Massachusetts General Hospital Manual of Cardiovascular Critical Care

 

With its focus on the advanced topics and procedures employed in this specialized field, Massachusetts General Hospital Manual of Cardiovascular Critical Care provides practical, must-know information to all practitioners caring for the increasing population of critical care patients with severely compromised cardiovascular function. Drs. Aranya Bagchi, David M. Dudzinski, Jonathan Ludmir, Ivana Nikolic, and Kenneth T. Shelton lead a multidisciplinary team of authors who expertly cover cardiology, cardiac surgery, anesthesia, and mechanical circulatory support topics for all ICU clinicians who focus on cardiovascular care.

 

Table of Contents:

 

SECTION 1: PHYSIOLOGY AND MONITORING

Chapter 1 Left Ventricular Physiology

MECHANISMS OF CARDIAC CONTRACTION

PROPERTIES OF MYOCARDIAL CONTRACTION

THE CARDIAC CYCLE

PRESSURE-VOLUME RELATIONSHIPS AND VENTRICULOARTERIAL COUPLING

DETERMINANTS OF LEFT VENTRICULAR FUNCTION

FRANK-STARLING LAW OF THE HEART

DIASTOLE AND LEFT VENTRICULAR DIASTOLIC FUNCTION

IMAGING ASSESSMENT OF LEFT VENTRICULAR FUNCTION

Echocardiography

Cardiac Magnetic Resonance

Additional Imaging Modalities

Chapter 2 Right Ventricular Physiology and the Management of Right Ventricular Failure

The Right Ventricle in Critical Illness

DEFINITION

Right Ventricular Dysfunction and Right Ventricular Failure

PHYSIOLOGY

Right Ventricular Failure

The Right and Left Ventricles, Compared

ASSESSMENT

Assessing a Patient With Impaired Right Ventricular Function

Point-of-Care Ultrasonography in Acute Right Ventricular Failure

INVASIVE MONITORING OF RIGHT VENTRICULAR FUNCTION

Central Venous Pressure Monitoring

Pulmonary Artery Catheter Pressure Monitoring

MANAGEMENT

Acute Right Ventricular Failure

OUTCOMES

Right Ventricular Dysfunction in Special Situations

Chapter 3 Acute Respiratory Distress Syndrome and 
Mechanical Ventilation in Patients With 
Compromised Cardiac Function

DEFINITIONS AND INCIDENCE

THE RELEVANCE OF MECHANICAL VENTILATION IN A CARDIOVASCULAR ICU

PRINCIPLES OF LUNG-PROTECTIVE VENTILATION

DRIVING PRESSURE AND ITS IMPORTANCE IN MECHANICAL VENTILATION

VENTILATING PATIENTS WITH LUNG INJURY AND POOR CARDIAC FUNCTION

CONSIDERATIONS FOR MECHANICAL VENTILATION IN PATIENTS WITH RIGHT VENTRICULAR DYSFUNCTION

Impact of Lung Injury on the Right Ventricle

Impact of Positive Pressure Ventilation on the Right Ventricle

Intubation

Choice of Induction Agent

Goals of Positive Pressure Ventilation in Patients With Right Ventricular Dysfunction

CONSIDERATIONS FOR MECHANICAL VENTILATION IN PATIENTS WITH LEFT VENTRICULAR DYSFUNCTION

Impact of Lung Injury on the Left Ventricle

Impact of Positive Pressure Ventilation on the Left Ventricle

SPONTANEOUS BREATHING TRIALS AND WEANING OF VENTILATORY SUPPORT

Changes in Transpulmonary Pressure With Pressure Support or Pressure Control Modes

