Critical Care Medicine E-Book

Jean, Louis Vincent, Serge Brimioulle

Description

This book is a quick reference pocket guide for physicians involved with critical care medicine providing on-the-spot answers to everyday queries regarding laboratory and other investigations, scoring systems, invasive procedures, equipment usage and relevant drug treatment.

• Quick reference guide to laboratory and other test results with associated normal values
• Includes guidance on equipment usage in the Intensive Care Unit
• Includes the latest guidelines from the European Resuscitation Council
• Abundant tables and artworks give rapid access to key information such as IV regimens and scoring systems
• Provides practical guidance on sedation and pain control

Informations

• Publié par: Churchill Livingstone
• Date de parution: 30 janvier 2009
• Nombre de lectures: 0
• EAN13: 9780702050862
• Langue: English
• Poids de l'ouvrage: 3 Mo

Extrait

Critical Care Medicine
Churchill’s Ready Reference

Jean-Louis Vincent, MD PhD
Head, Department of Intensive Care, Erasme Hospital, Université Libre de Bruxelles, Brussels, Belgium
Churchill Livingstone
Front-matter

Critical Care Medicine: Churchill’s Ready Reference
Commissioning Editor : Alison Taylor
Development Editor : Janice Urquhart
Project Manager : Gail Wright
Designer : Stewart Larking
Illustration Manager : Merlyn Harvey
Illustrator : Chartwell
Critical Care Medicine
Churchill’s Ready Reference
Jean-Louis Vincent md p h d Head, Department of Intensive Care, Erasme Hospital, Université Libre de Bruxelles, Brussels, Belgium
With a contribution by
Serge Brimioulle MD PhD Senior Staff Physician, Department of Intensive Care, Erasme Hospital, Université Libre de Bruxelles, Brussels, Belgium
Edinburgh London New York Oxford Philadelphia St Louis Sydney Toronto 2009
Copyright

© 2009, Elsevier Limited. All rights reserved.
No part of this publication may be reproduced or transmitted in any form or by any means, electronic or mechanical, including photocopying, recording, or any information storage and retrieval system, without permission in writing from the publisher. Permissions may be sought directly from Elsevier’s Rights Department: phone: [phone] (US) or ([phone] (UK); fax: [phone]; e-mail: [e-mail] . You may also complete your request on-line via the Elsevier website at http://www.elsevier.com/permissions .
First published 2009
ISBN 978-0-08-045136-7
British Library Cataloguing in Publication Data
A catalogue record for this book is available from the British Library
Library of Congress Cataloging in Publication Data
A catalog record for this book is available from the Library of Congress


Notice
Knowledge and best practice in this field are constantly changing. As new research and experience broaden our knowledge, changes in practice, treatment and drug therapy may become necessary or appropriate. Readers are advised to check the most current information provided (i) on procedures featured or (ii) by the manufacturer of each product to be administered, to verify the recommended dose or formula, the method and duration of administration, and contraindications. It is the responsibility of the practitioner, relying on their own experience and knowledge of the patient, to make diagnoses, to determine dosages and the best treatment for each individual patient, and to take all appropriate safety precautions. To the fullest extent of the law, neither the Publisher nor the Authors assume any liability for any injury and/or damage to persons or property arising out or related to any use of the material contained in this book.
The Publisher



Printed in China
Preface

J.-L. Vincent
Critical Care Medicine: Churchill’s Ready Reference provides a practical compilation of information to assist in the everyday clinical management of critically ill patients. This is a very heterogeneous group of individuals presenting with a multitude of disease processes, and the management of such patients is often complex.
In this volume, using a pathophysiological approach, we have included an abundance of diagrams, figures and tables that we find helpful in understanding some of the major disease processes and conditions encountered on the intensive care unit. The collection of practical illustrations will help clinicians to diagnose and manage these conditions. This volume is meant not to replace larger, more complete textbooks, but to complement them, and will be useful at the bedside, in the office and for teaching.
List of abbreviations

