe L, Pasquale MD, et al. (1997) Multicenter, randomized prospective trial of early tracheostomy. J Trauma 43:741–747PubMedGoogle Scholar
  24. 24.
    Dulgerov P, Gysin C, Pergener TV, Chevrolet JC (1999) Percutaneous or surgical tracheostomy: a meta-analysis. Crit Care Med 27:1617–1625Google Scholar

References

  1. 1.
    Berlauk JF, Abrams JH, Gilmour IJ, et al. (1991) Preoperative optimization of cardiovascular hemodynamics improves outcome in peripheral vascular surgery: a prospective, randomized clinical trial. Ann Surg 214:289–297PubMedGoogle Scholar
  2. 2.
    Bishop MH, Shoemaker WC, Appel PL, et al. (1995) Prospective, randomized trial of survivor values of cardiac index, oxygen delivery, and oxygen consumption as resuscitation endpoints in severe trauma. J Trauma 38:780–787PubMedGoogle Scholar
  3. 3.
    Bishop MH, Shoemaker WC, Appel PL, et al. (1993) Relationship between supranormal circulatory values, time delays, and outcome in severely traumatized patients. Crit Care Med 21:56–63PubMedGoogle Scholar
  4. 4.
    Boden WE, O’Rourke RA, Crawford MH, et al. (1998) Outcomes in patients with acute non-Qwave myocardial infarction randomly assigned to an invasive as compared with a conservative management strategy. N Engl J Med 338:1785–1792PubMedGoogle Scholar
  5. 5.
    Chang MC, Cheatham ML, Nelson LD, et al. (1994) Gastric tonometry supplements information provided by systemic indicators of oxygen transport. J Trauma 37:488–494PubMedGoogle Scholar
  6. 6.
    Chang MC, Meredith JW (1997) Cardiac preload, splanchnic perfusion, and their relationship during resuscitation in trauma patients. J Trauma 42:577–582PubMedGoogle Scholar
  7. 7.
    Connors AF, Speroff T, Dawson N, et al. (1996) The effectiveness of right heart catheterization in the initial care of critically ill patients. JAMA 276:889–897PubMedGoogle Scholar
  8. 8.
    Diebel LN, Wilson RF, Tagett MG, et al. (1992) End-diastolic volume: better indicators of preload in the critically ill. Arch Surg 127:817–822PubMedGoogle Scholar
  9. 9.
    Durham R, Neunaber K, Vogler G, et al. (1995) Right ventricular end-diastolic volume as a measure of preload. J Trauma 39:218–223PubMedGoogle Scholar
  10. 10.
    Echt DS, Liebson PR, Mitchell LB, et al. (1991) Mortality and morbidity in patients receiving encainide, flecainide, or placebo. The Cardiac Arrhythmia Suppression Trial. N Engl J Med 324:781–788PubMedGoogle Scholar
  11. 11.
    Eddy AC, Rice CL, Anardi DM (1988) Right ventricular dysfunction in multiple trauma victims. Am J Surg 155:712–715PubMedGoogle Scholar
  12. 12.
    Eisenberg PR, Jaffe AS, Schuster DP (1984) Clinical evaluation compared to pulmonary artery catheterization in the hemodynamic assessment of critically ill patients. Crit Care Med 12:549–553PubMedGoogle Scholar
  13. 13.
    Fein AM, Goldberg, SK, Walkenstein MD, et al. (1984) Is pulmonary artery catheterization necessary for the diagnosis of pulmonary edema? Am Rev Respir Dis 129:1006–1009PubMedGoogle Scholar
  14. 14.
    Gattinoni L, Brazzi L, Pelosi P, et al. (1995) A trial of goal-oriented hemodynamic therapy in critically ill patients: SvO2 Collaborative Group. N Engl J Med 333:1025–1032PubMedGoogle Scholar
  15. 15.
    Glantz SA, Parmley WW (1978) Factors which affect the diastolic pressure-volume curve. Circ Res 42:171–180PubMedGoogle Scholar
  16. 16.
    Gore JM, Goldberg RJ, Spodick DH, et al. (1987) A community-wide assessment of the use of pulmonary artery catheters in patients with acute myocardial infarction. Chest 92:721–727PubMedGoogle Scholar
  17. 17.
    Guyatt G (1991) A randomized control trial of right-heart catheterization in critically ill patients. Ontario Intensive Care Study Group. J Intensive Care Med 6:91–95PubMedGoogle Scholar
  18. 18.
    Hamilton-Davies C, Mythen MG, Salmon JB, et al. (1997) Comparison of commonly used indicators of hypovolaemia with gastrointestinal tonometry. Intensive Care Med 23:276–281PubMedGoogle Scholar
  19. 19.
    Hayes MA, Timmins AC, Yau EH, et al. (1994) Elevation of systemic oxygen delivery in the treatment of critically ill patients. N Engl J Med 330:1717–1722PubMedGoogle Scholar
