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Biomedical subjects

Alan S Multz

Publications and source records attributed to Alan S Multz.

7 recordsLinked to original sources
PubMed2005

Critical care organization.

The organizational structure of critical care services likely affects the quality of patient care, and ultimately, patient outcomes. Based on the available data, the ideal intensive care unit would be a closed-unit staffed by dedicated intensivists. Whether or not around-the-clock intensivist staffing is necessary, however, is debatable. Because financial realities preclude all units from being ideal, alternative strategies for organization must be explored.

Critical Care↗
PubMed2005

Ventilator strategy for status asthmaticus in pregnancy: a case-based review.

Asthma is a common and potentially serious condition complicating pregnancy. However, the literature available on the management of severe asthma in pregnancy is limited. We describe two episodes of respiratory failure due to asthma in pregnant women and discuss their management in the context of a review of the literature. In both patients, adequate oxygenation was maintained by using controlled hypoventilation with a permissive hypercapnia strategy. Both patients received aggressive steroid therapy, aerosolized bronchodilators, sedation, and paralysis. Aggressive asthma treatment as in a nongravid female is recommended.

Adult↗
PubMed2003

Prolonged dexmedetomidine infusion as an adjunct in treating sedation-induced withdrawal.

IMPLICATIONS: Dexmedetomidine, an alpha(2)-adrenoceptor agonist, is indicated for sedating patients on mechanical ventilation. It has been approved by the Food and Drug Administration for 24-h use. This is a report concerning a patient in whom a continuous infusion of dexmedetomidine was safely used for a week to help in averting frank withdrawal symptoms from an opioid and benzodiazepines.

Acinetobacter Infections↗
PubMed2003

Systemic response to pneumonia in the critically ill patient.

Pneumonia is a very common admission diagnosis of critically ill patients. Patients with severe episodes of pneumonia are at risk for development of the systemic inflammatory response syndrome, which is known to induce the production of proinflammatory cytokines, such as interleukins (ILs) and tumor necrosis factor alpha (TNF-alpha). This response subsequently triggers activation of anti-inflammatory cytokine production and specific soluble cytokine receptors. Lung cell apoptosis can be stimulated or inhibited by different cytokines and/or cell signals. Some of these mediators can be proapoptotic or antiapoptotic. This article discusses the clinical implications of the systemic response to pneumonia in the critically ill patient.

Bronchoalveolar Lavage Fluid↗
PubMed2002

Lung hernia as a sequela to limited-access mitral valve surgery.

We report a case of a 36-year-old man who developed a lung hernia after a minimally invasive mitral valve repair. Lung hernias are uncommon. Most are acquired and may be classified as traumatic, spontaneous, pathologic, or postoperative. In theory, minimal-access surgical techniques should decrease the likelihood of herniation, in comparison with open thoracotomy. Our review of the literature revealed only 2 reports of this sequela in association with this surgical procedure. Repair was performed due to persistent symptoms, including pleurisy and dyspnea, and interference with the patient's daily activities. Surgical repair led to complete resolution of these problems.

Adult↗