The aim of this book, part of the European Society of Intensive Care Medicine (ESICM) textbook series and designed by the NEXT Committee of the European Society of Intensive Care Medicine, is to provide the readers with a unique review of the main syndromes in Intensive Care Medicine by means of a collection of clinical cases. The book is structured in six sections (severe infections and sepsis, respiratory medicine, cardiovascular medicine, neurocritical care and severe trauma, severe endocrine and metabolic disorders, and severe inflammatory disorders), that allow the reader to focus on a specific area. Each section begins with an “introductory chapter” to maintain cohesion. Within each section, every chapter corresponds to a clinical case covering different aspects of a relevant disease. All the chapters have a uniform design: introduction/background, case presentation, investigations, differential diagnosis, treatment, evolution, outcome and follow-up, and discussion. The target audience of this work includes university students, fellows of intensive care medicine, critical care and emergency medicine residents, and experienced physicians aiming to review the most relevant syndromes of the specialty.

The FCCS program has been one of the main cornerstones of the Society's educational foundation and the successful completion of this new edition has been a priority of SCCM leadership. It is hoped that, in the tradition of the FCCS program and the previous versions of this book, many professionals will learn about critical care and, importantly, that many patients will benefit as a consequence of that knowledge.

Organized by body systems and using an outline format, this unique reference focuses on assessment of critically ill patients. It presents detailed information on history taking, the physical examination, and diagnostic studies. It also includes ACLS algorithms and universal precautions. 384 pp. Pub: 1/97. <p>The book contains both black-and-white and two-color illustrations.</p>

This official textbook of the Society of Neurocritical Care (SNCC) comprises a comprehensive review of all possible neurologic conditions that one may encounter in the practice of neuro-intensive care. It covers various topics, from the history and origin of neuro-intensive care to psychological and nursing care. Neurocritical care is the intensive care management of patients with life-threatening neurological and neurosurgical illnesses such as massive stroke, bleeding in or around the brain (subarachnoid hemorrhage, intracerebral hemorrhage, subdural hemorrhage, intraventricular hemorrhage), brain tumors, brain trauma, status epilepticus, nerve and muscle diseases (myasthenia gravis, Guillain-Barre Syndrome), spinal cord disorders and the cardiopulmonary complications of brain injury. Neurocritical care units specialize in managing the unique needs of such critically ill patients. The textbook is divided into many sections. Chapters discuss issues related to palliative care and describe some of the commonly performed procedures in the neuro-intensive care unit as well. It provides a straightforward and systematic approach to various clinical problems encountered during intensive care management of neurologic patients. It includes a separate section on special considerations in neurocritical care. The book includes ample figures, flowcharts and algorithms. The textbook is a valuable resource for residents, fellows and trainees in neuroanesthesia, neurointensive care, critical care, and anesthesia. It serves as a quick guide to all intensivists managing neurosurgical patients. It is also helpful for general intensivists who occasionally manages neurologic patients.

Intensive care medicine is a dynamic and evolving specialty, requiring its practitioners to be part physician, physiologist and anaesthetist. This requires a firm foundation of knowledge and an ability to apply this to the clinical situation. This book contains 270 multiple choice questions allowing self-assessment of the breadth of knowledge required of the modern intensivist. The book is divided into three papers each consisting of 60 multiple true false (MTF) and 30 single best answer (SBA) questions covering areas including resuscitation, diagnosis, disease management, organ support, and ethical and legal aspects of practice. The MTF questions test factual knowledge and understanding of the evidence base underpinning intensive care medicine, while the SBA questions test the ability of the candidate to prioritise, compete options and make the best decision for the patient. Each question is peer reviewed and accompanied by concise and detailed explanatory notes with references to guide further reading. All the authors are practising intensive care physicians with first-hand experience of professional examinations in the specialty. This book will appeal to intensive care physicians approaching professional examinations worldwide, including the European Diploma, American Board and Faculty of Intensive Care Medicine examinations. In addition, it will appeal to intensive care nurses and allied healthcare professionals wishing to update their knowledge as part of continuing professional development, and to physicians sitting professional examinations in related specialties requiring knowledge of intensive care medicine such as general medicine, general surgery and anaesthesia. This book will complement the existing international best-selling title "Multiple Choice Questions in Intensive Care Medicine" (9781903378 649), also written by Dr Steve Benington.

The second edition of this highly successful book includes up-to-date notes on the step-wise management of clinical emergencies encountered in everyday intensive care units (ICU). Each thoroughly revised chapter provides concise information for point-of-care treatment, making it a practical guide clinicians can refer to on a daily basis at work or while traveling, or just to expand their knowledge.  Volume 2 of ICU Protocols covers topics in the endocrine and metobolic systems, oncology, trauma, toxicology, envenomation and thermodysregulation, obstetrics, perioperative care, pediatrics and ICU procedures. Pulmonology, cardiology, neurology, gastroenterology, nephrology and infectious diseases are covered in the first volume of ICU Protocols.  This two-volume book is a must-read for intensivists, critical care specialists, junior trainees and residents working in ICUs. It is also relevant as course material for workshops on critical care, and essential for all hospital-based libraries.  “This book provides junior trainees with an introduction to the management of problems common to the critical care unit.” David J Dries, Doody’s Book Reviews, March, 2013, for the first edition of ICU Protocols.

This book, part of the European Society of Intensive Care Medicine (ESICM) textbook series, is a graphical, dense and concise text describing fundamental theoretical concepts needed for doctors and other professionals new to the field of Intensive Care Medicine. The book serves two main purposes: as study material for any junior doctor, nurse or other allied healthcare professional who is time-pressured and wants to quickly learn the essentials; and as a course volume of new ESICM educational initiative called Intensive Care Fundamentals©. The overarching goal of this initiative is to offer standardised high-quality introductory education to all starters in intensive care. There are two key elements of this initiative: the book, which is the prerequisite reading for attending the two day face-to-face course and the materials, registration of candidate and training and certifying the trainers that will be provided by ESICM.

This book identifies the key scientific articles in the field of Intensive Care and explains why these papers are important in contemporary clinical management. Identifying those influential contributors who have shaped the practice of modern Intensive care practice, the book includes commentaries on 50 seminal papers in a wide range of areas. enal This an invaluable reference for trainees, fellows, and surgeons studying for exams, as well as for seasoned surgeons and physicians who want to stay current in their field.

