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NOTICE t
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Medicine is an ever-changing science. As new research and clinical exprerience broaden our knowledge,
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Principles of Critical Care
Fourth Edition /
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Editors i
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Jesse B. Hall, MD Gregory A. Schmidt, MD
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Professor of Medicine and of Anesthesia Professor of Internal Medicine
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and Critical Care Division of Pulrmonary Diseases, Critical Care, and
Section of Pulmonary and Critical Care eOccupational Medicine
University of Chicago Department of Internal Medicine
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Chicago, Illinois Associate Chief Medical Officer, Critical Care
u University of Iowa
Iowa City, Iowa
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Associate Editor
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John P. Kress, MD
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Professor of Medicine
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Director, Medical ICU
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: Department of Medicine
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Chicago, Illinois
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New York Chicago San Francisco Athens London Madrid Mexico City Milan
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And taught us graciously.
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Contents
Contributors . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . xi 18 Providing Palliative Care and Withholding or Withdrawing
Life-Sustaining Therapy . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .120
Preface . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . xxiii
Dee W. Ford and J. Randall Curtis
Introduction . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .xxv /
19 Legal Issues in Critical Care . . . . . . . . . . . . . . .9 . . . . . . . . . . . . . . . . . .125
PART 1 An Overview of the Approach to and Marshall B. Kapp
9
Organization of Critical Care . . . . . . . . . . . . . . . . . . . . . . . . 1
PART 2 General Managemenrt of the Patient .......131
1 An Approach to Critical Care . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .2
20 Nutrition Therapy in the Criticially Ill . . . . . . . . . . . . . . . . . . . . . . . . .132
Jesse B. Hall, Gregory A. Schmidt, and Lawrence D. H. Wood h
Daren K. Heyland, Rupinder Dhaliwal, and
2 Measuring Quality . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .7
Stephen A. McClavea
Andre Carlos Kajdacsy-Balla Amaral and Gordon D. Rubenfeld
21 Glycemic Control . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .141
3 Intensive Care Unit Staffing . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .15 t
Jean-Charle/s Preiser and Carole Ichai
Allan Garland, Hayley Beth Gershengorn, and
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22 Pain Control, Sedation, and Use of Muscle Relaxants . . . . . . . . . . .145
Constantine A. Manthous
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Sarah Sokol, Bhakti K. Patel, Ishaq Lat, and John P. Kress
4 Infection Prevention and Surveillance in the
Intensive Care Unit . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .23 23 sSleep . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .155
Hitoshi Honda, David K. Warren, and Marin H. Kollef u Brian K. Gehlbach and Sairam Parthasarathy
5 Preventing Morbidity in the ICU . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .32 24 Physical Therapy . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .162
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Promise Ariyo, Theresa L. Hartsell, and Peter J. Pronovost r William Schweickert, Amy J. Pawlik, and John P. Kress
6 Assessing Cost-Effectiveness in the Intensive Care Unit . . . . . . .c . . .37 25 Cardiopulmonary Resuscitation . . . . . . . . . . . . . . . . . . . . . . . . . . . . .166
David J. Wallace and Derek C. Angus Benjamin S. Abella and Marion Leary
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7 Interpreting and Applying Evidence in Critical Care Medticine . . . . .44 26 Therapeutic Hypothermia . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .174
Elizabeth Lee Daugherty Biddison and Douglas Ba. White Benjamin S. Abella and Marion Leary
8 Principles of Medical Informatics and Clinical Iknformatics 27 Intravascular Devices in the ICU . . . . . . . . . . . . . . . . . . . . . . . . . . . . .179
in the ICU . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .49 John F. McConville and Bhakti K. Patel
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Vitaly Herasevich, Ognjen Gajic, and/ Brian W. Pickering 28 Interpretation of Hemodynamic Waveforms . . . . . . . . . . . . . . . . . .186
9 Preparedness for Catastrophe . . . . .: . . . . . . . . . . . . . . . . . . . . . . . . . . .56 James W. Leatherman and John Marini
