RPHICUTeaching2016.1-Special Groups

Critical illness is an uncommon but potentially devastating complication of pregnancy. The majority of pregnancy-related critical care admissions occur postpartum. Antenatally, the pregnant patient is more likely to be admitted with diseases non-specific to pregnancy, such as pneumonia. Pregnancy-specific diseases resulting in ICU admission include obstetric hemorrhage, pre-eclampsia/eclampsia, HELLP (hemolysis, elevated liver enzymes, and low platelet count) syndrome, amniotic fluid embolus syndrome, acute fatty liver of pregnancy, and peripartum cardiomyopathy...

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Nearly 20% of all patients admitted to an intensive-care unit are obese. Their excess weight puts them at risk for several problems and complications during their intensive-care unit stay. Especially, pulmonary problems need particular attention, and comprehensive knowledge of the specific pathophysiologic changes of the respiratory system is important. Lung protective ventilation strategies, supplemented by lung-recruiting manoeuvres, may be feasible in critically ill obese patients with lung injury. Careful positioning of the obese is essential to optimise ventilation and facilitate weaning from mechanical ventilation...

PURPOSE OF REVIEW: To review literature germane to the care of critically ill obese patients with emphasis upon the pathophysiology of obesity and its impact on clinical management. RECENT FINDINGS: Obesity continues to be a health epidemic of the industrialized world, and is associated with substantial morbidity and mortality. Chronic obesity results in derangements in cardiovascular, respiratory and metabolic function. Drug administration may be effected depending on the lipophilicity of the molecule administered...

OBJECTIVE: To review the effect of an aging society on the utilization of critical care services and the physiology of aging as it applies to critical illness and prognosis and management issues in the intensive care unit (ICU). DATA SOURCE: MEDLINE, Embase, and citation review of relevant primary and review articles. DATA SYNTHESIS: Elderly patients (age of >65 yrs) currently account for 42-52% of ICU admissions and for almost 60% of all ICU days...

No abstract text is available yet for this article.