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Relatives of patients in the intensive care unit (ICU) are often dissatisfied with family-physician communication. Our prospective preintervention and postintervention study tested the hypothesis that introducing this informed consent process would improve family satisfaction with the ICU process of care. We developed a consent form that included an introductory explanation of the main ICU interventions and a description of 8 common procedures in a surgical ICU. We administered it early in the ICU course during a scheduled family meeting. The study was a prospective preintervention and postintervention design. The “Family Satisfaction in the Intensive Care Unit” (FS-ICU) score was higher in the intervention than in the control group (95.4 ± 4 vs 78.2 ± 22, P < .001). The nursing perception of satisfaction with care was also higher in the intervention group (95.8 ± 13 vs 71.9 ± 28, P < .001). A bundled informed consent resulted in higher family satisfaction with the process of care in ICU.

A 35-year-old woman was transferred to this hospital because of abdominal pain, fever, and hypotension 3 days after an elective cesarean section. On examination, she appeared acutely ill. The temperature was 39.2°C, the blood pressure 70/52 mm Hg, and the pulse 149 beats per minute. The abdomen was distended and very tender, with rebound. There was erythema and edema in the region of the surgical incision, extending to the left flank, with no drainage. A diagnostic procedure was performed. A 35-year-old woman had abdominal pain, fever, and hypotension 3 days after an elective cesarean section. The abdomen was distended and very tender. There was erythema and edema in the region of the surgical incision. Presentation of Case Dr. Claudius H.O. Conrad (Surgery): A 35-year-old woman was transferred to this hospital because of abdominal pain, fever, and hypotension. Three days earlier, an elective cesarean section was performed at another hospital through a transverse incision of the lower uterine segment, and a healthy, full-term infant was delivered. Cefazolin was administered intravenously after clamping of the umbilical cord. That evening, an episode of rigors occurred, reportedly without fever. The next day the patient passed flatus and stool; abdominal distention developed, and a nasogastric tube was inserted. On the second postpartum day, diffuse abdominal pain developed, most severe . . .

Chapter 8 discusses postoperative paraplegia or paraparesis due to spinal cord injury (SCI), which is a devastating complication that continues to pose a major risk to patients undergoing surgery of the thoracic and thoracoabdominal aorta. It covers significant work that has contributed to improved descriptions of the epidemiology and risks factors for this complication, a better understanding of the mechanism of injury, and better identification of measures to prevent or reduce the risk.