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Cover image for Intensive care : a concise textbook
Title:
Intensive care : a concise textbook
Personal Author:
Edition:
3rd ed.
Publication Information:
New York, NY : Elsevier, 2008
Physical Description:
ix, 589 p. : ill. (some col.) ; 25 cm.
ISBN:
9780702025969
Subject Term:
Added Author:

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30000010206948 RC86.7 H56 2008 Open Access Book Book
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Summary

Summary

Now in its third edition, 'Intensive Care: A Concise Textbook' continues to provide an excellent introductory text to the practice of critical care medicine.

Extensively revised, expanded and updated, the format of the new edition has been radically altered to make the text more readable and the information even more accessible. Comprehensive yet concise, the book provides a sound working knowledge of the discipline, is packed with information and is extensively referenced. Current evidence based guidelines for managing critically ill patients with complex pathophysiology and multisystem involvement are highlighted throughout.

The book is intended primarily for trainees in intensive care medicine and has been designed particularly to meet the requirements of those preparing for examinations in this specialty (specifically European, UK and Irish Diplomas of Intensive Care). It is aimed not only at those embarking on specialist training in intensive care but also at trainees in other acute specialities who are increasingly becoming involved in the management of critically ill patients, and who may be sitting other postgraduate exams that include intensive care and acute medicine in the syllabus (e.g. FRCA, MRCS, MRCP). The book will also serve as a valuable reference text for both trainees and qualified specialists. Provides a balanced view of current controversies with citation of the most relevant publications Information readily accessible through the extensive use of bullet points, italics to highlight key words, headings, sub-headings, tables, figures and diagrams Written entirely by two authors to ensure consistency of style and content, each chapter has been reviewed by an expert to ensure completion, accuracy and currency Ideal for physicians preparing for the increasingly important examinations in the specialty Includes summary tables of recommended approaches to clinical management Also suitable for trainees in other acute specialities who are increasingly becoming involved in the management of critically ill patients and those who may be sitting other postgraduate exams that include aspects of intensive care and acute medicine in the syllabus All content fully updated and strongly evidence-based, with clear guidelines for the management of specific conditions Extensive new referencing focuses on key prospective, randomised, controlled trials, meta-analyses and systematic reviews Additional topics such as relative adrenal suppression, tight glycaemic control, acute coronary syndromes, ventilator-associated and community-acquired pneumonia, non-invasive and 'protective' ventilation, meningo-encephalitis and intracranial haemorrhage Updated antibiotic guidelines and the latest ALS/ATLS and 'surviving sepsis campaign guidelines' More detail given to a number of topics such as fluid and electrolyte balance, nutrition, and alternatives to the pulmonary artery catheter for haemodynamic monitoring


Author Notes

Charles Hinds FRCP FRCA Professor of Intensive Care Medicine William Harvey Research Institute, Barts and The London School of Medicine and Dentistry and Barts and the London NHS Trust, London, UK
David Watson BSc (Hons) FRCA Consultant and Senior Lecturer in Intensive Care Medicine William Harvey Research Institute, Barts and The London School of Medicine and Dentistry and Homerton University Hospital NHS Trust, London, UK