Contents Abbreviations Part I: Precision Medicine 1: The Role of Transcriptomics in Redefining Critical Illness 1.1 Introduction 1.2 Transcriptomes: An Indispensable Player in Unraveling the Mechanisms of Sepsis 1.2.1 Overview of the Molecular Pathophysiology of Sepsis 1.2.2 Messenger RNA: The Driving Force of Transcriptomics 1.2.3 MicroRNA: The Master Regulators of Gene Expression 1.2.4 Long Non-coding RNA: The miRNA Sponges 1.3 From Transcriptomics to Clinical Tools 1.3.1 Time Is Critical: Current Challenges in the Early Detection of Sepsis 1.3.1.1 Rapid Host Transcriptomic Biomarkers for Sepsis 1.3.2 Trials and Tribulations: Current Challenges in the Treatment of Sepsis 1.3.3 Deriving Transcriptomic Endotypes for Sepsis 1.4 Challenges of Applying Transcriptomics in Critical Care 1.5 Conclusion References 2: Metagenomic Sequencing in the ICU for Precision Diagnosis of Critical Infectious Illnesses 2.1 Introduction 2.2 Current Standards in Pathogen Detection 2.3 Principles of Metagenomics for Infectious Disease Diagnosis 2.4 DNA Sequencing vs. RNA Sequencing 2.5 Proof of Concept and Clinical Trial Data for Metagenomic Diagnostics 2.6 Metagenomics for Prediction of Pathogen Antimicrobial Resistance 2.7 Assessing the Host Response to Enhance Metagenomic Pathogen Detection 2.8 Metagenomics: Potential Hurdles and Important Considerations 2.9 Conclusion References 3: Risk Stratification and Precision Medicine: Is It Feasible for Severe Infections? 3.1 Introduction 3.2 Endotypes of Severe Infections 3.3 How to Transfer Endotypes into Everyday Clinical Practice 3.4 Protein Biomarkers for Unselected Risk Classification 3.5 The Use of Biomarkers to Guide Immunotherapy in Severe Infections 3.6 Conclusion References 4: Interrogating the Sepsis Host Immune Response Using Cytomics 4.1 Introduction 4.2 Historical Focus on Immature Granulocytes in Sepsis 4.3 Compensatory Anti-Inflammatory Response and Sepsis Immune Paresis 4.4 Lymphocyte Activation and Exhaustion 4.5 Pediatric Sepsis: Cytomics in the Developing Immune System 4.6 Conclusion References 5: Precision Medicine in Septic Shock 5.1 Introduction 5.2 Omics Technologies 5.3 Treatments for Specific Endotypes of Patients with Septic Shock 5.3.1 Hypogammaglobulinemia 5.3.2 Endotoxemia 5.3.3 Hypercytokinemia 5.3.4 Sequential Hemadsorption 5.4 Non-catecholaminergic Vasopressors 5.4.1 Vasopressin 5.4.2 Selepressin 5.4.3 Terlipressin 5.4.4 Methylene Blue 5.4.5 Angiotensin II 5.5 Metabolic Resuscitation 5.5.1 Vitamin C (Ascorbic Acid) 5.5.2 Hydroxocobalamin 5.6 New Molecules for Adjuvant Treatment of Sepsis 5.6.1 Nangibotide 5.6.2 Recombinant Alkaline Phosphatase 5.6.3 Adrecizumab 5.6.4 Apoptotic Cells 5.7 Conclusion References Part II: Sepsis Biomarkers and Organ Dysfunction Scores 6: Host Response Biomarkers for Sepsis in the Emergency Room 6.1 Introduction 6.2 Biomarkers in the Context of Sepsis 6.2.1 Traditional Biomarkers: CRP and Procalcitonin (PCT) 6.2.2 Emerging Biomarkers 6.2.2.1 Presepsin 6.2.2.2 sTREM-1 6.2.2.3 Proadrenomedullin 6.3 Transcriptomics 6.4 Proteomics and Metabolomics 6.5 Conclusion References 7: Repetitive Assessment of Biomarker Combinations as a New Paradigm to Detect Sepsis Early 7.1 Introduction 7.2 Limited Usefulness of Routinely Used Biomarkers of Sepsis 7.3 Time for a Paradigm Change in the Use of Sepsis Biomarkers 7.4 Pancreatic Stone Protein, A Novel Sepsis Biomarker That Is Released Early 7.5 Role of Repetitive Serial Assessments of CRP and PSP in the Diagnostic Workup of Sepsis 7.5.1 Pre-Symptomatic Diagnosis of Sepsis by Serial Assessment of PSP and CRP Levels in Patients at Risk 7.6 Conclusion References 8: Organ Dysfunction Scores in the Adult ICU 8.1 Introduction 8.2 Definition and Rationale for Assessment of Organ Dysfunction 8.3 Variables Representing Organ Dysfunction and Their Implementation into Scoring Systems 8.4 Organ Systems Included in the Organ Dysfunction Scores in the ICU 8.4.1 Neurological Component 8.4.2 Cardiovascular Component 8.4.3 Respiratory Component 8.4.4 Hematological Component 8.4.5 Renal Component 8.4.6 Hepatic Component 8.4.7 Abdominal Component 8.4.8 Metabolic Component 8.4.9 Physical Component 8.5 Modified SOFA Scores 8.6 The Future of Organ Dysfunction Scores 8.7 Conclusion References Part III: ARDS 9: Ex Vivo Lung Perfusion Models to Explore the Pathobiology of ARDS 9.1 Introduction 9.2 ARDS Pathobiology Overview 9.3 Different Approaches to Inducing and Attenuating Lung Injury in EVLP Models: Lipopolysaccharide Challenge as an Example 9.4 Technical Considerations in EVLP Models 9.4.1 Ventilation 9.4.2 Perfusion Pressures and Flow Rate of Perfusate 9.4.3 Controls for Experiments 9.4.4 Cellular or Acellular Perfusion? 9.5 Defining ARDS in EVLP Models 9.6 EVLP Challenges 9.7 Conclusion References 10: Interpretation of Lung Perfusion in ARDS 10.1 Introduction 10.2 Determinants of Gas Exchange 10.2.1 Ventilation 10.2.2 Perfusion 10.3 The Ventilation:Perfusion Ratio: Definition and Pitfalls 10.4 Static and Dynamic Assessment of Ventilation and Perfusion 10.5 Alveolar Perfusion Pressure 10.5.1 Perfusion as Determinant of Lung Injury 10.6 How to Assess Lung Perfusion 10.6.1 Assessment of Global Lung Perfusion 10.6.2 Assessment of Regional Perfusion 10.7 How to Manipulate Lung Perfusion 10.7.1 Drugs 10.7.2 Ventilation 10.7.3 Positioning 10.8 A Six-Compartment Model to Describe Regional V/Q Matching 10.9 Conclusion References 11: A Structured Diagnostic Algorithm for Patients with ARDS 11.1 Introduction 11.2 Diagnosis of ARDS 11.2.1 Practical Steps 11.2.2 Uncertainties 11.3 First Phase of Evaluation (Days 1 and 2) 11.3.1 Practical Steps 11.3.2 Uncertainties 11.4 Second Phase of Evaluation (Days 3–5) 11.4.1 Practical Steps 11.5 Third Phase of Evaluation (Days 6–7) 11.5.1 Practical Steps 11.5.2 Uncertainties 11.6 Conclusion References 12: Hemodynamic Implications of Prone Positioning in Patients with ARDS 12.1 Introduction 12.2 Hemodynamic Effects of Prone Positioning 12.2.1 Prone Positioning Affects Venous Return Determinants and May Increase Right Ventricular Preload 12.2.2 Prone Positioning May Decrease Pulmonary Vascular Resistance and Right Ventricular Afterload 12.2.3 Prone Positioning May Increase Left Ventricular Preload 12.2.4 Overall Effects of Prone Positioning on Cardiac Output 12.3 Detecting Preload Responsiveness in Patients in the Prone Position 12.3.1 Trendelenburg Maneuver 12.3.2 End-Expiratory Occlusion Test 12.3.3 Pulse Pressure Variation 12.3.4 Tidal Volume Challenge 12.3.5 Mini-Fluid Challenge 12.4 Conclusion References Part IV: Ventilatory Support 13: Update on the Management of Acute Respiratory Failure Using Non-invasive Ventilation and Pulse Oximetry 13.1 Introduction 13.2 Effectiveness and Utility of NIV 13.3 Key Clinical Trials from the Systematic Reviews 13.4 Current Knowledge of NIV for Respiratory Failure in the ICU 13.5 NIV for COVID-19 13.6 Key Clinical Trials and RECOVERY-RS 13.7 Current Knowledge About Use of NIV for COVID-19 13.8 Timing of Intubation When Patients Are Receiving NIV 13.9 Predicting Successful Treatment with HFNC 13.9.1 ROX Index in COVID-19 13.10 Monitoring Respiratory Failure Using SpO2: The Risk of Inaccuracy 13.10.1 Inaccuracy of Pulse Oximeters and Skin Color: New Investigations 13.11 Conclusion References 14: Managing the Physiologically Difficult Airway in Critically Ill Adults 14.1 Introduction 14.2 Adverse Outcomes and Risk Factors 14.2.1 What Are the Outcomes of Tracheal Intubation in Critically Ill Adults? 14.2.2 Which Patients Are at Risk? 14.3 Hemodynamic Optimization 14.3.1 Is There an Optimal Induction Agent? 14.3.2 What Is the Role of Fluids? 14.3.3 What Is the Role of Vasopressors? 14.4 Mitigating Hypoxemia 14.4.1 Are Standard Pre-oxygenation Strategies Adequate? 14.4.2 What About Non-invasive Ventilation? 14.4.3 What About Apneic Oxygenation? 14.4.4 Should Mask Ventilation Be Avoided? 14.5 First Pass Success 14.5.1 Is It Time to Universally Adopt Video Laryngoscopy? 14.5.2 What About Intubation Adjuncts and Checklists? 14.6 Is It Time for New Approaches? 14.7 Conclusion References 15: Dyspnea in Patients Receiving Invasive Mechanical Ventilation 15.1 Introduction 15.2 Definition, Prevalence and Intensity of Dyspnea 15.2.1 Definition 15.2.2 Prevalence and Intensity 15.3 Risk Factors for Dyspnea and Relation to Ventilator Settings 15.3.1 Pathophysiology of Dyspnea 15.3.2 Risk Factors Not Related to Ventilator Settings 15.3.3 How Often Do Ventilator Settings Contribute to Dyspnea? 15.4 Clinical Consequences of Dyspnea in Patients Receiving Invasive Mechanical Ventilation 15.4.1 Immediate Fear and Panic Related to Dyspnea 15.4.2 Impact of Dyspnea on Weaning 15.4.3 Association Between Dyspnea and Mortality 15.4.4 Delayed Psychological Consequences, Post-traumatic Stress Disorder 15.5 Underestimation of Dyspnea in Patients Receiving Invasive Mechanical Ventilation 15.5.1 Patients Are Not Asked 15.5.2 Discrepancies Between Patient Self-Reporting and Stakeholders’ Observations 15.6 Conclusion References 16: The Potential Risks of Pressure Support Ventilation 16.1 Introduction 16.2 Principles of Operation of Pressure Support Ventilation 16.3 Respiratory Drive, Rate and Effort During Pressure Support Ventilation 16.4 Patient-Ventilator Interaction During Pressure Support Ventilation 16.4.1 Risk of Periodic Breathing 16.4.2 Risk of Diaphragm Weakness 16.4.3 Risk of Ineffective Efforts 16.4.4 Risk of Expiratory Asynchrony 16.4.5 Risk of Lung Injury 16.5 Conclusion References 17: Advancing Sedation Strategies to Improve Clinical Outcomes in Ventilated Critically Ill Patients 17.1 Introduction 17.2 Evolution of Sedation Strategies and Evidence Evaluation 17.2.1 Daily Sedative Interruption 17.2.2 Light Sedation 17.2.3 No Sedation or Analgo-Sedation 17.2.4 Early Mobilization 17.3 Comparative Trials of Commonly Used Sedatives 17.4 Sedation Practice in Intensive Care Evaluation, the SPICE-III Trial 17.4.1 Early Sedation Depth in Ventilated Critically Ill Patients 17.4.2 Improving Patient-Centered Outcomes in Ventilated Critically Ill Adults 17.4.3 The Age Interaction with Early Dexmedetomidine Treatment 17.4.3.1 Critically Ill Older Patients 17.4.3.2 Critically Ill Younger Patients 17.4.3.3 Ventilated Critically Ill Surgical Patients 17.4.3.4 Critically Ill Patients with Sepsis 17.4.3.5 Critically Ill Cardiovascular Patients 17.5 Reducing the Burden of Delirium with Dexmedetomidine 17.6 Conclusion References Part V: Extracorporeal Support 18: Setting and Monitoring of Mechanical Ventilation During Venovenous ECMO 18.1 Introduction 18.2 Historical Perspective 18.2.1 Ventilation Strategies in ECMO Landmark Trials 18.2.2 Current Practice in ECMO-Experienced Centers 18.3 Targeting Ultra-Lung-Protective Mechanical Ventilation During ECMO 18.3.1 Tidal Volume 18.3.2 Plateau Pressure 18.3.3 Driving Pressure 18.3.4 Respiratory Rate 18.3.5 Mechanical Power 18.3.6 Applying Apneic Ventilation? 