Covering both the theoretical and practical aspects of critical care,Irwin & Rippe’s Intensive Care Medicine, Ninth Edition, provides state-of-the-art, evidence-based knowledge for specialty physicians and non-physicians practicing in the adult intensive care environment. Drs. Craig M. Lilly, Walter A. Boyle, and Richard S. Irwin, along with a team of expert contributing authors and education expert, William F. Kelly, offer authoritative, comprehensive guidance from an interprofessional, collaborative, educational, and scholarly perspective, encompassing all adult critical care specialties.
1. INTRODUCTION - p. 1 2. COMPETENCE - p. 2 3. CONCLUSIONS - p. 3 4. Chapter 1: Interactive Multiple Choice Question - p. 4 5. Chapter 2 Anesthesia for Bedside Procedures - p. 4 6. INTRODUCTION - p. 4 7. COMMON PAIN MANAGEMENT PROBLEMS IN ICU PATIENTS - p. 4 8. CHARACTERISTICS OF SPECIFIC AGENTS USED FOR BEDSIDE PROCEDURES - p. 6 9. NEUROMUSCULAR BLOCKING AGENTS - p. 10 10. PRACTICAL CONSIDERATIONS - p. 10 11. CONCLUSIONS - p. 10 12. Chapter 2: Interactive Multiple Choice Question - p. 11 13. Chapter 3 Management of Pain in the Critically Ill - p. 11 14. INTRODUCTION - p. 11 15. PHYSIOLOGICAL EFFECTS OF ACUTE PAIN - p. 12 16. EVALUATION OF PAIN AND SEDATION IN THE ICU PATIENT - p. 12 17. SUBJECTIVE PAIN ASSESSMENT - p. 12 18. OBJECTIVE PAIN ASSESSMENT - p. 12 19. FORMULATION OF A TREATMENT PLAN - p. 13 20. CHARACTER AND SITE - p. 13 21. MEDICAL MANAGEMENT OF PAIN FOR THE ICU PATIENT - p. 13 22. NONPHARMACOLOGIC TREATMENTS - p. 13 23. PHARMACOLOGIC TREATMENTS - p. 14 24. ACETAMINOPHEN—PARACETAMOL - p. 14 25. OPIOIDS - p. 14 26. ADJUVANT MEDICATIONS - p. 17 27. REGIONAL ANALGESIA TECHNIQUES - p. 18 28. NERVE BLOCKS FOR THORACIC AND ABDOMINAL WALL - p. 18 29. CONCLUSION - p. 20 30. Chapter 3: Interactive Multiple Choice Question - p. 22 31. Chapter 4 Therapeutic Paralysis - p. 22 32. INTRODUCTION - p. 22 33. PHARMACOLOGY OF NEUROMUSCULAR BLOCKING AGENTS - p. 23 34. THE NICOTINIC ACETYLCHOLINE RECEPTOR - p. 23 35. DEPOLARIZING NEUROMUSCULAR BLOCKERS - p. 23 36. NONDEPOLARIZING NMBAS - p. 23 37. REVERSAL AGENTS - p. 25 38. DRUG INTERACTIONS - p. 25 39. MONITORING OF NMBAS - p. 26 40. ADVERSE EFFECTS OF DEPOLARIZING AND NONDEPOLARIZING NMBAS IN CRITICALLY ILL PATIENTS - p. 26 41. INTENSIVE CARE UNIT–ACQUIRED WEAKNESS - p. 27 42. SUMMARY AND RECOMMENDATIONS - p. 28 43. Chapter 4: Interactive Multiple Choice Question - p. 29 44. Chapter 5 Cerebrospinal Fluid Aspiration - p. 29 45. INTRODUCTION - p. 29 46. CEREBROSPINAL FLUID ACCESS - p. 30 47. TECHNIQUES OF CEREBROSPINAL FLUID ACCESS - p. 32 48. SUMMARY - p. 38 49. Chapter 5: Interactive Multiple Choice Question - p. 38 50. Chapter 6 Central Venous Catheters - p. 38 51. INTRODUCTION - p. 39 52. INDICATIONS AND SITE SELECTION - p. 39 53. GENERAL CONSIDERATIONS - p. 40 54. ROUTES OF CENTRAL VENOUS CANNULATION - p. 42 55. Chapter 6: Interactive Multiple Choice Question - p. 53 56. Chapter 7 Arterial Line Placement and Care - p. 54 57. INTRODUCTION - p. 54 58. INDICATIONS FOR ARTERIAL CANNULATION - p. 54 59. EQUIPMENT, MONITORING, TECHNIQUES, AND SOURCES OF ERROR - p. 55 60. TECHNIQUE OF ARTERIAL CANNULATION - p. 57 61. COMPLICATIONS OF ARTERIAL CANNULATION - p. 61 62. RECOMMENDATIONS - p. 63 63. Chapter 7: Interactive Multiple Choice Question - p. 64 64. Chapter 8 Airway Management and Endotracheal Intubation - p. 64 65. INTRODUCTION - p. 64 66. CONCISE ANATOMY - p. 64 67. EMERGENCY AIRWAY MANAGEMENT - p. 66 68. INDICATIONS FOR INTUBATION - p. 67 69. EQUIPMENT FOR INTUBATION - p. 69 70. ANESTHESIA BEFORE INTUBATION - p. 71 71. TECHNIQUES OF INTUBATION - p. 73 72. COMPLICATIONS OF ENDOTRACHEAL INTUBATION - p. 78 73. EXTUBATION - p. 79 74. Chapter 8: Interactive Multiple Choice Question - p. 81 75. Chapter 9 Tracheostomy - p. 82 76. INTRODUCTION - p. 82 77. INDICATIONS - p. 82 78. CONTRAINDICATIONS - p. 82 79. TIMING OF TRACHEOSTOMY - p. 83 80. PROCEDURES - p. 83 81. TRACHEOSTOMY PROCEDURES FOR THE INTENSIVE CARE UNIT - p. 84 82. TUBES AND CANNULAS - p. 86 83. POSTOPERATIVE CARE - p. 86 84. COMPLICATIONS - p. 87 85. CONCLUSIONS - p. 90 86. Chapter 9: Interactive Multiple Choice Question - p. 91 87. Chapter 10 Bronchoscopy - p. 91 88. INTRODUCTION - p. 92 89. GENERAL CONSIDERATIONS - p. 92 90. COMMON DIAGNOSTIC INDICATIONS - p. 92 91. THERAPEUTIC INDICATIONS - p. 93 92. COMPLICATIONS - p. 94 93. CONTRAINDICATIONS - p. 94 94. PROCEDURE - p. 95 95. Chapter 10: Interactive Multiple Choice Question - p. 96 96. Chapter 11 Lung Ultrasonography - p. 97 97. INTRODUCTION - p. 97 98. BASIC PRINCIPLES OF LUS - p. 97 99. MACHINE REQUIREMENTS - p. 97 100. PERFORMANCE OF LUS - p. 97 101. IMAGING PATTERNS IN LUS - p. 97 102. NORMAL ANATOMY - p. 97 103. FINDINGS OF LUS - p. 98 104. PATTERN ANALYSIS OF LUS - p. 99 105. CLINICAL APPLICATIONS OF LUS - p. 99 106. LUS AND COVID-19 - p. 100 107. TRANSESOPHAGEAL LUNG ULTRASONOGRAPHY - p. 100 108. SUMMARY - p. 101 109. Chapter 11: Interactive Multiple Choice Question - p. 102 110. Chapter 12 Thoracentesis - p. 102 111. INTRODUCTION - p. 103 112. INDICATIONS - p. 103 113. CONTRAINDICATIONS - p. 103 114. COMPLICATIONS - p. 104 115. THORACENTESIS PROCEDURE - p. 105 116. PROCEDURE - p. 106 117. INTERPRETATION OF PLEURAL FLUID ANALYSIS - p. 108 118. CLINICAL APPROACH TO EFFUSION DRAINAGE AND FURTHER MANAGEMENT - p. 110 119. Chapter 12: Interactive Multiple Choice Question - p. 111 120. Chapter 13 Chest Tube Insertion and Care - p. 111 121. INTRODUCTION - p. 111 122. PLEURAL ANATOMY AND PHYSIOLOGY - p. 111 123. CHEST TUBE PLACEMENT - p. 111 124. CONTRAINDICATIONS - p. 113 125. TECHNIQUE - p. 114 126. COMPLICATIONS - p. 116 127. CHEST TUBE MANAGEMENT AND CARE - p. 117 128. CHEST TUBE REMOVAL - p. 117 129. RELATED SYSTEMS - p. 117 130. SUMMARY - p. 118 131. Chapter 13: Interactive Multiple Choice Question - p. 118 132. Chapter 14 Cardiopulmonary Resuscitation - p. 119 133. INTRODUCTION - p. 119 134. EFFICACY - p. 119 135. EXPERIMENTAL AND ALTERNATIVE TECHNIQUES OF CARDIOPULMONARY RESUSCITATION - p. 120 136. INFECTIOUS DISEASES AND CARDIOPULMONARY RESUSCITATION - p. 120 137. STANDARD PROCEDURES AND TEAM EFFORT - p. 120 138. BASIC LIFE SUPPORT FOR ADULTS WITH AN UNOBSTRUCTED AIRWAY - p. 121 139. PEDIATRIC RESUSCITATION - p. 123 140. OBSTRUCTED AIRWAY - p. 123 141. ADVANCED CARDIAC LIFE SUPPORT OF ADULTS - p. 125 142. DRUG THERAPIES - p. 128 143. CLINICAL SETTINGS - p. 131 144. CONCLUSIONS - p. 133 145. Chapter 14: Interactive Multiple Choice Question - p. 134 146. Chapter 15 Cardioversion and Defibrillation - p. 135 147. INTRODUCTION - p. 135 148. PHYSIOLOGY OF ARRHYTHMIA AND SHOCK - p. 135 149. INDICATIONS AND CONTRAINDICATIONS - p. 135 150. CLINICAL COMPETENCE - p. 135 151. Chapter 15: Interactive Multiple Choice Question - p. 140 152. Chapter 16 Critical Care Echocardiography - p. 140 153. INTRODUCTION - p. 140 154. BASIC CRITICAL CARE ECHOCARDIOGRAPHY - p. 141 155. ADVANCED CRITICAL CARE ECHOCARDIOGRAPHY - p. 145 156. Chapter 16: Interactive Multiple Choice Question - p. 146 157. Chapter 17 Pericardiocentesis - p. 146 158. INTRODUCTION - p. 146 159. INDICATIONS FOR PERICARDIOCENTESIS - p. 146 160. ANATOMY - p. 147 161. PROCEDURE - p. 147 162. SHORT-TERM AND LONG-TERM MANAGEMENT - p. 151 163. UTILITY OF ULTRASONOGRAPHY FOR MANAGEMENT OF PERICARDIAL EFFUSION - p. 152 164. SPECIAL CIRCUMSTANCES - p. 153 165. SUMMARY - p. 154 166. Chapter 17: Interactive Multiple Choice Question - p. 154 167. Chapter 18 Temporary Cardiac Pacing - p. 155 168. INTRODUCTION - p. 155 169. INDICATIONS FOR TEMPORARY CARDIAC PACING - p. 155 170. ATRIOVENTRICULAR BLOCK - p. 156 171. DIAGNOSIS OF RAPID RHYTHMS - p. 157 172. ACUTE MYOCARDIAL INFARCTION - p. 157 173. EQUIPMENT AVAILABLE FOR TEMPORARY PACING - p. 157 174. CHOICE OF PACING MODE - p. 158 175. PROCEDURE TO ESTABLISH TEMPORARY PACING - p. 159 176. COMPLICATIONS OF TEMPORARY PACING - p. 160 177. Chapter 18: Interactive Multiple Choice Question - p. 160 178. Chapter 19 Pulmonary Artery Catheters - p. 161 179. INTRODUCTION - p. 161 180. PHYSIOLOGIC RATIONALE FOR USE OF PULMONARY ARTERY CATHETER - p. 161 181. CONTROVERSIES REGARDING USE OF PULMONARY ARTERY CATHETER - p. 161 182. INDICATIONS FOR USE OF PULMONARY ARTERY CATHETER - p. 161 183. CONTRAINDICATIONS TO PULMONARY ARTERY CATHETERS - p. 161 184. CATHETER FEATURES AND EVOLUTION - p. 162 185. INSERTION TECHNIQUES - p. 163 186. PHYSIOLOGIC DATA - p. 167 187. CLINICAL APPLICATIONS OF THE PULMONARY ARTERY CATHETER - p. 170 188. COMPLICATIONS - p. 170 189. GUIDELINES FOR SAFE USE OF PULMONARY ARTERY CATHETERS - p. 173 190. SUMMARY - p. 174 191. Chapter 19: Interactive Multiple Choice Question - p. 175 192. Chapter 20 Gastrointestinal Endoscopy - p. 176 193. INTRODUCTION - p. 176 194. PATIENT SELECTION - p. 176 195. PREPROCEDURAL CARE - p. 179 196. INTRAPROCEDURAL CARE - p. 179 197. POSTPROCEDURAL CARE - p. 181 198. FUTURE DIRECTIONS - p. 182 199. Chapter 20: Interactive Multiple Choice Question - p. 183 200. Chapter 21 Endoscopic Placement of Feeding Tubes - p. 183 201. INDICATIONS FOR ENTERAL FEEDING - p. 183 202. ACCESS TO THE GASTROINTESTINAL TRACT - p. 183 203. TECHNIQUES - p. 184 204. SURGICAL PROCEDURES - p. 186 205. DELIVERING THE TUBE-FEEDING FORMULA - p. 187 206. MEDICATIONS - p. 188 207. COMPLICATIONS - p. 188 208. Chapter 21: Interactive Multiple Choice Question - p. 189 209. Chapter 22 Gastroesophageal Balloon Tamponade for Acute Variceal Hemorrhage - p. 190 210. INTRODUCTION - p. 190 211. ACUTE VARICEAL HEMORRHAGE OVERVIEW - p. 190 212. ROLE OF BALLOON TAMPONADE FOR THE MANAGEMENT OF ACUTE VARICEAL HEMORRHAGE - p. 190 213. CONTRAINDICATIONS TO BALLOON TAMPONADE - p. 190 214. PRACTICAL CONSIDERATIONS - p. 191 215. BALLOON TUBE INSERTION TECHNIQUE - p. 191 216. COMPLICATIONS AND ALTERNATIVES - p. 194 217. Chapter 22: Interactive Multiple Choice Question - p. 195 218. Chapter 23 Paracentesis and Diagnostic Peritoneal Lavage - p. 195 219. ABDOMINAL PARACENTESIS - p. 195 220. DIAGNOSTIC PERITONEAL LAVAGE - p. 200 221. DIAGNOSTIC PERITONEAL ASPIRATION - p. 200 222. Chapter 23: Interactive Multiple Choice Question - p. 204 223. Chapter 24 Interventional Radiology: Percutaneous Drainage Techniques - p. 204 224. INTRODUCTION - p. 204 225. GENERAL AIMS - p. 204 226. INDICATIONS - p. 204 227. CONTRAINDICATIONS - p. 205 228. RISKS, BENEFITS, AND ALTERNATIVES - p. 205 229. PREPROCEDURE PREPARATION - p. 206 230. IMAGING GUIDANCE - p. 207 231. ANESTHESIA AND MONITORING - p. 208 232. THERAPEUTIC CATHETER DRAINAGE - p. 208 233. CATHETER SELECTION, FIXATION, AND REMOVAL - p. 209 234. DIAGNOSTIC OR THERAPEUTIC ASPIRATION - p. 209 235. PROCEDURE - p. 209 236. SPECIAL SITUATIONS - p. 210 237. SUMMARY - p. 211 238. Chapter 24: Interactive Multiple Choice Question - p. 211 239. Chapter 25 Percutaneous Suprapubic Cystostomy - p. 212 240. INTRODUCTION - p. 212 241. URETHRAL CATHETERIZATION - p. 212 242. SUPRAPUBIC CATHETER CARE - p. 214 243. COMPLICATIONS - p. 214 244. UTILITY OF ULTRASONOGRAPHY FOR PERCUTANEOUS CYSTOSTOMY AND URETHRAL CATHETERIZATION - p. 215 245. Chapter 25: Interactive Multiple Choice Question - p. 216 246. Chapter 26 Aspiration of the Knee and Synovial Fluid Analysis - p. 216 247. INTRODUCTION - p. 216 248. INDICATIONS - p. 216 249. CONTRAINDICATIONS - p. 217 250. COMPLICATIONS - p. 217 251. TECHNIQUE - p. 218 252. UTILITY OF ULTRASONOGRAPHY FOR KNEE JOINT ASPIRATION - p. 219 253. SYNOVIAL FLUID ANALYSIS - p. 219 254. GROSS EXAMINATION - p. 220 255. CELL COUNT AND DIFFERENTIAL - p. 220 256. CRYSTALS - p. 220 257. GRAM STAIN AND CULTURE - p. 221 258. Chapter 26: Interactive Multiple Choice Question - p. 221 259. SECTION 2 MINIMALLY INVASIVE MONITORING - p. 222 260. Chapter 27 Routine Monitoring of Critically Ill Patients - p. 222 261. INTRODUCTION - p. 222 262. MONITORING SYSTEMS - p. 222 263. TEMPERATURE MONITORING - p. 222 264. ARTERIAL BLOOD PRESSURE MONITORING - p. 224 265. ELECTROCARDIOGRAPHIC MONITORING - p. 227 266. RESPIRATORY MONITORING - p. 228 267. NONINVASIVE TISSUE PERFUSION MONITORING - p. 232 268. Chapter 27: Interactive Multiple Choice Question - p. 236 269. Chapter 28 Minimally Invasive Hemodynamic Monitoring - p. 236 270. INTRODUCTION - p. 237 271. CARDIAC OUTPUT - p. 237 272. FUTURE DIRECTIONS - p. 243 273. OXYGEN DELIVERY AND TISSUE PERFUSION - p. 243 274. PRACTICE RECOMMENDATIONS - p. 246 275. Chapter 28: Interactive Multiple Choice Question - p. 248 276. Chapter 29 Respiratory Monitoring During Mechanical Ventilation - p. 248 277. INTRODUCTION - p. 249 278. GAS EXCHANGE - p. 249 279. RESPIRATORY MECHANICS - p. 251 280. PATIENT VENTILATOR INTERACTION - p. 257 281. SUMMARY - p. 260 282. Chapter 29: Interactive Multiple Choice Question - p. 261 283. Chapter 30 Neurologic Multimodal Monitoring - p. 261 284. GOALS OF BRAIN MONITORING - p. 262 285. CEREBRAL ISCHEMIA - p. 262 286. TECHNIQUES OF NEUROLOGIC MONITORING - p. 264 287. MULTIMODAL MONITORING STRATEGIES - p. 276 288. Chapter 30: Interactive Multiple Choice Question - p. 278 289. Chapter 31 Role of Tele-Critical Care in the Health Care