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James Geiling, Michael Rea, and Robert Gougelet 29 ICU Ultrasonography . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .202
10 Telemedicine and Regionaplization . . . . . . . . . . . . . . . . . . . . . . . . . . . .62 Paul Mayo and Seth Koenig
Jeremy M. Kahn 30 Interventional Radiology . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .209
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11 Transportation of tthe Critically Ill Patient . . . . . . . . . . . . . . . . . . . . . .69 Brian Funaki, Jonathan M. Lorenz, Rakesh Navuluri,
Charlotte Smahll, Andrew McDonald Johnston, and Julian Bion Thuong G. Van Ha, and Steven M. Zangan
12 Rapid Response Teams . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .77
Daryl Jones and Rinaldo Bellomo PART 3 Cardiovascular Disorders..................227
13 Assessment of Severity of Illness . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 83 31 The Pathophysiology of the Circulation in Critical Illness . . . . . . . .228
James A. Russell Edward T. Naureckas and Lawrence D. H. Wood
14 Chronic Critical Illness . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .97 32 Assessing the Circulation: Oximetry, Indicator Dilution, and
Shannon S. Carson Pulse Contour Analysis . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .242
Michael R. Pinsky
15 Long-Term Outcomes After Critical Illness . . . . . . . . . . . . . . . . . . . .103
Margaret S. Herridge, Jill I. Cameron, and 33 Shock . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .249
Ramona O. Hopkins Keith R. Walley
16 Care of the Caregiver in the ICU and After Critical Illness . . . . . . . .114 34 Judging the Adequacy of Fluid Resuscitation . . . . . . . . . . . . . . . . . .262
Yoanna Skrobik Gregory A. Schmidt
17 Caring for the Family . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 116 35 Ventricular Dysfunction in Critical Illness . . . . . . . . . . . . . . . . . . . . .266
Sabina Hunziker and Michael D. Howell Keith R. Walley
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viii Contents
36 Cardiac Arrhythmias, Pacing, Cardioversion, and 58 Restrictive Disease of the Respiratory System . . . . . . . . . . . . . . . . .513
Defibrillation in the Critical Care Setting . . . . . . . . . . . . . . . . . . . . . .278 Benjamin David Singer, Thomas Corbridge, and
Vikas P. Kuriachan and Anne M. Gillis Lawrence D. H. Wood
37 Myocardial Ischemia . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .293 59 Ventilator-Associated Pneumonia . . . . . . . . . . . . . . . . . . . . . . . . . . .520
Steven M. Hollenberg Jean Chastre and Jean-Yves Fagon
38 Acute Right Heart Syndromes . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .308 60 Liberation From Mechanical Ventilation . . . . . . . . . . . . . . . . . . . . . .535
Ivor S. Douglas Constantine A. Manthous, Gregory A. Schmidt, and
39 Pulmonary Embolic Disorders: Thrombus, Air, and Fat . . . . . . . . . .318 Jesse B. Hall
Nuala J. Meyer and Gregory A. Schmidt
PART 5 Infectious Disorders ......................543
40 Pericardial Disease . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .336 /
Paul Sorajja 61 Principles of Antimicrobial Therapy and the C9linical
Pharmacology of Antimicrobial Drugs . . . . . . . . . . . . . . . . . . . . . . . .544
41 Valvular Heart Disease . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .343 9
Amira Ashok Bhalodi and David P. Nicolau
Sorin V. Pislaru and Maurice Enriquez-Sarano
62 Sepsis and Immunoparalysis . . .r . . . . . . . . . . . . . . . . . . . . . . . . . . . .551
42 Aortic Dissection . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .356
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Pavlos M. Myrianthefs, Elias Karabatsos, and
Vlad Cotarlan and Joseph J. Austin h
George J. Baltopoulos
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63 Persistent Fever . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .557
PART 4 Pulmonary Disorders .....................369
Gretchen Yandtle and Bennett P. deBoisblanc
43 The Pathophysiology and Differential Diagnosis of 64 Sepsis, Seve/re Sepsis, and Septic Shock . . . . . . . . . . . . . . . . . . . . . .562
Acute Respiratory Failure . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .370 r
Jenny Han, Sushma K. Cribbs, and Greg S. Martin
Edward T. Naureckas and Lawrence D. H. Wood e
65 Pneumonia . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 576
44 Noninvasive Ventilation . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .377 sRichard G. Wunderink and Grant Waterer
Laurent Brochard, Evangelia Akoumianaki, and
u66 Infectious Complications of Intravascular Access Devices
Ricardo Luiz Cordioli
Used in Critical Care . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .588
45 Airway Management . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .384/
John Conly
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Michael F. O’Connor and David B. Glick
c 67 Endocarditis and Other Intravascular Infections . . . . . . . . . . . . . . .593
46 Tracheostomy . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .396
Mark B. Carr and Kanistha Verma
Jeffrey D. Doyle and Damon C. Scales .
