ICU英文版

Intensivecareunit(ICU),alsoknownasanintensivetherapyunitorintensivetreatmentunit(ITU)orcriticalcareunit(CCU),isaspecialdepartmentofahospitalorhealthcarefacilitythatprovidesintensivecaremedicine.Anintensivecareunit(ICU)isaspeciallystaffedandequippedhospitalwarddedicatedtothemanagementofpatientswithlife-threateningillnesses,injuriesorcomplications.年，FlorenceNightingale在克里米亚战争期间，就把可望救活的重伤员安置在最靠近护士站的地方，以加强巡视和及时救治，并主张把术后的患者安置在近手术室的小房间内，度过恢复期后再送回病房。1863年护理学先驱南丁格尔撰文：“在小的乡村医院里，把病人安置在一间由手术室通出的小房间内，直至病人恢复或至少从手术的即时影响中解脱的情况已不鲜见”。这种专门为术后病人开辟的“小房间”即被认定为ICU的雏形。1923年，Dandy在美国为脑外科病人开辟术后恢复室。1930年Kirschner在德国创建手术恢复室与ICU混合型病房。第二次世界大战期间，在欧洲以及军队中逐步建立起创伤单位。1943年建立休克病房。1942年开辟烧伤病房(BurnsUnit)。1945年建立产后恢复室。1952年丹麦哥本哈根发生脊髓灰质炎大流行，并发呼吸衰竭的患者大量死亡，人工气道持续的手法通气及后期Engstrom呼吸器的应用，使病死率由87%下降至40%以下，随后多家医院相继开设了ICU，并激发了危重病医学的崛起，这是医学发展史上的一个里程碑。在克里米亚战争期间，就把可望救活的重伤员安置在最靠近护士站的地方，以加强巡视和及时救治，并主张把术后的患者安置在近手术室的小房间内，度过恢复期后再送回病房。Althoughthiswasnotthecase,herexperiencesduringthewarformedthefoundationforherlaterdiscoveryoftheimportanceofsanitaryconditionsinhospitals,acriticalcomponentofintensivecare.In1950,anesthesiologistPeterSafarestablishedtheconceptofAdvancedSupportofLife,keepingpatientssedatedandventilatedinanintensivecareenvironment.Safarisconsideredtobethefirstpractitionerofintensivecaremedicineasaspeciality.Inresponsetoapolioepidemic(wheremanypatientsrequiredconstantventilationandsurveillance),BjørnAageIbsenestablishedthefirstintensivecareunitinCopenhagenin1953.[3][4][5]ThefirstapplicationofthisideaintheUnitedStateswasin1955byDr.WilliamMosenthal,asurgeonattheDartmouth-HitchcockMedicalCenter.[6]Inthe1960s,theimportanceofcardiacarrhythmiasasasourceofmorbidityandmortalityinmyocardialinfarctions(heartattacks)wasrecognized.ThisledtotheroutineuseofcardiacmonitoringinICUs,especiallyafterheartattacks.[7]Neonatalintensivecareunit(NICU)Pediatricintensivecareunit(PICU)Psychiatricintensivecareunit(PICU)Coronarycareunit(CCU)Medicalintensivecareunit(MICU)Neurologicalintensivecareunit(NeuroICU)Traumaintensivecareunit(TraumaICU)Post-anesthesiacareunit(PACU)Highdependencyunit(HDU)SurgicalIntensiveCareUnit(SICU)综合性ICU(generalICU)、专科ICUSICU外科ICU(surgeryICU)CICU，冠心病ICU(coronaryintensivecareunit,CCU)RICU，呼吸系统疾病ICU(respiratoryintensivecareunit,RCU)EICU，急诊ICU(emergencycareunit)NICU，新生儿ICU(neonatalICU)心肺重症监护治疗病房(CPICU)心脏外科重症监护治疗病房(CSICU)神经外科重症监护治疗病房(NSICU)危重肾病重症监护治疗病房(UICU)Intensivecareisusuallyonlyofferedtothosewhoseconditionispotentiallyreversibleandwhohaveagoodchanceofsurvivingwithintensivecaresupport.Patientsrequiringintensivecareusuallyrequiresupportforhemodynamicinstability(hypertension/hypotension)airwayorrespiratorycompromise(suchasventilatorsupport)acuterenalfailurepotentiallylethalcardiacdysrhythmias,frequentlythecumulativeeffectsofmultipleorgansystemfailureTerminalillnessorirreversibleTerminalcancerPermanentbraindamageCommonequipmentinanICUincludesmechanicalventilatorstoassistbreathingthroughanendotrachealtubeoratracheostomytube;cardiacmonitorsincludingthosewithtelemetry;externalpacemakers;defibrillators;dialysisequipmentforrenalproblems;equipmentfortheconstantmonitoringofbodilyfunctions;awebofintravenouslines,feedingtubes,nasogastrictubes,suctionpumps,drains,andcatheters;andawidearrayofdrugstotreattheprimarycondition(s)ofhospitalization.Medicallyinducedcomas,analgesics,andinducedsedationarecommonICUtoolsneededandusedtoreducepainandpreventsecondaryinfections.ECGheartrate,rhythm,ischemiaBloodpressurenon-invasiveinvasivearterial,centralvenous,pulmonaryarteryHemodynamicmeasurementcardiacoutputPulseoxymetryandcapnographyIntracranial,intraabdominalpressureManyotherselectrolyte,CNSHemodynamicsupport-inotropeandvasoactivemedicationMechanicalventilationOrgansupport(eg.dialysis)SedationandanalgesiaTreatmentofunderlyingillnessesEnteral/parenteralnutritionTheavailabledatasuggestsarelationbetweenICUvolumeandqualityofcareformechanicallyventilatedpatients.[10]Afteradjustmentforseverityofillnesses,demographicvariables,andcharacteristicsofdifferentICUs(includingstaffingbyintensivists),higherICUstaffingwassignif