Critical Care Medicine: Principles of Diagnosis and Management in the Adult, 4e

4289 Pages·2013·72.1 MB·English

by  Joseph E. Parrillo MD FCCM

Critical Care Medicine
Principles of Diagnosis and Management in
the Adult
FOURTH EDITION
Joseph E. Parrillo, MD
Chairman, Heart and Vascular Hospital, Hackensack University Medical Center
Professor of Medicine, Rutgers New Jersey Medical School, Hackensack, New Jersey
R. Phillip Dellinger, MD, MS
Professor of Medicine, Cooper Medical School of Rowan University
Director, Critical Care, Cooper University Hospital, Camden, New Jersey

Table of Contents
Instructions for online access
Cover image
Title page
Copyright
Dedication
Contributors
Preface
Video Contents
Part 1: Critical Care Procedures, Monitoring, and Pharmacology
Chapter 1: Cardiac Arrest and Cardiopulmonary Resuscitation
Epidemiology And General Principles
Cardiopulmonary Resuscitation And Advanced Cardiac Life Support
Postresuscitation Care
Chapter 2: Airway Management in the Critically Ill Adult
Structure And Function Of The Normal Airway
Assessing Adequacy Of The Airway
Management Of The Airway
Physiologic Sequelae And Complications Of Tracheal Intubation
The Difficult Airway
Confirming Tube Position In The Trachea
Surgical Airway
Extubation In The Difficult Airway Patient (Decannulation)
Tube Displacement In The Critical Care Unit
The NAP4 Project
Common Problems In Airway Management
Chapter 3: Assessment of Cardiac Filling and Blood Flow
Cardiac Filling
Hemodynamic Status And Blood Flow
Goal-Directed Therapy
Conclusions
Chapter 4: Arterial, Central Venous, and Pulmonary Artery Catheters
Arterial Catheters
Central Venous Catheters
Pulmonary Artery Catheters
Chapter 5: Cardiac Pacing
Indications For Permanent Pacemaker Implantation
Indications For Temporary Pacing
Conditions That Do Not Normally Require Pacing
Esophageal And Transthoracic Pacing
Transcutaneous Pacing
Epicardial Pacing
Transvenous Pacing
Special Considerations In Temporary Pacing
Complications Of Permanent Pacemaker Implantation
Special Considerations In Permanent Pacing
Conclusions
Chapter 6: Pericardial Tamponade: Clinical Presentation, Diagnosis, and Catheter-Based
Therapies
Etiology Of Pericardial Effusion And Tamponade
Clinical Presentation
Diagnostic Role Of Echocardiography
Catheter-Based Diagnostic And Therapeutic Strategies
Pericardiocentesis
Open Surgical Pericardial Window
Percutaneous Balloon Pericardiotomy
Other Pericardial Interventions
Chapter 7: Intra-aortic Balloon Counterpulsation
History
Physiology
The Intra-Aortic Balloon Pump Apparatus
Preparation
Balloon Insertion
Timing
Adjunctive Pharmacotherapy
Balloon Removal
Indications
Contraindications
Complications
Newer Technologies
Chapter 8: Echocardiography
Approach To Echocardiography
Additional Echocardiographic Modalities
Indications For Echocardiography
Hemodynamic Assessment
Stroke And Other Systemic Emboli
Summary
Chapter 9: General Principles of Mechanical Ventilation
History
Mechanical Ventilation
Indications For Mechanical Ventilation
Mechanical Breath Generation
Ventilator Modes
Other Modes Of Mechanical Ventilation
Positive End-Expiratory Pressure
Monitoring The Ventilated Patient
Maintaining Support Of The Ventilated Patient
Weaning From Mechanical Ventilation
Complications Of Mechanical Ventilation
Noninvasive Positive-Pressure Ventilation
Chapter 10: Ventilatory Management of Obstructive Airway Disease
Special Challenges Of Patients With Severe Airflow Obstruction
Problems And Hazards Of Ventilation With Positive Pressure
Principles Of Managing The Ventilated Patient With Severe Airflow Obstruction
Practical Management Of The Ventilated Patient
Chapter 11: Mechanical Ventilation in Acute Respiratory Distress Syndrome
History
Physiologic Basis Of Mechanical Ventilation
Patient Characterization
Mechanical Ventilation In Acute Respiratory Distress Syndrome: Available Evidence
Individualizing Mechanical Ventilation In Patients With Acute Respiratory Distress Syndrome
Possible Adjuncts To Mechanical Ventilation
Chapter 12: Bronchoscopy and Lung Biopsy in Critically Ill Patients
Fiberoptic Bronchoscopy–Induced Physiologic Changes
Airway Evaluation And Management
Diagnosis Of Infection
Lung Biopsy—Surgical And Transbronchial
Special Situations
Complications And Death
Summary
Chapter 13: Noninvasive Respiratory Monitoring
Gas Exchange
Respiratory Neuromuscular Function
Respiratory Mechanics
Chapter 14: Tracheostomy
History
The Artificial Airway
Timing Of Tracheostomy
Complications Of Tracheostomy
Percutaneous Tracheostomy
Chapter 15: Chest Tube Thoracostomy
History
Anatomy And Physiology Of The Pleural Space
Drainage Systems
Indications And Contraindications
Chest Tube Size
Technique Of Insertion
Management Of Thoracostomy Tubes
Complications
Imaging
Chapter 16: Intracranial Monitoring
Intracranial Pressure Monitoring
Cerebral Blood Flow Monitoring
Brain Tissue Oxygenation Monitoring
Summary
Chapter 17: Gastrointestinal Endoscopy
History
Endoscopic Equipment
Anesthesia
Esophagogastroduodenoscopy
Wireless Capsule Endoscopy
Enteroscopy
Colonoscopy
Endoscopic Retrograde Cholangiopancreatography
Endoscopic Ultrasound
Endoscopy In The Pregnant Patient
Chapter 18: Continuous Renal Replacement Therapy
Physiologic Principles
Modalities
Prescription Variables
Technical Considerations
Therapeutic Considerations
Summary
Chapter 19: Use of Sedatives, Analgesics, and Neuromuscular Blockers
PAIN Management In The Intensive Care Unit
Sedation Management
Neuromuscular Blocking Agents
Summary And Conclusions
Chapter 20: Principles of Drug Dosing in Critically Ill Patients
General Pharmacokinetic Principles
Pharmacodynamics
The Effect Of Critical Illness On Pharmacokinetics And Pharmacodynamics
Special Considerations Regarding Routes Of Administration
Drug-Dosing Considerations In Select Critical Care Populations
Pharmacogenetics
Principles Of Therapeutic Drug Monitoring
Conclusion
Part 2: Critical Care Cardiovascular Disease
Chapter 21: Circulatory Shock
Introduction
History
Definitions And Categorization Of Shock
Classification
Diagnostic Approach And Evaluation
Management And Therapy
Conclusion
Chapter 22: Cardiogenic Shock
Definition
Epidemiology
Pathogenesis
Clinical Assessment
Therapy
Other Causes Of Cardiogenic Shock
Conclusion
Chapter 23: Septic Shock
Overview
Historical Perspective
Contemporary Definitions
Epidemiology
Pathogenesis