Anaesthesia, Pain, Intensive Careand Emergency

418 Pages·2008·2.89 MB·English

A. Gullo(Editor)
Anaesthesia, Pain, Intensive Care and Emergency – A.P.I.C.E.
Proceedingsofthe
22ndPostgraduateCourseinCriticalCareMedicine
Venice-Mestre,Italy–November9-11,2007
A. Gullo (Editor)
Anaesthesia, Pain, Intensive Care
and Emergency
A.P.I.C.E.
Proceedings of the
22nd Postgraduate Course in Critical Care Medicine
Venice-Mestre, Italy – November 9-11, 2007
Springer
ANTONINOGULLO,M.D.
Head,DepartmentofAnaesthesiaandIntensiveCare
Head,PostgraduatedSchoolofAnaesthesiaandIntensiveCare
CataniaUniversityHospital
Catania,Italy
LibraryofCongressControlNumber:2007939172
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Table of Contents
ADVANCESONCRITICALCARE
Chapter1-OrganizationoftheRapidResponseSystem
P.DIGIACOMO,M.A.DEVITA . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3
Chapter2-TransoesophagealEchocardiography:ClinicalAssessment,
TechniquesandProceduresinCriticalCareandICU
F.GUARRACINO,C.CARIELLO. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 9
Chapter3-UseofPulseOximeterWaveformasaNonInvasiveFunctional
HaemodynamicMonitoringTechnique
M.CANNESSON,J.-J.LEHOT . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 23
Chapter4-ContinuousMonitoringofOrganChemistry–aParadigmShift
inManagementofIntensiveCare
U.UNGERSTEDT . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 29
Chapter5-GeneralAnaesthesiaandtheDevelopingBrain
V.JEVTOVIC-TODOROVIC . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 45
AIRWAY
Chapter6-AirwayManagement:TheEssential
G.FROVA,M.SORBELLO . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 53
Chapter7-BestMethodtoEstablishtheGradeofDifficultAirway.
ClinicalAssessment,TechniquesandProceduresinCriticalCareandICU
F.PETRINI,L.MOGGIA,G.MERLI . . . . . . . . . . . . . . . . . . . . . . . . . . . . 63
Chapter8-Out-Of-HospitalAirwayManagement:KnowledgeandEquipment
S.RUSSO,C.EICH,A.TIMMERMANN . . . . . . . . . . . . . . . . . . . . . . . . . . . 71
VI
Chapter9-PracticalAspectstoManageExtubationoftheDifficultAirway
M.SORBELLO,G.MORELLO,A.GUARINO . . . . . . . . . . . . . . . . . . . . . . . . 81
TRAUMA
Chapter10-HeadInjuryTreatmentin2007
M.G.ABATE,F.SALA,G.CITERIO . . . . . . . . . . . . . . . . . . . . . . . . . . . . 95
Chapter11-PenetratingInjuriestotheNeck:Operation,Observation
orAngiointervention
D.DEMETRIADES,J.DUBOSE . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 111
OBSTETRICS
Chapter12-ClinicalDecisionMakinginObstetricPatients
R.ALEXANDER,A.PARATORE . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 131
Chapter13-OrganizationofObstetricServices
R.ALEXANDER,A.SAXENA . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 145
PAEDIATRICANAESTHESIA
Chapter14-ClinicalDecisionMakinginPaediatricAnaesthesia
P. BUSONI . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 157
Chapter15-PerioperativeCareinPaediatrics:Organization
I.SALVO,A.CAMPORESI,E.ZOIA. . . . . . . . . . . . . . . . . . . . . . . . . . . . . 163
Chapter16-TechniquesandDrugsinPaediatrics:TIVAandTCI
M.ASTUTO,N.DISMA,E.SANALITRO . . . . . . . . . . . . . . . . . . . . . . . . . . 175
