Critical Care Medicine: The Essentials and More

 

Description:

With a full-color design and concise, easy-to-read chapters, Critical Care Medicine: The Essentials and a Bit More covers the core elements of critical care, with a unique focus on the pathophysiology underlying clinical disorders and how pathophysiologic concerns affect treatment options. There is much here that’s new: brand-new content, expanded discussions, and more graphical elements than ever before. Chapters follow a consistent structural template, with discussions of diagnosis, instrumentation, treatment and management techniques, and more. Expertly and succinctly captures all the fundamentals of the field!

 

 

Table of Contents:

 

SECTION I. TECHNIQUES AND METHODS IN CRITICAL CARE

Chapter 1 Hemodynamics

CHARACTERISTICS OF NORMAL AND ABNORMAL CIRCULATION

Anatomy

Circulatory Control

CHARACTERISTICS OF THE DISEASED CIRCULATION

Left Ventricular Insufficiency

Right Ventricular Dysfunction

Pericardial Constriction and Tamponade

Chapter 2 Hemodynamic Monitoring

CONDITIONAL IMPORTANCE OF MONITORING HEMODYNAMICS AND FLUID STATUS

STATIC VERSUS DYNAMIC ASSESSMENTS

Value of Dynamic Functional Monitoring

ARTERIAL BLOOD PRESSURE MONITORING

Noninvasive Arterial Pressure Monitoring

Arterial Pressure Waveform

Simplified Functional Hemodynamic Monitoring

Invasive Arterial Pressure Monitoring

DATA FROM VASCULAR CATHETERS

Inserting the Balloon Flotation Catheter

Interpreting Data from the Pulmonary Artery Catheter

Lactate, Anion Gap, and Central Venous Gases

Complications of the Pulmonary Artery Catheter

ECHOCARDIOGRAPHY, ULTRASOUND, AND OTHER IMAGING TECHNIQUES

Echocardiography

NUCLEAR CARDIOLOGY

Chapter 3 Shock and Support of the Failing Circulation

PHYSIOLOGY OF THE FAILING CIRCULATION

Circulatory Insufficiency—Decompensated Congestive Failure and Shock

Determinants of Cardiac Output

Effect of Shock on Organ Function

Evaluation of Perfusion Adequacy

THERAPY OF CIRCULATORY SHOCK

Goal-Directed Therapy

Indications for Monitoring

Fluid Therapy

Vasoactive and Inotropic Drugs

A General Strategy for Managing Hemodynamic Instability

Mechanical Interventions and Devices

CONGESTIVE LEFT HEART FAILURE

Causes

Precipitants

Diagnosis

Management of Congestive Failure

Chapter 4 Arrhythmias, Pacing, and Cardioversion

COMPONENTS OF THE ELECTROCARDIOGRAM

GENERAL APPROACH TO ARRHYTHMIAS

Dealing with Uncertainty

TACHYARRHYTHMIAS

Sinus Tachycardia

Nonsinus Supraventricular Tachycardias

Ventricular Extrasystoles

Ventricular Tachycardia

BRADYARRHYTHMIAS

Sinus Bradycardia

ATRIOVENTRICULAR BLOCK

First-Degree Atrioventricular Block

Second-Degree Atrioventricular Block

Third-Degree Atrioventricular Block

ANTIARRHYTHMIC DRUGS

Specific Antiarrhythmic Drugs

ELECTRICAL CARDIOVERSION

External Cardioversion

Implantable Defibrillators

PACEMAKERS

Permanent Pacemakers

Temporary Pacemakers

Chapter 5 Respiratory Monitoring

MONITORING GAS EXCHANGE

Blood Gas Analysis

INTERPRETATION

The Anion Gap

Rules for Compensation

Algorithm for Evaluating Blood Gas Data

Monitoring Oxygenation

INTERPRETATION

O2 Consumption

Efficiency of Oxygen Exchange

Monitoring Carbon Dioxide and Ventilation

MONITORING LUNG AND CHEST WALL MECHANICS

General Principles

Pressure–Volume Relationships

Calculation of CRS and RAW During Mechanical Ventilation

Role of Dynamics

Stress Index

Auto-PEEP (Intrinsic PEEP) Effects

Esophageal Pressure Monitoring

Abdominal Pressure Measurement

Value of Continuously Monitoring PAW and Flow

Mean Airway Pressure

MONITORING BREATHING EFFORT

Oxygen Consumption of the Respiratory System

Direct Measures of External Mechanical Output

MONITORING VENTILATORY DRIVE AND BREATHING PATTERN

Importance of Assessing Ventilatory Drive

Ventilatory Drive Indices

Breathing Pattern, Frequency, and Duty Cycle

MONITORING STRENGTH AND MUSCLE RESERVE (ENDURANCE)