NONINVASIVE VENTILATION, HIGH-FLOW NASAL OXYGEN, AND NOVEL VENTILATORY MODES IN THE CARDIOVASCULAR CRITICAL CARE UNIT

Noninvasive Ventilation

High-Flow Nasal Oxygen

Novel Modes of Ventilation

Chapter 4 An Overview of Cardiogenic Shock

DEFINITIONS

Universal Definition of Shock

Cardiogenic Shock

PHYSIOLOGY

PATHOPHYSIOLOGY

ASSESSMENT AND CLASSIFICATION

MANAGEMENT AND OUTCOMES

UNIQUE SUBTYPES OF CARDIOGENIC SHOCK

Chapter 5 Pharmacology of Commonly Used Medications 
in Cardiovascular Critical Care

Absorption

Distribution

Metabolism and Excretion

MEDICATIONS IN CARDIAC CRITICAL ILLNESS

Anticoagulants

Antiplatelet Agents

Agents That Impact Heart Rate and Rhythm

Chronotropes

Aminophylline/Theophylline

Vasoactive Agents

Diuretics

CARBONIC ANHYDRASE INHIBITOR (ACETAZOLAMIDE)

NONCARDIAC MEDICATIONS IN CARDIAC CRITICAL ILLNESS

Pain

Sedation/Agitation

Delirium

Neuromuscular Blocking Agents (Paralytics)

INTENSIVE CARE UNIT PROPHYLAXIS

Pharmacologic Venous Thromboembolism Prophylaxis

Gastrointestinal/Stress Ulcer Prophylaxis

Gastrointestinal Motility Agents

Chapter 6 Pulmonary Artery Catheterization and Its Utility 
in Cardiovascular Critical Care