  20. 20.
    Hochman JS, Boland J, Sleeper LA, et al. (1995) Current spectrum of cardiogenic shock and effect of early revascularization on mortality: results of an International Registry, SHOCK Registry Investigators. Circulation 91:873–881PubMedGoogle Scholar
  21. 21.
    Ivatury RR, Simon RJ, Havriliak D, et al. (1995) Gastric mucosal pH and oxygen delivery and oxygen consumption indices in the assessment of adequacy of resuscitation after trauma: A prospective, randomized study. J Trauma 39:128–134PubMedGoogle Scholar
  22. 22.
    Janicki JS, Weber KT (1980) Factors influencing the diastolic pressure-volume relation of the cardiac ventricles. Fed Proc 39:133–140PubMedGoogle Scholar
  23. 23.
    Komadina KH, Schenk DA, LaVeau P, et al. (1991) Interobserver variability in the interpretation of pulmonary artery catheter pressure tracings. Chest 100:1647–1654PubMedGoogle Scholar
  24. 24.
    Lappas D, Lell WA, Gabel, et al. (1973) Indirect measurement of left-atrial pressure in surgical patients — pulmonary-capillary wedge and pulmonary-artery diastolic pressures compared with left-atrial pressure. Anesthesiology 38:394–397PubMedGoogle Scholar
  25. 25.
    Madan AK, UyBarreta VV, Aliabadi-Wahle S, et al. (1999) Esophageal Doppler ultrasound monitor versus pulmonary artery catheter in the hemodynamic management of critically ill surgical patients. J Trauma 46:607–611PubMedGoogle Scholar
  26. 26.
    McKinley BA, Butler BD (1999) Comparison of skeletal muscle PO2, PCO2, and pH with gastric tonometric P(CO2) and pH in hemorrhagic shock. Crit Care Med 27:1869–1877PubMedGoogle Scholar
  27. 27.
    Miller JA, Singireddy S, Maldjian P, et al. (1999) A reevaluation of the radiographically detectable complications of percutaneous venous access lines inserted by four subcutaneous approaches. Am Surg 65:125–130PubMedGoogle Scholar
  28. 28.
    Mimoz O, Rauss A, Rekik N, et al. (1994) Pulmonary artery catheterization in critically ill patients: A prospective analysis of outcome changes associated with catheter-prompted changes in therapy. Crit Care Med 22:573–579PubMedGoogle Scholar
  29. 29.
    Moore EE, Moore FA, Franciose RJ, et al. (1994) The post-ischemic gut serves as a priming bed for circulating neutrophils that provoke multiple organ failure. J Trauma 37:881–887PubMedGoogle Scholar
  30. 30.
    Moore FA, Chang M, Cryer HG, et al. (1998) Symposium: Monitoring in the SICU: Current controversies in the use of pulmonary artery catheters. Contemporary Surg 53:213–228Google Scholar
  31. 31.
    Moore FA, Haenel JB, Moore EE, et al. (1992) Incommensurate oxygen consumption in response to maximal oxygen availability predicts postinjury multiple organ failure. J Trauma 33:58–65PubMedGoogle Scholar
  32. 32.
    Shoemaker WC (1990) Use and abuse of the balloon tip pulmonary artery (Swan-Ganz) catheter: Are patients getting their money’s worth? Crit Care Med 18:1294–1296PubMedGoogle Scholar
  33. 33.
    Steingrub JS, Celoria G, Vickers-Lahti M, et al. (1991) Therapeutic impact of pulmonary artery catheterization in a medical/surgical ICU. Chest 99:1451–1455PubMedGoogle Scholar
  34. 34.
    Tuman KJ, McCarthy RJ, Spiess BD, et al. (1989) Effect of pulmonary artery catheterization on outcome in patients undergoing coronary artery surgery. Anesthesiology 70:199–206PubMedGoogle Scholar
  35. 35.
    Shoemaker WC, Appel PL, Kram HB, et al. (1988) Prospective trial of supranormal values of survivors of therapeutic goals in high-risk surgical patients. Chest 94:1176–1186PubMedGoogle Scholar
  36. 36.
    Whittemore AD, Clowes AW, Hechtman HB, et al (1980) Aortic aneurysm repair: reduced operative mortality associated with maintenance of optimal cardiac performance. Ann Surg 192:414–421PubMedGoogle Scholar
  37. 37.
    Yilmazlar A, Bilgin H, Korfali G, et al. (1997) Complications of 1303 central venous cannulations. J R Soc Med 90:319–321PubMedGoogle Scholar
  38. 38.
    Zollner C, Polasek J, Kilger E, et al. (1999) Evaluation of a new continuous thermodilution cardiac output monitor in cardiac surgical patients: a prospective criterion standard study. Crit Care Med 27:293–299PubMedGoogle Scholar

