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Critical Care Medicine

Harry B. Greenberg, MD
JAMA. 1975;232(13):1379-1380. doi:10.1001/jama.1975.03250130061031.
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Reading about critical care medicine is easy and often entertaining. The recovery rooms and the newly expanded intensive care, coronary care, and respiratory care units of our hospitals provide elaborate life support systems. Patients get new drugs, treatment moves quickly, minutes count.

The man surviving a ruptured berry aneurysm needs surgery as soon as his condition permits. Unwarranted delay risks further hemorrhage, more brain damage, and death. On the other hand, surgery is best avoided when the patient has intracranial hemorrhage. Giving him cerebral dehydrating agents at the right time can help him escape uncal herniation and brain stem compression. Aggressively managing a patient with "stroke in evolution" may involve immediate anticoagulation with heparin as well as giving him vasopressor drugs, and urea, mannitol, glycerol, or dexamethasone, or all of these.

When trauma sends large quantities of liquid fat into a patient's bloodstream, he may suffer focal neurologic defects, confusion,


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