INDICATIONS AND CONTRAINDICATIONS

COMPLICATIONS

INSERTION OF THE PULMONARY ARTERY CATHETER

Preparation

Insertion

INTERPRETATION OF THE PAC WAVEFORMS

The Atrial Waveform

The Pulmonary Arterial Waveform

The Pulmonary Capillary Wedge Pressure

RESPIRATORY MECHANICS AND THE PULMONARY ARTERY CATHETERS

CARDIAC OUTPUT CALCULATIONS AND DERIVATIVES

Additional Hemodynamic Calculations

CLINICAL APPLICATIONS OF PULMONARY ARTERY CATHETERS IN THE INTENSIVE CARE UNIT SETTING

Etiology of Shock and Pulmonary Edema

Evaluation of Pericardial Pathology

Unstable Myocardial Infarction and Mechanical Complications

Other Uses of PAC

Chapter 7 Pulmonary Hypertension

PHYSIOLOGY

ASSESSMENT

CAUSES OF PRECAPILLARY PULMONARY HYPERTENSION

RISK STRATIFICATION

MANAGEMENT

MECHANICAL SUPPORT

SURGICAL MANAGEMENT

INTENSIVE CARE UNIT MANAGEMENT IN SPECIAL SITUATIONS

OUTCOMES

SECTION 2: CARDIOLOGY

Chapter 8 Coronary Angiography for Noncardiologists

INDICATIONS AND CONTRAINDICATIONS

ACCESS SITE

Radial Artery

Femoral Artery

Other Access Sites

EQUIPMENT

Sheaths

Guidewires

Diagnostic Catheters

Contrast Dye

Radiation

PHARMACOLOGY

Sedation

Anticoagulation

Vasodilators

BASIC CORONARY ANATOMY

ANGIOGRAPHIC VIEWS AND PROJECTIONS

Left Coronary Artery Projections

Right Coronary Artery Projections

Bypass Graft Projections

CORONARY LESIONS

Epicardial Coronary Flow

Microvascular Coronary Flow

Quantification of Stenosis

Physiologic Assessment of Lesion Severity

Angiographic Lesion Morphology

Other Coronary Abnormalities

INDICATIONS AND CONTRAINDICATIONS

EQUIPMENT

TECHNIQUE

PERIPROCEDURAL PHARMACOTHERAPY

Anticoagulants

Antiplatelet Agents

Vasodilators

PHARMACOLOGY

SHEATH MANAGEMENT

ACCESS SITE MONITORING

Complications

Chapter 9 Myocardial Infarction and Ischemia

CLASSIFICATION

CLINICAL PRESENTATION

ELECTROCARDIOGRAPHY

ST-Segment Elevation Myocardial Infarction

Non–ST-Segment Elevation Myocardial Infarction/Unstable Angina

Prior Left Bundle Branch Block or Paced Rhythm

BIOMARKERS/HIGH-SENSITIVITY CARDIAC TROPONIN

NONINVASIVE IMAGING

Echocardiography

Cardiac Magnetic Resonance

Nuclear imaging

Coronary Computed Tomography Angiography

DIFFERENTIAL DIAGNOSIS

RISK STRATIFICATION

MEDICAL THERAPY

Antiplatelet Therapy

Nitrates

Beta-Blockers

Renin-Angiotensin-Aldosterone System Inhibition

Aldosterone Antagonists

Statin Therapy

Oxygen

Anticoagulation

REPERFUSION

Non–ST-Segment Elevation Myocardial Infarction

ST-Segment Elevation Myocardial Infarction

Myocardial Injury and Type 2 Myocardial Infarction in the Intensive Care Unit

Chapter 10 Electrophysiologic Procedures 
in the Intensive Care Unit

PROCEDURAL MANAGEMENT AND PREVENTION OF UNSTABLE BRADYARRHYTHMIAS

Background and Indications

Transcutaneous Pacing

Temporary Transvenous Pacing

Other Transvenous Pacing Systems

Epicardial Pacing Wires

PROCEDURAL MANAGEMENT OF UNSTABLE TACHYARRHYTHMIAS

Cardioversion and Thromboembolism Risk

Synchronized Cardioversion

Defibrillation

Antitachycardia Pacing in Implantable Cardioverter-Defibrillator

Epicardial Wires

Stellate Ganglion Block

Vagal Maneuvers

COMMON ELECTROPHYSIOLOGIC PROCEDURES IN CARDIAC CRITICAL CARE PATIENTS

Magnets

Intracardiac Ablations

Surgical Cox-Maze Procedure (Maze Procedure)18

Placement of Permanent Devices in Intensive Care Unit Patients

Lead Extractions

Left Atrial Appendage Occlusion Devices

DEVICE MANAGEMENT AT PATIENT END OF LIFE

Chapter 11 Valve Disease: Aortic Stenosis and Aortic Insufficiency

INTRODUCTION

DEFINITIONS

Etiology

PHYSIOLOGY

ASSESSMENT

Physical Examination

Diagnostics

LOW-FLOW, LOW-GRADIENT AORTIC STENOSIS

MANAGEMENT

Other Considerations

INTRODUCTION

DEFINITIONS

Etiology

PHYSIOLOGY

ASSESSMENT

Physical Examination

Diagnostics

MANAGEMENT

Chapter 12 Myocarditis

DEFINITIONS

EPIDEMIOLOGY OF MYOCARDITIS

CLASSIFICATION AND ETIOLOGIES

ASSESSMENT

MANAGEMENT

Chapter 13 Stress Cardiomyopathy

EPIDEMIOLOGY

RISK FACTORS

PATHOPHYSIOLOGY

Catecholamine Cardiotoxicity

Coronary Artery Spasm and Microvascular Dysfunction

Estrogen

CLINICAL MANIFESTATION

History and Triggers

Symptoms

Physical Examination

Electrocardiogram

Serum Biomarkers

ASSESSMENT

Echocardiography

Cardiac Magnetic Resonance Imaging

Coronary Angiography

DIAGNOSIS

MANAGEMENT

Acute Heart Failure

Cardiogenic Shock

Arrhythmias

Ventricular Thrombus

OUTCOMES

Chapter 14 Evaluation and Management of the Patient With 
Heart Failure With Reduced Ejection Fraction in 
the Intensive Care Unit