18.3.7 Preserving Spontaneous Ventilation and Diaphragmatic Function to Minimize P-SILI? 18.4 How to Set the Optimal PEEP on ECMO? 18.4.1 Electrical Impedance Tomography-Guided Strategy 18.4.2 Transpulmonary Pressure-Guided Strategy 18.4.3 Other Methods 18.5 Prone Positioning During ECMO 18.6 Gas Exchange Targets on ECMO 18.7 Mechanical Ventilation During ECMO Weaning 18.8 Conclusion References 19: Early Mobilization in Patients Receiving ECMO for Respiratory Failure 19.1 Introduction 19.2 Evidence 19.3 Conclusion References 20: Physiological Adaptations During Weaning from Venovenous ECMO 20.1 Introduction 20.2 Intercenter Variability in the Approach to Weaning 20.2.1 Different Preconditions for Weaning 20.2.2 Different Ventilatory Strategies During Weaning 20.2.3 Different Targeted Parameters During Weaning 20.2.4 Different Evaluation Criteria for a Weaning Trial 20.3 Physiology of Weaning from VV-ECMO 20.3.1 The Extracorporeal Circuit 20.3.1.1 V′O2ML, V′CO2ML and the Effects of Weaning Effects of Reducing ECBF Effects of Reducing SGF Rate Without Altering the FdO2 Effects of Reducing the FdO2 Prior to Reducing the SGF 20.3.2 The Patient 20.3.2.1 Physiology of Breathing Control 20.3.2.2 Effects of Weaning on Respiratory Center Output Stepwise Decreases in SGF May Change the Position of the Metabolic Hyperbola Stepwise Decreases in FdO2 or ECBF May Change the Set-Point of the Brain Curve Changes in Breathing Pattern May Affect the Ventilation Curve 20.3.2.3 Monitoring Respiratory Center Output 20.3.3 The Ventilator 20.3.3.1 Passive, Controlled Patients 20.3.3.2 Spontaneously Breathing Patients Maneuvers Reducing Effort and Stress Maneuvers Reducing Effort But Not Stress 20.4 A Proposed Approach to Weaning 20.5 Conclusion References 21: Novel Strategies to Enhance the Efficiency of Extracorporeal CO2 Removal 21.1 Introduction 21.2 Blood CO2 Transportation 21.3 Factors Affecting Extracorporeal CO2 Removal 21.4 Novel Strategies to Enhance the Efficiency of Extracorporeal CO2 Removal 21.4.1 Blood Mixing 21.4.2 Bicarbonate Removal 21.4.3 Carbonic Anhydrase 21.4.4 Acidification 21.5 Limitations 21.6 Conclusion References 22: Extracorporeal Cardiopulmonary Resuscitation for Out-Of-Hospital Cardiac Arrest: A Systematic Approach 22.1 Introduction 22.2 System Design and Quality 22.3 Patient Selection 22.4 Transport 22.5 Patient Admission 22.6 ECMO Cannulation 22.7 Initial Diagnostic and Therapeutic Procedures 22.8 Intensive Care 22.9 Hospital Discharge and Long-Term Follow-Up 22.10 Conclusion References 23: Temporary and Durable Mechanical Circulatory Support in the ICU 23.1 Introduction 23.2 Temporary Mechanical Circulatory Support 23.2.1 Devices 23.2.1.1 Intra-Aortic Balloon Pump 23.2.1.2 Impella 23.2.1.3 Protek Duo 23.2.1.4 TandemHeart 23.2.1.5 Veno-Arterial Extracorporeal Membrane Oxygenation 23.2.1.6 Surgically-Implanted Temporary Ventricular Assist Devices 23.2.2 Principles of Device Selection and Weaning of Temporary Mechanical Circulatory Support 23.2.3 Complications 23.3 Durable Mechanical Circulatory Support 23.3.1 Devices 23.3.2 Complications 23.3.2.1 Right Ventricular Failure 23.3.2.2 Hemocompatibility-Related Adverse Events 23.3.2.3 Driveline Infection 23.3.2.4 Aortic Insufficiency 23.4 Conclusion References Part VI: Fluids and Transfusion 24: Venous Congestion: Why Examine the Abdomen with Ultrasound in Critically Ill Patients? 24.1 Introduction 24.2 Case Study 24.3 Importance of Fluid Overload 24.4 Diagnosis of Venous Congestion 24.4.1 Inferior Vena Cava 24.4.2 Hepatic Veins 24.4.3 Renal Veins 24.4.4 Portal Veins 24.4.5 Splenic Veins 24.4.6 Femoral Veins 24.4.7 The VExUS Score 24.4.8 Surface Ultrasound or Transesophageal Echocardiography 24.5 Venous Congestion and RV Dysfunction 24.6 The Importance of Examining the Abdomen of Critically Ill Patients 24.7 Limitations and Pitfalls of Venous Congestion Indices 24.8 Back to the Case Study 24.9 Conclusion References 25: The Most Important Questions in the Current Practice of Transfusion of Critically Bleeding Patients 25.1 Introduction 25.2 Therapeutic Goals in Treating Major Hemorrhage 25.3 Question 1: Fibrinogen Concentrate vs. Cryoprecipitate? 25.4 Question 2: Early Empiric Fibrinogen, Prothrombin Complex Concentrate, and Other Coagulation Factors (Usually in Combination with Crystalloid for Volume) vs. Fresh-Frozen Plasma? 25.5 Question 3: Whole Blood vs. Fractionated Blood Components? 25.6 Question 4: Lyophilized Plasma vs. FFP? 25.7 Question 5: The Value of Viscoelastic Testing 25.8 Question 6: The Value of Platelets (Including Cold Stored and Cryopreserved) 25.9 Conclusion References Part VII: Acute Renal Failure 26: Fluid Management and Acute Kidney Injury 26.1 Introduction 26.2 Fluid Status and Kidney Function 26.3 Why Prescribe Fluids? 26.4 What to Prescribe: Types of Fluids 26.4.1 Colloids 26.4.2 Crystalloids 26.4.3 Bicarbonate Infusion and Acute Kidney Injury 26.5 How to Prescribe: Volume of Fluids 26.6 When to Stop Fluid Therapy? 26.7 De-escalation of Fluid Therapy 26.8 Fluid Management During RRT 26.9 Areas for Further Research 26.10 Conclusion References 27: Cardiorenal Syndrome 1: What’s in a Name? 27.1 Introduction 27.2 Epidemiology 27.3 Pathophysiology 27.4 Definitions 27.4.1 Urine Output Criteria 27.4.2 Baseline Serum Creatinine 27.4.3 Serum Creatinine Criteria 27.4.3.1 Worsening Renal Function 27.4.3.2 Pseudo-AKI, Functional AKI, and Subclinical AKI 27.5 Management 27.5.1 Renal Replacement Therapy 27.6 Conclusion References Part VIII: The Microcirculation and Metabolism 28: Update on the Microcirculatory Assessment of the Critically Ill Patient 28.1 Introduction 28.2 What Microcirculatory Measurement Has Taught Us About Pathophysiology 28.3 Fluid Status 28.4 Sepsis 28.5 COVID-19 28.6 Analysis of Microcirculatory Images and MicroTools as a Point-of-Care Tool for Microcirculatory Assessment at the Bedside 28.7 Database Deep Learning and Artificial Intelligence 28.8 Future Developments 28.9 Conclusion References 29: Intracellular Measurements of Micronutrients in the Critically Ill 29.1 Introduction 29.2 Inflammation 29.3 Real vs. Apparent Deficiency 29.4 Elective Surgery as a Model for Inflammatory Response 29.5 Intracellular Measurements 29.5.1 Practical Issues: Erythrocytes 29.5.2 Practical Issues: Leukocytes 29.6 Clinical Studies with Intracellular Measurements 29.6.1 Elective Knee Arthroplasty 29.6.2 Critically Ill Patients 29.7 Discussion 29.8 Conclusion References 30: Optimal Glycemic Targets in Critically Ill Patients with Diabetes 30.1 Introduction 30.2 Early Trials of Glucose Control During Admission to the ICU 30.3 Clinical Practice Guidelines 30.4 Prevalence of Diabetes in Patients Admitted to the ICU 30.5 Evaluation of Previous Randomized Clinical Trials When Focusing on Patients with Pre-existing Diabetes 30.6 Pre-existing Diabetes Relationship to Blood Glucose Metrics 30.7 Rationale for a Personalized Approach to Glycemic Control 30.8 Studies of More Personalized Approach to Glucose Control 30.9 Future Research 30.10 Conclusion References Part IX: A Look Back at COVID-19 31: Hydroxychloroquine: Time for Reappraisal of Its Effect in COVID-19 Patients 31.1 Introduction 31.2 SARS-CoV-2 31.3 Aminoquinolones 31.3.1 In Vitro Studies 31.3.2 Clinical Studies 31.4 Conclusion References 32: Blood Purification in COVID-19 in the Absence of Acute Kidney Injury 32.1 Introduction 32.2 Tackling the Inflammatory Storm Initiated by COVID-19 32.2.1 Sorbents 32.2.2 Therapeutic Plasma Exchange 32.3 Removing SARS-CoV-2 and Nucleocapsids 32.3.1 SARS-CoV-2 Removal by Seraph® 100 32.3.2 Removal of Viral Nucleocapsids by Seraph® 100 32.4 Removing Endotoxin During Severe COVID-19 Infection 32.5 Conclusion References Part X: Neurologic Considerations 33: Epidemiology, Outcomes, and Costs of Pediatric Traumatic Brain Injury Treated in the ICU 33.1 Introduction 33.2 Epidemiology 33.3 Pediatric Anatomy and Physiology 33.4 Treatment 33.5 Outcomes and Sequelae 33.5.1 Neurological Sequelae 33.5.2 Cognitive and Psychiatric Sequelae 33.5.3 Endocrinological Dysfunction 33.6 Prognostication After Pediatric TBI 33.7 Costs 33.8 Future Perspectives 33.9 Conclusion References 34: Quality Improvement in the Determination of Death by Neurologic Criteria Around the World 34.1 Introduction 34.2 Brain Death/Death by Neurologic Criteria Mimics 34.3 Confounders That Interfere with the Clinical Brain Death/Death by Neurologic Criteria Evaluation 34.3.1 Hypothermia 34.3.2 Muscle Paralysis 34.3.3 Sedation/Analgesia 34.3.4 Hypoxia 34.3.5 Hypotension 34.3.6 Hypoglycemia or Other Endocrine or Metabolic Abnormality 34.3.7 Basal Skull Fracture with Hemotympanum 34.3.8 Facial Trauma 34.3.9 Pulmonary Injury/Disease 34.3.10 Cervical Spine Injury 34.3.11 Anophthalmia 34.4 Considerations for Performance of the Clinical Examination 34.5 Apnea Test Safety Considerations 34.5.1 Hypotension 34.5.2 Hypoxemia 34.5.3 Pneumothorax, Pneumomediastinum and Pneumoperitoneum 34.5.4 Arrhythmia/Cardiac Arrest 34.6 Ancillary Testing Confounders/Limitations 34.7 Special Considerations for Brain Death/Death by Neurologic Criteria Determination in Pediatric Patients 34.8 Conclusion References Part XI: Obstetric Issues 35: COVID-19 ARDS in Pregnancy: Implications for the Non-COVID Era 35.1 Introduction 35.2 Pregnancy, ARDS, and SARS-CoV-2 Infection 35.3 Maternal Management of COVID-19 ARDS 35.3.1 Prone Position 35.3.2 Extracorporeal Membrane Oxygenation (ECMO) 35.3.3 Pharmacological Treatment 35.4 Timing and Delivery of the Fetus 35.5 Conclusion References 36: Amniotic Fluid Embolism 36.1 Introduction 36.2 Pathophysiology 36.3 Incidence 36.4 Clinical Features 36.5 Diagnosis 36.6 Management 36.7 Conclusion References Part XII: Pre- and Post-Intensive Care 37: Remote Telehealth Aid During Humanitarian Crisis 37.1 Introduction 37.2 Methods of Remote Healthcare 37.3 Methods of Remote Education and Communication 37.4 Opportunities for Improvement with Remote Platforms 37.5 Remote Aid During a Humanitarian Crisis 37.5.1 Approaches to Providing Remote Aid During a Humanitarian Crisis 37.5.2 Barriers to NETCCN Telemedicine Application Adaptation for Remote Humanitarian Aid 37.6 Providing Materiel Aid 37.7 Patient Sharing 37.8 Operational Security Issues 37.9 Potentially Desirable Outcomes 37.10 Medical-Legal Considerations 37.11 Conclusion References 38: Boarding in the Emergency Department: Challenges and Success Strategies to Mitigate the Current Crisis 38.1 Introduction 38.2 ED Boarding Versus ED Crowding 38.3 Drivers of Boarding 38.4 Impact of Boarding 38.5 System Barriers that Enable Boarding 38.6 Potential Repair Strategies 38.7 Clinician and Team Education 38.8 Conclusion References 39: Post-Intensive Care Syndrome Revisited in Light of the COVID-19 Pandemic 39.1 Introduction 39.2 Definition and Epidemiology 39.3 Association with Functional Outcome 39.3.1 Cognitive Impairment 39.3.2 Psychiatric Symptoms 39.3.3 Physical Impairment 39.4 Diagnostics 39.5 Interventions 39.6 Post-Intensive Care/Post-COVID-19 Syndrome 39.7 Conclusion References Part XIII: Ethical Issues 40: Rethinking the Role of Palliative Care in the ICU 40.1 Introduction 40.2 Definition 40.3 Barriers to Palliative Care in the ICU 40.4 Models of Palliative Care 40.5 Primary (Generalist) Palliative Care 40.6 Specialist (Secondary) Palliative Care 40.7 Future Research 40.8 Conclusion References Index