Strength Measures

Measures of Endurance

Chapter 6 Airway Intubation

INDICATIONS

Need for Assisted Ventilation and Positive End-Expiratory Pressure

Airway Protection

Secretion Clearance

Upper Airway Obstruction

TYPES OF AIRWAYS AND ROUTES OF INTUBATION

Supraglottic Airways

Endotracheal Intubation

PHYSIOLOGIC RESPONSES TO INTUBATION

COMPLICATIONS OF AIRWAY INTUBATION

Anatomic Impairment

Insertion Trauma

Hypoxemia

Apneic, Rapid Sequence, or Ventilation-Assisted Intubation

Gastric Aspiration

Reflex Glottic Closure and Laryngospasm

Bronchospasm

Right Main Bronchus Intubation

POINTS OF TECHNIQUE

The Difficult Airway

Aids for Difficult Intubation

Distinguishing Tracheal from Esophageal Intubation

Intubation Sequence

Tube Exchange

Extubation

Decannulating the Difficult Airway

Postextubation Care

TRACHEOSTOMY

Benefits and Indications

Variants of Conventional Tracheostomy

Tracheostomy Tube Displacement

Chapter 7 Elements of Invasive and Noninvasive Mechanical Ventilation

INDICATIONS FOR MECHANICAL VENTILATION

Inadequate Alveolar Ventilation

Inadequate Oxygenation

Excessive Respiratory Workload

Cardiovascular Support

OPTIONS IN MECHANICAL VENTILATION

Types of Ventilation

Standard Modes

Ventilator Setup

Innovative Modes to Improve Ventilation

Nontraditional Modes to Improve Oxygenation

Adjuncts to Mechanical Ventilation

Noninvasive Ventilation

High-Flow Nasal Cannula

Daily Assessment of the Ventilated Patient

Chapter 8 Practical Problems and Complications of Mechanical Ventilation

ACUTE COMPLICATIONS OF MECHANICAL VENTILATION

Cardiovascular Impairment

Barotrauma

Ventilator-Induced Pulmonary Edema, Lung Injury, and Volutrauma

SUBACUTE AND CHRONIC COMPLICATIONS

Fluid Retention and Redistribution

Fluctuations in pH

Infections

Deconditioning and Diaphragmatic Dysfunction

PATIENT–VENTILATOR INTERACTIONS

Specific “Early Phase” Problems

Specific “Support Phase” Problems

Chapter 9 Positive End-Expiratory and Continuous Positive Airway Pressure

GENERAL CONCEPTS AND DEFINITIONS

PATHOPHYSIOLOGY

Actions of PEEP in Acute Hypoxemic Respiratory Failure

Interaction of PEEP and Tidal Volume

Importance of Chest Wall Compliance

Regional Effects of PEEP

Active Expiration

Time Course of PEEP Effect on Gas Exchange

PEEP and Mean Airway Pressure

ADVERSE EFFECTS OF PEEP

Cardiovascular Impairment

Barotrauma

Reduced Oxygen Delivery

Impaired CO2 Elimination

Alterations in the Work of Breathing

CLINICAL USE OF PEEP

Good Candidates for Higher PEEP

Poor Candidates for Higher PEEP

Physiologic PEEP

Choosing the Appropriate Level of PEEP

Selecting PEEP and Tidal Volume in ARDS

PEEP Withdrawal

“Prophylactic PEEP”