References

  1. 1.
    Morris JA, Mucha P., Ross SE, et al. (1991) Acute posttraumatic renal failure: a multi-central prospective. J Trauma 31:1584–1590PubMedGoogle Scholar
  2. 2.
    Harman PK, Kron IL, McLachlan HD, et al. (1982) Elevated intra-abdominal pressure and renal failure. Ann Surg 196:594–597PubMedGoogle Scholar
  3. 3.
    Klausner JM, Paterson IS, Goldman G, et al. (1989) Post ischemic renal injury. Am J Physiol 256:F794–802PubMedGoogle Scholar
  4. 4.
    Mudge GH (1980) Nephrotoxcity of urographic contrast drugs. Kidney Int 18:540–552PubMedGoogle Scholar
  5. 5.
    Brater DC (2000) Pharmacology of diuretics. Am J Med Sci 319:38–50PubMedGoogle Scholar
  6. 6.
    Risler T, Kramer B, Muller GA (1991) The efficacy of diuretics in acute and chronic renal failure. Focus on torasemide. Drugs 41[Suppl 3]:69–79Google Scholar
  7. 7.
    Epstein FH, Prasad P (2000) Effects of furosemide on medullary oxygenation in younger and older subjects. Kidney Int 57:2080–2083PubMedGoogle Scholar
  8. 8.
    Shilliday IR, Quinn KJ, Allison ME (1997) Loop diuretics in the management of acute renal failure: a prospective, double-blind, placebo-controlled, randomized study. Nephrol Dial Transplant 2:2592–2596Google Scholar
  9. 9.
    Lassnigg A, Donner E, Grubhofer G, et al. (2000) Lack of renoprotective effects of dopamine and furosemide during cardiac surgery. J Am Soc Nephrol 11:97–104PubMedGoogle Scholar
  10. 10.
    Allison ME, Shilliday I (1993) Loop diuretic therapy in acute and chronic renal failure. J Cardiovasc Pharmacol 22 [Suppl 3]:S59–70PubMedGoogle Scholar
  11. 11.
    Chertow GM, Sayegh MH, Allgren, et al. (1996) Is the administration of dopamine associated with adverse or favorable outcomes in acute renal failure? Am J Med 101:49–53PubMedGoogle Scholar
  12. 12.
    Luippold G, Schneider S, Vallon V, et al. (2000) Postglomerular vasoconstriction induced by dopamine D(3) receptor activation in anesthetized rats. Am J Physol Renal Physiol 278:F570–575Google Scholar
  13. 13.
    Benmalek F, Behforouz N, Benoist J, et al. (1999) Renal effects of low-dose dopamine during vasopressor therapy for posttraumatic intracranial hypertension. Intensive Care Med 25:399–405PubMedGoogle Scholar
  14. 14.
    Clark KL, Robertson MJ, Drew GM (1991) Do renal tubular dopamine receptors mediate dopamine-induced diuresis in the anesthetized cat? J Cardiovasc Pharmacol 17:267–276PubMedGoogle Scholar
  15. 15.
    Aperia AC (2000) Intrarenal dopamine: a key signal in the interactive regulation of sodium metabolism. Annu Rev Physiol 62:621–647PubMedGoogle Scholar
  16. 16.
    Varriale P, Mossavi A (1997) The benefit of low-dose dopamine during vigorous diuresis for congestive heart failure associated with renal insufficiency: does it protect renal function? Clin Cardiol 20:627–630PubMedGoogle Scholar
  17. 17.
    Ichai C, Passeron C, Carles M, et al. (2000) Prolonged low-dose dopamine infusion induces a transient improvement in renal function in hemodynamically stable, critically ill patients: a single-blind, prospective, controlled study. Crit Care Med 28:1329–1335PubMedGoogle Scholar
  18. 18.
    Lherm T, Troche G, Rossignol M et al. (1996) Renal effects of low-dose dopamine in patients with sepsis syndrome or septic shock treated with catecholamines. Intensive Care Med 22:213–219PubMedGoogle Scholar
  19. 19.
    Richer M, Robert S, Lebel M (1996) Renal hemodynamics during norepinephrine and lowdose dopamine infusions in man. Crit Care Med 24:1150–1156PubMedGoogle Scholar
  20. 20.
    Hoogenberg K, Smit AJ, Girbes AR (1998) Effects of low-dose dopamine on renal and systemic hemodynamics during incremental morepinephrine infusion in healthy volunteers. Crit Care Med 26:260–266PubMedGoogle Scholar
  21. 21.
    Ichai C, Soubielle J, Carles M, et al. (2000) Comparison of the renal effects of low to high doses of dopamine and dobutamine in critically ill patients: a single-blind randomized study. Crit Care Med 28:921–928PubMedGoogle Scholar
  22. 22.
    Perdue PW, Baiser JR, Lipsett PA, et al. (1998) Renal dose dopamine in surgical patients: dogma or science. Ann Surg 227:40–473Google Scholar
  23. 23.
    Rahman SN, Kim GE, Matthew AS, et al. (1994) Effect s of atrial natriuretic peptide in clinical renal failure. Kidney Int 45:1731–1738PubMedGoogle Scholar
  24. 24.
    Mehta RL (1994) Therapeutic alternatives to renal replacement for critically ill patients in acute renal failure. Sem in Neph 146-8 14; 64–82Google Scholar
  25. 25.
    Bellomo R, Farmer M, Boyce N (1995) A prospective study of continuous venovenous hemodiafiltration in critically ill patients with acute renal failure. J Intensive Care Med 10:187–192PubMedGoogle Scholar
  26. 26.
    Cosentino F (1995) Drugs for the prevention and treatment of acute renal failure. Cleve Clin J Med 62:248–53PubMedGoogle Scholar
  27. 27.
    Galley HF (2000) Can acute renal failure be prevented? J R Coll Surg Edinb 45:44–50PubMedGoogle Scholar