Der immer noch dynamischen Entwicklung der Neonatologie, die nun auch in Deutschland als Schwerpunkt innerhalb der Pädiatrie etabliert und mit einer eigenen Weiterbildungsordnung versehen ist, trägt diese komplett überarbeitete 5. Auflage der Neugeborenenintensivpflege Rechnung: -Neue Entwicklungen der neonatologischen Intensivmedizin wurden aufgenommen. -Spezielle Pflegetechniken sind bei den einzelnen Krankheitsbildern beschrieben. -Die aktuelle Literatur ist umfassend zitiert. Eine komprimierte, praxisorientierte Anleitung zum raschen und sachgerechten Handeln bei schwerkranken Neugeborenen in der Diagnostik und Therapie.

This book should represent a guideline for launching an extracorporeal membrane oxygenation (ECMO) program. It describes in detail particularities and special features of planning, setting up, developing, structuring and maintaining of ECMO support program for instable patients with the need of transportation from peripheral hospitals to an experienced ECMO centre for further treatment. Authors have condensed both the current evidence and Guidelines on ECMO and eCPR support and have highlighted in detail the issue of planning, setting up, developing, structuring and maintaining this program with the view to helping other centres launching this life-saving service taking into account their experience in this important field of medicine. In this context, the main benefit of this book is the outstanding and particular aim to educate the reader in developing and maintaining a large-spectrum ECMO program. The volume, richly illustrated and written by KOLs using an expository writing style to promote the readability will appeal to intensivists, anesthesiologists and cardiologists as well as cardiac- and thoracic-surgeons and pneumologists