System - p. 279 290. INTRODUCTION - p. 279 291. TECHNOLOGICAL AND ORGANIZATIONAL SOLUTIONS - p. 281 292. DATA AND OUTCOMES - p. 283 293. SUMMARY - p. 286 294. Chapter 31: Interactive Multiple Choice Question - p. 287 295. SECTION 3 PALLIATIVE CARE AND ETHICAL ISSUES IN THE INTENSIVE CARE UNIT - p. 288 296. Chapter 32 Palliative Care in the ICU - p. 288 297. INTRODUCTION - p. 288 298. MODELS OF ICU PALLIATIVE CARE DELIVERY - p. 289 299. CLINICAL TRIGGERS FOR ICU PALLIATIVE CARE - p. 290 300. BARRIERS TO PALLIATIVE CARE IN THE ICU - p. 290 301. ELEMENTS TO SUCCESSFUL INTEGRATION OF PALLIATIVE CARE IN THE ICU - p. 291 302. PALLIATIVE CARE QUALITY IMPROVEMENT - p. 291 303. SUMMARY - p. 292 304. Chapter 32: Interactive Multiple Choice Question - p. 293 305. Chapter 33 Effective Communication and Ethical Decision-Making in the ICU - p. 293 306. INTRODUCTION - p. 293 307. FAMILY MEETINGS AND GOALS OF CARE DISCUSSIONS - p. 294 308. Chapter 33: Interactive Multiple Choice Question - p. 308 309. Chapter 34 Managing Symptoms in Critically Ill Patients - p. 308 310. INTRODUCTION - p. 308 311. PAIN MANAGEMENT IN PALLIATIVE CARE - p. 308 312. GENERAL PRINCIPLES - p. 308 313. PEARLS FOR CLINICAL PRACTICE - p. 310 314. MANAGEMENT OF DYSPNEA - p. 310 315. INTERVENTIONS OF UNKNOWN EFFICACY - p. 312 316. GASTROINTESTINAL SYMPTOMS: CONSTIPATION, NAUSEA, AND VOMITING - p. 312 317. PSYCHIATRIC SYMPTOMS: DELIRIUM, ANXIETY, AND DEPRESSION - p. 315 318. Chapter 34: Interactive Multiple Choice Question - p. 321 319. Chapter 35 Being With Suffering: Addressing Existential and Spiritual Distress - p. 321 320. INTRODUCTION - p. 321 321. DEFINITIONS - p. 322 322. RELIGIOUS TRADITIONS AT THE END OF LIFE - p. 322 323. IMPACT OF RELIGIOSITY ON END-OF-LIFE DECISIONS - p. 323 324. DIAGNOSIS OF EXISTENTIAL SUFFERING AND LOSS OF PERSONHOOD - p. 323 325. ADDRESSING EXISTENTIAL AND SPIRITUAL DISTRESS: USE OF AN INTERDISCIPLINARY TEAM - p. 324 326. HOPE AND RESILIENCY—RESTORATION OF PERSONHOOD - p. 325 327. IMPACT OF MEDICAL DECISIONS ON GRIEF AND BEREAVEMENT - p. 325 328. SELF-CARE AND MORAL DISTRESS - p. 326 329. SUMMARY - p. 326 330. Chapter 35: Interactive Multiple Choice Question - p. 327 331. SECTION 4 SHOCK, TRAUMA AND SEPSIS MANAGEMENT - p. 328 332. Chapter 36 Resuscitation From Shock Following Hemorrhage - p. 328 333. INTRODUCTION - p. 328 334. PHYSIOLOGICAL RESPONSES TO HEMORRHAGE - p. 328 335. SHOCK RECOGNITION - p. 330 336. HEMORRHAGE CONTROL - p. 333 337. HISTORY OF HEMORRHAGIC SHOCK RESUSCITATION - p. 333 338. INITIAL RESUSCITATION - p. 334 339. ONGOING RESUSCITATION - p. 335 340. SUMMARY - p. 339 341. Chapter 36: Interactive Multiple Choice Question - p. 341 342. Chapter 37 Trauma Systems - p. 341 343. INTRODUCTION - p. 342 344. TRAUMA CENTER DESIGNATION AND VERIFICATION - p. 342 345. TRAUMA SCORING SYSTEMS - p. 342 346. PREHOSPITAL CARE - p. 343 347. IN-HOSPITAL CARE - p. 343 348. POSTHOSPITAL CARE - p. 345 349. DISASTER AND EMERGENCY PREPAREDNESS - p. 346 350. SPECIAL CONSIDERATIONS - p. 346 351. SUMMARY - p. 346 352. Chapter 37: Interactive Multiple Choice Question - p. 347 353. Chapter 38 Management of Sepsis - p. 347 354. INTRODUCTION - p. 348 355. DEFINITIONS - p. 348 356. PATHOGENS AND SITES OF INFECTION - p. 348 357. PATHOPHYSIOLOGY OF SEPSIS - p. 348 358. COMPLICATIONS ASSOCIATED WITH SEPSIS - p. 350 359. CLINICAL FEATURES AND DIAGNOSIS OF SEPSIS - p. 350 360. MANAGEMENT OF SEPSIS - p. 351 361. CONCLUSIONS - p. 356 362. Chapter 38: Interactive Multiple Choice Question - p. 358 363. Chapter 39 Multiple Organ Dysfunction Syndrome - p. 358 364. INTRODUCTION - p. 358 365. ETIOLOGY - p. 358 366. DIAGNOSTIC CRITERIA AND SCORING SYSTEMS - p. 359 367. MECHANISMS OF MULTIPLE ORGAN DYSFUNCTION SYNDROME - p. 359 368. CURRENT MANAGEMENT CONSIDERATIONS - p. 360 369. PROGNOSIS AND ICU LENGTH OF STAY - p. 361 370. SUMMARY - p. 362 371. Chapter 39: Interactive Multiple Choice Question - p. 363 372. Chapter 40 Traumatic Brain Injury - p. 363 373. INTRODUCTION - p. 363 374. TRAUMA BAY AND INITIAL CRITICAL CARE - p. 363 375. REVERSAL OF ANTICOAGULATION - p. 364 376. SURGICAL THERAPIES FOR TRAUMATIC BRAIN INJURY - p. 365 377. NEUROLOGICAL CRITICAL CARE - p. 365 378. CEREBRAL PERFUSION PRESSURE AND THE LUND CONCEPT - p. 366 379. TEMPERATURE MANAGEMENT - p. 366 380. INDUCED COMA - p. 367 381. SYSTEMIC CRITICAL CARE - p. 