References

  1. 1.
    Moore FA, Moore EE, Jones TN, et al. (1989) TEN vs. TPN following major abdominal trauma: reduced septic morbidity. J Trauma 29:916–923PubMedGoogle Scholar
  2. 2.
    Lipman TO (1998) Grains or veins: Is enterai nutrition really better than parenteral nutrition? A look at the evidence. JPEN 22:167–182Google Scholar
  3. 3.
    Kudsk KA, Croce MA, Fabian TC, et al. (1992) Enterai feeding versus parenteral feeding. Ann Surg 215:503–513PubMedGoogle Scholar
  4. 4.
    Kudsk KA, Stone JM, Carpenter G, et al. (1983) Enterai and parenteral feeding influences mortality after hemoglobin-E. coli peritonitis in rats. J Trauma 23:605–609PubMedGoogle Scholar
  5. 5.
    Magnotti LJ, Upperman JS, Xu D, Lu Q, Deitch EA (1998) Gut-derived mesenteric lymph but not portal blood increases endothelial cell permeability and potentiates lung injury following hemorrhagic shock. Ann Surg 228:518–527PubMedGoogle Scholar
  6. 6.
    Upperman JS, Deitch EA, Guo W, Lu Q, Xu D (1998) Post-hemorrhagic shock mesenteric lymph is cytotoxic to endothelial cells and activates neutrophils. Shock 10:407–414PubMedGoogle Scholar
  7. 7.
    Moore EE, Moore FA, Franciose RJ, Kim FJ, et al. (1994) The postischemic gut serves as a priming bed for circulating neutrophils that provoke multiple organ failure. J Trauma 37:881–887PubMedGoogle Scholar
  8. 8.
    Koike K, Moore EE, Moore FA, Kim FJ, et al. (1995) Gut phospholipase A2 mediates neutrophil priming and lung injury after mesenteric ischemia-reperfusion. Am J Physiol 268:G397–G403PubMedGoogle Scholar
  9. 9.
    DeWitt RC, Kudsk KA (1999) The gut’s role in metabolism, mucosal barrier function, and gut immunology. Inf Dis Clin N Amer 13:465–481Google Scholar
  10. 10.
    Meyer J, Yurt RW, Duhaney R, Hesse DG, et al. (1988) Differential neutrophil activation before and after endotoxin infusion in enterally versus parenterally fed volunteers. Surg Gynecol Obstet 167:504–509Google Scholar
  11. 11.
    Lowry SF (1990) The route of feeding influences injury response. J Trauma 30(12 Suppl):S10–15PubMedGoogle Scholar
  12. 12.
    Alverdy J, Chi HS, Sheldon G (1985) The effect of parenteral nutrition on gastrointestinal immunity: the importance of enterai immunity. Ann Surg 202:681–684PubMedGoogle Scholar
  13. 13.
    Demetriades H, Botsios D, Kazantzidou D, et al. (1999) Effects of early postoperative enterai feeding on the healing of colonic anastomoses in rats. Eur Surg Res 31:57–63PubMedGoogle Scholar
  14. 14.
    Kiyama T, Witte MB, Thornton FJ, Barbul A (1998) The route of nutrition support affects the early phase of wound healing. JPEN 22:276–279Google Scholar
  15. 15.
    Mochizuki H, Trocki O, Dominoni L, et al. (1984) Mechanism of prevention of postburn hypermetabolism and catabolism by early enterai feeding. Ann Surg 200: 297–310PubMedGoogle Scholar
  16. 16.
    Chiarelli A, Enzi G, Casadei A, et al. (1990) Very early nutrition supplementation in burned patients Am J Clin Nutr 51:1035–1039PubMedGoogle Scholar
  17. 17.
    Hasse JM, Blue LS, Liepa GU, et al. (1995) Early enterai nutrition support in patients undergoing liver transplantation. JPEN 19:437–443Google Scholar
  18. 18.
    Sand J, Luostarinen M, Matikainen M (1997) Enterai or parenteral feeding after total gastrectomy: prospective randomised pilot study. Eur J Surg 163:761–766PubMedGoogle Scholar
  19. 19.
    Stewart BT, Woods RJ, Collopy BT, et al. (1998) Early feeding after elective open colorectal resections: a prospective randomized trial. Aust NZ J Surg 68:125–128Google Scholar
  20. 20.
    Kalfarentzos F, Kehagias J, Kokkinis K, et al. (1997) Enterai nutrition is superior to parenteral nutrition in severe acute pancreatitis: results of a randomized prospective trial. Br J Surg 84:1665–1669PubMedGoogle Scholar
  21. 21.
    Singh G, Ram RP, Khanna SK (1998) Early postoperative enterai feedings in patients with nontraumatic intestinal perforation and peritonitis. J Am Coll Surg 187:142–146PubMedGoogle Scholar
  22. 22.
    Atkinson S, Sieffert E, Bihari D (1998) A prospective, randomized, double-blind, controlled clinical trial of enterai immunonutrition in the critically ill. Guy’s Hospital Intensive Care Group. Crit Care Med 26:1164–1172PubMedGoogle Scholar
  23. 23.
    Chellis MJ, Sanders SV, Webster H, et al. (1996) Early enterai feeding in the pediatric intensive care unit. JPEN 20:71–73Google Scholar
  24. 24.
    Frost P, Edwards N, Bihari D (1997) Gastric emptying in the critically ill: the way forward? Int Care Med 23:243–245Google Scholar
  25. 25.
    Montecalvo MA, Steger KA, Farber HW, et al. (1992) Nutritional outcome and pneumonia in critical care patients randomized to gastric or jejunal tube feedings. Crit Care Med 20:1377–1387PubMedGoogle Scholar
  26. 26.
    Weltz CR, Morris JB, Mullen JL (1992) Surgical jejunostomy in aspiration risk patients Ann Surg 215:140–145PubMedGoogle Scholar
  27. 27.