Intensive care medicine is a rapidly expanding medical specialty that commands a significant proportion of health care resources. It is predicted that the demand on intensive care resources will rapidly increase in the foreseeable future, partially due to an aging elderly population. There is an increasing wealth of literature as to the nature of the intensive care multi-disciplinary team, and how this impacts patient morbidity and mortality. This book presents current research from around the globe in the study of intensive care units including: intensive care unit staffing and its impact on patient outcome; medical and nursing intensive care delivery; acute compartment syndrome on intensive care units; and blood transfusions in the intensive care unit

Now well recognized, the critical role of the inflammatory response in the pathophysiology of peripheral and central neurological disorders, including Alzheimer's and Parkinson's diseases, is today the subject of intense investigation at the molecular level. In Inflammatory Disorders of the Nervous System: Pathogenesis, Immunology, and Clinical Management, a panel of influential basic scientists review in detail the fundamental biological principles underlying the more common inflammatory disorders of the nervous system. The authors provide extensive updates on the latest findings concerning the mechanisms of inflammation and introduce such new concepts and methodologies as "endothelial and leukocyte microparticles" and "gene microarray technology" to help explain important links between the central nervous system (CNS) and general inflammatory processes. Among the diseases examined from an inflammatory perspective are multiple sclerosis, acute disseminated encephalomyelitis, optic neuritis, transverse myelitis, CNS vasculitis, neuropsychiatric systemic lupus erythematosis, Alzheimer's disease, and Parkinson's disease. The role of the immune system in neuroinflammation is also explored in such disorders as neurosarcoidosis, HIV-associated dementia, and HTLV-associated neurological disorders. Cutting-edge and authoritative, Inflammatory Disorders of the Nervous System: Pathogenesis, Immunology, and Clinical Management offers basic research and clinical scientists an illuminating introduction to the new world of inflammatory CNS conditions and the emerging diagnostic and therapeutic opportunities they provide.

Minitracheostomy provides two challenges: the risk of incorrect placement and bleeding.

With more complex surgical patients requiring special perioperative care in an intensive care unit (ICU), there is an increased demand for Advanced Practice Providers (APPs) who are equipped to care for them. However, APPs, such as Physician Assistants (PAs) or Nurse Practitioners (NPs), have limited specialized training and exposure to the unique needs of the perioperative critically-ill population. That's where this book can help. Concepts in Surgical Critical Care is an indispensable resource for the APP, non-surgical intensivist, or non-intensivist surgeon who regularly provides critical care for surgical patients. It features a user-friendly organization designed for quick reference while at bedside with patients or in an office. It starts with foundational critical care topics across all surgical specialties followed by the specifics within 12 – including gastrointestinal surgery, cardiac surgery, neurosurgery, obstetrics, and more.

Edited By James L. Berk, James E. Sampliner ; Foreword By Francis D. Moore. Includes Bibliographical References And Index.

From the unique position of a decade in government service, I was given the opportunity to observe the changes in the provision of emer gency medical care across the country. In 1970, Emergency Medical Service (EMS) systems were a new and much needed development in the national health care delivery system. A systems approach to field casualty care has been progressively improved during each successive military conflict since the Civil War. These improvements were ini tiated after the rnedil:al care and evacuation disaster experienced by the Union Army of the Potomac at Bull Run on July 21, 1861. During the Civil War, major changes in administration, professional personnel, transportation, hospitals, sanitation, and medical records established patterns that have been continually refined and improved. Stimulated by the pressing demands of war surgery and coupled with parallel advances in medical care over the last century, an almost unbelievable level of performance was realized in Vietnam. Advances in field resuscitation, efficiency of aeromedical transportation, and energetic treatment of military casualties have proved to be major fac tors in the decrease in death rates of battle casualties reaching facilities: from 8% in World War I to 4. 5% in World War II to 2. 5% in Korea and to less than 2% in Vietnam. Erscheinungsdatum: 26.04.2012

This critical care medicine book substantially differs from others due to the range of peculiarities that characterize it. Since it deals with acute patients in critical conditions, this is, as it were, a 'borderline'book, in the sense that it is intended for those, who, in their activity, need a continuous and in-depth interdisciplinary approach to optimize the quality of the treatments offered to critically-ill patients. This book helps to have a better understanding of the current limits of human intervention and aims at supplying updated guidelines; in particular, it is intended for those who, although having to guarantee continuity and top-quality therapies, must decide when and why the collaboration with and intervention by experts is necessary

**Keine Angst vor Notfallen!** Der "Nicolai" in der Kitteltasche gibt Ihnen die Sicherheit, im Notfall die richtige Entscheidung zu treffen. Die Neuauflage wurde komplett uberarbeitet und aktualisiert. Hier finden Sie in Notsituationen alle wesentlichen Informationen knapp und prazise dargestellt. **Schnell und ubersichtlich** - praktische Handlungsanweisungen - knappe Differentialdiagnostik - nutzerfreundliche Dosiertabelle - Adressen wichtiger Zentren fur spezialisierte Diagnostik und Therapie - Pharmakokinetik-Tabellen unter intensivmedizinischen Aspekten - Konzentration auf das Wesentliche **Der Leitfaden fur die Padiatrische Notfall- und Intensivtherapie - wissen worauf es ankommt!**

As more critically ill patients are cared for on acute general wards rather than in ICUs, many nurses are having to cope with the particular problems of very sick patients without the specialist knowledge of an ICU trained nurse. This book considers the key issues surrounding the critical patient's care in the acute general hospital. The anatomy an

A source of information about the data, drugs and procedures which are necessary in emergencies. Each chapter looks at a different body system, giving physiological and technical data; information on drugs, dosages and infusion regimes and techniques for carrying out practical procedures.

Title from PDF title page (viewed on Sept. 9, 2008).

