Textbook of Critical Care

8th Edition - December 21, 2022
Editors: Jean-Louis Vincent, Frederick A. Moore, Rinaldo Bellomo, John J. Marini
Language: English
Hardback ISBN:
9 7 8 - 0 - 3 2 3 - 7 5 9 2 9 - 8
eBook ISBN:
9 7 8 - 0 - 3 2 3 - 7 5 9 3 0 - 4
eBook ISBN:
9 7 8 - 0 - 4 4 3 - 3 4 7 9 3 - 1

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**Selected for Doody’s Core Titles® 2024 with "Essential Purchase" designation in Critical Care**

Bridging the gap between medical and surgical specialties in critical care, Textbook of Critical Care, 8th Edition, offers a practical, multidisciplinary approach to the effective management of adult and pediatric patients in the ICU. An outstanding editorial team, led by world-renowned intensivist Dr. Jean-Louis Vincent, assisted by Dr. Frederick A. Moore and new editors Drs. Rinaldo Bellomo and John J. Marini, provides the evidence-based guidance you need to overcome a full range of practice challenges. A full-color art program, relevant basic science and key summary points in every chapter, and expert contributing authors from all over the world make this an indispensable resource for every member of the critical care team.

Cover image
Title page
Table of Contents
Copyright
Contributors
Preface
Video contents
List of Illustrations
List of Tables
Part I. Common Problems
1. Sudden deterioration in neurologic status
Impairment in consciousness
Stroke and other focal neurologic deficits
Seizures
Generalized weakness and neuromuscular disorders
Neurologic complications of procedures and treatments
Evaluation of sudden neurologic change
Monitoring for neurologic changes
Annotated references
References
2. Agitation and delirium
Agitation
Delirium
Pathophysiology
Assessment
Management
Summary
Annotated references
References
3. Management of acute pain in the intensive care unit
Introduction
Assessment
Opioids
Acetaminophen
NSAIDs
Gabapentinoids
Muscle relaxants
Ketamine
Lidocaine
α2 Agonists
Regional anesthesia
Music modalities
Cognitive behavioral modalities
Aromatherapy
Physical modalities
Annotated references
References
4. Fever and hyperthermia
Annotated references
References
5. Very high systemic arterial blood pressure
Pathophysiology
Clinical presentation
Hypertension and cerebrovascular disease
Hypertension and cardiovascular disease
Hypertension and renovascular disease
Hypertension in excess catecholamine states
Pharmacologically mediated hypertension
Hypertension and miscellaneous conditions
Antihypertensive medications
Annotated references
References
6. Low systemic arterial blood pressure
Introduction
Initial evaluation
What is the cause?
Treatment
Annotated references
References
7. Tachycardia and bradycardia
Tachyarrhythmias
Bradyarrhythmias
Annotated references
References
8. Arterial hypoxemia
Causes of arterial hypoxemia
4 Management of arterial hypoxemia
Annotated references
References
9. Acute respiratory failure
Components of the respiratory system
Pathophysiologic processes leading to ARF
Classification of ARF
Diagnostic workup
Management
Conclusion
Annotated references
References
10. Hyperbaric oxygen in critical care
Applications
Critical care in hyperbaric medicine
Adverse effects
Other risks
Annotated references
References
11. Pulmonary edema
Background and epidemiology of pulmonary edema
Pathophysiology of pulmonary edema
Cardiogenic pulmonary edema (increased capillary hydrostatic pressure)
Noncardiogenic pulmonary edema (increased vascular permeability)
Acute respiratory distress syndrome: A prototypical manifestation of noncardiogenic pulmonary edema
Transfusion-related acute lung injury
Vaping-associated lung injury
Other mechanisms resulting in pulmonary edema
Pulmonary edema associated with decreased interstitial hydrostatic pressure
Neurogenic pulmonary edema
Re-expansion pulmonary edema
Negative-pressure pulmonary edema
Establishing the etiology of pulmonary edema in the clinical setting
Clinical features favoring cardiogenic pulmonary edema
Clinical features favoring noncardiogenic pulmonary edema
Diagnosis and differential diagnosis of pulmonary edema
Management of pulmonary edema
Annotated references
References
12. Pleural effusion in the intensive care unit
Epidemiology
Pathophysiology
Diagnostic evaluation
Pleural fluid evaluation
Management
Annotated references
References
13. Polyuria
Pathophysiology and classification
Recognition of polyuria
Solute diuresis
Water diuresis
Conclusion
Annotated references
References
14. Oliguria
Definitions and epidemiology
Oliguria in acute kidney injury
Diagnostic approach to oliguria
Hemodynamic evaluation
Treatment of oliguria
Conclusion
Annotated references
References
15. Metabolic acidosis and alkalosis
Acid-base disorders
Normal acid-base homeostasis
Acid-base pathophysiology
Compensatory responses
Metabolic acidosis
High–anion gap metabolic acidosis
Lactic acidosis
Ketoacidosis
Toxic alcohol ingestions
Salicylates
Pyroglutamic acidosis
Renal failure
Non–anion gap (hyperchloremic) metabolic acidosis
Urinary anion gap
Renal tubular acidosis
Gastrointestinal tract loss
Other causes of non–anion gap acidosis
Metabolic alkalosis
Diagnosis of acid-base disorders
Summary
Annotated references
References
16. Hyperkalemia and hypokalemia
Overview of potassium homeostasis
Hyperkalemia
Hypokalemia
Annotated references
References
17. Hyperphosphatemia and hypophosphatemia
Introduction
Phosphate homeostasis
Hypophosphatemia
Hyperphosphatemia
Annotated references
References
18. Hypomagnesemia
Cellular physiology and metabolism of magnesium
Prevalence and etiology of hypomagnesemia in patients in the intensive care unit
Clinical signs and symptoms of hypomagnesemia
Treatment of hypomagnesemia
Annotated references
References
19. Hypocalcemia and hypercalcemia
Calcium physiology and metabolism
Hypocalcemia in critically ill patients
Hypocalcemia in sepsis and pancreatitis
Hypocalcemia and massive transfusion protocols
Signs and symptoms of hypocalcemia
Treatment of hypocalcemia
Hypercalcemia
Annotated references
References
20. Disorders of glucose control or blood glucose disorders
Introduction
Hyperglycemia
The glycemic domains and the influence of preexisting diabetes diagnosis on outcomes in the ICU
Glycemic goal in the ICU
Glucose monitoring in the ICU
Hypoglycemia
Incidence of hypoglycemia in the critically ill
Risk factors and barriers to recognition of hypoglycemia in the ICU