Chapter17-DepthofAnaesthesiaMonitoringinChildren
N.DISMA,S.PELLEGRINO,M.ASTUTO . . . . . . . . . . . . . . . . . . . . . . . . . . 185
CARDIACARREST
Chapter18-NewAspectsofBasicCardiopulmonaryResuscitationResearch:
FromClinicallyRelevantAnimalModelstoCells
G.RISTAGNO,T.WANG,W.TANG . . . . . . . . . . . . . . . . . . . . . . . . . . . . 197
VII
Chapter19-WarningSymptomsofSuddenCardiacDeath
G.BERLOT,A.VERGOLINI,C.CALDERAN . . . . . . . . . . . . . . . . . . . . . . . . 213
Chapter20-VasopressorsDuringCardiacArrest
G.CAMMARATA . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 215
INFECTIONS,SEPSIS,ORGANDYSFUNCTION
Chapter21-CandidaInfectioninCriticallyIllPatients
P.H.J.VANDERVOORT . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 229
Chapter22-PredispositiontoSepsis
J.C.MARSHALL . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 241
Chapter23-SOFAScore:AKeystoneforGradingMultipleOrganDysfunction
J.-L.VINCENT . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 255
PERIOPERATIVECARE
Chapter24-OperatingTheatres:Organization,CostsandAudit
M.KLIMEK,M.VANHOUDENHOVEN,T.H.OTTENS . . . . . . . . . . . . . . . . . . . 263
Chapter25-UseandMisuseofPreoperativeCardiacTesting
forNoncardiacSurgery
H.-J.PRIEBE . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 269
Chapter26-PerioperativeBeta-Blockade:MythsandRealities
G.HOWARD-ALPE,P.FOËX. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 279
Chapter27-ManagementofHypoxiaDuringOneLungVentilation
J.B. BRODSKY . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 291
Chapter28-RegionalAnaesthesiaforThoracicSurgery
J.B. BRODSKY . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 299
Chapter29-WhytheObesePatientisatRiskforPerioperativeComplications
J.B. BRODSKY . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 305
Chapter30-PerioperativeCareinNeurosurgery–IntraoperativeMonitoring
C.ORI,M.MUNARI,S.VOLPIN. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 313
VIII
Chapter31-IncidentsProvokedSpecificallybyCertainDrugsUsed
inAnaesthesia
M.KLIMEK,T.H.OTTENS,F.GRÜNE . . . . . . . . . . . . . . . . . . . . . . . . . . . 325
Chapter32-SideEffectsInducedbyAnaestheticManipulation
orbySurgicalOperation
Y.LEYKIN,N.NOAL . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 333
QUALITYOFCAREINTHEICU
Chapter33-QualityManagementintheICU:UnderstandingtheProcess
andImprovingtheArt
P.MURABITO,F.RUBULOTTA,A.GULLO . . . . . . . . . . . . . . . . . . . . . . . . . 345
List of Contributors
AbateM.G. CamporesiA.
UONeuroanestesiaeNeurorianimazione, PaediatricAnaesthesiaandIntensive
DipartimentodiMedicinaPerioperatoria Care,ChildrenHospital“VittoreBuzzi”,
eTerapieIntensive,HSanGerardo,Mon- Milan(Italy)
za(Italy),andDivisionofAnaesthesia,
UniversityofCambridge,Addenbrooke’s CannessonM.
Hospital,Cambridge(UK) DepartmentofAnaesthesiology,Hôpital
LouisPradel,Bron(France)
AlexanderR.
DepartmentofAnaesthetics,Worcester- CarielloC.
shireRoyalHospital,Worcester(UK) DepartmentofCardiothoracicAnaesthe-
siaandIntensiveCare,AziendaOspeda-
AstutoM. lieraUniversitariaPisana,Pisa(Italy)
DepartmentofAnaesthesiaandIntensive
Care,“Policlinico”UniversityHospital, CiterioG.