“Auto-PEEP” Effect

Chapter 10 Discontinuation of Mechanical Ventilation

PHYSIOLOGIC DETERMINANTS OF VENTILATOR DEPENDENCE

Stages of Ventilator-Supported Breathing

Psychological Factors

Arterial Hypoxemia

Cardiovascular Instability

Imbalance of Ventilatory Capability and Demand

PREDICTING INDEPENDENCE FROM VENTILATORY SUPPORT

Noninterventional Measures

Voluntary Measures

Other Useful Measures

Integrative Weaning Indices

WEANING TRIAL

Preparations for Withdrawing Ventilatory Support

Sequence of Ventilator Withdrawal

STRATEGIES AND METHODS TO PROMOTE VENTILATOR INDEPENDENCE

General Principles

Priorities

Methods of Removing Ventilator Support

REMOVAL OF THE ENDOTRACHEAL TUBE

AVOIDING DELAYED LIBERATION FAILURES AND REINTUBATION

The Persistently Ventilator-Dependent Patient

Tracheostomy

Chapter 11 Intensive Care Unit Imaging

OVERVIEW OF RECENT ADVANCES IN ICU IMAGING

CHEST RADIOGRAPHY

Technique

Film Timing

Placement of Tubes and Catheters

Specific Applications of Chest Radiography

Pulmonary Edema

Mediastinal Widening

Pericardial Effusion

Air–Fluid Levels (Lung Abscess vs. Empyema)

Postthoracotomy Changes

Fistulous Tracts

Pulmonary Embolism

Pneumonitis

Intra-abdominal Conditions

CT AND MRI

Expanding Imaging Potential—Reconstruction, Multiplanar, and Subtraction Views

General Preparing of the Patient for Imaging Studies

Chest CT and MRI

ABDOMINAL RADIOGRAPHY

Abdominal CT and Screening Films (KUB)

Findings Relevant to Specific Organs

ACUTE CARE ULTRASOUND

Limitations of Clinician-Applied US at the Bedside

Problem Categories and Protocols

INTERVENTIONAL RADIOLOGY FOR CRITICAL CARE

Vascular Interventions

Nonvascular Indications for IR

Chapter 12 Acid–Base Disorders

SYSTEMS USED TO ASSESS ACID–BASE STATUS

ARTERIAL BLOOD GASES

Obtaining Arterial Blood Gases

Pitfalls in Collection, Analysis, and Interpretation

Risks of Arterial Blood Sampling

BASIC CONCEPTS OF ABG ANALYSIS AND INTERPRETATION

Alterations in Oxygenation

Alterations in Ventilation

Evaluating Hydrogen Ion Concentration

Buffer Systems

ACID–BASE DERANGEMENTS

Terminology of Acid–Base Disorders

Stepwise ABG Analysis

SIMPLE ACID–BASE DISORDERS

Metabolic Acidosis

Metabolic Alkalosis

Respiratory Acidosis

Respiratory Alkalosis

MIXED ACID–BASE DISORDERS

Chapter 13 Fluid and Electrolyte Disorders

DISORDERS OF SODIUM AND OSMOLALITY

Hyponatremia

Hypernatremia

POTASSIUM DISORDERS

Hypokalemia

Hyperkalemia

CALCIUM DISORDERS

Hypercalcemia

Hypocalcemia

PHOSPHATE DISORDERS

Hyperphosphatemia

Hypophosphatemia

MAGNESIUM DISORDERS

Hypermagnesemia

Hypomagnesemia

Chapter 14 Blood Conservation and Transfusion

INDICATIONS FOR BLOOD PRODUCTS

ANEMIA

BLOOD PRODUCT CONSERVATION

SOURCES OF BLOOD LOSS

THE COMPONENT SYSTEM

Consequences of Blood Storage

Red Blood Cell Components

White Blood Cell Transfusions

Platelet Components

Clotting Factor Concentrates and Plasma Products

PROBLEMS ASSOCIATED WITH MASSIVE TRANSFUSION

Exsanguination and Cross-Matching

Massive Transfusion

COMPLICATIONS OF TRANSFUSION

Immunologic Complications

Infectious Complications

Miscellaneous Complications

BLOOD SUBSTITUTES

Chapter 15 Pharmacotherapy

QUALITY IMPROVEMENT AND COST CONTROL

Role of the Pharmacist

Quality Improvement Strategies

PHARMACOKINETICS

Absorption

Distribution and Protein Binding

Metabolism

Elimination

Half-life

ROUTES OF ADMINISTRATION

Goals of Drug Administration

Inhalation

Endotracheal Instillation

Intraosseous (IO)