1 online resource (xxiii, 858 pages 154 illustrations) The Yearbook compiles the most recent, widespread developments of experimental and clinical research and practice in one comprehensive reference book. The chapters are written by recognized experts in the field of intensive care and emergency medicine. It is addressed to everyone involved in internal medicine, anesthesia, surgery, pediatrics, intensive care and emergency medicine Sepsis -- Sepsis and Inflammation: The Process of Dying from Critical Illness -- Recognition of Bacteria and Bacterial Products by Host Immune Cells in Sepsis -- Endotoxin Immune Status and Protection Against Multiple Organ Dysfunction Syndrome in the Surgical Patient -- Cardiovascular Function in Septic Shock -- Changes in Cardiac Signal Transduction in Septic Shock -- Recent Advances in the Hemodynamic Therapy of Septic Shock -- Immunotherapy -- Cytokine Gene Polymorphism in Infectious and Inflammatory Diseases -- Neutrophil-induced Oxidative Stress -- Antioxidant Therapy in Critical Illness -- Interleukin-10 Production during Septic Shock -- Potential Role for Human Interleukin-11 in Bacterial Sepsis -- Cellular Response to Inflammation and its Antagonism by?2-Adrenoceptor Agonists -- Sepsis Treatment and Prophylaxis with Immunoglobulins: A Critical Appraisal -- Low Dose G-CSF to Augment Host Defense and Counteract Progression in Sepsis -- Rethinking the Anti-Inflammatory Approach to Septic Shock -- Immunotherapy of Severe Sepsis and Septic Shock: Is there a Future? -- Gut Dysfunction -- Intestinal Ischemia/Reperfusion: A Role for Mast Cells and Neutrophils -- Bacterial Translocation: Cause or Effect of Multiple Organ Failure? -- Gut Oxygenation after Reduced Oxygen Delivery -- Peri-Operative Gastrointestinal Tonometry -- Prokinetic Use to Facilitate Enteral Feeding -- Early Postinjury Enteral Nutrition: Does it make a Difference? -- Oxygen Availability -- The Cell, the Mitochondrion, Oxygen and Sepsis -- The Role of Microcirculation in Sepsis -- Sepsis, Anemia, and Tissue O2 Availability -- Critical Analysis of Venoarterial CO2 Gradient as a Marker of Tissue Hypoxia -- Does Cardiovascular Optimization Reduce Mortality? -- Hepato-splanchnic Blood Flow -- Pressure-Flow Relationships in Liver Vascular Beds during Sepsis --?-Adrenergic Drugs to improve Gastrointestinal Mucosal Blood Flow in Sepsis -- Role of Nitric Oxide -- Role of Nitric Oxide in the Pathogenesis of Gram-Positive Shock -- Nitric Oxide Involvement in Septic Shock: Do Human beings behave like Rodents? -- Nitric Oxide: Effects on the Airways -- Respiratory Failure -- A Broader View of ARDS -- Strategies to minimize Alveolar Stretch Injury during Mechanical Ventilation -- Lung Protective Ventilatory Strategies in ARDS -- Positive End-Expiratory Pressure and Permissive Hypercapnia in ARDS -- Methods to improve Matching between Ventilation and Perfusion during Ventilatory Support in ARDS -- Pharmacologic Approach of Hypoxemia in ARDS Patients -- Airflow Obstruction -- Management of Life-Threatening Airflow Obstruction -- Airway Resistance and Bronchodilator Responsiveness in ARDS -- Mechanical Ventilation -- Conditioning of Air in Mechanically Ventilated Patients -- New Histopathological Aspects of Human Ventilator-Associated Pneumonia -- Infectious Vignettes -- Necrotizing Fasciitis -- Acinetobacter Infections in Intensive Care Units -- Fungal Infections -- Fungal Infection in the Organ Transplant Recipient: Challenges and Opportunities -- When to Start Antifungal Therapy in the Non-Neutropenic Critically Ill? -- Cardiovascular Failure -- Hemorrhage and Injury: Cardiovascular and Regional Blood Flow Responses -- Myocardial Ischemia -- Detection of Myocardial Viability and Inducible Ischemia with Dobutamine -- Continuous Electrocardiographic Monitoring for Myocardial Ischemia -- Do ACE Inhibitors have a Place in the Critically Ill? -- Hematologic Failure -- Critical Hematocrit -- Acquired Coagulopathies -- Liver Failure -- Acetaminophen Overdose and Acute Liver Failure: Modern Management -- Kidney Failure -- Renal Rescue: Management of Impending Renal Failure -- Continuous High Flux Dialysis: An Efficient Renal Replacement -- Brain Failure -- Non-traumatic Coma and Status Epilepticus in Infants and Children -- Guidelines for Management of Severe Head Injury in Adults -- Goal-Directed Therapy in Neurotrauma -- How to Interpret Jugular Bulb Oximetry -- New Treatment Modalities to Improve Outcome after Subarachnoid Hemorrhage -- Analgesia and Sedation -- Pain Measurement in Children -- Pharmacokinetics and Drug-Protein Binding -- Emergency Medicine -- The Role of Emergency Medical Services in Mass Casualties -- Overview of 10 Years (1983-1992) of Poisoning Data -- Resuscitation -- Resuscitation Decisions -- Active Compression-Decompression Resuscitation -- Outcome Prediction -- Customized Probability Models for Early Severe Sepsis in Adult Intensive Care Patients -- Neural Networks: A New Tool for Predictive Models -- Today and Tomorrow -- Expanding the Role of Intensive Care Medicine -- Internet as a New Source of Information in the Intensive Care Field Includes bibliographical references at the end of each chapters and index

Core Principles of Acute Neurology is a series of short volumes that handles major topics not found in sufficient detail elsewhere and provides useful context. Solving Critical Consults provide practical information on how to evaluate complicated neurology consults in the ICU. The diagnosis and management of neurologic complications of acutely ill hospitalized patients remains challenging. The modern intensive care unit is a different place with different patients, and consultants may require a specific expertise in handling complications associated with critical illness. Some of these requests for consultation include not only diagnosis of the neurologic state, but also assistance with management at all levels. Prognostication in devastating situations or when the critical illness has come under control is a common request.

69p. : 24 cm Includes bibliographical references

“An engrossing human drama . . . The Shift is one nurse's story, but it contains elements of every nurse's experience." —The Wall Street Journal Practicing nurse and New York Times columnist Theresa Brown invites us to experience not just a day in the life of a nurse but all the life that happens in just one day on a busy teaching hospital’s cancer ward. In the span of twelve hours, lives can be lost, life-altering treatment decisions made, and dreams fulfilled or irrevocably stolen. Unfolding in real time—under the watchful eyes of this dedicated professional and insightful chronicler of events— The Shift gives an unprecedented view into the individual struggles as well as the larger truths about medicine in this country. By shift’s end, we have witnessed something profound about hope and humanity.

Das Buch behandelt erstmals die Kurz- und Langzeitprognose von Patienten, die einer neurologischen Intensivtherapie bedürfen. Grundlage ist das 5. Arbeitstreffen der Arbeitsgemeinschaft Neurologische Intensivmedizin. Die Autoren haben prognostische Parameter zu Schwerpunkterkrankungen im Bereich der neurologischen Intensivmedizin zusammengestellt. Dabei wurden auch die Ergebnisse hinsichtlich der Prognose, die durch moderne elektrophysiologische Meßmethoden bzw. neuroradiologische Untersuchungsverfahren ermöglicht worden sind, berücksichtigt. Das Buch vermittelt Neurologen, Neurochirurgen, Internisten, Anästhesiologen, Traumatologen und Allgemeinmedizinern die prognostisch relevanten Parameter neurologischer Erkrankungen und ermöglicht somit auch für Patienten mit lebensbedrohlicher Erkrankung eine optimale Therapie. Es ist ein Leitfaden bei der Beantwortung ethisch schwieriger Fragestellungen und wird insbesondere auch im Konsiliardienst eine besondere Hilfe sein, wenn der Arzt sich zur Prognose intensivmedizinisch betreuter Patienten äußern muß. Erscheinungsdatum: 14.02.2012

Intensivmedizinische Aspekte der Hepatologie und Gastroenterologie werden von Experten aus dem deutschen Sprachraum in Form von kurzen Übersichtsarbeiten bzw. in Form kurzer Originalarbeiten präsentiert. Schwerpunkte sind die hepatische Gerinnungsstörung, die Lebertransplantation, die nekrotisierende Pankreatitis sowie Durchfälle und Reflux beim Intentsivpatienten. Als neue Therapieformen werden die Vasokonstriktorentherapie beim hepatorenalen Syndrom, die Mannittherapie beim Coma hepaticum und die Ascitesdialyse abgehandelt. Der Leser soll damit sein Wissen auf dem Gebiet der hepatologischen und gastroenterologischen Intensivmedizin überprüfen und auf den letzten Stand der Wissenschaft bringen.

Advances in Tissue Engineering is a unique volume and the first of its kind to bring together leading names in the field of tissue engineering and stem cell research. A relatively young science, tissue engineering can be seen in both scientific and sociological contexts and successes in the field are now leading to clinical reality. This book attempts to define the path from basic science to practical application. A contribution from the UK Stem Cell Bank and opinions of venture capitalists offer a variety of viewpoints, and exciting new areas of stem cell biology are highlighted. With over fifty stellar contributors, this book presents the most up-to-date information in this very topical and exciting field. Contents: Tissue Engineering: Past, Present and Future; Cells for Tissue Engineering; Materials; Non-Invasive Methods to Monitor Tissue Re-Modelling; Biotechnology Sector; Tissue Engineering Products; Tissue Repair; Cardiac Repair; Osteoarticular Repair; Lung Repair.

