The Washington Manual of Critical Care

 

Part of the popular Washington Manual® handbook series, The Washington Manual® of Critical Care provides concise, high-yield content that reflects today’s fast-changing advances in the field. Edited by Drs. Marin H. Kollef, Vladimir N. Despotovic, Bryan D. Kraft, Rachel K. McDonald, and Nguyet Nguyen, and written by teams of Washington University residents and faculty, the fourth edition focuses on the essential information you need to know, using a brief, bulleted format, along with numerous figures, tables, algorithms, and images throughout. In one convenient, portable resource, you’ll find complete coverage of bedside diagnosis and management of the most frequently encountered illnesses and problems seen in the ICU—all at your fingertips for quick review and reference.

 

Table of Contents:

 

SECTION I Management of Shock

1 Introduction to Shock

2 Hypovolemic Shock

3 Sepsis and Septic Shock

4 Cardiogenic Shock

Etiology

Hemodynamic Profile and Phenotype

Pathophysiology

Clinical Assessment

VITALS AND PHYSICAL EXAM

LABORATORY EVALUATION

12-LEAD ELECTROCARDIOGRAM

IMAGING

POINT-OF-CARE ULTRASOUND

INVASIVE MONITORING

Treatment

TRIAGE AND INITIAL MANAGEMENT

Conclusion

5 Anaphylactic Shock

6 Mechanical Causes of Shock

Pulmonary Embolism

Air Embolism

Fat Embolism

Amniotic Fluid Embolism

7 Emergency Department as the Gateway to the Intensive 
Care Unit

Mechanically Ventilated Emergency Department Patients

MANAGEMENT OF MECHANICAL VENTILATOR SETTINGS

EMERGENCY DEPARTMENT MANAGEMENT OF SEDATION

Patients With Vasopressor-Dependent Shock

SEPTIC SHOCK

POST-RETURN OF SPONTANEOUS CIRCULATION (ROSC) IN OUT-OF-HOSPITAL CARDIAC ARREST

PERIPHERAL ADMINISTRATION OF VASOPRESSORS

SECTION II Management of Respiratory Disorders

8 An Approach to Respiratory Failure

Hypercapnic Respiratory Failure

Hypoxemic Respiratory Failure

Monitoring Oxygenation and Ventilation

9 Initial Ventilator Setup

10 Upper Airway Obstruction

Infectious Epiglottitis and Laryngitis

Angioedema

Postextubation Stridor

11 The Acute Respiratory Distress Syndrome

12 Acute Severe Asthma

Treatments

STANDARD TREATMENT FOR ALL PATIENTS

CORTICOSTEROIDS

ADDITIONAL THERAPEUTIC CONSIDERATIONS

VENTILATOR STRATEGIES

Intubation Considerations

Other Considerations

EXTRACORPOREAL MEMBRANE OXYGENATION

13 Acute Exacerbations of Chronic Obstructive Pulmonary Disease

Diagnosis

Management

INHALED BRONCHODILATORS

CORTICOSTEROIDS

ANTIMICROBIALS

NONRECOMMENDED THERAPIES

OXYGEN AND NONINVASIVE VENTILATION

INVASIVE MECHANICAL VENTILATION

Management of Acute Exacerbations of Chronic Obstructive Pulmonary Disease After Hospital Discharge