DEFINITIONS AND ETIOLOGIES OF HEART FAILURE WITH REDUCED EJECTION FRACTION

Ischemic Cardiomyopathy

Dilated Cardiomyopathy

Cardiotoxins

Arrhythmia-Induced Cardiomyopathy

Myocarditis

Stress-Induced Cardiomyopathy

Other Causes

PHYSIOLOGY

ASSESSMENT OF THE PATIENT WITH ACUTE DECOMPENSATED HEART FAILURE

Diagnostic Evaluation

Blood Work

Transthoracic Echocardiography

Ischemic Evaluation

Cardiac Magnetic Resonance Imaging

Endomyocardial Biopsy

CLINICAL ASSESSMENT

MANAGEMENT

Floor Patients

Intensive Care Unit Patients

NORMAL CARDIOPULMONARY PHYSIOLOGY

PATHOPHYSIOLOGY OF CONSTRICTION

PATHOPHYSIOLOGY OF RESTRICTION

CLINICAL PRESENTATION OF CONSTRICTION AND RESTRICTION

DIFFERENTIATING CONSTRICTION FROM RESTRICTION ON ECHOCARDIOGRAPHY

DIFFERENTIATING CONSTRICTION FROM RESTRICTION BY CARDIAC CATHETERIZATION

ADDITIONAL IMAGING STUDIES FOR DIFFERENTIATING CONSTRICTION FROM RESTRICTION

POSITIVE PRESSURE VENTILATION

Chapter 16 Congenital Heart Disease in the Adult

DEFINITIONS

Anatomic and Physiologic Classification

INTENSIVE CARE UNIT ASSESSMENT IN A PATIENT WITH CONGENITAL HEART DISEASE

Surgically Created Shunts and Their Relationship to Blood Pressure

Cyanosis

Airway Considerations/Perioperative Management

Vascular Access Issues

Pulmonary Considerations

Hepatic Considerations

Renal Considerations

Hematologic Considerations

Psychological Considerations

Imaging Considerations

Lesion-Specific Assessment

RESOURCES

Chapter 17 Enhanced Recovery After Surgery

ENHANCED RECOVERY AFTER SURGERY IN CARDIAC SURGERY

COMPONENTS OF CARDIAC ENHANCED RECOVERY AFTER SURGERY PROTOCOL

CURRENT EVIDENCE AND LIMITATIONS OF ENHANCED RECOVERY AFTER SURGERY IN CARDIAC SURGERY

CONCLUSION

SECTION 3: CARDIAC SURGERY/ANESTHESIOLOGY

Chapter 18 Cardiopulmonary Bypass for the Intensivist

THE CARDIOPULMONARY BYPASS CIRCUIT

Arterial and Venous Cannulation

Pumps

Gas Exchange and Temperature Management

Cardioplegia

Vents

COMPLICATIONS OF CARDIOPULMONARY BYPASS

Neurologic

Pulmonary

Cardiac

Iatrogenic Aortic Dissection

Renal

Anticoagulation and Coagulopathy

Vasoplegia

Complex Separation From Cardiopulmonary Bypass

Chapter 19 Immediate Postoperative Management and 
Complications in the Cardiac Surgical Patient