Dr. Wung is addressing an important component of critical care nursing: the role of technology in patient care. She has assembled top authors to provide current clinical information in the following areas: Sensory overload and technology in critical care; Alarm fatigue; Nurse-technology Interactions; Safety steps to prevent Infusion errors; Product design and medical devices for nurses ; Technologies to assess physiologic parameters (hemodynamics/cardio output); Technologies to support hemodynamics (e.g., balloon pump. ECMO, etc); Interactive computer programs for application of critical thinking skills; Information technology Electronic health records (EHR); Real-time detection of clinical care deviations in ICU; Medication safety technology; and eICU/iCARE. Readers will come away with the updates they need to improve patient outcomes.

A comprehensive text of intensive care would readily fill the equivalent of the Shorter Oxford English Dictionary. This is because the diseases treated are both numerous and varied; thus the patient can be medical, surgical, trauma or obstetric. It follows that the sum total of knowledge which needs to be available is truly encyclopaedic. This compact volume represents only a fragment of such information. The contributors were chosen because of their experience and because their methods were well-tried. The text therefore summarizes the best of current therapy and includes the controversial. The contributors come from four countries, adding an international flavour. One topic - The Recovery Room - outside the confines of intensive care has been included for two reasons. The recovery room is an important but neglected aspect of care, and it also seems important to define its relationships with the intensive care unit. It is hoped that the book will help the nurses and doctors involved in intensive care and, therefore, the patient. ERIC SHERWOOD JONES Vll Contributors P. M. ASHWORTH K. CHATTERJEE Department of N . using • Medicine Cardiology Division University of Manchester University of California San Francisco Stop ford Building Cardiovascular Research Institute Oxford Road Manchester M 13 9PT, UK Moffitt Hospital Rm. 1186 San Francisco California 94143, USA S. T. ATHERTON Intensive Care Unit Whiston Hospital E. M. COOKE Prescot Department of Microbiology Merseyside, UK University of Leeds Leeds LS2 91Z, UK B. J. BAIN W. E. Erscheinungsdatum: 12.10.2011

This aim of this book is to focus on a very common situation seen in medical practice, the acute catabolic state. This pathophysiological sit­ uation is rarely discussed as a separate entity, possibly because it is seen in all specialties of medicine and results from a great diversity of agents, insults, and diseases. It thus seemed to be high time to gather the most important and up-to-date knowledge on this entity, and the primary aim of the book is to offer a collection of updated information on the acute catabolic state. Another objective of the book is to make clear that, apart from the general response of the whole organism during the acute catabolic state, a series of organ-specific responses will also take place, which must also be considered during treatment. It has become very clear of these organ-spe­ from working on this book that current knowledge cific responses is very sparse and in some areas almost nonexistent; this book thus also focuses on the responses and changes which take place in different organs during the acute catabolic state and the inter­ action between these organs and their responses.

The thoroughly revised second edition of the Oxford Textbook of Critical Care is a comprehensive multi-disciplinary text covering all aspects of adult intensive care management. Uniquely the book takes a problem-orientated approach providing a reference source for clinical issues experienced every day in the intensive care unit. The text is organized into short topics allowing readers to rapidly access authoritative information on specific clinical problems. Each topic refers to basic physiological principles and provides up-to-date treatment advice supported by references to the most vital literature. Where international differences exist in clinical practice, authors cover alternative views. Key messages summarise each topic in order to aid quick review and decision making. Edited and written by an international group of recognized experts from many disciplines, the second edition of the Oxford Textbook of Critical Care provides an up-to-date reference that is relevant for intensive care units and emergency departments globally. This volume is the definitive text for all health care providers, including physicians, nurses, respiratory therapists, and other allied health professionals who take care of critically ill patients. This print edition of The Oxford Textbook of Critical Care comes with a year's access to the online version on Oxford Medicine Online . By activating your unique access code, you can read and annotate the full text online, follow links from the references to primary research materials, and view, enlarge and download all the figures and tables.

This book concentrates on problems generated by acute care in severely traumatized patients during the first 24 hours after injury. During this hectic period, highly complicated problems have to be solved at the site of the accident, during transport to hospital, and in hospital. Multiple medical and paramedical disciplines are involved in providing care to the severely injured. This book endeavors to present a problem-oriented approach to the diagnostic, therapeutic, and organizational aspects that may be encountered.

Intensive Care Medicine has been continuously growing and expanding, culturally, technically and geographically. Monitoring and instrumentation are continuously improving and more and more hospitals are getting Intensive Care facilities. The costs have proportionally increased over the years, so that ICUs represent today a major cost for health structures. Since the available resources are limited, a real need is emerging to set the limits and indications of Intensive Care. It is understood that the problem not only involves medical considerations, but also ethical and economical aspects of the utmost importance. For the first time in Europe, this book edited by Reis Miranda and his colleagues tackles systematically the many structural aspects of the European Intensive Care. The organisation and financing of health care in the Old Continent is deeply different from the American one, and the results and consequent proposals obtained in the USA cannot simply be transferred to this side of the Atlantic Ocean. Weare extremely pleased to welcome this first European attempt to discuss the Intensive Care problem. It lays no claims to giving definite replies in a continuously developing field, but it will surely become the basis for future discussions and proposals. I am particularly happy that this work has mainly developed within the European Society of Intensive Care, whose final target is to ensure a common standard of therapy in our old Europe, beyond national differences. We warmly congratulate the authors, and I am sure that their work will find wide diffusion and consent.

Surgical Intensive Care Medicine has been specifically designed to be a practical reference for medical students and house officers to help manage the critically ill surgical patient. The first section is titled “Resuscitation” and exposes the reader to a condensed version of generic topics in primary intensive care medicine. The sections that follow have been categorized according to medical and surgical subspecialties and cover the most germane of problems encountered in a tertiary surgical intensive care unit. Sections of certain chapters, while repetitive, have been left intact in an attempt to maintain the authors' messages and provide the reader with some contradictory but referenced views. The technical chapters describe a very introductory approach to various exercises such as airway management and vascular cannulation.

<p><P>Infection Control in the ICU Environment provides the details of the most common infection control problems facing intensive care units. Authors include noted scientists, intensivists and epidemiologists from the United States and Europe as well as infection control experts from the Centers for Disease Control and Prevention.<br> Acinetobacter, methicillin resistant staphylococcus aureus and vancomycin resistant enterococci are examined in detail. This volume also includes cutting edge information regarding the potential for prophylactic and pre-emptive therapy of fungal infections in intensive care units.<br> Innovations in vascular catheter care and prevention of bloodstream infections are discussed in this volume as well as the newest information in mathematical modeling to understand the epidemiology and control of infections in intensive care units.</p>

The book covers vigorously debated controversial topics in the field of critical care medicine over the years. It provides the reader with a balanced approach and guidance based on historical and currently available evidence in dealing with contentious clinical scenarios. The book reviews the most relevant, contemporaneous evidence on each topic and provides practical guidelines for clinical practice. The book includes chapters that follow a structured approach to controversies related to specific organ systems. The topics covered provide a summary of the most relevant, practice-changing studies in the field of critical care medicine. Each topic describes the basic applied physiology, points of controversy, the evidence base, and summarizes the key points at the end. It includes brief description of landmark studies on each controversial topic. The book serves as an important clinical guide to practitioners of critical care medicine when confronted with challenging clinical scenarios. Besides, it is a useful source of information to postgraduate trainees in various medical specialties. The topics addressed are among the most widely discussed during postgraduate examinations. It is also relevant for practitioners in general medicine and specialized areas of practice, including pulmonology (respiratory medicine), cardiology, neurology, nephrology, gastroenterology, and surgical specialties.

In March 2001, the National Institutes of Health issued the following warning: "The number of Web sites offering health-related resources grows every day. Many sites provide valuable information, while others may have information that is unreliable or misleading." Furthermore, because of the rapid increase in Internet-based information, many hours can be wasted searching, selecting, and printing.This book was created for medical professionals, students, and members of the general public who want to conduct medical research using the most advanced tools available and spending the least amount of time doing so.