Outcomes of hypoglycemia in the critically ill
Physiology and symptomatology of hypoglycemia
Management of hypoglycemia
Conclusion
Annotated references
References
21. Anemia
Introduction
Epidemiology
Etiology
Laboratory evaluation of anemia in the ICU
Prevention of anemia in the ICU
Management of anemia in the ICU
Novel strategies
Acknowledgments
Annotated references
References
22. Coagulopathy in the intensive care unit
Divergent patient populations: Trauma versus sepsis
Origins of the terminology of disseminated intravascular coagulation
Identification of early trauma-induced coagulopathy
Mechanisms of early TIC
Identification of sepsis-induced coagulopathy
Mechanism of SIC/DIC and treatment
The transition from early to late TIC: Hypocoagulable to hypercoagulable state
Annotated references
References
23. Jaundice
Differential diagnosis
Side effects of TPN usage in the critical care setting
Annotated references
References
24. Ascites
Definition and diagnosis
Pathophysiology
Management
Paracentesis
Prognosis and complications
Spontaneous bacterial peritonitis
Annotated references
References
25. Acute abdominal pain
Introduction
Initial approach
Physical examination
Diagnostic adjuncts
Differential diagnosis based on physical examination findings
Annotated references
References
26. Ileus in critical illness
Introduction
Defining gastrointestinal dysfunction
Mechanism of ileus in critical illness
Implications for delivery of enteral nutrition
Conclusions
Annotated references
References
27. Diarrhea
Criteria
Pathophysiology
Clinical consequences of diarrhea
Diagnosis
Treatment
Conclusion
Annotated references
References
28. Chest pain
Initial approach
History
Physical examination
Diagnostic adjuncts
Differential diagnoses
Potentially life-threatening causes of chest pain
Non–life-threatening causes of chest pain
Conclusion
Annotated references
References
29. Biochemical or electrocardiographic evidence of acute myocardial injury
Electrocardiographic evidence
CK-MB, troponin, and high-sensitivity troponin
Other biomarkers
Annotated references
References
Part II. Common Approaches for Organ Support, Diagnosis, and Monitoring
30. Point-of-care ultrasound
Ultrasound physics, probe selection, and manipulation
Assessment of pulmonary disorders
Advanced vascular access
Additional areas of assessment
Annotated references
References
31. Echocardiography
Indications, contraindications, and safety
Impact of echocardiography in the ICU
Training, accreditation, and investigation
Basics
Standard views and anatomy
Hemodynamic assessment
Circulatory failure
Specific evaluation
Future directions
Annotated references
References
32. Cardiovascular monitoring
Introduction
The available hemodynamic monitoring devices
Hemodynamic monitoring strategy in patients with shock (Fig. 32.2)
Hemodynamic monitoring strategy in the operating room setting
The future of hemodynamic monitoring
Annotated references
References
33. Bedside monitoring of pulmonary function
Pulse oximetry
Capnometry
Assessment of pulmonary mechanics
Assessment of breathing pattern and central drive
Annotated references
References
34. Arterial blood gas interpretation
Why am I obtaining the arterial blood gas?
Arterial blood gas sampling
Hypoxemia, hypoxia, and arterial blood gas analysis
A stepwise approach to acid-base disorders
Common acid-base disturbances in the ICU
Venous blood gas analysis
Annotated references
References
35. Tracheal intubation
Introduction
Patient factors and airway assessment
Optimizing airway management in the critically ill
Rapid-sequence intubation and airway pharmacology
Laryngoscopy
Difficult airway management
Human factors
Conclusion
Annotated references
References
36. Tracheostomy
Indications
Tracheostomy techniques
Complications
Timing of tracheostomy
Tracheostomy and safety
Tracheostomy in neurocritical patients
Management and care of the tracheostomized patient
Tracheostomy emergency
Tracheostomy training
Acknowledgments
Annotated references
References
37. Basic principles of mechanical ventilation
Design features of modern mechanical ventilators
Physiologic effects of mechanical ventilation
Adverse effects of positive-pressure mechanical ventilation
Conclusion
Annotated references
References
38. Basic principles of renal replacement therapy
Technical aspects of RRT
Initiation of RRT
Choice of RRT modality
Special indications
Conclusion
Annotated references
References
39. Target temperature management in critically ill patients
Definitions
Physiology and pathophysiology
Clinical application of hypothermia/TTM in cardiac arrest
Other clinical applications of hypothermia/TTM in brain injury
Other potential applications
Practical aspects
Conclusions
Annotated references
References
40. Extracorporeal membrane oxygenation (venovenous and venoarterial ECMO)
Introduction
Modes of ECMO
Physical systems for ECMO
Management of anticoagulation and blood transfusion
Complications
ECMO for respiratory failure
ECLS in heart failure
Left ventricular unloading
ECPR
New indications
Weaning from ECMO
Pediatric ECMO
Ethical considerations
Future considerations
Annotated references
References
41. Nutritional support
Nutritional risk assessment
Refeeding syndrome
Enteral nutrition
Parenteral nutrition
Caloric requirements
Protein requirements
Recommendations for calories and proteins during disease and recovery phases
Specific macronutrients
Specific micronutrients
Prebiotics and probiotics
Special pediatric considerations
Annotated references
References
Part III. Central Nervous System
42. Advanced bedside neuromonitoring
Introduction
Monitoring neurologic status
Intracranial pressure and cerebral perfusion pressure
Intracranial pressure monitoring devices
ICP waveforms
Complications
Jugular venous oxygen saturation
Side of jugular catheterization
Normal jugular venous oxygen saturation
Transcranial doppler flow velocity and flow volume
Brain tissue oxygen partial pressure
Near-infrared spectroscopy
Electroencephalogram
Microdialysis
Annotated references
References
43. Coma
Coma
Defining disorders of consciousness
Differential diagnosis
Anatomy and physiology
Etiology
Approach to a patient with coma
Diagnostic evaluation
Management
Prognosis
Conclusion
Annotated references
References
44. Use of brain injury biomarkers in critical care settings
Biofluid-based biomarkers for detecting brain injury in the ICU
