Wollschlager C M, Conrad A R, Khan F A
Department of Medicine, Nassau County Medical Center, East Meadow, New York.
Dis Mon. 1988 May;34(5):221-93. doi: 10.1016/0011-5029(88)90009-0.
Patients in intensive care units (ICUs) are subject to many complications connected with the advanced therapy required for their serious illnesses. Complications of ventilatory support include problems associated with short-term and long-term intubation, barotrauma, gastrointestinal tract bleeding, and weaning errors. Cardiac tachyarrhythmias can arise from a patient's intrinsic cardiac disease, as well as from drug therapy itself. Hemodynamic monitoring is crucial to careful patient management, but it is associated with technical complications during insertion such as pneumothorax, as well as interpretive errors such as those caused by positive end-inspiratory pressure. Acute renal failure can develop as a result both of therapy with drugs such as aminoglycosides and hypotension of many etiologies, as well as the use of contrast media. Nosocomial infection, which is a dreaded complication in ICU patients, usually arises from sources in the urinary tract, bloodstream, or lung. Complications frequently can arise if the interactions of drugs commonly used in the ICU are not recognized. Further, the ICU patient is subject to nutritional complications, acid base problems, and psychological disturbances. This monograph deals with the frequency, etiology, and prevention of these common ICU complications.
重症监护病房（ICU）的患者会出现许多与重病所需的高级治疗相关的并发症。通气支持的并发症包括与短期和长期插管、气压伤、胃肠道出血及撤机失误相关的问题。心脏快速性心律失常可源于患者自身的心脏疾病，也可由药物治疗本身引起。血流动力学监测对于精心的患者管理至关重要，但在插入过程中会伴有技术并发症，如气胸，以及解释错误，如由吸气末正压引起的错误。急性肾衰竭可因使用氨基糖苷类等药物治疗以及多种病因导致的低血压，还有使用造影剂而发生。医院感染是ICU患者可怕的并发症，通常源于泌尿道、血流或肺部。如果不了解ICU常用药物之间的相互作用，并发症常常会出现。此外，ICU患者还会出现营养并发症、酸碱问题及心理障碍。本专著论述了这些常见ICU并发症的发生率、病因及预防。