MEDICAL THERAPIES

OXYGEN AND NOCTURNAL NONINVASIVE VENTILATION

PULMONARY REHABILITATION

PALLIATIVE AND END-OF-LIFE CARE

14 Sleep-Disordered Breathing in the Intensive Care Unit

15 Pulmonary Hypertension and Right Ventricular Failure in the Intensive Care Unit

Pathophysiology of Right Ventricle Failure

Causes of Decompensated Right Ventricular Failure

Diagnosis of Decompensated Right Ventricular Failure

CLINICAL PRESENTATION

DIAGNOSTIC TESTING

Treatment of Acute Decompensated Right Ventricle Failure

IDENTIFY AND CORRECT PRECIPITATING FACTORS

CORRECT HYPOXEMIA

REVERSE HYPOTENSION AND RESTORE CIRCULATION

TREAT VOLUME OVERLOAD AND RIGHT VENTRICLE ENCROACHMENT

Mechanical Support

Surgical Interventions

General Measures

16 Pulmonary Embolism

Pathophysiology

Diagnosis

DIAGNOSTIC MODALITIES

STABILITY ASSESSMENT

Prognosis

RISK STRATIFICATION

TRIAGE

Treatment

GENERAL APPROACHES

ANTICOAGULATION

THROMBOLYTIC THERAPY

CATHETER-DIRECTED THERAPY

SURGICAL EMBOLECTOMY

INFERIOR VENA CAVA FILTERS

RISKS OF TREATMENT

17 Pleural Disorders in the Intensive Care Unit

Pleural Effusions

Special Situations

PARAPNEUMONIC EFFUSION

MALIGNANT EFFUSION

HEMOTHORAX

PNEUMOTHORAX

CHEST TUBE SIZE

18 Weaning of Mechanical Ventilation

19 Noninvasive Ventilation

Patient Selection

MODES

SPECIFIC CLINICAL SCENARIOS

Monitoring

Conclusions

SECTION III Cardiac Disorders

20 Acute Myocardial Infarction

ST-Elevation Acute Coronary Syndrome

Non–ST Elevation Acute Coronary Syndrome

Hospital Care of the Patient With Acute Coronary Syndrome

CLASSIFYING MYOCARDIAL INFARCTIONS

Complications After Myocardial Infarction

FAILURE

EMBOLISM AND EFFUSIONS/PERICARDITIS

ARRHYTHMIA

RUPTURE AND REGURGITATION

ANEURYSM

RECURRENT MYOCARDIAL INFARCTION

21 Cardiac Arrhythmias and Conduction Abnormalities

Tachyarrhythmias

SUPRAVENTRICULAR TACHYCARDIAS

VENTRICULAR TACHYCARDIAS

Bradyarrhythmias

Cardiac Arrest

PULSELESS VENTRICULAR TACHYCARDIA AND VENTRICULAR FIBRILLATION

PULSELESS ELECTRICAL ACTIVITY AND ASYSTOLE

22 Aortic Dissection

23 Acute Decompensated Heart Failure

Treatment

GENERAL MEASURES

MANAGEMENT OF CHRONIC HEART FAILURE MEDICATIONS IN ACUTE DECOMPOSED HEART FAILURE

DIURESIS

AFTERLOAD REDUCTION

ARRHYTHMIAS

INOTROPES AND VASOPRESSORS

MECHANICAL SUPPORT

24 Approach to Hypertensive Emergencies

25 Post–Cardiac Arrest Management

SECTION IV Electrolyte Abnormalities

26 Electrolyte Abnormalities

Disorders of Water Balance

HYPONATREMIA

ETIOLOGIES OF SPECIAL IMPORTANCE IN THE CRITICALLY ILL PATIENT

Treatment

Hypernatremia

Etiologies of Special Importance in the Critically Ill Patient

Treatment

Disorders of Volume Balance

Disorders of Potassium Concentration

Hypokalemia

Etiologies of Special Importance in the Critically Ill Patient

Treatment

Hyperkalemia

Etiologies of Special Importance in the Critically Ill Patient

Treatment

Disorders of Calcium Concentration

Hypocalcemia

Etiologies of Special Importance in the Critically Ill Patient

Treatment

Hypercalcemia

Etiologies of Special Importance in the Critically Ill Patient

Treatment