Intravenous Injection

Subcutaneous Injections

Intra-arterial Injections

Intrathecal Therapy

Intraperitoneal Therapy

Transcutaneous/Transdermal Administration (Patches)

Intraocular Drugs

Enteral Administration

Sublingual/Buccal Administration

Rectal Administration

Chapter 16 Nutritional Support and Therapy

THE METABOLIC RESPONSE TO STRESS IN CRITICALLY ILL PATIENTS

MALNUTRITION IN THE ICU

NUTRITION ASSESSMENT AND CANDIDATE SELECTION FOR NUTRITION SUPPORT

Refeeding Syndrome

NUTRITIONAL REQUIREMENTS

Energy/Calories

Protein

Lipids

Vitamins and Trace Elements

ROUTES OF NUTRITIONAL SUPPLEMENTATION

Enteral Nutrition Therapy

Parenteral Nutrition Therapy

DISEASE-SPECIFIC CONSIDERATIONS

Pulmonary Failure

Renal Failure

Hepatic Failure

Pancreatitis

Burns

Chapter 17 Analgesia, Sedation, Neuromuscular Blockade, and Delirium

GOALS OF THERAPY

MONITORING TREATMENT

CORRECTABLE FACTORS CAUSING AGITATION

CHOOSING PHARMACOLOGIC AGENTS

Analgesics

Sedatives

Neuroleptics/Antipsychotics

Neuromuscular Blocking Agents

Delirium

Chapter 18 General Supportive Care

BEDSIDE EVALUATION OF THE CRITICALLY ILL PATIENT

Therapeutic Perspective

Elements of the Bedside Evaluation

THERAPEUTIC SUPPORTIVE CARE

Post-ICU Syndrome (PICS)

Physiology of Prolonged Bed Rest

IMMOBILITY: PREVENTATIVE AND THERAPEUTIC MEASURES

Skin Breakdown and Pressure Ulcers

Isolation Precautions

Ambient Environment

Comfort Measures

Gastrointestinal Care

Bladder Care

Dressing and Wound Care

Transportation Issues

Gastrointestinal Ulcer Prophylaxis

Leg-Clotting Prophylaxis

Respiratory Care

Chapter 19 Quality Improvement and Cost Control

BUILDING QUALITY

ICU Leadership

Outcomes, Processes, and Practices

Medical Records and Order Systems

FACTORS INFLUENCING CRITICAL CARE COSTS

DIFFERENCES BETWEEN COST AND CHARGE

WHERE THE MONEY GOES

RADICAL COST-CONTROL MEASURES

SPECIFIC COST-CONTROL SUGGESTIONS

Imaging Costs

Supplies

Respiratory Therapy

LABORATORY STUDIES

Microbiology Laboratory

Chemistry Laboratory

Hematology Laboratory

Coagulation Laboratory

Blood Gases

SUMMARY

SECTION II. MEDICAL AND SURGICAL CRISES

Chapter 20 Cardiopulmonary Arrest

PRIMARY PULMONARY EVENTS (RESPIRATORY ARREST AND SECONDARY CARDIAC ARREST)

PRIMARY CARDIOVASCULAR EVENTS (CARDIOPULMONARY ARREST)

CARDIOPULMONARY RESUSCITATION

Principles of Resuscitation

Controversies in Resuscitation

DECIDING WHEN TO FORGO OR TERMINATE RESUSCITATION

PROGNOSTICATION

Chapter 21 Acute Coronary Syndromes

NON–ST ELEVATION ACUTE CORONARY SYNDROMES: UNSTABLE ANGINA AND NON–ST ELEVATION MYOCARDIAL INFARCTION

Definitions and Pathophysiology of Acute Coronary Syndrome

Diagnosis

Prognostic Factors

Management of NSTE-ACS

ACUTE CORONARY SYNDROMES: ST ELEVATION MYOCARDIAL INFARCTION (ACS-STEMI)

Mechanisms

Diagnosis

Treatment

General Support of the ACS Patient

Outcome of Myocardial Infarction

COMPLICATIONS OF MYOCARDIAL INFARCTION

Electrical Complications

Mechanical (Structural) Complications (Fig. 21-7)

