Biochemistry for Anesthesiologists and Intensivists

This book discusses and explains the importance of biochemistry knowledge in understanding what happens to patients during anesthesia and/or to those being in intensive care. It covers a wide range of topics, such as Cerebral Edema, Shock, Blood-Brain Barrier, The Pulmonary surfactant, The Acid – Base equilibrium, Local anaesthetics, Perineural adjuvants, Normobaric Oxygen Therapy, Theories of Narcosis. Hyperventilation effects and consequences are also presented. For instance, by hyperventilating a patient with a PaCO2 significantly below 25 mmHg, we risk blocking pyruvic acid carboxylation and transforming it into oxalacetic acid, which in turn knocks out the Krebs cycle, possibly leading to a complication, i.e. to metabolic acidosis and not to compensation for respiratory alkalosis. It is also worth remembering that vitamins are actually molecules of pretty considerable potency and should not be simply intended as integrators. If we inject a patient under intensive care with vitamin C, this not only plays a capillary-protective role but facilitates the conversion of dopamine to noradrenaline. As far as vitamin B₆ goes, not only is it the most natural of antiemetics but the coenzyme responsible for transforming glutamate as one of the most powerful excitatory mediators into GABA, one of the fiercest inhibitors. Anesthesiological and intensive care practice require a detailed biochemistry knowledge to avoid onset of complications and/or to deal with unexpected events promptly and appropriately.

The book is intended for anesthesiologists, intensivists, anesthesia teachers, anesthesia trainees and residents.

Table of contents (19 chapters)

Enzymes and Coenzymes (A Brief, Boring but Necessary Preamble)

Pages 1-5

Alemanno, Fernando

Anaerobic Glycolysis or Embden–Meyerhof Pathway

Pages 7-14

Alemanno, Fernando

Tricarboxylic Acids Cycle or Krebs Cycle

Pages 15-21

Alemanno, Fernando

Glutamate – GABA Collateral Cycle

Pages 23-34

Alemanno, Fernando

Hexose-Monophosphate Shunt or Horecker Cycle (The Sleep Pathway)

Pages 35-47

Alemanno, Fernando

Neurotransmitters

Pages 49-70

Alemanno, Francesca (et al.)

Blood–Brain Barrier

Pages 71-74

Alemanno, Fernando

Shock

Pages 75-95

Bosco, Mario (et al.)

Cerebral Oedema

Pages 97-117

Alemanno, Fernando

Pulmonary Surfactant

Pages 119-121

Alemanno, Fernando

When the Mind Does Not Work as It Should

Pages 123-138

Alemanno, Francesca (et al.)

Thiamine (Vitamin B1)

Pages 139-159

Alemanno, Fernando

Normobaric Oxygen Therapy

Pages 161-166

Alemanno, Fernando

Acid–Base Equilibrium

Pages 167-188

Alemanno, Fernando

Theories of Narcosis

Pages 189-205

Alemanno, Fernando

Local Anaesthetics

Pages 207-223

Grossi, Paolo (et al.)

Perineural Adjuvants

Pages 225-237

Alemanno, Fernando

The Grand Design

Pages 239-247

Alemanno, Fernando

Epilogue and Farewell

Pages 249-250

Alemanno, Fernando