Disorders of Phosphorus Concentration

Hypophosphatemia

Etiologies of Special Importance in the Critically Ill Patient

Treatment

Hyperphosphatemia

Etiologies of Special Importance in the Critically Ill Patient

Treatment

Disorders of Magnesium Concentration

Hypomagnesemia

Etiologies of Special Importance in the Critically Ill Patient

Treatment

Hypermagnesemia

SECTION V Acid-Base Disorders

27 Metabolic Acid-Base Disorders

Metabolic Acidosis

Anion Gap Acidosis

Nonanion Gap Acidosis

Renal Tubular Acidosis

Treatment

Metabolic Alkalosis

Common Causes of Metabolic Alkalosis

Treatment

Mixed Acid-Base Disorders

28 Respiratory Acid-Base Disorders

SECTION VI Endocrine Disorders

29 Thyroid Disorders

Hyperthyroidism

TREATMENT

Hypothyroidism

TREATMENT

30 Adrenal Insufficiency in Critical Illness

31 Diabetic Ketoacidosis and Hyperosmolar 
Hyperglycemic State

Diabetic Ketoacidosis

Hyperosmolar Hyperglycemic State

Cerebral Edema

32 Glucose Control in the Intensive Care Unit

Trials

Management

SECTION VII Oncologic Emergencies

33 Oncologic Emergencies

Malignant Spinal Cord Compression

Superior Vena Cava Syndrome

Hyperleukocytosis and Leukostasis

Tumor Lysis Syndrome

Cytokine Release Syndrome and Immune Effector Cell–Associated Neurotoxicity Syndrome

SECTION VIII Temperature Alterations

34 Temperature Alterations

Temperature Regulation

Fever and Hyperthermia

TREATMENT

Hypothermia

TREATMENT

Induced Hypothermia as Therapy

35 High-Altitude Illness

Acute Mountain Sickness/High-Altitude Cerebral Edema

High-Altitude Pulmonary Edema

Prevention

SECTION IX Toxicology

36 Toxicology

Key Steps in the Management of the Poisoned Patient

Initial Evaluation

Diagnostic Strategies

IMPORTANT PRINCIPLES

TOXIDROMES

INGESTION HISTORY

OPTIMAL USE OF LABORATORY TESTS

EVALUATION OF LABORATORY ABNORMALITIES

Treatment Strategies

ANTIDOTES

GASTRIC DECONTAMINATION

ENHANCING DRUG ELIMINATION

APPROACH TO POISONING ASSOCIATED ORGAN FAILURE IN THE INTENSIVE CARE UNIT

Management of Common Intoxications: Common Medications

ACETAMINOPHEN

SALICYLATES

BETA-BLOCKERS AND CALCIUM CHANNEL BLOCKERS

DIGOXIN AND CARDIAC GLYCOSIDES

NEUROLEPTIC MALIGNANT SYNDROME

SEROTONIN SYNDROME

TRICYCLIC ANTIDEPRESSANTS

Drugs of Abuse

ALCOHOLS

OPIOIDS

COCAINE AND AMPHETAMINE-RELATED TOXINS

SYNTHETIC CANNABINOIDS

Environmental Exposures

CARBON MONOXIDE

SNAKE ENVENOMATION

SECTION X Infectious Diseases

37 Central Nervous System Infections

Community-Acquired Central Nervous System Infections: Approach to the Patient With Suspected Meningitis or Encephalitis

Nosocomial Central Nervous System Infections

38 Community-Acquired Pneumonia

39 Nosocomial Pneumonia

40 Cellulitis/Fasciitis/Myositis

Cellulitis

Necrotizing Fasciitis

Myositis/Pyomyositis/Gas Gangrene

Ecthyma Gangrenosum

Diagnosis and Treatment of Necrotizing Infections

41 Bacteremia and Catheter-Related Bloodstream Infections

Bacteremia

Central Line–Associated Bloodstream Infections

42 Invasive Fungal Infection

Yeast

CANDIDA SPP.

Cryptococcus SPP.

Dimorphic Fungi

HISTOPLASMA

BLASTOMYCES SPP.

Coccidioides Spp.