t 68 Approach to Infection in Patients Receiving Cytotoxic
47 Upper Airway Obstruction . . . . . . . . . . . . . . . . . . . . . .a . . . . . . . . . . .404 Chemotherapy for Malignancy . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .600
Brian K. Gehlbach and John P. Kress
E. J. Bow
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48 Ventilator Waveforms: Clinical Interpretation . . . . . . . . . . . . . . . . .411
69 Human Immunodeficiency Virus (HIV) and AIDS in the
Gregory A. Schmidt /
Intensive Care Unit . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .625
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49 Management of the Ventilated Pati:ent . . . . . . . . . . . . . . . . . . . . . . .424 Mark Hull, Adam M. Linder, JSG Montaner, and
Gregory A. Schmidt and Jesses B. Hall James A. Russell
50 Novel Modes of Mechanicapl Ventilation . . . . . . . . . . . . . . . . . . . . . .434 70 Fungal Infections . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 643
Mashael Al-Hegelan and Neil R. MacIntyre Carol A. Kauffman
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51 Ventilator-Induced Lung Injury . . . . . . . . . . . . . . . . . . . . . . . . . . . . .439 71 Bacterial Infections of the Central Nervous System . . . . . . . . . . . . .651
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Vito Fanelli, Johhn T. Granton, and Arthur S. Slutsky Allan R. Tunkel and W. Michael Scheld
52 Acute Lung Injury and the Acute Respiratory Distress 72 Encephalomyelitis . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .665
Syndrome . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .449 Peter Spiro, Venkata Ranganadh Dodda, and
Mark E. Mikkelsen, Paul N. Lanken, and Jason D. Christie Vel Sivapalan
53 Extracorporeal Lung Support . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .470 73 Life-Threatening Infections of the Head, Neck, and Upper
Lena M. Napolitano Respiratory Tract . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .676
54 Acute-on-Chronic Respiratory Failure . . . . . . . . . . . . . . . . . . . . . . . .482 Anthony W. Chow
Ivor S. Douglas 74 Soft Tissue Infections . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .688
55 Status Asthmaticus . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .496 John Conly
Thomas Corbridge and Jesse B. Hall 75 Urinary Tract Infections . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .696
56 Thoracostomy . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .505 Gerard J. Sheehan and Eoghan de Barra
Shruti B. Patel and John F. McConville 76 Gastrointestinal Infections and
Clostridium Difficile . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .703
57 Massive Hemoptysis . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .509
Alexander Benson and Richard K. Albert Jodi Galaydick and Stephen G. Weber
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Contents ix
77 Management of the Critically Ill Traveler . . . . . . . . . . . . . . . . . . . . .711 PART 8 Renal and Metabolic Disorders ............915
Christian Sandrock and Hugh Black 97 Acute Kidney Injury . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .916
78 Severe Malaria . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .721 Claire Hannon and Patrick T. Murray
Sanjeev Krishna and Arjen M. Dondorp 98 Renal Replacement Therapy in the Intensive Care Unit . . . . . . . . . .932
79 Tetanus . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .729 Suneel M. Udani, Jay L. Koyner, and Patrick T. Murray
David L. Pitrak, Jason T. Poston, and Jodi Galaydick 99 Electrolyte Disorders in Critical Care . . . . . . . . . . . . . . . . . . . . . . . . .943
80 Viral Hemorrhagic Fevers . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .733 Caitriona McEvoy and Patrick T. Murray
Jean-Luc Benoit 100 Acid-Base Balance . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .968
81 Biological Warfare . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .744 David C. Kaufman, Andrew J. Kitching, and John A. Kellum
Richard H. Savel, Ariel L. Shiloh, and 101 Hyperglycemic Crisis and Hypoglycemia . . . . . . ./ . . . . . . . . . . . . . . .974
9
Vladimir Kvetan
David Carmody and Louis Philipson
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102 Critical Illness–Related Corticosteroid Insufficiency . . . . . . . . . . . .980
PART 6 Neurologic Disorders .....................755
Paul E. Marik r