ROUTINE POSTOPERATIVE MANAGEMENT

Intensive Care Unit Transport

Operating Room to Intensive Care Unit Transfer of Care

Monitors, Labs, and Imaging

Hemodynamic Management

Respiratory Management

EARLY COMPLICATIONS AFTER CARDIAC SURGERY

HEMODYNAMIC COMPLICATIONS

Bleeding

Tamponade in Cardiac Surgery Patients

Arrhythmias and Arrest After Cardiac Surgery

Cardiac Arrest

Open Cardiac Massage

Delayed Sternal Closure

Low Cardiac Output Syndrome

PULMONARY COMPLICATIONS

Atelectasis

Pleural Effusions

Phrenic Nerve Injury

Pneumonia

Acute Respiratory Distress Syndrome

NEUROLOGIC COMPLICATIONS

Stroke

Delirium

Seizures

Chapter 20 Postoperative Bleeding

PHYSIOLOGY

ASSESSMENT

Imaging

Laboratory Tests

MANAGEMENT

Pharmacologic and Transfusion

Surgical Management

OUTCOMES

Chapter 21 Postoperative Management of Pulmonary Thromboendarterectomy

DEFINITION, ETIOLOGY, AND EPIDEMIOLOGY

KEY PHYSIOLOGIC CONCEPTS

Pulmonary Vasculature

Ventilation/Perfusion Mismatch

Impact of Pulmonary Hypertension on the Cardiovascular System

ASSESSMENT OF CHRONIC THROMBOEMBOLIC PULMONARY HYPERTENSION

MEDICAL MANAGEMENT

PULMONARY THROMBOENDARTERECTOMY

Surgical Technique

Anesthetic Considerations

Weaning From Cardiopulmonary Bypass

POST-PULMONARY THROMBOENDARTERECTOMY CARE

POSTOPERATIVE COMPLICATIONS

Pulmonary Artery Steal Syndrome

Reperfusion Lung Injury

Pulmonary Hemorrhage

SPECIAL SITUATIONS

Mechanical Support

Persistence of Pulmonary Hypertension

Balloon Pulmonary Angioplasty

Concurrent Cardiac Procedures

Chapter 22 Neurologic Complications After Cardiac Surgery 
and Procedures

INTRODUCTION

EPIDEMIOLOGY OF PERIOPERATIVE STROKE

MECHANISM AND TIMING OF PERIOPERATIVE STROKE

RISK FACTORS FOR PERIOPERATIVE STROKE

PERIOPERATIVE STRATEGIES FOR STROKE PREVENTION

Perioperative Pharmacologic Interventions for Stroke Prevention

Concomitant Cerebrovascular Atherosclerotic Disease

INTRAOPERATIVE BLOOD PRESSURE MANAGEMENT

Atheroma Detection and Avoidance

ACUTE STROKE MANAGEMENT

Introduction

CEREBRAL ARTERY RECANALIZATION

Medical Management of Acute Ischemic Stroke

INTRACRANIAL HEMORRHAGE

SPECIAL INSTANCES OF CEREBROVASCULAR COMPLICATIONS

Spinal Cord Ischemia

Support Device–Related Cerebrovascular Complications

Recovery After Cerebrovascular Complications

INTRODUCTION

POSTOPERATIVE DELIRIUM

POSTOPERATIVE COGNITIVE DECLINE

DIRECT INJURY TO PERIPHERAL NERVES

CRITICAL ILLNESS PERIPHERAL NEUROPATHY AND MYOPATHY

Chapter 23 Intensive Care Unit Management of Patients 
After Heart and Lung Transplant

PREOPERATIVE CONSIDERATIONS

RELEVANT INTRAOPERATIVE CONSIDERATIONS

POSTOPERATIVE CARE

PRETRANSPLANT CONSIDERATIONS

RELEVANT INTRAOPERATIVE CONSIDERATIONS

POSTOPERATIVE CARE

Chapter 24 Postcardiotomy Shock

ASSESSMENT OF SHOCK

HYPOVOLEMIA: INADEQUATE PRELOAD

POSTCARDIOTOMY VASOPLEGIC SHOCK

Pathophysiology2

Diagnosis

Pharmacologic Treatment

Postcardiotomy Cardiogenic Shock

Diagnosis

Pharmacologic Treatment (Table 24.3)

Mechanical Circulatory Support

OBSTRUCTIVE SHOCK (TAMPONADE)