PENICILLIUM

Monomorphic Molds

PNEUMONIA

RHINOSINUSITIS

CUTANEOUS LESIONS

43 Infections in the Immunocompromised Host

Immune System Function and Dysfunction

Neutropenia

Solid-Organ Transplantation

Hematopoietic Stem Cell Transplantation

Human Immunodeficiency Virus

Asplenia

Biologic Agents

44 Infection Prevention in the Intensive Care Unit

General Measures

Catheter-Associated Urinary Tract Infection

Ventilator-Associated Pneumonia

Central Line–Associated Bloodstream Infection

Emerging Infectious Diseases

Quality Improvement

45 Clostridioides difficile and Other Infectious Causes 
of Diarrhea

Clostridioides difficile Infection

ASSESSMENT

DIAGNOSIS

TREATMENT

RECURRENCE

INFECTION PREVENTION AND CONTROL

Non–Clostridioides difficile Infectious Diarrhea

46 COVID-19 and Other Viral Pneumonias

Preventive and Supportive Measures

Management of Influenza Viruses

Management of Severe Acute Respiratory Syndrome Coronavirus 2

SECTION XI Renal Disorders

47 Acute Kidney Injury

Definition

Diagnostic Approach to the Patient With Acute Kidney Injury

Urine Chemistries

URINE SODIUM

URINALYSIS AND URINE MICROSCOPY

URINE BIOMARKERS

Etiology of Acute Kidney Injury

PRERENAL ACUTE KIDNEY INJURY

Postrenal Acute Kidney Injury

Intrinsic Acute Kidney Injury

ACUTE TUBULAR NECROSIS

GLOMERULAR AND MICROVASCULAR PROCESSES

INTERSTITIAL PROCESSES

Summary

48 Renal Replacement Therapy

Indications

ACIDOSIS

HYPERKALEMIA

VOLUME OVERLOAD

UREMIA

Timing of Initiation of Renal Replacement Therapy

Modalities

Dialysis Dose

Drug Dosing During Continuous Renal Replacement Therapy

Drug Dosing During Prolonged Intermittent Renal Replacement Therapy

Complications of Renal Replacement Therapy

HYPOTENSION

ARRHYTHMIAS

DIALYZER REACTIONS

DIALYSIS CATHETER-RELATED PROBLEMS

PROBLEMS ASSOCIATED WITH CONTINUOUS RENAL REPLACEMENT THERAPY

Discontinuation of Renal Replacement Therapy

Summary

SECTION XII Hepatic Diseases

49 Acute Liver Failure

Causes and Diagnosis

Etiology-Specific Management of Acute Liver Failure

ACETAMINOPHEN TOXICITY

NONACETAMINOPHEN ETIOLOGIES

Management of Systemic Complications

CENTRAL NERVOUS SYSTEM

COAGULOPATHY

HYPOTENSION

INFECTION

RENAL FAILURE

METABOLIC COMPLICATIONS

Prognostic Indicators

Liver Transplantation

50 Hyperbilirubinemia

Physiology

INDIRECT HYPERBILIRUBINEMIA

DIRECT HYPERBILIRUBINEMIA

DIAGNOSIS AND THERAPY

51 End-Stage Liver Disease

Ascites

Spontaneous Bacterial Peritonitis

Acute Kidney Injury

Hepatic Encephalopathy

Variceal Hemorrhage

Transjugular Intrahepatic Portosystemic Shunt

Acute-on-Chronic Liver Failure

Malnutrition

SECTION XIII Gastrointestinal Disorders

52 Gastrointestinal Bleeding

Resuscitation and Early Management

Upper Gastrointestinal Bleeding

Lower Gastrointestinal Bleeding

Small Bowel Bleeding

53 Acute Pancreatitis

Evaluation

Prediction of Severity

Management

Summary

SECTION XIV Neurologic Disorders

54 Status Epilepticus

Definition of Status Epilepticus