367 382. SPECIALTY INJURY SUBTYPES - p. 368 383. LONG-TERM OUTCOMES - p. 368 384. Chapter 40: Interactive Multiple Choice Question - p. 371 385. Chapter 41 Spinal Cord Trauma - p. 371 386. INTRODUCTION - p. 371 387. ANATOMY - p. 371 388. SPINAL COLUMN: CLASSIFICATION OF INJURY AND ASSESSMENT OF SPINAL STABILITY - p. 372 389. TREATMENT - p. 378 390. Chapter 41: Interactive Multiple Choice Question - p. 381 391. Chapter 42 Thoracic and Cardiac Trauma - p. 381 392. INTRODUCTION - p. 381 393. INDICATIONS FOR URGENT SURGICAL INTERVENTION - p. 381 394. DIAGNOSTICS - p. 382 395. SPECIFIC INJURIES - p. 384 396. UTILITY OF ULTRASONOGRAPHY FOR EVALUATION OF THORACIC AND CARDIAC TRAUMA - p. 391 397. SUMMARY - p. 392 398. Chapter 42: Interactive Multiple Choice Question - p. 394 399. Chapter 43 Critical Care of the Patient With Abdominal Trauma - p. 394 400. INTRODUCTION - p. 394 401. ICU ADMISSION - p. 394 402. NONOPERATIVE MANAGEMENT - p. 394 403. BLUNT TRAUMA - p. 395 404. PENETRATING INJURY - p. 397 405. MISSED INJURIES - p. 397 406. ABDOMINAL COMPARTMENT SYNDROME - p. 398 407. DAMAGE CONTROL RESUSCITATION - p. 399 408. SUMMARY - p. 400 409. Chapter 43: Interactive Multiple Choice Question - p. 402 410. Chapter 44 Orthopedic Injury - p. 402 411. EPIDEMIOLOGY - p. 402 412. OPEN FRACTURES - p. 402 413. PELVIC FRACTURES - p. 404 414. LONG BONE FRACTURES - p. 407 415. COMPARTMENT SYNDROMES - p. 409 416. OTHER SEQUELAE OF ORTHOPEDIC TRAUMA - p. 411 417. SCAPULOTHORACIC DISSOCIATION - p. 413 418. Chapter 44: Interactive Multiple Choice Question - p. 416 419. Chapter 45 Burn Management - p. 417 420. DEFINITION AND GENERAL CONSIDERATIONS - p. 417 421. BURN SHOCK - p. 418 422. CARDIOVASCULAR RESPONSE - p. 418 423. INHALATIONAL INJURY - p. 419 424. METABOLIC AND NUTRITIONAL CONSIDERATIONS - p. 419 425. BURN WOUND SEPSIS - p. 419 426. SURGICAL CONSIDERATIONS - p. 420 427. TOPICAL WOUND CARE - p. 420 428. SPECIFIC INJURIES - p. 420 429. PSYCHIATRIC AND ANALGESIC CONSIDERATIONS - p. 421 430. Chapter 45: Interactive Multiple Choice Question - p. 422 431. SECTION 5 Surgical Problems In The Intensive Care Unit - p. 423 432. Chapter 46 Surgeon and Intensivist Collaboration in the Care of the ICU Patient - p. 423 433. INTRODUCTION - p. 423 434. DEFINITION OF ICU MODELS AND LEVELS OF CARE - p. 423 435. COMMUNICATION AMONG ICU TEAM MEMBERS - p. 424 436. METHODS FOR ACHIEVING AND MAINTAINING ICU TEAM CONSENSUS - p. 424 437. SUMMARY - p. 425 438. Chapter 46: Interactive Multiple Choice Question - p. 426 439. Chapter 47 Surgical Infections in the Intensive Care Unit - p. 427 440. INTRODUCTION - p. 427 441. PATHOGENESIS - p. 427 442. DIAGNOSIS - p. 428 443. THERAPY - p. 428 444. PROGNOSIS - p. 429 445. Chapter 47: Interactive Multiple Choice Question - p. 429 446. Chapter 48 Care of the Patient with Necrotizing Fasciitis - p. 430 447. INTRODUCTION - p. 430 448. EPIDEMIOLOGY AND RISK FACTORS - p. 430 449. ETIOLOGIES - p. 430 450. PATHOPHYSIOLOGY - p. 430 451. CLASSIFICATION - p. 431 452. SIGNS AND SYMPTOMS - p. 432 453. DIAGNOSTICS - p. 432 454. TREATMENT - p. 433 455. SUMMARY - p. 434 456. Chapter 48: Interactive Multiple Choice Question - p. 434 457. Chapter 49 The ICU Management of Patients Undergoing Major Surgery for Gastrointestinal Cancers - p. 435 458. INTRODUCTION - p. 435 459. PANCREATIC RESECTION - p. 435 460. ESOPHAGEAL RESECTION - p. 436 461. GASTRIC RESECTION - p. 438 462. COLORECTAL RESECTION - p. 438 463. EMERGING ADVANCES - p. 439 464. Chapter 49: Interactive Multiple Choice Question - p. 440 465. Chapter 50 The ICU Approach to the Acute Abdomen - p. 440 466. INTRODUCTION - p. 440 467. EPIDEMIOLOGY - p. 440 468. HISTORY - p. 441 469. PHYSICAL EXAMINATION - p. 441 470. IMAGING - p. 442 471. SPECIFIC CAUSES OF ABDOMINAL PAIN - p. 442 472. SPECIAL POPULATIONS - p. 443 473. MANAGEMENT - p. 443 474. CONCLUSIONS - p. 443 475. Chapter 50: Interactive Multiple Choice Question - p. 443 476. Chapter 51 Abdominal Compartment Syndrome - p. 444 477. INTRODUCTION - p. 444 478. INCIDENCE - p. 444 479. MEASUREMENT OF INTRA-ABDOMINAL PRESSURE - p. 444 480. PHYSIOLOGY - p. 444 481. ABDOMINAL COMPARTMENT SYNDROME - p. 445 482. TREATMENT OPTIONS - p. 446 483. PREVENTION - p. 447 484. SUMMARY - p. 447 485. Chapter 51: Interactive Multiple Choice Question - p. 448 486. Chapter 52 Management of the Obstetrical Patient in