ACE angiotensin-converting enzyme
ADP adenosine diphosphate
AED automatic external defibrillation
ALI acute lung injury
APC activated protein C
APTT activated partial thromboplastin time
ARDS acute respiratory distress syndrome
AT antithrombin
AV atrioventricular
BUN blood urea nitrogen
Ca O 2 arterial O 2 content
CBF cerebral blood flow
CNS central nervous system
CO cardiac output
COPD chronic obstructive pulmonary disease
CPAP continuous positive airway pressure
CPP cerebral perfusion pressure
CPR cardiopulmonary resuscitation
CRP C-reactive protein
CSF cerebrospinal fluid
CT computed tomography
CVP central venous pressure
CVVH continuous veno-venous haemofiltration
DIC disseminated intravascular coagulation
DNAR do not attempt to resuscitate
DNE do not escalate
DNR do not resuscitate
D O 2 oxygen delivery
EMD electromechanical dissociation
ESBL extended spectrum beta-lactams
FE fractional excretion
FFP fresh frozen plasma
Fi O 2 inspired oxygen fraction
FRC forced residual capacity
GCS Glasgow Coma Scale
GP glycoprotein
HAP hospital-acquired pneumonia
Hb haemoglobin
HES hydroxyethyl starches
HLA human leucocyte antigen
IAP intra-abdominal pressure
ICP intracranial pressure
I/E (ratio) inspiratory/expiratory ratio
IL interleukin
IM intramuscular
INH isoniazid
IV intravenous
LV left ventricle
LVSWI left ventricular stroke work index
MAP mean arterial pressure
MI myocardial infarction
MOF multiple organ failure
MRSA methicillin-resistant Staphylococcus aureus
MSSA methicillin-sensitive Staphylococcus aureus
MV O 2 myocardial oxygen consumption
MW molecular weight
NG nasogastric
NIV non-invasive ventilation
NO nitric oxide
NSAID non-steroidal anti-inflammatory drug
NSTEMI non-ST elevation myocardial infarction
PA pulmonary artery
Pa CO 2 arterial P CO 2
P O 2 oxygen partial pressure
Pa O 2 arterial P O 2
PAOP pulmonary artery balloon-occluded pressure
PAP pulmonary artery pressure
PCO 2 carbon dioxide partial pressure
PCT procalcitonin
PEEP positive end-expiratory pressure
PG prostaglandin
PPI proton pump inhibitor
PT prothrombin time
PTCA percutaneous transluminal coronary angioplasty
PTS post-traumatic seizures
Pv O 2 venous P O 2
PVR pulmonary vascular resistance
RAP right atrial pressure
RFI renal failure index
rFVIIa recombinant activated factor VII
RV right ventricle
RVSWI right ventricular stroke work index
SAH subarachnoid haemorrhage
Sa O 2 arterial oxygen saturation
Scv O 2 central venous oxygen saturation
SIADH syndrome of inappropriate secretion of antidiuretic hormone
Sj O 2 jugular venous oxygen saturation
SO 2 oxygen saturation
SOFA sequential organ failure assessment
STEMI ST elevation myocardial infarction
SV stroke volume
Sv O 2 mixed venous oxygen saturation
SVR systemic vascular resistance
TAC temporary abdominal closure
TF tissue factor
TIA transient ischaemic attack
TNF tumour necrosis factor
TV tidal volume
UNa urinary sodium
UOsm urinary osmolarity
VAP ventilator-associated pneumonia
V O 2 oxygen consumption
VTE venous thrombo-embolism
WBC white blood cells
ZEEP zero end-expiratory pressure
Table of Contents
Front-matter
Copyright
Preface
List of abbreviations
TOPIC 1: Ethical aspects and management essentials
TOPIC 2: Resuscitation and acute respiratory failure
TOPIC 3: Treatment of sepsis
TOPIC 4: Abdominal compartment syndrome
TOPIC 5: Cardiovascular emergencies
TOPIC 6: Metabolic issues
TOPIC 7: Nutritional support
TOPIC 8: Sedation and analgesia
TOPIC 9: Renal failure and intoxication
TOPIC 10: Gastrointestinal abnormalities and hyperbilirubinaemia
TOPIC 11: Trauma
Index
TOPIC 1 Ethical aspects and management essentials

Primary aim of medicine

To maintain/restore health (physical, mental and social well-being).

Four principles in bioethics

Autonomy: ensure everyone has the right to decide.
Beneficence: do good.
Non-maleficence: avoid doing harm.
Distributive justice: offer the same possibilities to everyone.

Foregoing life support

Withholding: no escalation (no endotracheal intubation and/or no extracorporeal support and/or no vasopressor support in shock).
Withdrawing: de-escalation.
DNR orders: do not resuscitate (or DNAR: do not attempt to resuscitate).
DNE orders: do not escalate.

Determinants of outcome

Physiological reserve: age, comorbidities.
Severity of the acute problem.
Therapeutic possibilities.

Management essentials in the ICU: FASTHUG

F= feeding.
A= analgesia.
S= sedation.
T= thrombo-embolism prophylaxis.
H= head of the bed elevated (30–45°).
U= ulcer prophylaxis (PPI or H 2 antagonists).
G= glucose control.

Table 1.1 The SOFA score
TOPIC 2 Resuscitation and acute respiratory failure

Signs of acute circulatory failure


Fig. 2.1 Signs of acute circulatory failure.


Fig. 2.2 Suggested approach in the presence of a hypotensive episode.

Types of circulatory shock

Hypovolaemic: bleeding, d