Initial Management of Status Epilepticus

Refractory Status Epilepticus

Super-Refractory Status Epilepticus

Therapy De-Escalation

Prognosis

55 Acute Ischemic Stroke

Presentation

Management

INTRAVENOUS THROMBOLYSIS AND MECHANICAL THROMBECTOMY

POSTSTROKE MANAGEMENT

Cerebral Edema

SEIZURES

56 Aneurysmal Subarachnoid Hemorrhage

Diagnosis and Initial Management

Complications of Subarachnoid Hemorrhage

Cerebral Vasospasm and Delayed Cerebral Ischemia

57 Intracerebral Hemorrhage

Clinical Presentation

Diagnosis

Management

AIRWAY

BLOOD PRESSURE MANAGEMENT

COAGULOPATHY

VENTRICULOSTOMY AND INTRACRANIAL PRESSURE MANAGEMENT

SEIZURES

NEUROSURGICAL INTERVENTION

FEVER

GENERAL CARE

Prognosis

58 Coma

Localization of Coma

APPROACH TO COMA

DIAGNOSTIC STUDIES IN COMA

STABILIZATION OF THE PATIENT IN COMA

Prognosis

59 Declaration of Brain Death

History

Definition

Prerequisites

Physical Examination

Apnea Test

Ancillary Tests

Special Situations

EXTRACORPOREAL MEMBRANE OXYGENATION

HYPOTHERMIA IN CARDIAC ARREST PATIENTS

Communication With Family

Summary

60 Sedation and Delirium in the Intensive Care Unit

Sedation

Delirium

PREVENTION OF DELIRIUM

TREATMENT OF DELIRIUM

Conclusion

61 Acute Spinal Cord Disorders

Traumatic Spinal Cord Injury

NEUROPROTECTION

CARDIOVASCULAR MANAGEMENT

AIRWAY AND BREATHING

THROMBOEMBOLISM PREVENTION

GASTROINTESTINAL MANAGEMENT

SKIN

OTHER ISSUES

Nontraumatic Myelopathy

62 Neuromuscular Disorders in the Critically Ill

Neuromuscular Respiratory Failure

Motor Neuron Diseases

Guillain-Barré Syndrome

Myasthenia Gravis

Rhabdomyolysis, Malignant Hyperthermia, and Critical Illness Myopathy

63 Traumatic Brain Injury and Elevated Intracranial Pressure

Initial Stabilization and Management

Intensive Care Unit Management of Patients With Severe Traumatic Brain Injury

Intracranial Pressure Control

Cerebral Perfusion Pressure Threshold

Seizure Prophylaxis

Venous Thromboembolism Prevention

Nutritional Support

64 Neurologic Approach to Central Nervous System Infections

General Measures

Meningitis

BACTERIAL MENINGITIS

ASEPTIC MENINGITIS

Encephalitis

HERPES SIMPLEX VIRUS ENCEPHALITIS

VARICELLA-ZOSTER VIRUS ENCEPHALITIS

ARTHROPOD-BORNE ENCEPHALITIS

Brain Abscess

Infections Related to Neurosurgery

Tropical Central Nervous System Infections

Immunocompromised Patients

SECTION XV Hematopoietic Disorders

65 Thrombocytopenia in the Intensive Care Unit

Immune Thrombocytopenic Purpura

Heparin-Induced Thrombocytopenia

Sepsis-Induced Thrombocytopenia

Thrombotic Thrombocytopenic Purpura

Vaccine-Induced Immune Thrombotic Thrombocytopenia

Platelet Transfusions

66 Acute Management of the Bleeding Patient/Coagulopathy

Coagulation

SCREENING TESTS FOR COAGULATION

FURTHER TESTS TO ASSESS ACUTE BLEEDING

Common Acquired Disorders of Coagulation in the Critical Care Setting

LIVER DISEASE

DISSEMINATED INTRAVASCULAR COAGULATION

UREMIC BLEEDING

VITAMIN K DEFICIENCY AND WARFARIN THERAPY

BLEEDING DUE TO DIRECT ORAL ANTICOAGULANTS