the Intensive Care Setting - p. 448 487. INTRODUCTION - p. 448 488. MATERNAL PHYSIOLOGIC ADAPTATIONS TO PREGNANCY - p. 448 489. DIAGNOSTIC RADIATION EXPOSURE - p. 449 490. MEDICATIONS AND PREGNANCY - p. 450 491. SPECIFIC PREGNANCY DISORDERS - p. 451 492. Chapter 52: Interactive Multiple Choice Question - p. 454 493. Chapter 53 Acute Limb Ischemia in the ICU Population - p. 454 494. INTRODUCTION - p. 454 495. ETIOLOGY - p. 454 496. EVALUATION AND DIAGNOSIS OF ACUTE LIMB ISCHEMIA IN THE ICU POPULATION - p. 455 497. TREATMENT OF ACUTE LIMB ISCHEMIA IN THE ICU POPULATION - p. 455 498. OPEN SURGICAL REVASCULARIZATION - p. 456 499. ENDOVASCULAR ANGIOGRAPHY AND THROMBOLYSIS - p. 456 500. POSTOPERATIVE CARE - p. 457 501. MANAGEMENT OF ISCHEMIA-REPERFUSION INJURY AND RHABDOMYOLYSIS - p. 457 502. COMPARTMENT SYNDROME - p. 458 503. UPPER EXTREMITY ACUTE LIMB ISCHEMIA - p. 458 504. RECOMMENDATIONS - p. 458 505. Chapter 53: Interactive Multiple Choice Question - p. 459 506. Chapter 54 Palliative Surgery in the Intensive Care Unit - p. 459 507. INTRODUCTION - p. 459 508. CURRENT STATUS OF PALLIATIVE SURGERY - p. 459 509. MANAGEMENT OF COMMON PALLIATIVE SURGERY CONSULTATIONS - p. 461 510. BENEFITS OF EARLY PALLIATIVE CARE CONSULTS - p. 465 511. SUMMARY - p. 465 512. Chapter 54: Interactive Multiple Choice Question - p. 466 513. SECTION 6 TRANSPLANTATION - p. 467 514. Chapter 55 Management of the Organ Donor - p. 467 515. INTRODUCTION - p. 467 516. DONOR CLASSIFICATION BASED ON THE CRITERIA USED FOR DETERMINATION OF DEATH - p. 468 517. CURRENT STATUS OF SOLID-ORGAN TRANSPLANTATION - p. 469 518. CURRENT STATUS OF ORGAN DONATION - p. 470 519. OTHER OPTIONS TO INCREASE ORGAN AVAILABILITY - p. 471 520. REGULATION AND ORGANIZATION OF ORGAN PROCUREMENT AND ALLOCATION - p. 472 521. LEGAL ASPECTS OF ORGAN DONATION AND BRAIN DEATH - p. 472 522. ORGAN DONATION PROCESS - p. 475 523. PERIOPERATIVE CRITICAL CARE OF THE BRAIN-DEAD ORGAN DONOR - p. 479 524. PERIOPERATIVE CRITICAL CARE OF THE DCD ORGAN DONOR - p. 487 525. Chapter 55: Interactive Multiple Choice Question - p. 490 526. Chapter 56 Critical Care Problems in Kidney Recipients - p. 491 527. INTRODUCTION - p. 491 528. PRETRANSPLANT EVALUATION - p. 491 529. PERIOPERATIVE CARE - p. 492 530. CRITICAL EVALUATION OF DYSFUNCTIONAL GRAFTS - p. 492 531. NONRENAL POSTTRANSPLANTATION COMPLICATIONS - p. 494 532. CURRENT CHALLENGES IN KIDNEY TRANSPLANTATION - p. 498 533. Chapter 56: Interactive Multiple Choice Question - p. 500 534. Chapter 57 Critical Care of Liver Transplant Recipients and Live Liver Donors - p. 501 535. INTRODUCTION - p. 501 536. ORGAN ALLOCATION AND DISPARITY - p. 501 537. CAUSES OF LIVER FAILURE AND LIVER TRANSPLANT CANDIDATE SELECTION - p. 502 538. INTRAOPERATIVE MANAGEMENT - p. 504 539. POSTOPERATIVE MANAGEMENT - p. 505 540. POSTTRANSPLANT SURGICAL COMPLICATIONS - p. 507 541. POSTTRANSPLANTATION MEDICAL COMPLICATIONS - p. 509 542. CARE OF THE LIVING LIVER DONOR - p. 512 543. SUMMARY - p. 513 544. Chapter 57: Interactive Multiple Choice Question - p. 515 545. Chapter 58 Critical Care of the Lung Transplant Recipient - p. 515 546. INTRODUCTION - p. 515 547. INDICATIONS - p. 516 548. GUIDELINES FOR RECIPIENT SELECTION - p. 516 549. DONOR ALLOCATION AND SELECTION - p. 518 550. SURGICAL TECHNIQUES - p. 519 551. GENERAL POSTOPERATIVE MANAGEMENT - p. 519 552. IMMUNOSUPPRESSION - p. 519 553. POSTOPERATIVE COMPLICATIONS - p. 520 554. ICU OUTCOMES - p. 527 555. SUMMARY - p. 527 556. Chapter 58: Interactive Multiple Choice Question - p. 529 557. Chapter 59 Critical Care Problems in Heart and Heart-Lung Transplant Recipients - p. 530 558. INTRODUCTION - p. 530 559. HEART TRANSPLANTATION - p. 530 560. POSTOPERATIVE CARE - p. 533 561. POSTTRANSPLANT LYMPHOPROLIFERATIVE DISEASE - p. 536 562. HEART-LUNG TRANSPLANTATION - p. 536 563. POSTOPERATIVE CARE - p. 537 564. CONCLUSION - p. 537 565. Chapter 59: Interactive Multiple Choice Question - p. 538 566. Chapter 60 Care of the Pancreas Transplant Recipient - p. 538 567. INTRODUCTION - p. 538 568. TECHNICAL ASPECTS OF PANCREAS TRANSPLANTATION - p. 540 569. PRETRANSPLANT EVALUATION - p. 540 570. CONTRAINDICATIONS - p. 541 571. DONOR SELECTION - p. 541 572. IMMUNOLOGY - p. 541 573. ANESTHETIC CONSIDERATIONS FOR THE RECIPIENT - p. 541 574. INTRAOPERATIVE TECHNIQUES - p. 542 575. POSTOPERATIVE CARE - p. 543 576. SURGICAL