Current biomarker candidates and their properties
Potential uses of brain biomarkers for TBI patient management
Acknowledgments
Annotated references
References
45. Cardiopulmonary cerebral resuscitation
Epidemiology
Restoring circulation
Aspects of cardiac arrest in specific situations
Post–cardiac arrest care to minimize brain injury
Rehabilitation
Withdrawal of life-sustaining treatment
Summary
Annotated references
References
46. Management of acute ischemic stroke
Emergent stroke evaluation
Imaging of acute stroke
Treatment of acute stroke
Summary
Annotated references
References
47. Nontraumatic intracerebral and subarachnoid hemorrhage
Hemorrhage
Subarachnoid hemorrhage
Annotated references
References
48. Seizures in the critically ill
Introduction
Epidemiology
Classification
Pathogenesis and pathophysiology
Clinical manifestations
Diagnostic approach
Management approach
Treating status epilepticus
Annotated references
References
49. Neuromuscular disorders in the critically ill
The motor unit and its physiology
Muscles of respiration
Neuromuscular disorders
Acknowledgment
Annotated references
References
50. Traumatic brain injury
Introduction
Prehospital care
Pathophysiology
Forms of primary brain injury
Characterization and management
Elevated intracranial pressure monitoring
Elevated intracranial pressure management
Special considerations
Acknowledgment
Annotated references
References
51. Spinal cord injury
Introduction
Epidemiology
Etiology
Pathophysiology
Initial management
Prognostic factors for recovery
Pediatric spinal cord injury
Therapeutic hypothermia
Management in the intensive care unit
Pharmacotherapy
Chronic complications
Future interventions
Conclusion
Annotated references
References
52. Neuroimaging
Imaging modalities
Brain
Spine
Annotated references
References
Part IV. Pulmonary
53. Core principles of respiratory physiology and pathophysiology in critical illness
Introduction
Respiratory mechanics
Gas exchange
Conclusion
Annotated references
References
54. Patient–ventilator interaction
Respiratory physiology
Patient and ventilator variables
Respiratory drive–ventilator trigger asynchrony
Ventilatory requirement–gas delivery asynchrony
Inspiratory timing–ventilator cycling asynchrony
Patient-ventilator asynchrony during pressure support ventilation
Total patient-controlled mechanical support
Proportional assisted ventilation, proportional pressure support, and proportional assisted ventilation plus
Neurally-adjusted ventilatory assistance
Adaptive support ventilation
Acknowledgments
Annotated references
References
55. Noninvasive positive-pressure ventilation
Rationale
Mechanisms of action
Indications
Roles of HFNC vs. NIV
Practical application
Adverse effects and complications
Annotated references
References
56. Advanced techniques in mechanical ventilation
Introduction
Advanced modes
Control of ventilation
Conclusion
Annotated references
References
57. Weaning from mechanical ventilation
The concept of liberation and extubation
Mechanisms that explain liberation failure
Cardiovascular dysfunction
Prediction of weaning and extubation outcomes
Extubation failure
Progressive withdrawal of mechanical ventilation
Pressure support ventilation
New modalities
Spontaneous breathing with a T-tube
Ventilatory support after extubation
Classification of weaning
Summary
Annotated references
References
58. Adjunctive respiratory therapy
Methods to improve pulmonary mucociliary clearance
Methods to improve lung expansion
Methods to improve oxygenation and ventilation
Summary
Annotated references
References
59. Intensive care unit imaging
Recent advances in ICU imaging
Chest radiography
Normal PA CXR/normal AP obese CXR
CT and MRI
Abdominal radiography
Ultrasound
Interventional radiology for critical care
Acknowledgment
Annotated references
References
60. Acute respiratory distress syndrome
Epidemiology
Risk factors
Pathophysiology
Diagnosis
Clinical course
Treatment
Complications
Clinical outcomes and prognosis
Annotated references
References
61. Drowning
Definition
Epidemiology
Pathophysiology
Drowning chain of survival
Prehospital advanced life support
Decision to admit to the ICU, general ward, or discharge
Outcome
Annotated references
References
62. Aspiration pneumonitis and pneumonia
Aspiration pneumonitis
Aspiration pneumonia
Conclusion
Annotated references
References
63. Severe asthma exacerbation in adults
Magnitude of the problem and risk factors
Pathophysiology of acute airflow obstruction
Clinical features
Peak flow measurements
Acid-base status
Chest radiography
Emergency department disposition
Oxygen
Pharmacologic management
Noninvasive ventilation
Intubation and mechanical ventilation
Postexacerbation management
Annotated references
References
64. Chronic obstructive pulmonary disease
Definition and natural history
Pathology
Physiology
Systemic effects
Exacerbations
Intensive care unit referral
Principles of treatment
Noninvasive ventilation
Mechanical ventilation
Nonventilatory issues
Prognosis
Annotated references
References
65. Pulmonary embolism
Introduction
Epidemiology
Risk factors
Pathophysiology
Diagnosis
Classification, prognostic assessment, and severity
Treatment of acute PE
Annotated references
References
66. Pneumothorax
Introduction
Pathophysiology
Diagnosis and evaluation
Management
Persistent air leak
Annotated references
References
67. Community-acquired pneumonia
Introduction
Incidence
Risk factors for developing SCAP
Prognostic factors
Pathogenesis
Clinical features
Radiographic features
Severity scoring in CAP
Role of biomarkers in severe CAP
Etiologic pathogens
Risk factors for specific pathogens
Features of specific pathogens
Other organisms
Influenza
Severe acute respiratory syndrome
Middle east respiratory syndrome coronavirus
Bioterrorism considerations
Diagnostic evaluation
Treatment
Timeliness of initial therapy
Duration of therapy
Adjunctive therapy measures
Evaluation of response to therapy
Prevention
Pneumococcal vaccine
Influenza vaccination
Annotated references
References
68. Nosocomial pneumonia
Definitions
Epidemiology
Pathogenesis
Prevention
Diagnosis
Treatment
Annotated references
References
Part V. Cardiovascular
69. Core principles of cardiovascular physiology and pathophysiology in critical illness
Introduction
The guytonian universe
Intersection of return and cardiac function
Physiologically based approach at the bedside