Common Congenital Disorders of Coagulation

HEMOPHILIA A AND B

von WILLEBRAND DISEASE

67 Transfusion Practices

Dosing and Administration

Types of Red Blood Cell Products

WHOLE BLOOD

PACKED RED BLOOD CELLS

LEUKOREDUCED RED BLOOD CELLS

GAMMA-IRRADIATED RED BLOOD CELLS

SALINE-WASHED RED BLOOD CELLS

Risk of Transfusions

ACUTE TRANSFUSION RISKS

LONG-TERM TRANSFUSION RISKS

68 Hypercoagulable States

Deep Venous Thrombosis and Pulmonary Embolism

Arterial Thromboembolism

Hypercoagulability Evaluation

Conditions Associated With Decreased Platelets and Hypercoagulability

69 Critical Care Rheumatology

General Rules

Pulmonary Renal Syndrome and Diffuse Alveolar Hemorrhage

Critical Complications of Autoimmune Diseases

SYSTEMIC LUPUS ERYTHEMATOSUS

Vasculitis

LARGE-VESSEL VASCULITIS

SMALL-VESSEL VASCULITIS

Catastrophic Antiphospholipid Syndrome

Guidance to Laboratory Test Interpretation and Key-Associated Facts

70 Management of the Solid Organ Transplant Recipients in the Intensive Care Unit

Infectious Complications

Complications of Immunosuppressive Therapy

Anatomic or Surgical Concerns

FINAL CONSIDERATIONS

SECTION XVI Pregnancy

71 Maternal-Fetal Critical Care

Respiratory Changes of Pregnancy

Cardiovascular Changes in Pregnancy

Hemodynamics of Delivery

Importance of Gestational Age

Pregnancy-Specific Disorders

INTRODUCTION

Amniotic Fluid Embolism

Acute Fatty Liver

Obstetric Hemorrhage

Peripartum Cardiomyopathy

Hypercoagulability/Thromboembolism

Extracorporeal Membrane Oxygenation in Pregnancy

Cardiopulmonary Resuscitation/Resuscitative Hysterotomy

Medication Safety in Pregnancy

Imaging

Blood Transfusion in Patients of Childbearing Potential

Practical Considerations for the Pregnant Patient

72 Preeclampsia and Eclampsia

Diagnosis

Pathophysiology by Organ System

VASCULAR

HEMATOLOGIC

HEPATIC

CENTRAL NERVOUS SYSTEM

RENAL

FETAL

Treatment

SECTION XVII Surgical Problems

73 Trauma Care for the Intensive Care Unit

Trauma Evaluation

PRIMARY SURVEY

MAJOR IMMEDIATE LIFE-THREATENING CONDITIONS

Other Injuries Requiring Intensive Care Unit Care

HEMORRHAGIC SHOCK

DISTRIBUTIVE (SPINAL) SHOCK

FLAIL CHEST

PULMONARY CONTUSION

SPLEEN AND LIVER INJURIES, PELVIC HEMATOMAS

HEAD INJURY

CERVICAL SPINE INJURY

Later Complications

Conclusion

74 The Acute Abdomen

Patient History

Laboratory History

Physical Examination

Radiographic Examination

75 Management of the Organ Donor

Organ Donation

Donor Management Protocols

NORMALIZE HEMODYNAMICS

OPTIMIZE PULMONARY FUNCTION

CORRECT ACID-BASE AND ELECTROLYTE DISTURBANCES

MAINTAIN NORMOTHERMIA

Specialized Donor Care Facilities

Summary

SECTION XVIII Nutrition in the ICU

76 Nutrition in the Intensive Care Unit

Nutrition Assessment and Risk Determination

Nutrition Monitoring

Nutrition Prescription and Initiation

SECTION XIX Procedures

77 Arterial Catheterization

Steps for Radial Artery Cannulation

Tips

78 Central Venous Catheterization

