"We Can't Kill Your Mother" and Other Stories of Intensive Care
by Lawrence Martin, M.D.
Table of Contents

• AIDS - acquired immunodeficiency syndrome; in AIDS the body's infection-fighting immune system is severely depressed and altered. AIDS is caused by the human immunodeficiency virus (HIV).

• angiogram - a test whereby dye is injected into a blood vessel to outline the vessel and any abnormality within it. See pulmonary angiogram.

• apnea - absence of breathing; an apneic episode or spell is a short interval of not breathing.

• arterial - pertaining to the arteries, e.g. arterial blood.

• arterial blood gas - refers to the pressure of oxygen and/or carbon dioxide in arterial blood; abbreviated ABG. An 'ABG' test routinely measures pressures of both gases, along with the level of blood acidity.

• arterial line - a thin tube inserted into a patient's artery, usually the radial artery, for purposes of monitoring blood pressure or drawing frequent arterial blood gases. This technique is only used in intensive care units or in the operating room.

• artery - blood vessel that carries oxygen-rich blood from the heart to the body's organs and tissues.

• artificial ventilation - method of supplementing or taking over a patient's breathing with a machine (ventilator). The patient is connected to the ventilator via an endotracheal tube inserted through the mouth or nose.

• artificial ventilator - see ventilator.

• autoimmune diseases - a large and heterogeneous group of diseases characterized by altered immunity; usually, antibodies form in the blood directed against some part of healthy tissue

• biopsy - removal of a piece of tissue from some part of the body for diagnosis.

• blood gases - general term for carbon dioxide and oxygen in the blood; see arterial blood gas.

• bronchitis - inflammation or infection of the airways (bronchi).

• bronchodilator - a drug that relaxes airway smooth muscle and helps open up narrowed airways; useful in treating asthma.

• bronchoscope - thin, flexible tube used to perform bronchoscopy; useful to diagnose many pulmonary conditions.

• bronchoscopy - procedure whereby a thin, flexible tube (the bron- choscope) is inserted, via the mouth or nose, into the lungs; used to visualize the airways and diagnose many lung diseases. A biopsy can be done through the bronchoscope.

• capillary - the smallest blood vessel. Capillaries go to all organs to bring vital oxygen and take up carbon dioxide; in the lungs the process is reversed: fresh oxygen is taken up and carbon dioxide excreted.

• carbon dioxide - colorless, odorless gas, a byproduct of normal metabolism; abbreviated CO₂. Carbon dioxide is excreted by the lungs through the natural process of ventilation.

• catheter - a thin, plastic tube that can be inserted into part of the body, such as a blood vessel or the bladder.

• catheterization - general term for inserting a tube into a blood vessel. In cardiac catheterization a thin tube (catheter) is inserted through a vein or artery and into the chambers of the heart.

• coronary - pertaining to blood vessels that serve the heart muscle; so-called because the coronary vessels encircle the heart like a corona.

• coronary care unit - area of hospital for patients with acute heart disease, including suspected or diagnosed heart attack.

• CT scan - Computerized tomography scan (also sometimes called CAT scan for computerized axial tomography); a sophisticated x-ray technique which can "slice" any section of the body to reveal details of anatomy not seen with conventional x-rays.

• coumadin - a medication that makes the blood less likely to clot; used to treat many medical conditions, including pulmonary embolism; can only be taken by mouth.

• dialysis - process of cleansing the blood of toxins; in hemodialysis, used to treat kidney failure, blood is removed through a vein, passed through a special filter that removes the toxins, then returned to the patient.

• diuretic - a drug that promotes urine flow; a diuretic can be taken by mouth as a pill or administered by the intravenous route.

• dopamine - an intravenous drug used to raise a patient's low blood pressure. See pressors.

• dyspnea - shortness of breath.

• emboli, embolism - when a blood clot moves from one part of the part of the body to another; in pulmonary embolism the clot moves from some region of the body to the lungs.

• emphysema - a chronic pulmonary disease, usually due to smoking, that leads to shortness of breath and blockage of airflow.

• encephalitis - inflammation of the brain; see encephalopathy.

• encephalopathy - a general term for confusion due to global brain disease. There are many possible causes including inflammation (encephalitis) and lack of oxygen.

• endoscopy - general term for insertion of a flexible, diagnostic tube (endoscope) into a hollow organ; gastrointestinal endoscopy involves inserting an endoscope into the stomach or intestines.

• endotracheal tube - a hollow plastic tube, approximately a foot long and a centimeter in diameter, inserted through the mouth or nose and into the trachea. It is used to facilitate artificial ventilation.

• esophagus - hollow tube that connects the mount with the stomach.

• exsanguinate - to bleed out, hemorrhage.

• gastroenterology - specialty of medicine involved with diagnosing and treating gastrointestinal (stomach and intestinal) disorders; a specialist in this field is a gastroenterologist.

• hematocrit - percentage of blood volume comprised of red blood cells (oxygen-carrying cells); normal range for hematocrit is 38-45% in women, 42-50% in men.

• hemodialysis - see dialysis.

• hemoptysis - coughing up blood.

• heparin - a medication that makes the blood less likely to clot; used to treat many medical conditions, including pulmonary embolism; is given intravenously or subcutaneously.

• HIV - human immunodeficiency virus, the virus responsible for causing AIDS.

• housestaff - the interns and residents in a teaching hospital; also spelled house staff.

• hyperthyroid - elevated level of thyroid hormone, the hormone that regulates metabolism.