Table of Contents

Prefacep. vii
List of physiological abbreviationsp. ix
1 Planning, organization and managementp. 1
Introductionp. 1
Levels of care and facilities required to deliver a critical care servicep. 1
Designing critical care areasp. 4
Management of the critical care servicep. 5
2 Outcome and costsp. 15
Mortality, long-term survival and quality of lifep. 15
Costsp. 16
End-of-life decision making, withholding and withdrawing treatmentp. 16
Severity-scoring systemsp. 21
3 Applied cardiovascular and respiratory physiologyp. 33
Oxygen deliveryp. 33
Cardiac outputp. 33
Oxygen contentp. 36
Pulmonary ventilation and gas exchangep. 38
Mixed venous oxygen tensionp. 45
Lung volumesp. 45
Lung mechanics and work of breathingp. 45
Control of breathingp. 47
4 Assessment and monitoring of cardiovascular functionp. 51
Heart ratep. 51
Blood pressurep. 51
Preloadp. 54
Cardiac output and myocardial functionp. 64
Assessment of tissue perfusion and oxygenationp. 76
5 Shock, sepsis and multiple-organ failurep. 81
Definitionp. 81
Causesp. 81
Pathophysiologyp. 81
Clinical features of shockp. 99
Monitoring and laboratory investigations in shockp. 103
Managementp. 106
Multiple-organ failurep. 123
Adjunctive therapy in shock, sepsis and organ failurep. 124
Anaphylactic shockp. 128
Pulmonary embolismp. 130
6 Assessment and monitoring of respiratory functionp. 139
Measurement of lung volumesp. 139
Assessing airways obstructionp. 141
Maximum mouth pressuresp. 141
Flow-volume and pressure-volume loopsp. 142
Measuring the work of breathingp. 143
Non-invasive monitoring of ventilationp. 143
Monitoring inspired and expired gas compositionp. 143
Measurement of respiratory gas exchangep. 144
Blood gas analysis and acid-base disturbancesp. 145
Determination of oxygen contentp. 151
In vivo blood gas measurementp. 151
Other indices of pulmonary oxygen transfer and lung functionp. 153
7 Respiratory supportp. 157
Negative-pressure ventilationp. 157
Positive-pressure ventilationp. 158
Beneficial effects of mechanical ventilationp. 161
Indications for mechanical ventilationp. 162
Dangers of mechanical ventilationp. 162
Institution of invasive respiratory supportp. 169
Management of patients on ventilatorsp. 170
Discontinuing and weaning ventilatory supportp. 179
Tracheal intubationp. 184
Tracheostomyp. 186
8 Respiratory failurep. 195
Definitionp. 195
Types, mechanisms and clinical featuresp. 195
Causes of respiratory failurep. 197
Principles of managementp. 199
Some common causes of respiratory failurep. 207
9 Myocardial ischaemia, cardiopulmonary resuscitation and management of arrhythmiasp. 241
Acute coronary syndromesp. 241
Cardiorespiratory arrestp. 246
Postresuscitation managementp. 251
Cardiorespiratory arrest associated with special circumstancesp. 253
Prognosis of cardiorespiratory arrestp. 255
Management of arrhythmiasp. 256
10 Traumap. 265
Advanced trauma life support and trauma resuscitationp. 265
Chest injuriesp. 268
Burnsp. 273
Spinal injuriesp. 279
Near-drowningp. 284
Crush injuriesp. 287
Fat embolism syndromep. 288
Complications of traumap. 289
11 General aspects of managing critically ill patientsp. 291
Fluid and electrolyte balancep. 291
Nutritional supportp. 301
Sedation, analgesia and muscle relaxationp. 310
Prevention of deep venous thrombosis and pulmonary thromboembolismp. 318
Prevention of stress ulcerationp. 319
Psychological and behavioural disordersp. 320
12 Infection in the critically illp. 329
Factors predisposing to infection in hospitalized patientsp. 329
Sources and prevention of infectionp. 331
Nosocomial infections in the critically illp. 334
The rational use of antibioticsp. 338
Antibiotic-associated diarrhoeap. 344
Unusual pathogens - diagnosis and treatmentp. 344
The immunocompromised patientp. 347
13 Acute renal failurep. 359
Definition, incidence and causesp. 359
Pathogenesis and pathophysiology of acute renal failurep. 360
Diagnosis and investigationsp. 362
Clinical course and managementp. 365
Prognosis of ARFp. 378
14 Acute liver failurep. 381
Types of acute liver failurep. 381
Acute liver failurep. 381
Acute decompensation of chronic liver diseasep. 397
15 Neurological disordersp. 401
Head injuries and raised intracranial pressurep. 401
Acute bacterial meningitisp. 420
Encephalitisp. 422
Non-traumatic intracranial haemorrhagep. 422
Brain death and irreversible cerebral damagep. 423
Organ donationp. 427
Status epilepticusp. 432
Tetanusp. 436
Myasthenia gravisp. 439
Acute inflammatory polyradiculoneuropathyp. 442
Critical illness polyneuromyopathyp. 445
16 Gastrointestinal disordersp. 453
Gastrointestinal haemorrhagep. 453
Abdominal emergenciesp. 461
17 Endocrine emergenciesp. 473
Diabetes mellitusp. 473
Thyroid emergenciesp. 481
Calcium metabolismp. 485
Phaeochromocytomap. 488
Adrenal crisisp. 489
Pituitary emergenciesp. 491
18 Obstetric intensive carep. 495
Physiological alterations in pregnancyp. 495
Severity-scoring systems in the obstetric populationp. 496
Pre-eclampsiap. 496
Acute lung injury/acute respiratory distress syndrome in obstetric patientsp. 501
Peripartum cardiomyopathyp. 503
Acute coagulopathy in pregnancyp. 503
19 Poisoningp. 507
Types of poisoningp. 507
Diagnosis and asessmentp. 507
Principles of managementp. 508
Management of specific poisoningsp. 512
20 Disturbances of body temperaturep. 529
Accidental hypothermiap. 529
Hyperthermiap. 533
21 Transporting the critically illp. 541
Primary transportp. 541
Secondary transportp. 543
Modes of transportp. 545
Equipment for transportp. 547
Transport within the hospitalp. 548
Transport over long distancesp. 549
Appendicesp. 551
Normal valuesp. 552
Indexp. 555
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