Difficult Decisions in Cardiothoracic Critical Care Surgery: An Evidence-Based Approach (Difficult Decisions in Surgery: An Evidence-Based Approach)

Description:

Critical care medicine is responsible for many of the most important advances in outcomes after cardiothoracic surgery in the past two decades.  The expertise developed in this subspecialty accounts for the resiliency that characterizes gold standard results evident in institutions recognized for excellence.  This volume is intended to share ideas and algorithms that will improve outcomes in cardiothoracic critical care units.  This book is part of the Difficult Decisions in Surgery series that covers surgical specialties.  The volumes are multi-authored, containing brief chapters, each of which are devoted to one or two specific questions or decisions within that specialty that are difficult or controversial.  The volumes are intended as a current and timely reference source for practicing surgeons, surgeons in training, and educators that describe the recommended ideal approach, rather than customary care, in selected clinical situations.  

Table of Contents:

1. Introduction

Part I. Quality, Care and Ethics

2. Quality and Value in the Cardiothoracic Intensive Care Unit

3. OR to ICU Patient Handoff: A Matter of Communication

4. Palliative Care in the Intensive Care Unit: A Universal Need

5. Ethics: When to Turn Off the VAD

6. Communication Surrounding Prognostication in the ICU: More Than Mere Talk?

Part II. Resuscitation

7. Defibrillation/Pacing First for Witnessed Cardiac Arrest in Post-cardiac Surgery Patients

8. Emergency Resternotomy in Post-operative Cardiac Surgery Patients Who Suffer Cardiac Arrest

9. Epinephrine and Vasopressin Use Following Cardiac Arrest After Cardiac Surgery

10. Cardiac Arrest in the Minimally Invasive Cardiac Surgery Patient: Is Conservatism an Aggressive Approach?

Part III. Hemodynamics

11. Intravascular Devices in the ICU

12. Role of Ultrasound Guidance for Central Venous Access, Chest Tube Insertion, and Interventional Management of Cholecystitis in ICU Patients

13. Focused Cardiac Ultrasound in the CT ICU: Helpful or Just Another Toy?

14. Inotropes and Vasopressors in the CT ICU: Getting the Mixture Right

15. Prevention of Postoperative Atrial Fibrillation After Adult Cardiac Surgery

16. Atrial Fibrillation: Aggressive Treatment in the Postoperative Cardiothoracic Surgery Patient

Part IV. Pulmonary Support in the CT Patient

17. What is the Role of the ABCDEF Bundle in Patients on Extracorporeal Membrane Oxygenation?

18. ECMO as a Bridge to Lung Transplantation

19. When on ECMO: Awaken, Extubate and Mobilize

Part V. Mechanical Assist Devices

20. Percutaneous Assist Devices as Salvage from Cardiogenic Shock

21. The LVAD Patient with Dark Urine and Elevated LDH: Diagnosis and Treatment of Pump Thrombosis

22. Liver Dysfunction in a Patient with Ventricular Assist Device

Part VI. Transplantation

23. Vasoplegia in the Postoperative Period After Cardiac Transplantation

24. Severe Hypertension After Cardiac Transplantation

25. Post-Transplant Right Ventricular Failure

26. Lung Infiltrates in Post-Operative Lung Transplant Patients: Pneumonia, Rejection or Edema?

27. Clearance of Pulmonary Secretions After Lung Transplantation

Part VII. Electrolytes and Nutrition

28. Perioperative Nutrition Support in Cardiothoracic Surgery

29. Glycemic Control Does Matter in the Cardiac Surgery Patient

Part VIII. Coagulopathy

30. The Bleeding Post-op CT Patient: Coagulation Tests Versus Thromboelastography

31. Bleeding in Cardiac Surgery: Should Massive Transfusion Be in a 1:1:1 Ratio?

32. If the Platelets Are Low, Is It HIT?

33. Newest Antithrombotic Agents: Uses, Challenges, and Reversal Strategies for Surgical Procedures

34. Complex Cardiac Surgery Without Blood Transfusions: Lessons Learned from Managing Jehovah Witness Patients

Part IX. Acute Kidney Injury

35. Cardiac Surgery Acute Kidney Injury: Controversy in Renal Support

36. Role of Biomarkers in Predicting AKI in the CT ICU

37. Cardiorenal Syndrome in Heart Failure Patients: ICU Management

38. Management of Patients with Difficult Vascular Access Issues

Part X. ICU Catastrophes

39. Free Air in the Postoperative CT Patient: Observe or Operate?

40. Ischemic Bowel in the Post Cardiothoracic Patient

41. Confusion in the ICU: Anticoagulated VAD Patient with MS Changes

42. Acute Ischemic Stroke in the Cardiothoracic Surgery Patient: Thrombolytic Therapy or Mechanical Thrombectomy?

43. Neurologic Catastrophe in the CT ICU: A Neurosurgeon’s Dilemma

44. Management of Malperfusion Syndrome in Acute Type A Aortic Dissection

45. Ischemic Leg Following IABP Insertion: Timing of Diagnosis and Treatment

Correction to: Introduction

Back Matter