9781859962374

Cardiopulmonary Critical Care

by
  • ISBN13:

    9781859962374

  • ISBN10:

    1859962378

  • Edition: 1st
  • Format: Hardcover
  • Copyright: 2002-06-15
  • Publisher: Informa Healthc

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Supplemental Materials

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  • The New copy of this book will include any supplemental materials advertised. Please check the title of the book to determine if it should include any access cards, study guides, lab manuals, CDs, etc.
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Summary

A thorough understanding of the cardiopulmonary system is one of the foundations of critical care. In this new book, specialists in respiratory medicine, cardiology and critical care have united to present information essential for effective patient management. Cardiopulmonary Critical Care is a clinically relevant reference, not only as a study resource, but also for everyday use in the unit. Experts discuss thoracic trauma, fluid resuscitation in the ICU, acid base disorders, oxygen transport and tissue oxygenation, acute myocardial infarction and many other topics. This book, complete with diagrams, flowcharts and checklists, is essential for every ICU and hospital emergency room.

Table of Contents

Abbreviations xii
Contributors xv
Introduction xvi
Acknowledgements xviii
Respiratory physiology/pulmonary gas exchange
1(16)
Robert M. Kacmarek
Introduction
2(1)
Lung mechanics
2(4)
The law of motion
6(1)
Auto-PEEP
7(1)
V/Q relationships
8(2)
Evaluation of hypoxemia
10(7)
Cardiac physiology
17(18)
Jay S. Steingrub
Cardiac function
18(1)
Preload
18(2)
Afterload
20(1)
Contractility
21(1)
Heart rate
22(1)
Diastolic function
22(2)
Diagnosis and therapy of acute congestive heart failure
24(3)
Therapy
27(2)
Patient subsets
29(6)
Oxygen transport and tissue oxygenation
35(14)
William T. McGee
Paul Jodka
Introduction
36(1)
Calculating oxygen transport
36(2)
Balancing oxygen supply and demand
38(1)
Clinical factors influencing oxygen supply
39(1)
Determinants of oxygen consumption
40(1)
Critical factors influencing cellular oxygen utilization
40(1)
Evaluation of tissue oxygenation
41(2)
Influence of loss of vasoregulation
43(1)
Continuous mixed venous oxygen saturation in clinical medicine
43(1)
Goal-directed therapy with DO2 and VO2
44(2)
Summary
46(1)
Essential equations
46(3)
Acid-base disorders
49(14)
Ali Al-Khafaji
Marcus J. Hampers
Howard L. Corwin
Introduction
50(1)
Basic concepts and definitions
50(2)
Approach to acid-base abnormalities
52(1)
Metabolic acidosis
52(1)
Anion gap metabolic acidosis
52(4)
Normal anion gap metabolic acidosis
56(2)
Respiratory acidosis
58(1)
Metabolic alkalosis
59(1)
Respiratory alkalosis
60(3)
Bedside hemodynamic monitoring
63(18)
Jay S. Steingrub
Introduction
64(1)
Central venous monitoring
64(2)
Pulmonary artery catheterization
66(4)
Validity of measurements
70(2)
Intrathoracic pressure changes during spontaneous respiration
72(1)
Positive end-expiratory pressure (PEEP)
73(1)
Ventricular compliance
73(1)
Limitations of pulmonary artery wedge pressure
74(1)
Thermodilution cardiac output
75(1)
Derived hemodynamic parameters
75(3)
Risk versus benefit
78(3)
Shock in the intensive care unit
81(18)
Jay S. Steingrub
Introduction
82(1)
Pathophysiology
82(1)
Specific shock syndromes
82(1)
Hypovolemic shock
83(3)
Distributive shock
86(5)
Anaphylactic shock
91(3)
Cardiogenic shock
94(2)
Obstructive shock
96(1)
Shock states
96(3)
Fluid resuscitation in the ICU
99(12)
Laurie A. Loiacono
Introduction
100(1)
Definitions
100(1)
Physiology of resuscitation
101(3)
Strategy
104(1)
Red blood cells (RBCs)
105(1)
Crystalloid products
105(2)
Cell-free colloids
107(1)
Summary and conclusions
108(1)
Recommendations for fluid resuscitation in the ICU
109(2)
Circulatory support
111(16)
Thomas L. Higgins
Introduction
112(1)
The sympathetic nervous system
112(2)
Receptors and signal transduction
114(1)
Monitoring
115(1)
Catecholamines and sympathomimetics
116(5)
Alterations in adrenergic response
121(2)
Bypassing the adrenergic receptor
123(1)
Vasopressin
123(1)
Weaning pharmacologic support
124(1)
Summary
124(3)
Hypertensive urgencies and emergencies
127(20)
Thomas L. Higgins
Introduction
128(1)
Definitions
128(2)
Physiology of blood pressure control: MAP = SVR x CO
130(2)
Monitoring considerations
132(1)
Agents to decrease blood pressure
132(9)
Specific clinical considerations
141(3)
Medication-related hypertension
144(1)
Conclusions
144(3)
Acute myocardial infarction
147(18)
Marc Schweiger
Overview
148(1)
Diagnosis, definitions and triage
148(3)
Initial treatment of acute ischemic syndrome
151(4)
Thrombolytic therapy
155(1)
Primary angioplasty
156(1)