• hyperventilation - over-ventilation or over-breathing. Hyperventilation is accompanied by a reduced carbon dioxide level in the blood.

• hypothyroid - low level of thyroid hormone.

• hypoventilation - under-ventilation or under-breathing. Hypo- ventilation is always accompanied by an elevated carbon dioxide level in the blood.

• hypoxemia - low oxygen level in the blood. Hypoxemia can manifest as either a low oxygen pressure (PO₂) or a low oxygen saturation; see PO₂.

• immunosuppressed - when the body's immune system for fighting infection is suppressed or altered; this is the principal problem in AIDS patients. Immunosuppression is also found in many other situations, e.g. during treatment with cancer drugs.

• insulin - a hormone made by the pancreas, necessary to allow glucose to enter the cells; a lack of insulin leads to diabetes.

• insult - in medical terminology, refers to damage or injury to a part of the body, e.g., an insult to the liver

• intravenous - refers to route for medication or fluids given directly into a vein.

• intubation - the placement of an endotracheal tube into the patient's airway, usually for purposes of providing artificial ventilation; see artificial ventilation.

• meningitis - inflammation of the meninges, the thin membrane that covers the brain and spinal cord.

• MICU - medical intensive care unit; area of the hospital for acutely ill patients, excluding those with surgical problems or primary cardiac disease.

• Munchausen - name given to a patient who fakes illness in order to gain medical attention or admission to the hospital; after Baron von Munchausen, an 18th century teller of tall tales.

• mycoplasma - a bacteria-like organism that can cause pneumonia.

• O₂ - Chemical symbol for oxygen.

• opportunistic infection - an infection by an uncommon organism (may be a bacteria, virus or fungus), one that takes advantage of a patient's suppressed or altered immunity (hence opportunistic), such as is found in AIDS patients.

• overdose - general term for taking an excess of medication; an overdose can be intentional (e.g., suicidal), or accidental (e.g., swallowing too many pills for headache relief).

• oxygen - essential element of life; a colorless, odorless gas that comprises 21% of earth's atmosphere. Abbreviated O₂.

• Pickwickian syndrome - term used to characterize a patient who is obese, falls asleep easily during the day and has an elevated level of blood carbon dioxide.

• plasmapheresis - technique of separating out certain proteins from the plasma. Plasmapheresis is used to treat Guillain Barré syndrome and other illnesses.

• pneumonia - infection of the lung tissues; can arise from many different types of micro-organisms, e.g. bacteria and viruses.

• PO₂ - Partial pressure of oxygen (O₂) in the blood. Any value for PO₂ above 60 is usually considered a safe level; lower than 60 indicates hypoxemia and potential danger for the patient.

• pressors - intravenous drugs used to support or raise a low blood pressure. One commonly used pressor is dopamine.

• psychosis - severe mental disturbance characterized by personality disintegration or some loss of contact with reality; schizophrenia is one form of psychosis.

• pulmonary - referring to the lungs.

• pulmonary angiogram - dye is injected into the main pulmonary through a catheter, to outline the arteries within the lungs; this test is occasionally used to help diagnose pulmonary emboli.

• pulmonary embolism - see emboli

• respiration - general term for the process of bringing in oxygen from the atmosphere to the blood and excreting carbon dioxide from the blood to the atmosphere. Respiration is made possible by the process of breathing.

• respirator - see ventilator.

• respiratory failure - condition where the lungs have failed in their primary function of bringing adequate oxygen to the blood and of excreting carbon dioxide; in respiratory failure the level of blood oxygen is either reduced or the level of carbon dioxide is increased, or both.

• scan - a general term for a variety of tests that "scan" or survey a part of the body, usually done in the radiology department. A lung scan is done to look for pulmonary emboli.

• sepsis - infection involving the blood stream.

• subcutaneous - under the skin; a subcutaneous injection is one given just under the skin, into the subcutaneous tissue.

• surgical intensive care unit - area of hospital for patients who need intensive care after an operation (e.g., after heart surgery), or patients who have suffered major trauma (e.g., gunshot wound). (Compare with MICU, coronary care unit.)

• tachycardia - fast heart rate, usually over 100 beats per minute.

• TB - see tuberculosis.

• teratogenic - able to cause birth defects.

• trachea - medical name for `windpipe,' the airway that connects the back of the throat to the lungs. The trachea is the largest airway and divides into two bronchi.

• tracheostomy - a surgical procedure that places a hole in the trachea, through which is inserted a short (usually plastic) tube. Tracheostomy is almost always done on patients who need long term artificial ventilation.

• tuberculosis - disease caused by a bacteria called mycobacteria tuberculosis; abbreviated TB. TB usually involves the lungs but may also appear in any part of the body.

• vasoconstrictor - any substance that constricts or narrows blood vessels.

• vein - blood vessel that carries venous blood from the tissues back to the heart; venous blood is low in oxygen. See arterial.

• venous - pertaining to the veins, e.g. venous blood.

• ventilation - a general term for the physiologic process of delivering fresh air to the lungs for gas exchange. The term is sometimes used interchangeably with respiration.

• ventilator - a machine capable of taking over a patient's breath- ing, also called a respirator. See artificial ventilation.

  
  
  

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  Dr. Martin was Chief of the Division of Pulmonary and Critical Care Medicine, Mt. Sinai Medical Center, in Cleveland from 1976-2000, when the hospital closed its doors. He is now practicing pulmonary medicine with University Mednet, and is an Associate Professor of Medicine, CWRU School of Medicine. Send e-mail to

  martin@lightstream.net
  
  Table of Contents