Role of ICD in Myocardial Infarction

Chapter 22 Hypertensive Emergencies

DEFINITIONS

PATHOPHYSIOLOGY

HISTORY AND PHYSICAL EXAMINATION

TREATMENT PRINCIPLES

Hypertension with Organ Failure (Hypertensive Emergency)

Hypertension Without Organ Failure (Hypertensive Urgency)

SPECIFIC HYPERTENSIVE PROBLEMS

Hypertensive Encephalopathy

Cerebral Ischemia and Hemorrhage

Aortic Dissection

Renal Failure

Pulmonary Edema

Angina and Myocardial Infarction

Catecholamine Excess

Preeclampsia/Eclampsia

THERAPY FOR HYPERTENSIVE EMERGENCIES

Commonly Used Agents

Chapter 23 Venous Thromboembolism

MECHANISMS

DEEP VENOUS THROMBOSIS

Risk Factors

Clot Sources

Prevention

Diagnosis

Diagnostic Testing

PULMONARY EMBOLISM

Natural History

Symptoms and Signs

Routine Diagnostic Tests

Specialized Diagnostic Tests

VTE Diagnostic Plan

Prognosis and Rate of Resolution

DVT and PE Treatment

Chapter 24 Oxygenation Failure, ARDS, and Acute Lung Injury

OXYGENATION FAILURE: DEFINITION

MECHANISMS OF ARTERIAL HYPOXEMIA

Low Inspired Oxygen Fraction

Hypoventilation

Impaired Diffusion

Ventilation–Perfusion Mismatching

Shunting

Abnormal Desaturation of Systemic Venous Blood

DISEASE-INDUCED HYPOXEMIA

Atelectasis

Diffuse Pulmonary Infiltration

Hypoxemia with a Clear Chest Radiograph

Unilateral Lung Disease

TECHNIQUES TO IMPROVE TISSUE OXYGENATION (Table 24-2)

Basic Therapeutic Principles

Improving Tissue Oxygen Delivery

Mechanical Ventilation of Acute Lung Injury and ARDS

Chapter 25 Obstructive Disease and Ventilatory Failure

PATHOGENESIS OF VENTILATORY FAILURE

Definition

Mechanisms of Ventilatory Failure

General Principles of Managing Ventilatory Failure

SPECIFIC PROBLEMS CAUSING VENTILATORY FAILURE

Airflow Obstruction

Chapter 26 ICU Infections

OVERVIEW

CATEGORIES AND CAUSES

Urinary Tract Infections

Pneumonia

Empyema and Parapneumonic Effusions

Intravascular Catheter-Related Infections

Infectious Diarrhea

Sinusitis

Meningitis

Soft Tissue Infections

Infection in the Immunocompromised Host

Chapter 27 Sepsis and Septic Shock

TERMINOLOGY

EPIDEMIOLOGY

RELATIONSHIP OF INFECTION TO SEPSIS

MICROBIOLOGY

PATHOPHYSIOLOGY

CLINICAL DIAGNOSIS

ORGAN SYSTEM FAILURES

Specific Organ System Failures

SEPSIS THERAPY

Source Control

Antimicrobial Therapy

Respiratory Support

Resuscitation and Post-resuscitation Fluid Management

Cardiovascular Support

Glucose Control

Addressing Metabolic Acidosis

Support of the Kidney

Nutritional Support

Directions in Detection and Treatment for the Near Future

Chapter 28 Thermal Disorders

NORMAL TEMPERATURE REGULATION

TEMPERATURE MEASUREMENT

Types of Measuring Devices

Sites of Measurement

HYPOTHERMIA

Definition and Problems in Detection

Etiology

Clinical Manifestations

Treatment

Diagnosis of Death

HYPERTHERMIA

Causes of Temperature Elevation

SYNDROMES OF EXTREME HYPERTHERMIA

Nonexertional (Classic) Heatstroke

Exertional Heatstroke

Malignant Hyperthermia

Neuroleptic Malignant Syndrome (Drug-Induced Central Hyperthermia)

Serotonin Syndrome (SS)