Supply–demand considerations
Conclusion
Annotated references
References
70. Acute coronary syndromes: Therapy
Definition and clinical manifestations
Pathophysiology of acute coronary syndromes
STEMI
UA and NSTE-ACS
Right ventricular infarction
Cardiogenic shock
Annotated references
References
71. Supraventricular arrhythmias
Classification and epidemiology
Clinical presentation
Electrocardiography
Atrioventricular nodal reentry tachycardia
Atrioventricular reentry tachycardia
Accelerated atrioventricular rhythm
Atrial fibrillation and atrial flutter
Atrial tachycardia
Inappropriate sinus tachycardia
Annotated references
References
72. Ventricular arrhythmias
Normal electrophysiology
Mechanisms of ventricular tachyarrhythmias
Preexisting conditions predisposing to ventricular arrhythmias
Clinical diagnosis
Acute management
Conclusion
Annotated references
References
73. Conduction disturbances and cardiac pacemakers
Conduction disturbances
Cardiac implanted devices
Annotated references
References
74. Myocarditis and acute myopathies
Myocarditis
Pathogenesis
Clinical presentation and diagnosis
Endomyocardial biopsy
Clinical course
Prognosis
Giant cell myocarditis
Eosinophilic myocarditis
Therapy
Summary
Stress cardiomypathy
Tachycardia-induced cardiomyopathy
Annotated references
References
75. Pericardial diseases
Etiology and classification of pericardial disease
Pericardial syndromes
Specific forms of pericarditis
Rare forms of pericardial disease
Annotated references
References
76. Emergency heart valve disorders
Mitral regurgitation
Aortic regurgitation
Mitral stenosis
Aortic stenosis
Right-sided valve disease
Prosthetic valves
Annotated references
References
77. Pulmonary hypertension and right ventricular failure
Diagnosis
Treatment
Annotated references
References
78. Hypertensive crisis: Emergency and urgency
Pathophysiology of hypertensive emergency
Diagnosis of hypertensive emergencies
Treatment of hypertensive emergency
Specific treatment recommendations for hypertensive emergency based on etiology
Hypertensive urgency
Annotated references
References
79. Pathophysiology and classification of shock states
Pathophysiology of shock
Classification of shock
Clinical aspects of shock
Annotated references
References
80. Resuscitation from circulatory shock
Introduction
From macro to micro circulation: Pathophysiology of inadequate oxygen use by the cells
From micro to macro circulation: Systemic targets of resuscitation from circulatory shock
A physiologic cause-related approach to circulatory shock
Annotated references
References
81. Inotropic therapy
Rationale for using inotropic therapy in the critically ill
Pharmacologic properties of inotropic agents
Hemodynamic effects of inotropic agents in critically ill patients
Main indications of inotropic therapy in patients with circulatory failure
Annotated references
References
82. Mechanical support in cardiogenic shock
History of mechanical circulatory support
Initial management of cardiogenic shock
Current use of mechanical circulatory support devices
Treatment of cardiogenic shock: An algorithm for mechanical circulatory support
Outcomes of cardiogenic shock with MCS support
Heart team approach to CS requiring MCS
Conclusion
Annotated references
References
Part VI. Gastrointestinal
83. Portal hypertension: Critical care considerations
The change of a paradigm
Some new achievements in the management of complications of cirrhosis
Some still unmet or new aims in the management of complications
Annotated references
References
84. Hepatorenal syndrome
Renal dysfunction in cirrhosis
Pathogenesis of HRS
Diagnosis
Clinical types
Treatment
Prevention
Conclusion
Annotated references
References
85. Hepatopulmonary syndrome
Definition
Clinical features
Pathophysiology
Diagnosis
Prevalence
Prognosis
Therapy
Annotated references
References
86. Hepatic encephalopathy
Current concepts on the pathophysiology associated with hepatic encephalopathy
Encephalopathy in the setting of acute liver failure
Management of encephalopathy and intracranial hypertension
Encephalopathy in the setting of chronic liver disease
Conclusion
Acknowledgment
Annotated references
References
87. Acute liver failure
Introduction
Clinical features of acute liver failure
Investigations
Management
Conclusion
Annotated references
References
88. Calculous and acalculous cholecystitis
Risk factors and pathophysiology
Incidence
Clinical presentation
Imaging studies
Diagnosis
Management
Endoscopic drainage
Complications and outcome
Prevention
Summary
Annotated references
References
89. Acute pancreatitis
Etiology and epidemiology
Pathogenesis and genetic susceptibility
Diagnosis
Severity and scoring
Imaging
Computed tomography
Endoscopic retrograde cholangiopancreatography
Magnetic resonance cholangiopancreatography
Management
Pulmonary dysfunction
Pulmonary management
Pain relief
Specific support
Pathogenesis of pancreatic infection and antibiotic prophylaxis
Management of pancreatic necrosis and abscess
Laboratory markers of infected necrosis
Indication and timing of intervention
Interventional procedures
Necrosectomy
Outcome
Summary
Annotated references
References
90. Abdominal sepsis
Introduction
Definitions and classifications
Enteric microbiota
Pathogenesis
Spectrum of disease causing critical illness
Diagnosis
Management
Complications
Annotated references
91. Mechanical bowel obstruction
Etiology
Pathophysiology
Clinical presentation
Evaluation
Management
Annotated references
References
92. Toxic megacolon and Ogilvie’s syndrome
Clinical features
Pathogenesis of acute megacolon
Predisposing factors
Diagnosis of acute megacolon
Management
Summary
Annotated references
References
93. Severe gastrointestinal bleeding
Resuscitation
Management of antiplatelet agents
Management of anticoagulants
Localization and treatment
Upper gastrointestinal bleeding
Lower intestinal bleeding
Prognosis
Acknowledgments
Annotated references
References
Part VII. Renal
94. Core principles of renal physiology and pathophysiology in critical illness
Introduction
Structures of the nephron
Glomerular filtration, renal blood flow, and metabolism
Physiologic functions of the kidney
Diuretics
Disorders of function: Acute kidney injury
Specific acute kidney injury syndromes
Annotated references
References
95. Clinical assessment of renal function
Renal blood flow
Glomerular filtration rate