Internal Jugular Central Venous Catheter Placement

Femoral Central Venous Catheter Placement

Subclavian Central Venous Catheter Placement

79 Endotracheal Intubation

Required Preparations

How to Intubate

Additional Techniques

Confirmation

80 Percutaneous Tracheostomy

Indications

Contraindications

Timing of Tracheostomy Procedure in Patients Who Are Critically Ill

Considerations in Patients Tested Positive for COVID-19

Procedure for Percutaneous Tracheostomy

Complications

81 Chest Tube Insertion

Definition

Indications

Contraindications

Imaging

Site Selection

Choosing the Optimal Tube Size and Approach

PROCEDURE STEPS

Drainage Systems

Guidelines for Chest Tube Removal

REMOVAL STEPS

Complications

82 Paracentesis

Performance of Paracentesis

Diagnostic Considerations

83 Lumbar Puncture

Indications and Contraindications

Technique

COLLECT THE SUPPLIES

POSITION THE PATIENT

FIND THE L4-5 SPACE

SCRUB AND ANESTHETIZE THE SPACE

INSERT THE SPINAL NEEDLE

ADVANCE THE SPINAL NEEDLE

MEASURE CEREBROSPINAL FLUID PRESSURE AND COLLECT FLUID

Complications

84 Thoracentesis

Definition

Indications

Relative Contraindications

History

Site Selection

Procedure

Complications

85 Pulmonary Artery Catheterization

Procedure Technique

Cardiac Output Determination

86 Alternative Hemodynamic Monitoring

Aortic Doppler

Transpulmonary Thermodilution

Pulse Contour Analysis

Partial Carbon Dioxide Rebreathing

Thoracic Bioimpedance

Thoracic Bioreactance

Conclusion

87 Functional Hemodynamic Monitoring

Hemodynamic Assessment and Monitoring

Noninvasive Hemodynamic Tools and Methods

PHYSICAL EXAMINATION

NONINVASIVE BLOOD PRESSURE CUFF

PULSE PRESSURE AND STROKE VOLUME VARIATION ANALYSIS

POINT-OF-CARE ULTRASOUND

Invasive Hemodynamic Tools and Methods

ARTERIAL LINES

CENTRAL VENOUS CATHETERS

SWAN-GANZ CATHETERS

The Frank-Starling Mechanism

Hemodynamic Profiles of Shock

HEMORRHAGIC OR HYPOVOLEMIC SHOCK

CARDIOGENIC SHOCK

SEPTIC SHOCK

MIXED SHOCK

COEXISTING ENDOGENOUS AND EXOGENOUS FORCES

Hemodynamics in the Treatment of Shock

HEMORRHAGIC OR HYPOVOLEMIC SHOCK

CARDIOGENIC SHOCK

SEPTIC SHOCK

88 Pericardiocentesis

Steps for Bedside Pericardiocentesis

89 Extracorporeal Life Support

Extracorporeal Life Support Function

Cannulation

Extracorporeal Life Support Modes

Venovenous Extracorporeal Membrane Oxygenation

Venoarterial Extracorporeal Membrane Oxygenation

Extracorporeal CO2 Removal

Patient Selection and Complications

Management of Patients on Extracorporeal Life Support

Separating From Extracorporeal Life Support

90 Basic Critical Care Ultrasound

Introduction

Basic Ultrasound Physics

Ultrasound Machine

Lung Ultrasound and the Evaluation of Acute Respiratory Failure

Key Points

Performing the Examination

The Five Lung Signatures

Approach to Acute Respiratory Failure

Focused Echocardiography

Key Points

Limitations

Image Acquisition and Interpretation

Measuring Stroke Volume by Bedside Echocardiography

Shock

Pneumothorax

Tamponade