    Lazarus BA, Murphy JB, Culpepper L (1990) Aspiration associated with long-term gastric versus jejunal feeding: a critical analysis of the literature. Arch Phys Med Rehab 71:46–53Google Scholar
  28. 28.
    DiSario JA, Foutch PG, Sanowski RA (1990) Poor results with percutaneous endoscopic jejunostomy. Gastroint Endos 36:257–260Google Scholar
  29. 29.
    Spain DA, DeWeese RC, Reynolds MA, et al. (1995) Transpyloric passage of feeding tubes in patients with head injuries does not decrease complications. J Trauma 39:1100–1102PubMedGoogle Scholar
  30. 30.
    Strong RM, Condon SC, Solinger MR, et al. (1992) Equal aspiration rates from postpylorus and intragastric-placed small-bore nasoenteric feeding tubes: a randomized, prospective study. JPEN 16:59–63Google Scholar
  31. 31.
    Sands JA (1991) Incidence of pulmonary aspiration in intubated patients receiving enterai nutrition through wide-and narrow-bore nasogastric feeding tubes Heart Lung 20:75–80PubMedGoogle Scholar
  32. 32.
    Ciocon JO, et al. (1992) Continuous compared with intermittent tube feeding in the elderly. JPEN 16:525–528Google Scholar
  33. 33.
    Kortbeek JB, Haigh PI, Doig C (1999) Duodenal versus gastric feeding in ventilated blunt trauma patients: a randomized controlled trial. J Trauma 46:992–998PubMedGoogle Scholar
  34. 34.
    Solem LD, Strate RG, Fischer RP (1979) Antacid therapy and nutritional supplementation in the prevention of Curling’s ulcer. Surg Gynecol Obstet 148:3767–3780Google Scholar
  35. 35.
    Choctaw WT, Fujita C, Zawacki BE (1980) Prevention of upper gastrointestinal bleeding in burn patients. Arch Surg 115:1073–1076PubMedGoogle Scholar
  36. 36.
    Pingleton SK, Hadzima SK (1983) Enterai alimentation and gastrointestinal bleeding in mechanically ventilated patients. Crit Care Med 11:13–16PubMedGoogle Scholar
  37. 37.
    Heyland D, Bradley C, Mandell LA (1992) Effect of acidified enterai feedings on gastric colonization in the critically ill patient. Crit Care Med 20:1388–1394PubMedGoogle Scholar
  38. 38.
    Pingleton SK, Hinthorn DR, Liu C (1986) Enterai nutrition in patients receiving mechanical ventilation. Am J Med 80:827–832PubMedGoogle Scholar
  39. 39.
    Lee B, Chang RWS, Jacobs S (1990) Intermittent nasogastric feeding: a simple and effective method to reduce pneumonia among ventilated ICU patients. Clin Intens Care 1:100–102Google Scholar
  40. 40.
    Skiest DJ, Khan N, Feld R (1996) The role of enterai feeding in gastric colonization: a randomized controlled trial comparing continuous to intermittent enterai feeding in mechanically ventilated patients. Clin Intens Care 7:138–143Google Scholar
  41. 41.
    Spilker CA, Hinthorn DR, Pingleton SK (1996) Intermittent enterai feeding in mechanically ventilated patients. Chest 110:243–248PubMedGoogle Scholar
  42. 42.
    Tinckler LF, Kulke W (1963) Post-operative absorption of water from the small intestine. Gut 4:8–12PubMedGoogle Scholar
  43. 43.
    Raper S, Maynard N (1992) Feeding the critically ill patient. Br J Nursing 1:273–279Google Scholar
  44. 44.
    Moore FA, Moore EE, Kudsk KA, et al. (1994) Clinical benefits of an immune-enhancing diet for early postinjury enterai feeding. J Trauma 40:37607–37615Google Scholar
  45. 45.
    Kudsk KA, Minard G, Croce MA, et al. (1996) A randomized trial of isonitrogenous enterai diets after severe trauma: an immune enhancing diet reduces septic complications. Ann Surg 224:531–543PubMedGoogle Scholar
  46. 46.
    Hernandez-Scorro CR, Marin J, Ruiz-Santana S, et al. (1996) Bedside sonographic-guided versus blind nasoenteric feeding tube placement in critically ill patients. Crit Care Med 24:1690–1694Google Scholar
  47. 47.
    Napolitano LM, Wagle M, Heard S (1998) Endoscopic placement of nasoenteric feeding tubes in critically ill patients: a reliable alternative. J Laparoendo Adv Surg Tech 8:395–400Google Scholar
  48. 48.
    Zaloga GP (1991) Bedside method for placing small-bore feeding tubes in critically ill patients. A prospective study. Chest 100:1643–1646PubMedGoogle Scholar
  49. 49.
    Thurlow PM (1986) Bedside enterai feeding tube placement into duodenum and jejunum. JPEN 10:104–105Google Scholar
  50. 50.
    Stern MA, Wolf DC (1994) Erythromycin as a prokinetic agent: a prospective, randomized, controlled study of efficacy in nasoenteric tube placement. Am J Gastroenterol 89:2011–2013PubMedGoogle Scholar
  51. 51.
    Kalifas S, Choban PS, Ziegler D, et al. (1996) Erythromycin facilitates postpyloric placement of nasoduodenal feeding tubes in intensive care unit patients: randomized, double-blinded, placebo-controlled trial. JPEN 20:385–388Google Scholar
  52. 52.
    Kittinger JW, Sandier RS, Heizer WD (1987) Efficacy of metoclopramide as an adjunct to duodenal placement of small-bore feeding tubes: a randomized, placebo-controlled, double-blind study. JPEN 11:33–37Google Scholar
  53. 53.
    Salasidis R, Fleiszer T, Johnston R (1998) Air insufflation technique of enterai tube insertion: a randomized, controlled trial. Crit Care Med 26:1036–1039PubMedGoogle Scholar
