Intensive Care Unit Manual E-Book

C. William Hanson, Benjamin A. Kohl, Scott Manaker, Paul N. Lanken

Description

Intensive Care Unit Manual is a practical, hands-on, how-to manual that covers the full spectrum of conditions encountered in the ICU, guiding you step-by-step from your initial approach to the patient through diagnosis and treatment. Compact, affordable, and comprehensive, the ICU Manual puts all the critical care information you need right at your fingertips!

• Stay at the forefront of critical care with a practice-oriented, relevant, and well-illustrated account of the pathophysiology of critical disease, presented in a highly readable format.
• Gain valuable insight into the recognition, evaluation, and management of critical conditions such as respiratory, hemodynamic, and infectious diseases; management of ICU patients with special clinical conditions; cardiovascular, hematologic, and neurological disorders; poisoning and overdoses; trauma and burns; and much more!

• Grasp the latest developments in critical care with extensive updates and revisions to several key chapters, as well as brand-new chapters on Alcohol Withdrawal Syndromes; Acute Heart Failure Syndromes; Noninvasive Ventilation; and more ICU conditions.
• Understand and apply the most important ICU practices, including management of acute respiratory failure, mechanical ventilation, invasive hemodynamic monitoring, and the care of patients with special needs, AIDS, end-stage renal disease, or end-stage liver disease.
• Get convenient access to the full text and image library online at Expert Consult, in addition to online-only text, figures, and tables from the Alcohol Withdrawal Syndromes and Acute Heart Failure Syndromes chapters.

Sujets

• Médecine
• Spécialités médicales
• Médecine d'urgence
• Critical Care
• Medical

Informations

• Publié par: Saunders
• Date de parution: 26 septembre 2013
• Nombre de lectures: 0
• EAN13: 9781455737857
• Langue: English
• Poids de l'ouvrage: 22 Mo