Creatinine clearance and serum creatinine
Future methodologies
Sodium balance and extracellular fluid volume
Annotated references
References
96. Biomarkers of acute kidney injury
Epidemiology of acute kidney injury in the intensive care unit
Biologic characteristics of current tools in AKI
Biologic characteristics of novel AKI biomarkers with short turn-around times
Clinical characteristics of AKI biomarkers with short turn-around times
Biologic and clinical characteristics of other novel AKI biomarkers
Conclusion
Acknowledgment
Annotated references
References
97. Water metabolism
Water ingestion and production
Water metabolism disorders
Conclusion
Annotated references
References
98. Advanced techniques in blood purification
Introduction
Pathophysiology of dysregulated immune response in sepsis and targets for blood purification techniques
Blood purification techniques for sepsis
Blood purification for nonseptic indications
Conclusion
Annotated references
References
99. Fluid and volume therapy in the ICU
Timing of initial volume therapy
Type of volume therapy
Crystalloids versus colloids
Hydroxyethyl starch
Albumin use in select clinical settings
Chloride-restrictive and balanced crystalloid strategies
Blood transfusions
Effects of volume overload
Conclusion
Acknowledgment
Annotated references
References
100. Acute kidney injury
Renal hypoperfusion
Postrenal causes of AKI
Intrinsic and syndromic causes of AKI
Definition and diagnosis
Epidemiology and outcomes
Prevention and treatment
Glycemic control and nutritional support
Special types of AKI
Role of the nephrologist in the ICU
Renal replacement therapy
Conclusion
Acknowledgment
Annotated references
References
101. Urinary tract obstruction
Epidemiology
Etiology
Clinical presentation
Imaging in urinary tract obstruction
Pathophysiology of obstruction
Treatment
Recovery of kidney function
Annotated references
References
102. Contrast-induced acute kidney injury
Epidemiology
Pathophysiology
Clinical features and diagnosis
Prognosis
Prevention
Fluid administration
Choice and volume of contrast agent
Prophylactic RRT
Pharmacologic strategies
Diuretics
Statins
Others
Management
Conclusion
Acknowledgments
Annotated references
References
103. Glomerulonephritis
Glomerulonephritis
Pauci-immune necrotizing glomerulonephritis
Anti–glomerular basement membrane glomerulonephritis
Lupus nephritis
Infection-related glomerulonephritis
IgA nephropathy
IgA vasculitis
Thrombotic microangiopathies
Annotated references
References
104. Interstitial nephritis
Annotated references
References
Part VIII. Infectious Diseases
105. Antimicrobial stewardship
Optimization of antimicrobial therapy
Avoidance of unnecessary antibiotic administration
Conclusion
Annotated references
References
106. Prevention and control of nosocomial pneumonia
Pathogenesis
Colonization with pathogenic microorganisms
Avoidance of antibiotics
Avoidance of increased gastric pH
Modified endotracheal tubes
Cross-infection
Aspiration
Large-volume aspiration
Small-volume aspiration
Microaspiration
Semirecumbent positioning
Overwhelming lower respiratory tract host defenses
Minimizing antibiotic use
Corticosteroids
Transfusions
Annotated references
References
107. Antimicrobial agents with primary activity against gram-negative bacteria
Beta-lactams
Fluoroquinolones
Aminoglycosides
Tetracyclines
Polymyxins
Fosfonic acid derivatives: Fosfomycin
Annotated references
References
108. Antimicrobial agents with primary activity against gram-positive bacteria
Vancomycin
Teicoplanin
Telavancin
Daptomycin
Linezolid
Tedizolid
Quinupristin/dalfopristin
Annotated references
References
109. Antimicrobial agents active against anaerobic bacteria
Antimicrobial agents effective against anaerobic bacteria
General consideration of antimicrobial selection
Results/discussion
Annotated references
References
110. Selective decontamination of the digestive tract
Background
Clinical results
Microbiologic effects of selective decontamination
Annotated references
References
111. Intravascular catheter-related infections
Introduction
Pathophysiology and microbiology
Definitions
Diagnosis of catheter infections
Prevention
Management of catheter-related infections
Conclusion
Peripherally inserted central catheters
Arterial catheters
Short-term hemodialysis catheters
Acknowledgments
Annotated references
References
112. Septic shock
Incidence
Etiology of septic shock
Pathophysiology of septic shock
Classification
Clinical presentation
Hemodynamic changes
Monitoring
Management
Conclusion
Annotated references
References
113. Infections of the urogenital tract
Definition
Etiology
Epidemiology
Pathophysiology
Diagnosis
Therapy
Special clinical issues
Annotated references
References
114. Central nervous system infections
Meningitis
Brain abscess
Encephalitis
Myelitis and myelopathy
Central nervous system infection and the acquired immunodeficiency syndrome patient
Extracranial infections
Sepsis syndrome with central nervous system involvement
Conclusion
Annotated references
References
115. Infections of skin, muscle, and necrotizing soft tissue infections
Cellulitis
Necrotizing soft tissue infections
Pyomyositis
Burn wounds
Pressure ulcers
Conclusion
Annotated references
References
116. Head and neck infections
Normal head and neck flora
Sites of deep head and neck infection
Clinical syndromes
Conclusion
Annotated references
References
117. Infectious endocarditis
Infectious endocarditis: General information
Healthcare–associated native valve endocarditis
Healthcare–associated prosthetic valve endocarditis
Infective endocarditis in the ICU
The endocarditis team39
Annotated references
References
118. Fungal infections
Fungal infections in the critically ill
Systemic antifungal agents
In vitro susceptibility testing of systemic antifungal agents
Treatment of fungal infections in the critically ill
Conclusions
Annotated references
References
119. Influenza and acute viral syndromes
Influenza
Other critical respiratory viral infections
Critical viral infections causing vesicular skin lesions
Critical neurotropic viruses
Viral hemorrhagic fevers
Other systemic critical viral infections
Antiviral drugs
Annotated references
References
120. Human immunodeficiency virus infection
Introduction
The continuum of HIV infection: Impact on clinical presentation at ICU admission