  54. 54.
    Ugo PJ, Mohler PA, Wilson GL (1992) Bedside postpyloric placement of weighted feeding tubes. Nutr Clin Pract 7:284–287PubMedGoogle Scholar
  55. 55.
    Gabriel SA, Ackermann RJ, Castresana MR (1997) A new technique for placement of nasoenteral feeding tubes using external magnetic guidance. Crit Care Med 25:641–645PubMedGoogle Scholar
  56. 56.
    Metheny NA (1986) Aspiration pneumonia in patients fed through nasoenteral tubes. Heart Lung 15:256–261PubMedGoogle Scholar
  57. 57.
    Pinchcofsky-Devin GD, Kaminski MV (1992) Visceral protein increase associated with interrupt versus continuous enterai hyperalimentation. JPEN 16:525–528Google Scholar
  58. 58.
    Ivatury RR, Simon RJ, Islam S, et al. (1996) A prospective randomized study of end points of resuscitation after major trauma: global oxygen transport indices versus organ-specific gastric mucosal pH. J Am Coll Surg 183:145–154PubMedGoogle Scholar
  59. 59.
    Chang MC, Cheatham ML, Nelson LD, et al. (1994) Gastric tonometry supplements information provided by systemic indicators of oxygen transport. J Trauma 37:488–494PubMedGoogle Scholar
  60. 60.
    Kirton OC, Windsor J, Wedderburn R, et al. (1998) Failure of splanchnic resuscitation in the acutely injured trauma patient correlates with multiple organ system failure and length of stay in the ICU. Chest 113:1064–1069PubMedGoogle Scholar
  61. 61.
    Marik PE (1993) Gastric intramucosal pH. A better predictor of multiorgan dysfunction and death than oxygen-derived variables in patients with sepsis. Chest 104:225–229PubMedGoogle Scholar
  62. 62.
    Toninelli A, Agapiti C, Terenghi P, et al. (1995) Gastric intramucosal pH in trauma patients: an index for organ failure risk? Minerva Anestesiol 61:9–14PubMedGoogle Scholar
  63. 63.
    Barquist E, Kirton O, Windsor J, et al. (1998) The impact of antioxidant and splanchnicdirected therapy on persistent uncorrected gastric mucosal pH in the critically injured trauma patient. J Trauma 44:355–360PubMedGoogle Scholar
  64. 64.
    Gottschlich MM, Jenkins M, Warden GD, et al. (1990) Differential effects of three enterai dietary regimens on selected outcome variables in burn patients. JPEN 14:225–236Google Scholar
  65. 65.
    Daly JM, Lieberman MD, Goldfine J, et al. (1992) Enterai nutrition with supplemental arginine, RNA, and omega-3 fatty acids in patients after operation: immunologic, metabolic, and clinical outcome. Surgery 112:56–67PubMedGoogle Scholar
  66. 66.
    Chlebowski RT, Beall G, Grosvenor M, et al. (1993) Long-term effects of early nutritional support with new enterotropic peptide-based formula vs. standard formula in HIV-infected patients: randomized prospective trial. Nutrition 9:507–512PubMedGoogle Scholar
  67. 67.
    Brown RO, Hunt H, Mowatt-Larssen CA, et al. (1994) Comparison of specialized and standard enterai formulas in trauma patients. Pharmacotherapy 14:314–320PubMedGoogle Scholar
  68. 68.
    Bower RH, Cerra FB, Bershadsky B, et al. (1995) Early enterai administration of a formula (Impact®) supplemented with arginine, nudeotides, and fish oil in intensive care patients: results of a multicenter, prospective randomized clinical trial. Crit Care Med 23:436–449PubMedGoogle Scholar
  69. 69.
    Daly JM, Weintraub FN, Shou J, et al. (1995) Enterai nutrition during multimodality therapy in upper gastrointestinal cancer patients. Ann Surg 221:327–338PubMedGoogle Scholar
  70. 70.
    Mendez C, Jurkovich GJ, Garcia I, et al. (1997) Effects of an immune-enhancing diet in critically injured patients. J Trauma 42:933–941PubMedGoogle Scholar
  71. 71.
    Senkal M, Mumme A, Eickhoff U, et al. (1997) Early postoperative enterai immunonutrition: clinical outcome and cost-comparison analysis in surgical patients. Crit Care Med 25:1489–1496PubMedGoogle Scholar
  72. 72.
    Braga M, Gianotti L, Vignali A, et al. (1998) Artificial nutrition after major abdominal surgery: impact of route administration and composition of the diet. Crit Care Med 26:24–30PubMedGoogle Scholar
  73. 73.
    Galban C, Celaya S, Marco P, et al. (1998) An immune-enhancing enterai diet reduces mortality and episodes of bacteremia in septic ICU patients (abstract). JPEN 22:S13Google Scholar
  74. 74.
    Zaloga GP, Roberts PR (1997) Early enterai feeding improves outcome. In: Vincent JL (ed.) Yearbook of Intensive Care and Emergency Medicine. Berlin, Springer, pp 701–714Google Scholar
  75. 75.
    Porter JM, Ivatury RR, Azimuddin KA, et al. (1999) Antioxidant therapy in the prevention of organ dysfunction syndrome and infectious complications after trauma: early results of a prospective randomized study. Amer Surg 65:478–483Google Scholar
  76. 76.
    Gadek JE, DeMichele SJ, Karlstad MD, et al. (1999) Effect of enterai feeding with eicosapentaenoic acid, gamma-linolenic acid, and antioxidants in patients with acute respiratory distress syndrome. Enterai Nutrition in ARDS Study Group. Crit Care Med 27:1409–1420PubMedGoogle Scholar

