Management Of Critical Disease Research Articles

A journey between high altitude hypoxia and critical patient hypoxia: What can it teach us about compression and the management of critical disease?

High altitude sickness (hypobaric hypoxia) is a form of cellular hypoxia similar to that suffered by critically ill patients.The study of mountaineers exposed to extreme hypoxia offers the advantage of involving a relatively homogeneous and healthy population compared to those typically found in Intensive Care Units (ICUs), which are heterogeneous and generally less healthy.Knowledge of altitude physiology and pathology allows us to understanding how hypoxia affects critical patients.Comparable changes in mitochondrial biogenesis between both groups may reflect similar adaptive responses and suggest therapeutic interventions based on the protection or stimulation of such mitochondrial biogenesis.Predominance of the homozygous insertion (II) allele of the angiotensin-converting enzyme gene is present in both individuals who perform successful ascensions without oxygen above 8000m and in critical patients who overcome certain disease conditions.

Community-Based Screening and the Detection of Critical Carotid Artery Stenosis and Abdominal Aortic Aneurysm

Background: Community-based cardiovascular screening has the opportunity to detect critical cardiovascular disease and positively affect public health outcomes. Disease deemed to be critical or severe at detection requires appropriate medical follow-up. This article examined the self-reported outcomes of individuals who had undergone community-based cardiovascular screening and had critical findings for abdominal aortic aneurysm (AAA) or carotid artery stenosis (CAS). Methods: Over 390,000 screening records for AAA and over 490,000 screening records for CAS were reviewed to identify individuals with critical screening findings. A critical AAA is defined as an aneurysm ≥ 5cm and critical CAS is defined as a hemodynamically significant stenosis with recorded peak systolic velocities of ≥300 cm/s, in this population. Identified individuals were then contacted via phone and surveyed about the medical care they received after their screening. Results: Review of the screening records found a prevalence of critical AAA findings of 0.037% (146 participants) and critical CAS findings of 0.12% (579 participants). 61% of participants with critical findings were reached for follow-up from both groups. Over 96% of participants with critical AAA and over 92% of participants with critical CAS had some forms of medical follow-up. Conclusions: Community-based cardiovascular screening has the ability to detect critical levels of disease. Findings of critical disease in the reviewed population are similar to the findings from previously published studies. Importantly, medical treatment received by those who seek follow-up appears to be consistent with recommended treatment guidelines. Identification and management of critical disease represent meaningful public and individual health benefits and the possibility of cost-savings.

The use of echocardiography in the diagnosis and management of critical disease: A window to the heart provides a window of opportunity

The use of echocardiography in the diagnosis and management of critical disease: A window to the heart provides a window of opportunity