Lipid-lowering therapy
157(1)
Complications of myocardial infarction
157(1)
Subsequent treatment strategies
158(3)
Summary
161(4)
Cardiac rhythm disturbances
165(18)
Magdy Migeed
Lawrence S. Rosenthal
Introduction
166(1)
ECG analysis and interpretation
166(1)
Supraventricular tachycardias
166(2)
Treatment of supraventricular arrhythmias
168(2)
Atrial fibrillation
170(1)
Therapy of AF
171(1)
Wide complex tachycardias
172(2)
Approach to the patient with cardiac arrest
174(5)
Bradyarrhythmias
179(1)
Summary
179(4)
Pulmonary embolism in the critically ill patient
183(18)
Jay S. Steingrub
Introduction
184(1)
Risk factors
184(2)
Pathophysiology of pulmonary embolism
186(1)
Differential diagnosis in the ICU
186(1)
Diagnostic tests
187(4)
Treatment
191(5)
Right ventricular function
196(1)
Other clinical interventions
197(1)
Risk reduction
197(4)
Modes of mechanical ventilation
201(10)
Robert M. Kacmarek
Introduction
202(1)
Volume versus pressure targeting
202(4)
Traditional modes of ventilation
206(3)
Pressure control inverse ratio ventilation (PCIRV)
209(2)
Airway pressure release ventilation (APRV)
211(1)
Combined modes of ventilation
212
The acute respiratory distress syndrome
221(24)
C. Allen Bashour
James K. Stoller
Introduction
222(1)
Historical perspective
222(1)
Pathogenesis
223(2)
Clinical presentation
225(1)
Treatment
225(6)
Prognosis and outcome
231(1)
Conclusions
231(4)
Lung-protective ventilation strategies
235(18)
Robert M. Kacmarek
Ventilator-induced lung injury (VILI)
236(6)
Lung-protective ventilatory strategies (LPVSs)
242(6)
Setting of PEEP
248(1)
Prone positioning
248(2)
Summary
250(3)
Nosocomial pneumonia
253(18)
Thomas L. Higgins
Introduction
254(1)
Risk factors for developing nosocomial pneumonia
254(1)
Pathogens and routes of entry
255(1)
Diagnosis
255(3)
Antibiotic therapy
258(2)
Choice of antibiotic
260(4)
Prevention of nosocomial pneumonia
264(1)
Antimicrobial resistance
265(1)
Summary
266(5)
Obstructive lung disease: asthma and COPD
271(16)
Robert M. Kacmarek
Introduction
272(1)
Auto-PEEP
272(1)
Non-ventilatory management
272(6)
Intubation
278(1)
Mechanical ventilation
278(3)
Weaning from ventilatory support
281(6)
Weaning from mechanical ventilation
287(20)
James K. Stoller
Thomas L. Higgins
Introduction
288(1)
Who requires gradual withdrawal of mechanical ventilation
288(1)
Sequelae of prolonged intubation and ventilation
289(1)
Overview of the logic of weaning
289(1)
Evaluation of breathing pattern
290(2)
Work of breathing (WOB)
292(1)
Tracheal occlusion pressure
293(1)
Endurance measurements
293(1)
Techniques of weaning
293(2)
Studies comparing weaning modes
295(1)
Non-respiratory impediments to successful weaning
296(3)
Respiratory impediments to weaning
299(1)
Pharmacologic aids to weaning
300(1)
Weaning failure
301(1)
Long-term prognosis
301(6)
Noninvasive positive pressure ventilation (NIPPV)
307(22)
Robert M. Kacmarek
Introduction
308(1)
NIPPV for acute respiratory failure
308(1)
Indication for noninvasive positive pressure
308(9)
When should NIPPV be initiated for acute respiratory failure?
317(1)
Complications or problems with NIPPV
317(1)
The application of NIPPV
318(6)
Summary
324(5)
Postoperative care of the cardiac surgical patient
329(16)
Thomas L. Higgins
Introduction
330(1)
Delivery of the patient to the ICU
330(1)
Respiratory management
330(3)
Cardiovastular support
333(3)
Postoperative complications
336(4)
Discharge criteria
340(1)
Prognosis and outcome
341(1)
Summary
342(3)
Postoperative care of the thoracic surgical patient
345(18)
Thomas L. Higgins
Introduction
346(1)
Identifying the high-risk patient
346(1)
Operating room events affecting ICU care
347(2)
Immediate postoperative issues
349(1)
Endotracheal extubation and airway concerns
350(1)
Postoperative fluid management
351(1)
Prolonged ventilator support
352(3)
Specific postoperative complications
355(3)
Pulmonary parenchymal complications
358(1)
Pleural complications
359(1)
Other considerations
360(3)
Thoracic trauma
363(18)
Imtiaz A. Munshi
Introduction
364(1)
Anatomy
364(1)
Pathophysiology
364(1)
Initial evaluation-ABCs
365(1)
Injuries to the chest wall
366(1)
Injuries to the bony thorax
367(2)
Injuries to the lung
369(5)
Tracheobronchial injury
374(1)
Blunt aortic injury
375(2)
Blunt cardiac injury
377(4)
Techniques of vascular access for invasive hemodynamic monitoring
381(24)
William T. McGee
Jay S. Steingrub
Thomas L. Higgins
Introduction
382(1)
Intraarterial blood pressure monitoring
382(2)
Central venous access
384(5)
Femoral venous cannulation
389(1)
Internal jugular vein
390(4)
Subclavian vein cannulation
394(4)
Introducer placement
398(1)
Complications and their prevention
399(6)
Index 405

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