References

  1. 1.
    Jacobellis v. State of Ohio (1964) 84 S Ct 1676.Google Scholar
  2. 2.
    Ethics Committee of the Society of Critical Care Medicine (1997) Consensus statement of the Society of Critical Care Medicine’s Ethics Committee regarding futile and other possibly inadvisable treatments. Crit Care Med 25:887–891Google Scholar
  3. 3.
    Schneiderman LJ, Jecker NS, Jonseri AR (1990) Medical futility: its meaning and ethical implications. Ann Intern Med 112:949–954PubMedGoogle Scholar
  4. 4.
    Truog RD, Brett AS, Frader J (1992) The problem with futility. N Engl J Med 326:1560–1564PubMedGoogle Scholar
  5. 5.
    Paris JJ, Schreiber MD, Statter M, Arensman R, Siegler M (1993) Beyond autonomy — physicians’ refusal to use life-prolonging extracorporeal membrane oxygenation. N Engl J Med 329: 354–357PubMedGoogle Scholar
  6. 6.
    Angell M (1991) The case of Helga Wanglie: a new kind of right to die case. N Engl J Med 325:511–512PubMedGoogle Scholar
  7. 7.
    Miles SH (1991) Informed demand for “non-beneficial” medical treatment. N Engl J Med 325: 512–515PubMedGoogle Scholar
  8. 8.
    Brophy v. New England Sinai Hospital (1986) 389 Mass. 497 NE 2d 626Google Scholar
  9. 9.
    Youngner SJ (1996) Medical futility. Crit Care Clin 12:165–178PubMedGoogle Scholar
  10. 10.
    Lemeshow S, Klar J, Teres D (1995) Outcome prediction for individual intensive care patients: useful, misused, or abused. Intensive Care Med 21:770–776PubMedGoogle Scholar
  11. 11.
    Blackhall LJ (1987) Must we always use CPR? N Engl J Med 317:1285Google Scholar
  12. 12.
    Faber-Longendoen K (1991) Resuscitation of patients with metastatic cancer: Is transient benefit still futile? Arch Intern Med 151:235–239Google Scholar
  13. 13.
    Vitelli CE, Cooper K, Rogatko A, et al. (1991) Cardiopulmonary resuscitation and the patient with cancer. J Clin Oncol 9:111–115PubMedGoogle Scholar
  14. 14.
    Halevy A, Neal RC, Brody BA (1996) The low frequency of futility in an adult intensive care unit setting. Arch Intern Med 156:100–104PubMedGoogle Scholar
  15. 15.
    Halevy A, Brody BA (1996) A multi-institution collaborative policy on medical futility. JAMA 276:571–574PubMedGoogle Scholar