Medicine 100 Cases in Acute Medicine presents 100 acute conditions commonly seen by medical students and junior doctors in the emergency department or on the ward or in the community setting. A succinct summary of the patient's history, examination and initial investigations, including photographs where relevant, is followed by questions on the diagnosis and management of each case. The answer includes a detailed discussion on each topic, with further illustration where appropriate, providing an essential revision aid, as well as a practical guide for students and junior doctors.Making clinical decisions and choosing the best course of action is one of the most challenging and difcult parts of training to become a doctor. Fully revised and updated for this second edition, these cases will teach students and junior doctors to recognise important clinical symptoms and signs and to develop their diagnostic and management skills. About the Series Making speedy and appropriate clinical decisions, and choosing the best course of action to take as a result, is one of the most important and challenging parts of training to become a doctor. The real-life cases presented in the 100 Cases series encompass emergency, ward, and outpatient and community scenarios, and have been designed specifically to help medical students and junior doctors to develop their diagnostic and management skills.

This reprint has been authorized by Springer-Verlag for sale in India, Pakistan, Bangladesh, Nepal, and Sri Lanka.

Anaesthesiologie und Intensivmedizin Anaesthesiology and Intensive Care Medicine Erscheinungsdatum: 01.11.1980

The book will provide some basic aspects of the pathophysiology of infection, but essentially the book will be practical-based and use case-illustrations to highlight key aspects of diagnosis, management and prevention. Through a combination of text, tables, figures/line drawings, clinical illustrations and other illustrations, it is hoped to provide a comprehensive, interesting and stimulating approach to this important subject. Guidance on the appropriate use of laboratory investigations, as well as radiology, together with templates to use for deciding on the optimal choice of anti-infective agents will be amongst the strengths of this book. Erscheinungsdatum: 19.10.2012

Critical care medicine is an evolving specialty in which the amount of available information is growing daily and spread across a myriad of books, journals, and websites. This essential guide brings together this information in an easy-to-use format. Up-to-date, relevant, and evidence-based information on the management of the critically ill is combined in one resource, ideal for the use of Intensive Care Units, High Dependency Units, acute medical or surgical wards, Accident and Emergency departments, and operating theatres. The book is designed such that each subject forms a self-contained topic in its own right, laid out across two or four pages to facilitate the key aim of rapid and easy access to information. This makes the information included simple to find, read, and absorbo, so that the book can be consulted in the clinic or ward setting for informtion on the optimum management of a particular condition. With chapters written by internationally renowned critical care specialists and edited by three of the leading figures in UK Critical Care, this book should be an essential resource for all critical care physicians.

ix, 179 p. : 24 cm, Includes bibliographical references and index, Machine generated contents note: I Diagnosis of Pneumonia -- Jean-Yves Fagon and Jean Chastre -- 2, Diagnosis of Ventilator-Associated Pneumonia -- One American's Perspective -- Michael S. Niedenran -- Prevention of Pneumonia in Mechanically -- Ventilated Patients -- Jordi Valles -- 4, Is Prevention of Ventilator-Associated Pneumonia -- Cost Effective? -- Marin H. Kollef -- Role of the Oropharynx and Digestive Tract in -- the Pathogenesis of Ventilator-Associated Pneumonia -- Christianne A. van Nieuwenhoven and -- Marc J.M. Bonten -- B;6. Treatment of Ventilator-Associated Pneumonia -- European Perspective. -- .1. Sole-Violan, and -- F. Rodriguez de Castro -- 7. Treatment of Ventilator-Associated Pneumonia -- North American Perspective: -- Richard G. Wunderink -- 8. Resistant Pathogens: Emergence and Control -- in ICU Patients -- Jean Chastre -- 9. Resistant Pathogens: Emergence and Control -- Patricia Winokur, Carol E. Chenoweth, Louis Rice, -- Borna Mehrad, and Joseph P. Lynch, III -- 10. Mortality and Morbidity of Ventilator-Associated -- Pneumonia: The Controversy -- Jean Carlet, Jean-Francois Timsit, Benoit Misset, -- M. Garrouste, and L. Soufir -- INDEX

In theory, treatment decisions and assessments of response to therapy in critically ill patients should usually be based on measures of physiological function. Nevertheless, the most appropriate use of the information embodied in such measures is often unclear, and rarely supported by prospective clinical trials. In reality, the bedside clinician is therefore forced to rely primarily on physiological principles when deciding upon the best treatment. Unfortunately, however, the necessary knowledge base of the clinician is often less than optimal for the purpose, and habit or prior training may be more influential than science. Against this background, this second, revised edition of Applied Physiology in Intensive Care Medicine aims to help overcome the fundamental unevenness in clinicians' understanding of applied physiology. It is divided into three sections. The first comprises a series of "physiological notes" that concisely and clearly capture the essence of the physiological perspectives underpinning our understanding of disease and response to therapy. The second section contains more detailed associated reviews on measurement techniques and physiological processes, while the third provides a number of seminal studies on diverse topics in intensive care. This up-to-date compendium of practical bedside knowledge essential to the effective delivery of acute care medicine has been written by some of the most renowned experts in the field. It will serve the clinician as an invaluable reference source on key issues regularly confronted in everyday practice

<p><p>critical Care Of The Surgical Patient Is A Vital Component Of Modern Surgical Practice. Today's Surgeon Must Be Aware Of The Principles Of Critical Care In Order To Facilitate Perioperative Management, Optimize Outcomes And Have Meaningful Discussions With Intensivist Colleagues.</p>

Intensive care staat vooral bekend om het medisch-technisch handelen bij ernstig zieke patiënten. Dit hoogtechnologische handelen leidt helaas niet altijd tot genezing van de patiënt. De sterfte op een intensive care is, vergeleken met andere afdelingen in het ziekenhuis, dan ook hoog. Van alle patiënten die op een IC komen te overlijden, sterven in Nederland acht van de tien nadat besloten is dat verder behandelen niet meer in het belang van de patiënt is en de ingezette behandeling gestaakt wordt. Omdat de meeste patiënten bij wie de behandeling gestaakt wordt ernstig orgaanfalen hebben, kan dit aanleiding geven tot belastende symptomen zoals benauwdheid, reutelen, onrust, pijn en andere vormen van discomfort. Artsen en verpleegkundigen hebben de morele taak om deze symptomen zo goed mogelijk te behandelen teneinde de patiënt zo rustig mogelijk te kunnen laten overlijden. Beter is het om te anticiperen op mogelijk belastende symptomen. Helaas zijn veel artsen en verpleegkundigen onwennig in het geven van anticiperende palliatieve zorg op de IC. In dit boekje worden praktische routeplanners gegeven die artsen en verpleegkundigen op de IC stap voor stap kunnen helpen bij de zorg voor stervende patiënten op de IC.

Die parenterale Ernährung hat in den letzten 15 Jahren eine stürmische Entwicklung durchgemacht und muß heute als fester Bestandteil der therapeutischen Medizin an­ gesehen werden. Ausreichende Kenntnisse über die technischen Möglichkeiten dieser Therapie, die Auswirkungen ihrer einzelnen Bausteine auf den Stoffwechsel des Kran­ ken sowie ihre Risiken sollten zum Rüstzeug jedes klinisch tätigen Arztes gehören. Es kann heute keine Entschuldigung mehr dafür geben, daß der Nahrungsbedarf eines Kranken ungedeckt bleibt, nur weil er nicht mehr in der Lage ist, oral genügend Nah­ rung aufzunehmen. Die Standardinfusionstherapie, üblicherweise bestehend aus 2 bis 3 Liter Elek­ trolyt-Aminosäuren- oder niedrigprozentigen Kohlenhydratlösungen unterscheidet sich von der hochkalorischen parenteralen Ernährung vor allem durch die Osmolarität des Infusionsgemisches und dem Zugangsweg. Bei der Standardtherapie ist der peri­ phere Zugang die Regel und ein Verlust an Struktur- oder Funktionsproteinen wird bewußt in Kauf genommen, da eine ausreichende Energiezufuhr zur Verstoffwechse­ lung der zugeführten Aminosäuren nicht möglich ist, ohne Schäden an der Venen­ wand hervorzurufen. Durch die hochkalorische parenterale Ernährung werden, wobei der zentrale Venenkatheter eine Grundvoraussetzung ist, dem Kranken hochprozen­ tige Kohlenhydratlösungen, Fette und Aminosäuren in einer Größenordnung verab­ reicht, die nicht nur seinen aktuellen Bedarf decken, sondern auch vorbestehende Mangelzustände ausgleichen können. Die Kathetertechnik und die Entwicklung der Infusionslösungen befindet sich auf einem so hohen Stand, daß eine parenterale Versorgung des Organismus mit Nährstoffen auch über Monate hinweg möglich ist. Besondere Beobachtungen erfuhr in der letzten Zeit die Anwendung der hoch­ kalorischen parenteralen Ernährung bei den entzündlichen Darmerkrankungen und in der Onkologie.