Risk Factors

Diagnosis

Intervention

Chapter 25 Critical Care of a Patient After Transcatheter 
Valve Interventions

AORTIC STENOSIS AND TRANSCATHETER AORTIC VALVE REPLACEMENT

TRANSCATHETER AORTIC VALVE REPLACEMENT–RELATED COMPLICATIONS

Rhythm Disturbances

Acute Hemodynamic Compromise

Vascular Complications and Bleeding

Acute Kidney Injury

Delirium and Acute Stroke

TRANSCATHETER MITRAL VALVE THERAPIES

TRANSCATHETER MITRAL VALVE THERAPY–RELATED COMPLICATIONS

TRANSCATHETER TRICUSPID VALVE THERAPY–RELATED COMPLICATIONS

LEFT ATRIAL APPENDAGE OCCLUSION PROCEDURE–RELATED COMPLICATIONS

SECTION 4: MECHANICAL CIRCULATORY SUPPORT

Chapter 26 Venovenous Extracorporeal Membrane Oxygenation

INDICATIONS

CANNULATION STRATEGIES

TWO-CANNULA STRATEGIES

SINGLE CANNULA STRATEGY

TRIPLE CANNULATION

CENTRAL CANNULATION

MANAGEMENT OF A PATIENT VENOVENOUS EXTRACORPOREAL MEMBRANE OXYGENATION

INITIATION

ANTICOAGULATION

VENTILATOR MANAGEMENT

INVASIVE HEMODYNAMIC MONITORING

GOAL FLOWS

RECIRCULATION

DAILY MANAGEMENT

WEANING FROM VENOVENOUS EXTRACORPOREAL MEMBRANE OXYGENATION

LIBERATION FROM VENOVENOUS EXTRACORPOREAL MEMBRANE OXYGENATION IN DIFFICULT TO WEAN PATIENT

VENOPULMONARY ARTERIAL EXTRACORPOREAL MEMBRANE OXYGENATION

EXTRACORPOREAL CARBON DIOXIDE REMOVAL

COMPLICATIONS

VENOVENOUS EXTRACORPOREAL MEMBRANE OXYGENATION TROUBLESHOOTING/EMERGENCIES

POOR FLOW

BLEEDING

PUMP FAILURE

ACCIDENTAL DECANNULATION

AIR ENTRAINMENT

CARDIAC ARREST

EVIDENCE FOR VENOVENOUS EXTRACORPOREAL MEMBRANE OXYGENATION

VENOVENOUS EXTRACORPOREAL MEMBRANE OXYGENATION IN PATIENTS WITH COVID-19 ASSOCIATED- ACUTE RESPIRATORY DISTRESS SYNDROME

Chapter 27 Venoarterial Extracorporeal Membrane Oxygenation

INDICATIONS

CANNULATION STRATEGIES

MANAGEMENT OF A PATIENT ON VENOARTERIAL EXTRACORPOREAL MEMBRANE OXYGENATION

INITIATION

ANTICOAGULATION

VENTILATOR MANAGEMENT

INVASIVE HEMODYNAMIC MONITORING

GOAL FLOWS

NORTH/SOUTH SYNDROME

LEFT VENTRICULAR DISTENSION

LIMB ISCHEMIA

DAILY MANAGEMENT

WEANING FROM VA-ECMO

COMPLICATIONS

VA-ECMO TROUBLESHOOTING/EMERGENCIES

POOR FLOW

BLEEDING

PUMP FAILURE

ACCIDENTAL DECANNULATION

EVIDENCE BASE FOR VA-ECMO

Chapter 28 Percutaneous Ventricular Assist Devices: 
Left Ventricle/Right Ventricle