Chapter 29 Acute Kidney Injury and Renal Replacement Therapy

EPIDEMIOLOGY

INDICES OF RENAL FUNCTION AND INJURY

Urine Volume

Blood Urea Nitrogen

Creatinine

Biomarkers of AKI

DEFINITIONS OF ACUTE KIDNEY INJURY

ETIOLOGY OF ACUTE KIDNEY INJURY

Prerenal Failure

Postrenal Failure

Intrarenal Failure

COMPLICATIONS AND TREATMENT OF ACUTE RENAL FAILURE

Prevention

Established Oliguric Renal Failure

Early Oliguric Renal Failure

Hemodynamic Management

Electrolyte Disorders

Infection

Bleeding Disorders

Nutrition

Drug Therapy

Renal Replacement Therapy

PROGNOSIS

Chapter 30 Clotting Problems, Bleeding Disorders, and Anticoagulation Therapy

BLEEDING DISORDERS

Approach to the Bleeding Patient

PLATELET DISORDERS

Thrombocytopenia

Platelet Dysfunction

INTERPRETATION OF ABNORMAL CLOTTING TESTS

Prothrombin Time

Activated Partial Thromboplastin Time

Combined PT and aPTT Abnormalities

Anti-Xa Activity Assay

Activated Clotting Time

Thrombin Time

Bleeding Time and Platelet Function

Inhibitor Testing

Fibrinogen Levels and Fibrin Degradation Products

SPECIFIC CLOTTING DISORDERS

Heparin-Induced Thrombocytopenia

Hemophilia

Liver Disease

Vitamin K Deficiency: Warfarin Excess

Renal Disease

Disseminated Intravascular Coagulation

Dilutional Coagulopathy

Acquired Inhibitors of Coagulation

von Willebrand Disease

Paraproteinemia

Thrombolytic Therapy

Anticoagulant Therapy

Direct Oral Anticoagulant Agents (Table 30-7)

HYPERCOAGULABLE DISORDERS

Inherited Thrombotic Disorders

Chapter 31 Hepatic Failure

CLASSIFICATION

ACUTE HEPATIC FAILURE

Clinical Features

Laboratory Features

Etiology

Acetaminophen

Viral Hepatitis

Treatment

Complications

Prognosis

CHRONIC LIVER FAILURE

Etiology and Pathophysiology

Clinical and Laboratory Features

Treatment and Complications

Chapter 32 Endocrine Disturbances in Critical Care

GENERAL IMPACT OF CRITICAL ILLNESS ON ENDOCRINE AND METABOLIC HOMEOSTASIS

THYROID DISEASE

Critical Illness, Thyroid Kinetics, and Testing

Severe Hyperthyroidism and Thyroid Storm

Severe Hypothyroidism (Myxedema Coma)

ADRENAL DISEASES

Classic Adrenal Insufficiency

Withdrawal of Exogenous Steroids

Excessive Corticosteroid Administration

DISORDERS OF GLUCOSE METABOLISM

ICU Glucose Control

Hypoglycemia

Diabetic Ketoacidosis

Hyperosmolar Nonketotic Coma

DIABETES INSIPIDUS

PHEOCHROMOCYTOMA

ENDOCRINE CONSIDERATIONS DURING RECOVERY

Grhelin

Growth Hormone

Leptin

Exogenous Anabolic Steroids

Chapter 33 Drug Overdose and Poisoning

DIAGNOSIS

Clinical History

Physical Examination

Laboratory Testing

Use of the Drug Screen

TREATMENT OF DRUG OVERDOSE

Prevention of Toxin Absorption

Enhancement of Drug Removal

Inhibition of Toxic Metabolite Formation

SPECIFIC POISONS

Acetaminophen

Salicylates

Stimulants

Alcohols

Sedative–Hypnotic–Analgesic Drugs

Organophosphates and Carbamates

Digitalis Compounds

Cyclic Antidepressants

Serotonin Reuptake Inhibitors

Calcium Channel Blocking and β-Blocking Drugs

Lithium

Chapter 34 Neurologic Emergencies

DELIRIUM

COMA

Pathophysiology

Etiology

Approach to the Comatose Patient

SEIZURES

Pathophysiology

Etiology

Diagnosis

Systemic Effects of Seizures

Treatment

STROKE

Pathophysiology

Initial Evaluation

General Care of the Stroke Patient

Ischemic Stroke

Embolic Strokes

Lacunar Strokes

Hemorrhagic Stroke

Subarachnoid Hemorrhage (SAH)