Convergence of clinical presentation and outcomes in critically ill HIV-infected and seronegative patients
Diagnostic workflow and therapeutic approaches in critically ill HIV-infected patients
Management of antiretroviral therapy in the ICU
Concluding remarks and potential research axes
Annotated references
References
121. Infections in the immunocompromised patient
Commonly encountered immunocompromising conditions
General diagnostic approach to immunocompromised patients with severe infections
Major manifestations of infection in immunocompromised patients
Sepsis without a defined site of infection
Therapeutic difficulties in immunocompromised patients
Conclusion
Acknowledgment
Annotated references
References
122. Tuberculosis
Epidemiology
Drug-resistant tuberculosis is a foreboding problem
Tuberculosis in the intensive care unit
Pulmonary tuberculosis
Disseminated tuberculosis
Neurologic tuberculosis
Cardiovascular tuberculosis
Tuberculosis in human immunodeficiency virus–positive patients
Tuberculosis and immunomodulatory therapies
Diagnosis of tuberculosis
Treatment of tuberculosis
Risk to healthcare workers
Annotated references
References
123. Malaria and other tropical infections in the intensive care unit
Epidemiology
Pathophysiology
Clinical presentation
Diagnosis
Clinical management
Prognosis and sequelae
Acknowledgments
Annotated references
References
124. Clostridioides difficile infection
Introduction
Pathogenesis
Risk factors
Patient factors
Diagnosis
Treatment
Treatment of recurrent CDI
Infection prevention and control
Conclusions
Annotated references
References
Part IX. Hematology
125. Anemia and RBC transfusion
Epidemiology
Etiology
Consequences of anemia
Red blood cell transfusion
Physiologic effects of RBC transfusion
Transfusion-related complications
RBC storage
When to transfuse blood in the critically ill
Transfusion thresholds for specific subpopulations
Conclusion
Annotated references
References
126. Guidelines for blood component therapy
Red blood cell concentrates
Platelet concentrates
Fresh frozen plasma
Cryoprecipitate
Plasma-derived products
Recombinant blood products
Blood substitutes
Transfusion management of massive acute traumatic hemorrhage
Novel concepts for damage control resuscitation in trauma
Goal-directed correction of coagulopathy
Hazards of allogeneic transfusion
Blood storage lesions and potential clinical consequences
Hyperbilirubinemia in the setting of massive transfusion
Basic immunohematology
Regular and irregular (atypical) antibodies
Antibody screen
Crossmatch (compatibility test)
Annotated references
References
127. Venous thromboembolism
Introduction
Deep vein thrombosis
Pulmonary embolism
Annotated references
References
128. Anticoagulation in the intensive care unit
Introduction
Anticoagulation
Heparin
Synthetic Xa inhibitors
Direct thrombin inhibitors: Parenteral agents
Oral anticoagulants
Platelet inhibitors
ICU/Perioperative management of antithrombotic therapy
Annotated references
References
129. Monitoring of coagulation status
Overview of effective coagulation
Basic necessary conditions for proper hemostasis
Laboratory analysis for coagulation
Monitoring anticoagulation
Annotated references
References
130. Critical care of the hematopoietic stem cell transplant recipient
Indications for ICU admission
Common infectious complications requiring ICU care
Common noninfectious complications requiring ICU care
Outcomes after ICU admission
Annotated references
References
Part X. Obstetrics
131. Cardiovascular and endocrinologic changes associated with pregnancy
Cardiovascular changes in pregnancy
Endocrine and metabolic changes in pregnancy
Annotated references
References
132. Hypertensive disorders in pregnancy
Blood pressure measurements in pregnancy
Physiologic changes in pregnancy
Causes of hypertension in pregnancy
Pathology of preeclampsia
Clinical presentation of preeclampsia
Other causes of hypertension in pregnancy
General treatment principles
Antihypertensive drug therapy
Management of hypertension during labor and delivery
Annotated references
References
133. Acute pulmonary complications during pregnancy
Pulmonary physiology in pregnancy
Asthma
Status asthmaticus
Pulmonary edema
Acute respiratory distress syndrome
Embolism
Pneumonia
Conclusion
Annotated references
References
134. Postpartum hemorrhage
Definition
Incidence and mortality
Pathophysiology
Presentation
Causes
Diagnostic studies
Prevention
General treatment measures
Specific treatment measures
Surgical therapy
Complications
Prognosis
Annotated references
References
Part XI. Endocrine
135. Diabetic ketoacidosis and hyperosmolar hyperglycemic state
Pathophysiology
Diagnosis
Treatment
Complications and outcome
Prevention of recurrent episodes
Conclusion
Annotated references
References
136. Adrenal insufficiency
Anatomy of the adrenal gland
Physiology of the hypothalamic-pituitary-adrenal axis
Cellular response to adrenocortical hormones and related drugs
Definitions of adrenal insufficiency
Relative adrenal insufficiency
Evaluation of adrenal insufficiency
Clinical symptoms
Therapeutic approaches
Glucocorticoid replacement in patients with septic shock
Further implications for anesthesia and critical care
Conclusion
Annotated references
References
137. Thyroid disorders
Normal thyroid hormone economy
Thyroid hormone economy in critical illness
Evaluation of thyroid function in critically ill patients
Nonthyroidal illness
Thyroid storm
Myxedema coma
Annotated references
References
138. Diabetes insipidus
Central diabetes insipidus
Clinical picture
Differential diagnosis
Treatment
Nephrogenic diabetes insipidus
Annotated references
References
Part XII. Pharmacology and Toxicology
139. General principles of pharmacokinetics and pharmacodynamics
General principles of pharmacokinetics
Pharmacokinetic models
Pharmacodynamics
Protein binding
Nonlinear pharmacokinetics
Large-molecule therapeutics
Acknowledgment
Annotated references
References
140. Poisoning: Overview of approaches for evaluation and treatment
History
Physical examination
Laboratory analysis
Toxicology laboratory
Gastrointestinal decontamination
Enhanced elimination
Selected antidotes
Hypotension in the poisoned patient
Cardiac arrhythmias
Acute renal failure
Seizures
Mechanical ventilation and extubation
Annotated references
References
Part XIII. Surgery/Trauma
141. Resuscitation of hypovolemic shock
Nonhemorrhagic hypovolemic shock