Acute Left Ventricle Failure

Hypovolemic/Septic Shock

Right Ventricular Pressure/Volume Overload

Deep Vein Thrombosis

Basic Abdomen

Key Points

Free Peritoneal Fluid

Renal Ultrasound

Bladder Ultrasound

Critical Care Ultrasound

Physics

Pulmonary/Respiratory Failure

Focused Echocardiography

DVT

Volume Responsiveness/Advanced Echocardiography

Abdominal

SECTION XX End-of-Life Issues and Informatics

91 Patient and Family Engagement, Goals of Care Communication, and End-of-Life Care in the Intensive Care Unit

Core Ethical Principles

Establishing Goals of Care

Shared Decision-Making

Surrogate Decision-Making

Communication Strategies

Surgical and Procedural Considerations

Withdrawing and Withholding Life-Sustaining Treatments

Futility

Death by Whole Brain Criteria

Conclusion

92 Informatics in the Intensive Care Unit

Clinical Informatics

The Rise of Health Information Technology

Building an Integrated Intensive Care Unit

Factors Affecting Health Information Technology Adoption

Toward a Smart Intensive Care Unit

SECTION XXI Appendices

93 Common Equations and Rules of Thumb in the 
Intensive Care Unit

Pulmonary Equations

ALVEOLAR GAS EQUATION

ALVEOLAR-ARTERIAL OXYGEN GRADIENT

PARTIAL PRESSURE OF ARTERIAL CARBON DIOXIDE

LUNG COMPLIANCE

AIRWAY RESISTANCE

DRIVING PRESSURE (DP)

TRANSPULMONARY PRESSURE (PTP)

Acid-Base Equations

ACUTE RESPIRATORY ACIDOSIS OR RESPIRATORY ALKALOSIS

CHRONIC RESPIRATORY ACIDOSIS OR RESPIRATORY ALKALOSIS

METABOLIC ACIDOSIS

METABOLIC ALKALOSIS

Validity of the Data, Henderson’s Equation for Concentration of H+

ANION GAP

DELTA GAP

Renal Equations

CALCULATED OSMOLARITY

OSMOLAR GAP

ESTIMATED CREATININE CLEARANCE

CREATININE CLEARANCE

Fractional Excretion of Sodium (FENa+)

FRACTIONAL EXCRETION OF UREA (FE UREA)

CORRECTING SODIUM FOR HYPERGLYCEMIA

FREE WATER DEFICIT

USEFUL FORMULA FOR SLOWLY CORRECTING HYPONATREMIA

Hemodynamic Equations

Mean Arterial Pressure (MAP) (70-100 MM HG)

Arterial Oxygen Content (CaO2) (18-21 ML O2/DL)

Mixed Venous Oxygen Content (CvO2) (14.5-15.5 ML O2/DL)

Arterial-Mixed Venous Oxygen Content Difference (3.5-5.5 ML O2/DL)

Oxygen Delivery (mL/min) (1,000 ML/MIN)

Oxygen Uptake (mL/min) (1,000 ML/MIN)

OXYGEN EXTRACTION RATIO (O2ER)

Cardiac Output (CO) (4-7 L/MIN)

Cardiac Index (CI) (2.5-4 L/MIN/M2)

Systemic Vascular Resistance (SVR) (800-1,200 DYNE∙S∙CM-5)

Pulmonary Vascular Resistance (PVR) (120-220 DYNE∙S∙CM–5)

Point-of-Care Ultrasound Equations

Left Ventricle Stroke Volume (LV SV) (50-120 ML per contraction)

Stroke Volume Index (SVI) (35-50 ML/M2)

CARDIAC OUTPUT (CO)

LEFT VENTRICLE FRACTIONAL SHORTENING (LV FS%)

RESPIRATORY VARIATION OF INFERIOR VENA CAVA (IVC% COLLAPSIBILITY)

RIGHT VENTRICULAR SYSTOLIC PRESSURE (RVSP)

94 Drug-Drug Interactions

95 Common Drug Dosages and Side Effects

Index

 

An aparitie	25 sep 2024
Autor	Marin Kollef
Dimensiuni	127 x 203 mm
Editura	LWW
Format	Paperback
ISBN	9781975215453
Limba	Engleza
Nr pag	912
Versiune digitala	DA