Extrait

The Intensive Care Unit
Manual
SECOND EDITION
Paul N. Lanken, MD
Professor of Medicine and Medical Ethics and Health Policy, Hospital of the University of
Pennsylvania, Pulmonary, Allergy, and Critical Care Division, Department of Medicine
Associate Dean for Professionalism and Humanism, Perelman School of Medicine at the
University of Pennsylvania, Philadelphia, Pennsylvania
Scott Manaker, MD, PhD
Associate Professor of Medicine and Pharmacology, Pulmonary, Allergy, and Critical Care
Division, Perelman School of Medicine at the University of Pennsylvania
Vice Chair, Regulatory Affairs, Department of Medicine, Hospital of the University of
Pennsylvania, Philadelphia, Pennsylvania
Benjamin A. Kohl, MD, FCCM
Assistant Professor of Anesthesiology and Critical Care, and Internal Medicine
Chief, Division of Critical Care, Perelman School of Medicine at the University of
Pennsylvania, Philadelphia, Pennsylvania
C. William Hanson, III, MD
Professor of Anesthesia and Critical Care, Surgery, and Medicine, Perelman School of
Medicine at the University of Pennsylvania
Former Medical Director, Surgical Intensive Care Unit
Chief Medical Information Officer and Vice President, Hospital of the University of
Pennsylvania, Philadelphia, PennsylvaniaTable of Contents
Cover image
Title page
Copyright
Dedication
Contributors
Preface to First Edition
Preface to Second Edition
Section 1: Basic Pathophysiologic Principles and Their Application in the Intensive
Care Unit
Chapter 1: Approach to Acute Respiratory Failure
Definitions
Four Components of the Respiratory System
Respiratory Pump and Control of Paco2
Respiratory Muscle Fatigue
Failure of Components of the Respiratory System
Chapter 2: Approach to Mechanical Ventilation
The “Generic” Positive Pressure Ventilator
Principles and Practice of Positive Pressure Ventilation
Basic Traditional Modes of Ventilation
Alternative Closed Loop Modes of Ventilation
Volume Support (VS)Proportional Assist Ventilation Plus (PAV+)
Neurally Adjusted Ventilatory Assist (NAVA)
Patient Management during Mechanical Ventilation
Patient Dysphoria
Auto-PEEP (Intrinsic PEEP)
Clinical Pearl
Chapter 3: Noninvasive Ventilation
The Evolution of NIV
Practical Application of NIV
Interface Used in NIV
Appropriate Patient Selection
Complications
Chapter 4: Liberation and Weaning from Mechanical Ventilation and Extubation
When to Stop Mechanical Ventilation: The “First Fix What’s Broken” Approach
Categories of Problems to Consider and Fix
Chapter 5: Sedation and Analgesia during Mechanical Ventilation
Distress and Agitation
Assessment of the Patient with Distress or Agitation
General Treatment Guidelines
Pharmacologic Treatment
Drug De-escalation and Patient Mobilization
Chapter 6: Use of Neuromuscular Blocking Agents
Physiology of Neuromuscular Excitation
Mechanism of Neuromuscular Blocking Drugs
Drug and Electrolyte Interactions
Chapter 7: Assessment and Monitoring of Hemodynamic Function
Basic Physiologic Components
Hemodynamic MeasurementsChapter 8: Cardiogenic Shock and Other Pump Failure States
Pathophysiology
Differential Diagnosis
Clinical Pearls and Pitfalls
Myocardial Infarction and Cardiogenic Shock
Other Causes of Cardiogenic Shock
Chapter 9: Hemorrhagic Shock
Pathophysiology of Decreased Preload
Clinical Manifestations
Clinical Management
Chapter 10: Septic Shock
Clinical Considerations
Clinical Management of Septic Shock
Chapter 11: Vascular Access Issues and Procedures
Bedside Ultrasonography in the ICU
Arterial Catheterization
Peripheral Venous Catheterization
Central Venous Catheterization
Pulmonary Artery Catheterization
Section 2: Supportive Care for Intensive Care Unit Patients
Chapter 12: Approach to Supportive Care and Noninvasive Bedside Monitoring
Body Positioning
Skin Care (see also Chapter 42)
Aseptic Technique
Non-invasive Monitoring
Invasive Catheters
Eye Care
Stress Ulcer ProphylaxisGlucose Control
Prophylaxis for Thromboembolism
Phlebotomy and Erythropoietin
Chapter 13: Management of the Critical Care Patient
A Primer on Data Collection
Monitoring of Overnight Events and Patient Assessment
Medication Reconciliation and Nutritional Management
Laboratory Data
Other Studies
Falling Urine Output and Rising Creatinine
Fever/Hypothermia and Leukocytosis
Chapter 14: Health Care–Associated Infections
Approach to Infection Control in the Intensive Care Unit
Infections Due to Intravascular Catheters
Ventilator-Associated Pneumonia
Urinary Tract Infection
Chapter 15: Nutritional Therapy
Nutritional and Metabolic Assessment
Providing Nutritional Support
Measuring Nutritional Goal Achievement
Clinical Pearls and Pitfalls
Chapter 16: Nutrition-Related Access Procedures
Background
Indications
Contraindications
Preprocedure Assessment
Technical Considerations
Practical Aspects of Tube Care
Special ConsiderationsComplications of PEG Tube Insertions
Chapter 17: Pharmacokinetic Alterations in the Critically Ill
Effects of Altered Physiology on Pharmacokinetics
Chapter 18: Rational Use of Antimicrobials