Hemorrhagic shock
Annotated references
References
142. Mediastinitis
Acute anterior mediastinitis
Posterior mediastinitis
Migratory and chronic mediastinal inflammation
Acknowledgment
Annotated references
References
143. Epistaxis
Anatomy
Diagnosis
Treatment
Medicolegal thoughts
Specific intensive care unit situations: Nasal intubation
Specific intensive care unit situations: Postoperative epistaxis
Specific intensive care unit situations: Massive facial trauma
Novel and adjunctive therapies
Mortality
Algorithm50
Annotated references
References
144. Management of the postoperative cardiac surgical patient
Cardiac surgery patients in the intensive care unit
Separation from cardiopulmonary bypass and the end of surgery
Monitoring the postoperative cardiac surgery patient
Clinical manifestations in the postbypass period
Management of common postoperative problems
Outcomes of cardiac surgery
Specific procedures and considerations126
Conclusions
Acknowledgments
Annotated references
References
145. Intensive care unit management of lung transplant patients
Overview of lung transplant
Management of critically ill lung transplant candidates: Bridge to lung transplant
Postoperative complications
Primary graft dysfunction after lung transplantation
Annotated references
References
146. Perioperative management of the liver transplant patient
Introduction
Donor selection
A systems-based approach to management of the post–liver transplant patient
Assessment of graft function
Conclusions
Annotated references
References
147. Intestinal and multivisceral transplantation: The ultimate treatment for intestinal failure
Introduction
Definition and management of intestinal failure
Indications for transplant
Evaluation for transplant
Transplantation procedures
Postoperative management
Management of allograft rejection
Management of complications
Outcomes
Conclusion
Acknowledgment
Annotated references
References
148. Aortic dissection
Introduction
Pathophysiology and definition
Classification
Epidemiology and prognosis
Risk factors
Clinical presentation
Diagnosis
Medical management for acute aortic dissection
Interventions for acute aortic dissection
Long-term management of aortic dissection
Conclusions
Annotated references
References
149. Mesenteric ischemia
Introduction
Chronic mesenteric ischemia
Acute mesenteric ischemia
Annotated references
References
150. Abdominal compartment syndrome
Historical perspective
Terminology
Damage control laparotomy
Abdominal decompression
Pathophysiology
Cerebral perfusion
Cardiac function
Renal function
Gut perfusion
Lower extremity perfusion
Prediction
Treatment
Percutaneous methods
Surgical decompression
Management of the open abdomen
Annotated references
References
151. Extremity compartment syndromes
Epidemiology
Clinical presentation
Diagnosis
Management
Fasciotomy
Fasciotomy of the upper extremity
Fasciotomy of the lower extremity
Potential complications
Conclusion
Annotated references
References
152. Thromboembolization and thrombolytic therapy
Introduction
Drugs
Clinical indications
Management/laboratory values
Conclusion
Acknowledgment
Annotated references
References
153. Atheroembolization
Pathophysiology
Clinical consequences of atheromatous embolization
Diagnosis and screening
Vascular manipulation and embolic events
Prevention and management
Annotated references
References
154. Pressure ulcers
Epidemiology
Risk factors
Pathophysiology
Classification
Prevention
Treatment
Conclusion
Annotated references
References
155. Burns, including inhalation injury
Introduction
Initial care of the burn patient
Acute burn resuscitation
Inhalation injury
Circumferential extremity burns
Perioperative management of the burn patient
Wound coverage
Analgesia and sedation
Infection in the burn patient
Gastrointestinal stress ulceration
Nutrition
Rehabilitation in the burn ICU
Pediatric patients
Ophthalmic injury
Chemical burns
Electrical injury
Cold injury
Radiation injury
Desquamative disorders
Conclusion
Annotated references
References
156. Thoracic trauma
Initial assessment
Pleural space
Blunt lung injury
Penetrating lung injury
Mediastinal injuries
Tracheobronchial injury
Esophageal injury
Cardiac injury
Transmediastinal penetrating trauma
Thoracic great vessel injury
Blunt thoracic aortic injury
Annotated references
References
157. Abdominal trauma
Introduction
Etiology of injury
Surgical exploration
Organ-specific injury
Annotated references
References
158. Pelvic fractures and long bone fractures
Introduction
Initial management
Complications of pelvic and long bone fractures
Pelvic fracture
Long bone fracture
Conclusion
Annotated references
References
159. Determination of brain death and management of the brain-dead organ donor
Introduction
Determination of brain death
Management of the brain-dead organ donor
Annotated references
References
160. Donation after cardiac death (non–heart-beating donation)
Historical perspective
Identification and categorization of potential donation after cardiac death donors
Current status of donation after cardiac death
Principles of donation after cardiac death donor management
Determination of death: The exact scientific concept?
DCD in the ICU setting
Final considerations
Conclusion
Annotated references
References
Part XIV. Ethical and End-of-Life Issues
161. Conversations with families of critically ill patients
Medical decision making
Family conferences in the ICU
Conclusion
Annotated references
References
162. Resource allocation in the intensive care unit
Introduction
Allocation versus evidence-based medicine
Allocation strategies
Illusory cost savings
Strategies for bedside allocation of resources in the ICU
Special scenarios
Conclusion
The future
Annotated references
References
163. Basic ethical principles in critical care
Background
Goals of care and medical decision making
Futility
Annotated references
References
Part XV. Organization and Management
164. Building teamwork to improve outcomes
The importance of teamwork in critical care
Components of effective teamwork
Impact of teamwork on outcomes
Strategies to establish better teamwork
Examples of initiatives requiring an interprofessional approach in critical care
Conclusion
Annotated references
References
165. Severity of illness indices and outcome prediction
What should be measured
Databases and definitions
Model development
What independent variables affect outcome?