References

  1. 1.
    The Acute Respiratory Distress Network (2000) Ventilation with lower tidal volumes as compared with traditional tidal volumes for acute lung injury and the respiratory distress syndrome. N Eng J Med 242:1301–1321Google Scholar
  2. 2.
    Ridings PC, Bloomfield GL, Blocher CR, Sugerman H (1995) Cardiopulmonary effects of raised intra-abdominal pressure before and after intravascular expansion. J Trauma 39:1071–1075PubMedGoogle Scholar
  3. 3.
    Brochard L, Rauss A, Benito S, et al. (1994) Comparison of three methods of gradual withdrawal from ventilatory support during weaning from mechanical ventilation. Am J Respir Crit Care Med 150:896–903PubMedGoogle Scholar
  4. 4.
    Esteban A, Frutos F, Tobin MJ, et al. (1995) A comparison of four methods of weaning patients from mechanical ventilation. N Eng J Med 332:345–350Google Scholar
  5. 5.
    Harman PK, Kron IL, McLachlan HD, Freedlender AE, Nolan ST (1982) Elevated intra-abdominal pressure and renal function. Ann Surg 196:594–597PubMedGoogle Scholar
  6. 6.
    Marin C, Eon B, Saux P, Aknin P, Gouin F (1990) Renal effects of norepinephrine used to treat septic shock patients. Crit Care Med 18:282–285PubMedGoogle Scholar
  7. 7.
    Khaodhiar L, McCowen K, Bistrian B (1999) Perioperative hyperglycemia, infection or risk? Curr Opin Clin Nutr Metab Care 2:79–82PubMedGoogle Scholar
  8. 8.
    Elsasser TH, Kahl S, Steele NC, et al. (1997) Nutritional modulation of somatotrophic axiscytokine relationships in cattle: a brief review. Comp Biochem Physiol 116:209–221Google Scholar
  9. 9.
    Grimble RF (1994) Malnutrition and the immune response. 2. Impact of nutrients on cytokine biology in infection. Trans R Soc Trop Med Hyg 88:615–619PubMedGoogle Scholar
  10. 10.
    Clouva-Molyvdas P, Peck MD, et al. (1990) Short-term dietary protein manipulation does not affect survival from intraperitoneal pseudomonas infection in mice. J Parentr Entr Nutr 14:366–370Google Scholar
  11. 11.
    Bhuyan UN, Ramalingaswami V (1972) Responses of the protein deficient rabbit to Staphylococcal bacteremia. Am J Pathol 69:359–366PubMedGoogle Scholar
  12. 12.
    Jakab GJ, Warr GA, Astry CL (1981) Alterations of pulmonary defense mechanisms by protein depletion diet. Infect Immun 34:610–622PubMedGoogle Scholar
  13. 13.
    Peck MD, Alexander JW, Gonce SJ, et al. (1989) Low protein diets improve survival from peritonitis in guinea pigs. Ann Surg 209:448PubMedGoogle Scholar
  14. 14.
    Peck MD, Babcock GF, Alexander JW (1992) The role of protein and calorie restriction in outcome from Salmonella infection in mice. J Parentr Entr Nutr 16:561–565Google Scholar
  15. 15.
    Alexander JW, Gonce SJ, Miskell PW, et al. (1989) A new model for studying nutrition in peritonitis: the adverse effect of overfeeding. Ann Surg 209:334–340PubMedGoogle Scholar
  16. 16.
    Matsui J, Cameron RG, Kurian R, et al. (1993) Nutritional, hepatic and metabolic effects of cachectin/tumor necrosis factor in rats receiving total parenteral nutrition. Gastroenterology 104:235–243PubMedGoogle Scholar
  17. 17.
    Keith ME, Norwich KH, Jeejeebhoy KN (1995) Nutrition support affects the distribution and organ uptake of cachectin/tumor necrosis factor in rats. J Parentr Etr Nutr 19:341–350Google Scholar
  18. 18.
    Zaloga GP (1999) Full Nutritional Support in the Critically 111. In: Technique and Technology. Society of Critical Care Medicine Symposium Syllabus, Anaheim, CAGoogle Scholar

References

  1. 1.
    Seely AJ, Christou NV (2000) Multiple organ dysfunction syndrome: exploring the paradigm of complex nonlinear systems. Crit Care Med 28:2193–2200PubMedGoogle Scholar
  2. 2.
    Takala J, Ruokonen E, Webster NR, et al. (1999) Increased mortality associated with growth hormone treatment in critically ill adults. N Engl J Med 341:785–792PubMedGoogle Scholar
  3. 3.
    Franklin C (2000) 100 thoughts for the critical care practitioner in the new millennium. Crit Care Med 28:3050–3052PubMedGoogle Scholar

Copyright information

© Springer-Verlag Berlin Heidelberg 2001

Authors and Affiliations

  • Philip S. Barie
  • David T. Harrington
  • William G. Cioffi
  • Bashar Fahoum
  • Charles A. AdamsJr.
  • Edwin A. Deitch
  • Avery B. Nathens
  • Larry M. Gentilello

There are no affiliations available

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