82 Delirium in the Intensive Care Unit . . . . . . . . . . . . . . . . . . . . . . . . . .756
103 Thyroid Disease . . . . . . . . . . .i . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .986
Nathan E. Brummel and Timothy D. Girard h
Roy E. Weiss and Samuel Refetoff
83 ICU-Acquired Weakness . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .763
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William Schweickert and John P. Kress
PART 9 Gastrointestinal Disorders.................997
84 Cerebrovascular Disease . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .770 t
104 Jaundice, Di/arrhea, Obstruction, and Pseudoobstruction . . . . . . . .998
William J. Powers and Dedrick Jordan
Paul T. Enrgels and L. N. Tremblay
85 Seizures in the Intensive Care Unit . . . . . . . . . . . . . . . . . . . . . . . . . . .779 e
105 Gastrointestinal Hemorrhage . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .1008
Katharina M. Busl and Thomas P. Bleck
sEmad Qayed and Ram M. Subramanian
86 Intracranial Pressure: Monitoring and Management . . . . . . . . . . .786
106 Acute Liver Failure . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .1022
Geraldine Siena L. Mariano, Matthew E. Fink, u
Julia Wendon
Caitlin Hoffman, and Axel Rosengart
/ 107 Management of the Patient With Cirrhosis . . . . . . . . . . . . . . . . . . .1026
87 Neuromuscular Diseases Leading to Respiratory Failure . . . . . . . . .8r21
Sonali Sakaria and Ram M. Subramanian
William Marinelli and James W. Leatherman c
108 Acute Pancreatitis . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .1031
88 Coma, Persistent Vegetative State, and .
Ajaypal Singh and Andres Gelrud
Brain Death . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .t . . . . . . . . .829
a 109 Mesenteric Ischemia . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .1036
Halinder S. Mangat and Axel Rosengart
Hassan A. Al-Zahrani and Thomas Lindsay
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PART 7 Hematologic and Oncologic
Disorders......................../................841 PART 10 The Surgical Patient ....................1045
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89 Anemia and Red Blood Cell Transfu:sion in Critically 110 Special Considerations in the Surgical Patient . . . . . . . . . . . . . . . .1046
Ill Patients . . . . . . . . . . . . . . . . . .s . . . . . . . . . . . . . . . . . . . . . . . . . . . . .842 Aziz S. Alali, Andrew J. Baker, and Jameel Ali
Kevin P. Desrosiers and Hpoward L. Corwin 111 Preoperative Assessment of the High-Risk
90 Bleeding Disorders . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .844 Surgical Patient . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .1053
t
Karl Thomas Robert Chen and Jameel Ali
t
91 TTP, HUS, and Ohther Thrombotic Microangiopathies . . . . . . . . . . . .858 112 Principles of Postoperative Critical Care . . . . . . . . . . . . . . . . . . . . .1060
X. Long Zheng and Nilam Mangalmurti Jonathan Simmons and Laura A. Adam
92 Acute Leukemia . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .865 113 The Acute Abdomen and Intra-abdominal Sepsis . . . . . . . . . . . . . 1077
Karen-Sue B. Carlson Elisa F. Greco and John M. A. Bohnen
93 Oncologic Emergencies . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 872 114 Abdominal Compartment Syndrome . . . . . . . . . . . . . . . . . . . . . . .1084
Cristina Gutierrez and Stephen M. Pastores Adam Schlichting and Gregory A. Schmidt
94 Hematopoietic Stem Cell Transplantation and 115 The Transplant Patient . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .1087
Graft-Versus-Host Disease . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .881 Laveena Munshi, Damon C. Scales, and John T. Granton
Stephen M. Pastores, Michael A. Rosenzweig, and 116 Care of the Multiorgan Donor . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .1108
Ann A. Jakubowski Masaki Anraku and Shaf Keshavjee
95 Toxicities of Chemotherapy . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .891 117 Priorities in Multisystem Trauma . . . . . . . . . . . . . . . . . . . . . . . . . . .1116
Kaye E. Hale Jameel Ali
96 Sickle Cell Disease . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .902 118 Head Injury . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .1121
Gregory J. Kato and Mark T. Gladwin John M. Oropello, Nirav Mistry, and Jamie S. Ullman
FM.indd 9 1/22/2015 8:29:40 AM