Catania(Italy) UONeuroanestesiaeNeurorianimazione,
DipartimentodiMedicinaPerioperatoria
BerlotG. eTerapieIntensive,HSanGerardo,Mon-
DepartmentofPerioperativeMedicine, za(Italy)
IntensiveCareandEmergency,Trieste
UniversityMedicalSchool,Trieste(Italy) DemetriadesD.
DivisionofTraumaandSurgicalCritical
BrodskyJ.B. Care,DepartmentofSurgery,University
DepartmentofAnesthesia,StanfordUni- ofSouthernCalifornia,LosAngeles(USA)
versitySchoolofMedicine,Stanford,CA
(USA) DeVitaM.A.
DepartmentofCriticalCareMedicine,
BusoniP. UniversityofPittsburgh(USA)
DepartmentofAnaesthesiaandIntensive
Care,A.MeyerHospital,Florence(Italy) DiGiacomoP.
DepartmentofCriticalCareMedicine,
CalderanC. UniversityofPittsburgh(USA)
DepartmentofPerioperativeMedicine,
IntensiveCareandEmergency,Trieste DismaN.
UniversityMedicalSchool,Trieste(Italy) DepartmentofAnaesthesiaandIntensive
Care,“Policlinico”UniversityHospital,
CammarataG. Catania(Italy)
DepartmentofAnaesthesiaandIntensive
Care,UniversityofCatania,Cannizzaro DuBoseJ.
(Italy) DivisionofTraumaandSurgicalCritical
Care,DepartmentofSurgery,University
ofSouthernCalifornia,LosAngeles(USA)
X
EichC. MarshallJ.C.
DepartmentofAnaesthesiology,Emer- DepartmentofSurgery,andtheInterde-
gencyandIntensiveCareMedicine,Uni- partmentalDivisionofCriticalCareMedi-
versityofGöttingen(Germany) cine,UniversityofToronto,LiKaShing
KnowledgeInstitute,St.Michael’sHospi-
FoëxP. tal,Toronto,Ontario(Canada)
NuffieldDepartmentofAnaesthetics,Uni-
versityofOxford(UK) MerliG.
CentroCardiologicoMonzino,Milan
FrovaG. (Italy)
EmergencyDepartmentofAnaesthesia
andICU,CiviliHospital,Brescia(Italy) MoggiaL.
AnaesthesiologyandIntensiveCare,Uni-
GrüneF. versityG.D’AnnunzioChieti-Pescara,
DepartmentofAnaesthesiology,Erasmus Chieti(Italy)
UniversityMedicalCentre,Rotterdam
(TheNetherlands) MorelloG.
DepartmentofAnaesthesiaandIntensive
GuarinoA. Care,“Policlinico”UniversityHospital,
AnaesthesiaandIntensiveCare,PO“Villa Catania(Italy)
Scassi”,Genoa(Italy)
MunariM.
GuarracinoF. DepartmentofPharmacologyand
DepartmentofCardiothoracicAnaesthe- Anaesthesiology,AnaesthesiaandInten-
siaandIntensiveCare,AziendaOspeda- siveCareUnit,UniversityofPadua,
lieraUniversitariaPisana,Pisa(Italy) Padua(Italy)
GulloA. MurabitoP.
DepartmentofAnaesthesiaandIntensive DepartmentofAnaesthesiaandIntensive
Care,“Policlinico”UniversityHospital, Care,“Policlinico”UniversityHospital,
Catania(Italy) Catania(Italy)
Howard-AlpeG. NoalN.
NuffieldDepartmentofAnaesthetics,Uni- DepartmentofAnaesthesia,S.M.degli
versityofOxford(UK) AngeliHospital,Pordenone(Italy)
Jevtovic-TodorovicV. OriC.
DepartmentsofAnesthesiologyandNeu- DepartmentofPharmacologyand
roscience,UniversityofVirginiaHealth Anaesthesiology,AnaesthesiaandInten-
System,Charlottesville(USA) siveCareUnit,UniversityofPadua,
Padua(Italy)
KlimekM.