IMPELLA

Overview and Hemodynamics

Device Setup and Routine Management

Common Intensive Care Unit Issues and Complications

Device Weaning

Device Removal

INTRA-AORTIC BALLOON PUMP

Overview and Hemodynamics

Device Setup and Routine Management

Device Removal

PROTEK-DUO

Overview and Hemodynamics

Common Intensive Care Unit Issues and Complications

Device Removal

IMPELLA RP

Overview and Hemodynamics

Common Intensive Care Unit Issues and Complications

Device Removal

Chapter 29 Durable Left Ventricular Assist Devices

COMPONENTS OF A LEFT VENTRICULAR ASSIST DEVICE

EVOLUTION OF LEFT VENTRICULAR ASSIST DEVICES

LEFT VENTRICULAR ASSIST DEVICE PARAMETERS

OPTIMIZING THE PATIENT ON LEFT VENTRICULAR ASSIST DEVICE IN THE INTENSIVE CARE UNIT

WHO SHOULD BE CONSIDERED FOR LEFT VENTRICULAR ASSIST DEVICE SUPPORT?

WHO IS TOO CRITICALLY ILL TO RECEIVE A LEFT VENTRICULAR ASSIST DEVICE?

CONTRAINDICATIONS TO VENTRICULAR ASSIST DEVICES

OPTIMIZATION OF PATIENTS PRIOR TO VENTRICULAR ASSIST DEVICE IMPLANT

Surgical Planning

HEMODYNAMIC OPTIMIZATION

RIGHT VENTRICULAR ASSESSMENT AND OPTIMIZATION

TEMPORARY CARDIAC SUPPORT PREIMPLANT

PERIOPERATIVE MANAGEMENT OF THE PATIENT AFTER IMPLANT

POSTOPERATIVE RIGHT VENTRICULAR FAILURE

PUMP OPTIMIZATION

Echocardiographic Methods

Hemodynamic Ramp Studies

BLOOD PRESSURE MONITORING

MANAGEMENT OF MECHANICAL VENTILATION

BLEEDING AND TRANSFUSION TARGETS

POSTOPERATIVE ANTICOAGULATION

ANTIBIOTIC PROPHYLAXIS

SPECIAL CONSIDERATIONS

Arrhythmias After Left Ventricular Assist Device Implantation

Left Ventricular Assist Device Pump Thrombosis

Mucocutaneous Bleeding Complications

Driveline Infections

Neurologic Complications

CARDIAC ARREST AND CARDIOPULMONARY RESUSCITATION IN PATIENTS WITH DURABLE LEFT VENTRICULAR ASSIST DEVICES

PATIENTS ON BIVENTRICULAR VENTRICULAR ASSIST DEVICE SUPPORT24

CONCLUSION

Chapter 30 Echocardiography in the Patient on Mechanical 
Circulatory Support

TRANSTHORACIC VIEWS FOR ECHOCARDIOGRAPHIC EVALUATION

Parasternal Long-Axis View

Parasternal Short-Axis View

Apical Four-Chamber View

Subcostal Four-Chamber View

Subcostal Inferior Vena Cava

TRANSESOPHAGEAL VIEWS FOR ECHOCARDIOGRAPHIC EVALUATION

Midesophageal Four-Chamber View

Midesophageal Bicaval View

Midesophageal Aortic Valve Long-Axis View

Midesophageal Aortic Valve Short-Axis View

Midesophageal Descending Aorta

Transgastric Left Ventricular Short-Axis View

MECHANICAL CIRCULATORY SUPPORT DEVICES

Extracorporeal Membrane Oxygenation

IMPELLA

Preprocedural Echocardiography

Placement

Management and Troubleshooting

Removal of Impella and Assessment for Iatrogenic Injury

PROTEKDUO

INTRA-AORTIC BALLOON PUMP

DURABLE LEFT VENTRICULAR ASSIST DEVICES

Preoperative Assessment

Immediate Intensive Care Unit Assessment

Troubleshooting

Chapter 31 Frontiers in Mechanical Circulatory Support: Ventricular Assist Devices for the Right Ventricle, Adult Congenital, Miniature Ventricular Assist Devices, and Military and Mobile Extracorporeal Membrane Oxygenation Teams