Complications

INCREASED INTRACRANIAL PRESSURE

Mechanisms

Cerebral Hemodynamics

Intracranial Pressure Monitoring

Reducing Intracranial Pressure

Therapy to Minimize Cerebral Oxygen Requirements

HEAD TRAUMA

Pathophysiology

Initial Management

Cranial Disruption

Injury to Brain Tissue

Complications of Head Trauma

Monitoring the Brain-Injured Patient

Recovery Phase

SPINAL CORD TRAUMA

Epidemiology

Mechanisms

Initial Management

Physical Examination

Clinical Syndromes (Fig. 34-16)

Radiographic Evaluation

Treatment

Complications

BRAIN DEATH

Chapter 35 Chest and Abdominal Trauma

INITIAL APPROACH TO THE INJURED PATIENT

CHEST TRAUMA: EPIDEMIOLOGY

MECHANISMS OF CHEST TRAUMA

Penetrating Chest Injuries

Blunt Chest Injuries

Rib and Sternal Fractures

Increased Intracavitary Pressures

Shearing Forces

INITIAL MANAGEMENT OF CHEST TRAUMA

SPECIFIC CONDITIONS

Bronchial and Tracheal Disruptions

Hemothorax

Pericardial Tamponade

Cardiac Injury

Aortic Disruption

Diaphragm Injuries

Flail Chest

Pulmonary Contusions

ARDS and Ventilator-Associated Pneumonia

Esophageal Rupture (Boerhaave Syndrome)

Fat Embolism

ABDOMINAL TRAUMA: EPIDEMIOLOGY

Blunt Trauma to the Abdomen

Penetrating Trauma to the Abdomen

Physical Examination

Adjuncts to Physical Examination

Patterns of Injury

Pelvic Fractures

Compartment Syndromes

Chapter 36 Acute Abdomen

PRINCIPLES OF MANAGEMENT

DIAGNOSIS

History

Physical Examination

Routine Laboratory Tests

Plain Radiographs of the Abdomen

Ultrasound

Computed Tomographic Scanning

Magnetic Resonance Imaging

Biliary Scans

SPECIFIC CONDITIONS PRODUCING THE ACUTE ABDOMEN

Ruptured Aortic Aneurysm

Female Pelvic Disease

Mesenteric Ischemia

Appendicitis

Pancreatitis

Abdominal Compartment Syndrome

Cholecystitis and Cholangitis

Small Bowel Obstruction

Colonic Obstruction

Diverticulitis

Retroperitoneal Hemorrhage

Perforated Viscus

UNUSUAL CAUSES OF ACUTE ABDOMINAL PAIN

Chapter 37 Gastrointestinal Bleeding

PREVENTION

Indications

Medication Options

Risks

EVALUATION OF THE BLEEDING PATIENT

First Steps

Examination

Assessing Bleeding Severity

Initial Treatment

UPPER GASTROINTESTINAL (UGI) BLEEDING

Sources

Diagnostic Tests

Specific Causes of UGI Bleeding

Surgical Intervention

Prognosis

LOWER GASTROINTESTINAL (LGI) BLEEDING

The Diagnostic Approach

Angiography

Specific Conditions and Causes of LGI Bleeding

LGI Bleeding Therapy

Chapter 38 Burns and Inhalation Injury

PATHOPHYSIOLOGY

BURN EVALUATION

Estimation of Burn Size and Severity

INITIAL MANAGEMENT

Fluid Therapy

Inhalation Injury

Other Important Considerations

COMPLICATIONS OF BURNS

Infection and Sepsis

Gastrointestinal Bleeding

Hypermetabolism and Nutrition

Burn Wound Care

Mechanical Problems of the Burn Wound

NONTHERMAL BURNS

Chemical Injury

Electrical Burns

Appendix

DEFINITIONS AND NORMAL VALUES

 

 

An aparitie	3 Nov. 2018
Autor	Dr. John J Marini , David J Dries
Dimensiuni	17.78 x 2.54 x 25.4 cm
Editura	LWW
Format	Paperback
ISBN	9781496302915
Limba	Engleza
Nr pag	832
Versiune digitala	DA