Validation and testing model performance
Standardized mortality ratio
Models based on physiologic derangement
Sequential organ failure assessment score
Administrative models
Comparisons among models
Utility of severity of illness indices
Pitfalls in the application of severity of illness indices
Recent developments
Pediatric illness severity scores
Conclusion
Acknowledgments
Annotated references
References
166. Long-term outcomes of critical illness
Cognitive impairments after critical illness
Psychiatric sequelae of critical illness
Critical illness–associated neuromuscular dysfunction
Critical illness–associated morbidity and persistent immune dysfunction
Quality of life
Caregiver and family burden in critical illness
Models of aftercare for critical illness survivors
Palliative care for critical illness survivors
Future directions
Conclusion
Acknowledgment
Annotated references
References
167. Early ambulation in the ICU
The physiology of bedrest
ICU-acquired weakness
Early mobilization and ambulation in the ICU
Early mobilization programs in the ICU
Conclusion
Annotated references
References
168. Mass critical care
Background
Terminology
Classification of disasters
Natural disasters
Other natural disasters
Man-made disasters
Medical disaster syndromes
Disaster preparedness
Issues unique to the intensive care unit
Critical care in unconventional situations
Critical care transport
Conclusion
Annotated references
References
169. Telemedicine in intensive care
Definition
Telemedicine in intensive care
Tele-ICU in the future
Annotated references
References
170. Teaching critical care
Introduction
The role of the educator
Adult learning theories
Curriculum development
Learning experiences
Teaching skills and strategies
Providing effective feedback
Conclusion
Acknowledgment
Annotated references
References
Online Chapters
E1. Difficult airway management for intensivists
Preoxygenation and per-oxygenation
Supraglottic Airway Placement
Before the procedure
Anatomy
After the procedure
Outcomes and evidence
Suggested reading
Bougie-Assisted Intubation
Before the procedure
Anatomy
Procedure
After the procedure
Outcomes and evidence
Suggested reading
Intubating Model of the SGA for Emergency Airway Rescue (LMA Model [Fastrach] Intubating LMA [ILMA] Will Serve as an Example But Other Brands are Available)
Before the procedure
Anatomy
Procedure
After the procedure
Outcomes and evidence
Suggested reading
Retrograde Wire Intubation
Before the procedure
Anatomy
Procedure
After the procedure
Outcomes and evidence
Suggested reading
Needle Cricothyrotomy with Transtracheal Jet Ventilation
Before the procedure
Anatomy
Procedure
After the procedure
Outcomes and evidence
Suggested reading
Needle and Surgical Cricothyrotomy
Before the procedure
Anatomy
Procedure: Conventional approach
Procedure: Stylet-dilator method
Procedure: Seldinger technique—melker cook critical care
Procedure: Surgical approach—Rapid 4-step, modified 3-step (Bougie-assisted) technique
After the procedure
Outcomes and evidence
Suggested reading
Esophageal-Tracheal Combitube: Alternatively, the Rusch Easy Tube (Smaller—Latex-Free Combitube Look-Alike and the King LT-Laryngeal Tube-Single Lumen, Esophageal Placement, One Syringe for Dual Cuff Inflation)
Before the procedure
Anatomy
Procedure: Combitube
Procedure: King laryngeal tube
After the procedure
Outcomes and evidence
Suggested reading
Evaluation of a Cuff Leak in The ICU
Before the procedure
Procedure
After the procedure
Outcomes and evidence
Suggested reading
Extubation of the Difficult Airway
Before the procedure
Anatomy
Procedure
After the procedure
Outcomes and evidence
Suggested reading
Videolaryngoscope-Assisted Intubation
Before the procedure
Anatomy
Procedure
After the procedure
Outcomes and evidence
Suggested reading
ETT Exchange
Before the procedure
Anatomy
Procedure
After the procedure
Outcomes and evidence
Suggested reading
E2. Bedside ultrasonography
Use of bedside ultrasonography in the intensive care unit
Bedside echocardiography in a critically ill patient
Use of contrast and harmonic technology to enhance transthoracic examinations with poor image quality in a critically ill patient
Comparison between bedside echocardiography and pulmonary artery catheter in the intensive care unit
Impact of bedside echocardiography on diagnosis and management in a critically ill patient
Other applications of bedside ultrasonography in the intensive care unit
Annotated references
References
E3. Central venous catheterization
Before the procedure
After the procedure
Suggested reading
E4. Arterial cannulation and invasive blood pressure measurement
Sites of insertion
Equipment
Complications
Annotated references
References
E5. Bedside pulmonary artery catheterization
Before the procedure
Anatomy
Procedure
After the procedure
Annotated references
E6. Cardioversion and defibrillation
Before the procedure
Anatomy
Procedure
After the procedure
Annotated references
E7. Transvenous and transcutaneous cardiac pacing
Before the procedure
Anatomy
Procedure
After the procedure
Annotated references
E8. Ventricular assist device implantation
Before the procedure
After the procedure
Outcomes and evidence
Suggested reading
E9. Pericardiocentesis
Preprocedure
Anatomy
Procedure
After the procedure
Outcomes and evidence
Suggested reading
E10. Paracentesis and diagnostic peritoneal lavage
Paracentesis: Before the procedure
Anatomy
Procedure
After the procedure
Outcomes and evidence
Diagnostic peritoneal lavage: Before the procedure
Anatomy
Procedure
After the procedure
Outcomes and evidence
References
E11. Thoracentesis
Before the procedure
Anatomy
Procedure
After the procedure
Outcomes and evidence
Suggested reading
E12. Chest tube placement, care, and removal
Before the procedure
Anatomy
Procedure
After the procedure
Suggested reading
E13. Flexible bronchoscopy
Specialty and category within specialty
CPT codes
ICD-9 codes
Preprocedure
Anatomy
Procedure
After the procedure
Outcomes and evidence
Suggested reading
E14. Bronchoalveolar lavage and protected specimen bronchial brushing
Before the procedure
Anatomy
Procedure: Bronchoalveolar lavage
Procedure: Protected specimen bronchial brushing
After the procedure
Suggested reading
E15. Percutaneous dilatational tracheostomy
Before the procedure
Anatomy
Ultrasound
Procedure
After the procedure
Outcomes and evidence
Suggested reading
E16. Esophageal balloon tamponade
Before procedure
Procedure
After procedure
Outcomes and evidence
Suggested reading
E17. Nasoenteric feeding tube insertion
Before procedure
Anatomy
After procedure
Suggested reading
E18. Lumbar puncture
Before procedure
Anatomy
Procedure
After procedure
Outcomes and evidence
Suggested reading
E19. Jugular venous and brain tissue oxygen tension monitoring
Ultrasound-guided internal jugular vein oxygen saturation (SjvO2) catheter placement: Before the procedure
Anatomy
Procedure
Outcomes and evidence
Brain tissue oxygen probe placement: Before the procedure
Anatomy
Procedure
After the procedure
Outcomes and evidence
Suggested reading
E20. Intracranial pressure monitoring
Before procedure
Anatomy
Procedure
After procedure
Outcomes and evidence
Suggested reading
E21. Indirect calorimetry
Before the procedure
Procedure
After the procedure
Complications
Annotated references
E22. Extracorporeal membrane oxygenation cannulation
Specialty and category within specialty
Before procedure
Anatomy
Procedure
After the procedure
Outcomes and evidence
Annotated references
Index

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Textbook of Critical Care

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Jean-Louis Vincent

Frederick A. Moore

Rinaldo Bellomo

John J. Marini