VENTRICULAR ASSIST DEVICES FOR THE RIGHT VENTRICLE

Clinical Outcomes in Acute Right Ventricular Failure

ADULT CONGENITAL VENTRICULAR ASSIST DEVICES

Heart Failure in Adult Congenital Heart Disease

Challenges With Mechanical Circulatory Support in Adult Congenital Heart Disease

Mechanical Circulatory Support Applications in Adult Congenital Heart Disease

Extracorporeal Membrane Oxygenation in Adult Congenital Heart Disease

MINIATURE VENTRICULAR ASSIST DEVICES

MINIMALLY INVASIVE PLACEMENT OF DEVICES

MILITARY AND MOBILE EXTRACORPOREAL MEMBRANE OXYGENATION TEAMS

Transporting Patients on Extracorporeal Membrane Oxygenation

Mobile Extracorporeal Membrane Oxygenation Teams

Involvement of the Military in Extracorporeal Membrane Oxygenation Care

CONCLUSION

Chapter 32 Cannulation Strategies

VENOVENOUS EXTRACORPOREAL MEMBRANE OXYGENATION CANNULATION STRATEGIES

Physiology

VENOARTERIAL EXTRACORPOREAL MEMBRANE OXYGENATION CANNULATION STRATEGIES

Physiology

CANNULA TYPES AND WHICH CANNULA(S) TO USE

Cannulas for Peripheral Extracorporeal Membrane Oxygenation

Cannulas for Central Extracorporeal Membrane Oxygenation

HYBRID STRATEGIES (VENOVENOUS ARTERIAL, VENOARTERIAL VENOUS, LEFT ATRIAL VENOUS ARTERIAL ECMO, AMBULATORY STRATEGIES)

Venovenous Arterial Extracorporeal Membrane Oxygenation

Venoarterial Venous Extracorporeal Membrane Oxygenation

Left Atrial Venous Arterial Extracorporeal Membrane Oxygenation

AMBULATORY EXTRACORPOREAL MEMBRANE OXYGENATION CANNULATION STRATEGIES

CONCLUSION

SECTION 5: MISCELLANEOUS

Chapter 33 Transport of Patients on Mechanical Circulatory 
Support

INDICATIONS FOR TRANSPORT ON MECHANICAL CIRCULATORY SUPPORT

Patients Who Require Durable Ventricular Assist Device or Heart Transplantation

Patients With Sudden Cardiac Deterioration

Patients With Gradual Cardiac Deterioration

PRETRANSPORT PLANNING

GENERAL TRANSPORT CONSIDERATIONS

Primary Versus Secondary MCS Transports

MANAGEMENT IN TRANSPORT

Bleeding and Loss of Flow

Hypoxia

Decannulation

Chapter 34 Ethics in Mechanical Circulatory Support

DURABLE LEFT VENTRICULAR ASSIST DEVICES

Preimplantation: Clarification of Therapeutic Goal

Consent and Patient Decision-Making for Durable Left Ventricular Assist Device

Disparities in Left Ventricular Assist Device Implantation

End-of-Life Scenarios in Patients With Left Ventricular Assist Device

Legal Considerations for Left Ventricular Assist Device Deactivation

TEMPORARY CIRCULATORY SUPPORT

Program Design and Patient Selection

Ethics of Time-Limited Trials

EXTRACORPOREAL MEMBRANE OXYGENATION

Extracorporeal Membrane Oxygenation During Cardiopulmonary Resuscitation

Ethics of Extracorporeal Membrane Oxygenation Candidacy

Treatment Limitations and End-of-Life Care on Extracorporeal Membrane Oxygenation

Recommendations for Ethical Extracorporeal Membrane Oxygenation Practices

CONCLUSION

Index

 

An aparitie	noi 2024
Autor	Aranya Bagchi
Dimensiuni	178 x 254 mm
Editura	LWW
Format	Paperback
ISBN	9781975174330
Limba	Engleza
Nr pag	464
Versiune digitala	DA