Empirical Antimicrobial Therapy
Antibiotic Stewardship in the ICU
Antimicrobial Agents
Common Health Care–Associated Infections in the ICU
Chapter 19: Rational Use of Blood Products
Basis for Transfusion of Blood Products: Benefits and Risks
Risks of Transfusion
Massive Exsanguination and Transfusion
Recombinant Factor VIIa
Tranexamic Acid
Section 3: Specialized Care for Intensive Care Unit Patients
Chapter 20: Renal Replacement Therapy
When to Start Renal Replacement Therapy
Available Modalities
Factors Influencing Selection of a Specific Modality
Other Factors That May Influence Modality Choice
Optimal Dosing of Solute Clearance during RRT
Chapter 21: Rehabilitation Interventions and Recovery from Critical Illness
Starting Rehabilitation in the Intensive Care Unit
Specific Rehabilitation Problems and Their Interventions in the Intensive Care Unit
Planning for Rehabilitation after Leaving the Intensive Care Unit
Chapter 22: Swallowing and Communication Disorders
Approach to Swallowing Dysfunction in the Intensive Care Unit PatientThe Swallowing Mechanism
Clinical Assessment for Swallowing Dysfunction
Management of Swallowing Dysfunction
Verbal Communication Problems
Tracheostomy Tubes
Tracheostomy Tubes and Communication
Conclusion
Chapter 23: Care of the Patient Infected with Human Immunodeficiency Virus
Infection
HIV-Related Complications
Pulmonary Complications
Neurologic Complications
Differential Diagnosis of Hypotension in the Patient with Human Immunodeficiency
Virus Infection
Other Organ System Dysfunction in Patients Infected with Human Immunodeficiency
Virus
Chapter 24: Care of the Cancer Patient with Neutropenia or Thrombocytopenia
Clinical Disorders
Diagnostic Evaluation
Clinical Management
Chapter 25: Care of the Challenge-to-Wean Patient
Definition
Prevalence
Predictors of Weaning Success
Factors Associated with Prolonged Mechanical Ventilation
Factors That Increase Work of Breathing (WOB)
Rehabilitation in Patients Receiving PMV
Specialized Patient Populations Receiving PMV
Treatments
ObesityPostcardiac Surgery Patients
Choice of Weaning Techniques
Lack of Progress in Weaning
Options for the Persistently Ventilator-Dependent Patient
Chapter 26: Care of the Patient with End-Stage Renal Disease
Common Problems in Patients with End-Stage Renal Disease in the Intensive Care
Unit
Diagnostic Considerations
Management
Clinical Pearls and Pitfalls
Chapter 27: Care of the Patient with End-Stage Liver Disease
Ascites
Hepatic Hydrothorax
Spontaneous Bacterial Peritonitis (SBP)
Variceal Hemorrhage
Hepatic Encephalopathy
Hepatorenal Syndrome (HRS)
Conclusion
Chapter 28: Care of the Maternal-Fetal Unit
Maternal Physiologic Changes in Pregnancy
Effects of Common Intensive Care Unit Interventions on the Maternal-Fetal Unit
Fetal Monitoring
Chapter 29: Care of the Patient with Morbid Obesity
Background/Epidemiology
Respiratory Effects of Obesity
Cardiovascular Effects of Obesity
Other Organ System Manifestations
Implications for Management
Bariatric Surgery and Postoperative Critical CareObesity and Outcomes from Critical Illness
Section 4: Problems Arising in the Intensive Care Unit Setting: Evaluation and
Management
Chapter 30: Airways and Emergency Airway Management
Useful Drugs in Emergency Airway Management
Gastric Aspiration Precautions
Equipment for Emergency Airway Management
Obtaining a Secure Airway
Troubleshooting Artificial Airways
Chapter 31: Alcohol Withdrawal: Diagnosis and Management
Alcohol Dependency and Alcohol Withdrawal Syndrome
Treatment
Chapter 32: Allergies to Antibiotics
Evaluations of Patients with a History of Antibiotic Allergy
Skin Testing for Beta-Lactam Antibiotics
Predictive Value of Skin Testing
Indications for Skin Testing
Evaluation of Allergies to Cephalosporins and Other Non–Beta-Lactam Antibiotics
Management of Patients with Positive Skin Test Results to Penicillin
Chapter 33: Arrhythmias (Bradycardias)
Definitions
Approach to the Patient Presenting with a Bradyarrhythmia
Classification of Bradyarrhythmias
Bradyarrhythmias under Special Circumstances
Obstructive Sleep Apnea
Treatment
Chronic Management
SummaryChapter 34: Arrhythmias (Tachycardias)
General Approach to Tachyarrhythmias in the ICU Setting
Narrow Complex Tachycardias
Wide Complex Tachycardias
Special Considerations
Chapter 35: Barotrauma and Chest Tubes
Manifestations of Barotrauma
Chest Tube Selection, Insertion, and Management
Chapter 36: Change in Mental Status
Definition
Clinical Approach to Change in Mental Status
Chapter 37: Delirium in the Intensive Care Unit: Diagnosis and Treatment
Diagnosis
Treatment
Conclusion
Chapter 38: Diarrhea Developing in the Intensive Care Unit Patient
Pathophysiology
Differential Diagnosis (Box 38.1)
Diagnostic Evaluation
Management and Treatment
Clinical Pearls and Pitfalls
Chapter 39: Electrolyte Disorders
Potassium Disorders
Calcium Disorders
Magnesium Disorders
Phosphate Disorders
Chapter 40: IleusPathophysiology
Causes of Ileus in the Intensive Care Unit
Diagnost