DepartmentofAnaesthesiology,Erasmus OttensT.H.
UniversityMedicalCentre,Rotterdam DepartmentofAnaesthesiology,Erasmus
(TheNetherlands) UniversityMedicalCentre,Rotterdam
(TheNetherlands)
LehotJ.-J.
DepartmentofAnaesthesiology,Hôpital ParatoreA.
LouisPradel,Bron(France) DepartmentofAnaesthesiaandIntensive
Care,“Policlinico”UniversityHospital,
LeykinY. Catania(Italy)
DepartmentofAnaesthesia,S.M.degli
AngeliHospital,Pordenone(Italy)
XI
PellegrinoS. TangW.
DepartmentofAnaesthesiaandIntensive WeilInstituteofCriticalCareMedicine,
Care,“Policlinico”UniversityHospital, RanchoMirage,CA(USA)andKeck
Catania(Italy) SchoolofMedicine,UniversityofSouth-
ernCalifornia,LosAngeles,CA(USA)
PetriniF.
AnaesthesiologyandIntensiveCare,Uni- TimmermannA.
versityG.D’AnnunzioChieti-Pescara, DepartmentofAnaesthesiology,Emer-
Chieti(Italy) gencyandIntensiveCareMedicine,Uni-
versityofGöttingen(Germany)
PriebeH.-J.
DepartmentofAnaesthesia,University UngerstedtU.
Hospital,Freiburg(Germany) DeptofPhysiologyandPharmacology,
KarolinskaInstitutet,Stockholm(Swe-
RistagnoG. den)
WeilInstituteofCriticalCareMedicine,
RanchoMirage,CA(USA)andDepart- vanderVoortP.H.J.
mentofPerioperativeMedicine,Intensive DepartmentofIntensiveCare,OnzeLieve
CareandEmergency,TriesteUniversity VrouweGasthuis,Amsterdam
MedicalSchool,Trieste(Italy) (TheNetherlands)
RubulottaF. vanHoudenhovenM.
DepartmentofAnaesthesiaandIntensive DirectorBeatrix-Hospital,Gorinchem
Care,“Policlinico”UniversityHospital, (TheNetherlands)
Catania(Italy)
VergoliniA.
RussoS. DepartmentofPerioperativeMedicine,
DepartmentofAnaesthesiology,Emer- IntensiveCareandEmergency,Trieste
gencyandIntensiveCareMedicine,Uni- UniversityMedicalSchool,Trieste(Italy)
versityofGöttingen(Germany)
VincentJ.-L.
SalaF. DepartmentofIntensiveCare,Erasme
UONeuroanestesiaeNeurorianimazione, Hospital,FreeUniversityofBrussels(Bel-
DipartimentodiMedicinaPerioperatoria gium)
eTerapieIntensive,HSanGerardo,Mon-
za(Italy) VolpinS.
DepartmentofPharmacologyand
SalvoI. Anaesthesiology,AnaesthesiaandInten-
PaediatricAnaesthesiaandIntensive siveCareUnit,UniversityofPadua,
Care,ChildrenHospital“VittoreBuzzi”, Padua(Italy)
Milan(Italy)
WangT.
SanalitroE. WeilInstituteofCriticalCareMedicine,
DepartmentofAnaesthesiaandIntensive RanchoMirage,CA(USA)
Care,“Policlinico”UniversityHospital,
Catania(Italy) ZoiaE.
PaediatricAnaesthesiaandIntensive
SaxenaA. Care,ChildrenHospital“VittoreBuzzi”,
DepartmentofAnaesthesia,Worcester- Milan(Italy)
shireRoyalHospital,Worcester(UK)
SorbelloM.
DepartmentofAnaesthesiaandIntensive
Care,“Policlinico”UniversityHospital,
Catania(Italy)