COMPLICATIONS - p. 544 577. SUMMARY - p. 551 578. Chapter 60: Interactive Multiple Choice Question - p. 553 579. Chapter 61 Critical Care of Intestinal Transplant Recipients - p. 553 580. INTRODUCTION - p. 553 581. SUMMARY - p. 560 582. Chapter 61: Interactive Multiple Choice Question - p. 561 583. Chapter 62 Immunosuppression in Solid-Organ Transplantation - p. 562 584. INTRODUCTION - p. 562 585. IMMUNOSUPPRESSIVE STRATEGIES - p. 562 586. PHARMACOLOGIC AGENTS - p. 563 587. ANTIPROLIFERATIVE AGENTS - p. 564 588. BIOLOGIC IMMUNOSUPPRESSION - p. 566 589. ATGAM - p. 566 590. TREATMENT OF ACUTE REJECTION - p. 567 591. SUMMARY - p. 567 592. Chapter 62: Interactive Multiple Choice Question - p. 569 593. Chapter 63 Hematopoietic Cell Transplantation - p. 569 594. GENERAL PRINCIPLES - p. 570 595. TRANSPLANT-RELATED COMPLICATIONS - p. 571 596. COMPLICATIONS OF T CELL THERAPIES - p. 583 597. Chapter 63: Interactive Multiple Choice Question - p. 586 598. Chapter 64 Management of Graft-vs-Host Disease, Infection, Malignancy, and Rejection in Transplant Recipients - p. 586 599. INTRODUCTION - p. 587 600. GRAFT-VS-HOST DISEASE - p. 587 601. INFECTIONS - p. 588 602. MALIGNANCY - p. 594 603. REJECTION - p. 596 604. SUMMARY - p. 601 605. Chapter 64: Interactive Multiple Choice Question - p. 605 606. SECTION 7 RHEUMATOLOGIC, IMMUNOLOGIC, AND DERMATOLOGIC DISEASES IN THE INTENSIVE CARE UNIT - p. 606 607. Chapter 65 Rheumatologic Diseases in the Intensive Care Unit - p. 606 608. ACUTE RHEUMATIC DISEASES IN THE INTENSIVE CARE SETTING - p. 606 609. ASPECTS OF RHEUMATIC DISEASES COMPLICATING INTENSIVE CARE PROCEDURES - p. 611 610. RHEUMATOID ARTHRITIS - p. 612 611. SYSTEMIC LUPUS ERYTHEMATOSUS - p. 615 612. ANTIPHOSPHOLIPID SYNDROME - p. 622 613. SYSTEMIC SCLEROSIS - p. 623 614. IDIOPATHIC INFLAMMATORY MYOPATHIES - p. 626 615. Chapter 65: Interactive Multiple Choice Question - p. 630 616. Chapter 66 Vasculitis in the Intensive Care Unit - p. 631 617. INTRODUCTION - p. 631 618. POLYARTERITIS NODOSA - p. 631 619. MICROSCOPIC POLYANGIITIS - p. 632 620. CRYOGLOBULINEMIC VASCULITIS - p. 633 621. DRUG-INDUCED VASCULITIS - p. 635 622. CNS VASCULITIS - p. 635 623. OTHER VASCULITIDES - p. 636 624. CHOLESTEROL EMBOLISM - p. 636 625. TREATMENT STRATEGIES IN UNDIFFERENTIATED RHEUMATIC DISEASES PRESENTING WITH CRITICAL ILLNESS AND RELAPSE OR WORSENING KNOWN RHEUMATIC DISEASE - p. 636 626. Chapter 66: Interactive Multiple Choice Question - p. 638 627. Chapter 67 Therapeutics in Immune-Mediated Rheumatic Diseases - p. 639 628. INTRODUCTION - p. 639 629. NONSTEROIDAL ANTI-INFLAMMATORY DRUGS - p. 639 630. CORTICOSTEROID THERAPY - p. 639 631. DISEASE-MODIFYING ANTIRHEUMATIC DRUGS - p. 640 632. BIOLOGIC MODIFIERS - p. 642 633. INTRAVENOUS IMMUNOGLOBULIN - p. 646 634. DMARDS, BIOLOGICS, AND PREGNANCY - p. 646 635. SUMMARY - p. 647 636. Chapter 67: Interactive Multiple Choice Question - p. 647 637. Chapter 68 Anaphylaxis - p. 648 638. PATHOPHYSIOLOGY OF ANAPHYLACTIC REACTIONS - p. 648 639. CLINICAL AND LABORATORY FEATURES - p. 650 640. DIAGNOSIS AND DIFFERENTIAL DIAGNOSIS OF ANAPHYLAXIS - p. 650 641. CLINICAL COURSE OF ANAPHYLACTIC REACTIONS - p. 652 642. TREATMENT OF ANAPHYLAXIS - p. 652 643. PREVENTION OF ANAPHYLACTIC REACTIONS - p. 653 644. MANAGEMENT OF ANAPHYLAXIS TO SPECIFIC AGENTS AND PRECIPITANTS - p. 654 645. Chapter 68: Interactive Multiple Choice Question - p. 660 646. Chapter 69 Dermatology in the Intensive Care Unit - p. 661 647. INTRODUCTION - p. 661 648. DRUG ERUPTIONS - p. 661 649. INFECTIONS - p. 667 650. BLISTERING DISEASES - p. 672 651. VASCULAR DISORDERS - p. 674 652. AUTOIMMUNE SKIN DISEASE - p. 678 653. SUMMARY - p. 681 654. Chapter 69: Interactive Multiple Choice Question - p. 682 655. SECTION 8 INFECTIOUS DISEASE PROBLEMS IN THE INTENSIVE CARE UNIT - p. 683 656. Chapter 70 Approach to Fever for the ICU Patient - p. 683 657. APPROACH TO THE FEBRILE PATIENT - p. 683 658. ETIOLOGY OF FEVER IN THE INTENSIVE CARE PATIENT - p. 683 659. DIAGNOSTIC CONSIDERATIONS - p. 685 660. TREATMENT CONSIDERATIONS - p. 686 661. Chapter 70: Interactive Multiple Choice Question - p. 689 662. Chapter 71 Prevention and Control of Health Care–Acquired Infections in the Intensive Care Unit - p. 690 663. INTRODUCTION - p. 690 664. EPIDEMIOLOGY OF HEALTH CARE–ACQUIRED ICU INFECTIONS - p. 690 665. MICROBIOLOGY OF ICU INFECTIONS - p. 690 666. RISK FACTORS - p. 691 667. PREVENTIVE AND CONTROL MEASURES - p. 691 668. SELECTED HEALTH CARE–ACQUIRED PATHOGENS - p. 694 669. Chapter 71: Interactive Multiple Choice Question - p. 697 670. Chapter 72 Use of Antimicrobials in the Treatment of Infection in the Critically Ill Patient - p. 697 671. INTRODUCTION - p. 697 672. PENICILLINS - p. 697 673. CEPHALOSPORINS - p. 698 674. CARBAPENEMS - p. 701 675. AZTREONAM - p. 701 676. AMINOGLYCOSIDES - p. 701 677. FLUOROQUINOLONES - p. 703 678. VANCOMYCIN - p. 704 679. LIPOGLYCOPEPTIDES - p. 705 680. THERAPY OF ANAEROBIC INFECTIONS - p. 705 681. MACROLIDES - p. 705 682. OXAZOLIDINONES - p. 706 683. TETRACYCLINES - p. 706 684. THERAPY OF FUNGAL INFECTIONS - p. 707 685. TRIAZOLES - p. 708 686. ECHINOCANDINS - p. 709 687. THERAPY OF VIRAL INFECTIONS - p. 709 688. Chapter 72: Interactive Multiple Choice Question - p. 712 689. Chapter 73 Life-Threatening Community-Acquired Bacterial and Parasitic Infections - p. 713 690. INTRODUCTION - p. 713 691. TOXIC SHOCK SYNDROMES - p. 713 692. MENINGOCOCCEMIA - p. 715 693. INTRODUCTION - p. 715 694. OVERWHELMING POST-SPLENECTOMY INFECTION - p. 716 695. INTRODUCTION - p. 716 696. MALARIA - p. 717 697. INTRODUCTION - p. 717 698. TICK-BORNE ILLNESSES - p. 719 699. INTRODUCTION - p. 719 700. MISCELLANEOUS INFECTIOUS DISEASES - p. 720 701. Chapter 73: Interactive Multiple Choice Question - p. 722 702. Chapter 74 Acute Infection in the Non–HIV-Infected Immunocompromised Host - p. 722 703. INTRODUCTION - p. 722 704. SPECIFIC DISEASES WITH ASSOCIATED IMMUNOCOMPROMISE AND ASSOCIATED INFECTIONS - p. 723 705. DIAGNOSTIC APPROACH TO FEVER IN IMMUNOCOMPROMISED PATIENTS - p. 726 706. APPROACH TO SPECIFIC INFECTIOUS DISEASE PRESENTATIONS - p. 726 707. Chapter 74: Interactive Multiple Choice Question - p. 731 708. Chapter 75 Intensive Care of Patients With HIV Infection - p. 732 709. INTRODUCTION - p. 732 710. REASONS FOR INTENSIVE CARE UNIT ADMISSION - p. 732 711. PULMONARY DISORDERS - p. 733 712. CENTRAL NERVOUS SYSTEM DISORDERS - p. 734 713. HEPATIC DISORDERS - p. 735 714. IMMUNE RECONSTITUTION DISORDERS - p. 735 715. OTHER CRITICAL ILLNESSES - p. 735 716. TOXIC EFFECTS OF ANTIRETROVIRAL THERAPY - p. 735 717. MANAGEMENT OF ANTIRETROVIRAL AND PROPHYLACTIC AGENTS - p. 736 718. PREDICTORS OF OUTCOMES - p. 737 719. RISK TO HEALTH CARE WORKERS AND POSTEXPOSURE PROPHYLAXIS - p. 737 720. SUMMARY - p. 738 721. Chapter 75: Interactive Multiple Choice Question - p. 739 722. Chapter 76 Infectious Complications of Persons Who Inject Drugs - p. 740 723. INTRODUCTION - p. 740 724. FEVER - p. 740 725. BACTEREMIA - p. 740 726. SOFT-TISSUE INFECTIONS - p. 741 727. PERIPHERAL VASCULAR INFECTIONS - p. 741 728. ENDOCARDITIS - p. 741 729. SKELETAL INFECTIONS - p. 743 730. SYSTEMIC SYNDROMES WITH SPORE-FORMING BACTERIA - p. 743 731. HUMAN IMMUNODEFICIENCY VIRUS INFECTION - p. 743 732. VIRAL HEPATITIS - p. 744 733. PULMONARY DISEASE AND TUBERCULOSIS - p. 744 734. DISSEMINATED CANDIDIASIS - p. 744 735. OCULAR INFECTIONS - p. 745 736. CENTRAL NERVOUS SYSTEM INFECTIONS - p. 745 737. Chapter 76: Interactive Multiple Choice Question - p. 746 738. Chapter 77 Infective Endocarditis and Infections of Intracardiac Prosthetic Devices - p. 746 739. INTRODUCTION - p. 747 740. ETIOLOGY - p. 747 741. PATHOPHYSIOLOGY - p. 749 742. DIAGNOSIS - p. 750 743. CRITERIA - p. 750 744. HISTORY - p. 751 745. PHYSICAL EXAMINATION - p. 751 746. LABORATORY TESTS - p. 752 747. OTHER DIAGNOSTIC TESTS - p. 753 748. DIFFERENTIAL DIAGNOSIS - p. 754 749. INFECTIONS OF CARDIOVASCULAR IMPLANTABLE ELECTRONIC DEVICES: PACEMAKERS, AUTOMATIC IMPLANTABLE CARDIOVERTER DEFIBRILLATORS, AND VENTRICULAR ASSIST DEVICES - p. 755 750. TREATMENT - p. 756 751. EMPIRIC ANTIBIOTICS - p. 756 752. ANTIMICROBIAL THERAPY - p. 756 753. VALVE SURGERY - p. 756 754. TIMING OF VALVE SURGERY - p. 756 755. PREVENTION OF RECURRENT INFECTIVE ENDOCARDITIS - p. 757 756. RECURRENT INFECTIVE ENDOCARDITIS IN PEOPLE WHO INJECT DRUGS - p. 757 757. ANTIMICROBIAL THERAPY FOR LEFT-SIDED NATIVE VALVE ENDOCARDITIS - p. 757 758. NATIVE VALVE ENDOCARDITIS SECONDARY TO STAPHYLOCOCCI - p. 757 759. NATIVE VALVE ENDOCARDITIS SECONDARY TO STREPTOCOCCI - p. 758 760. NATIVE VALVE ENDOCARDITIS SECONDARY TO ENTEROCOCCI - p. 758 761. NATIVE VALVE ENDOCARDITIS SECONDARY TO HAEMOPHILUS SP, AGGREGATIBACTER ACTINOMYCETEMCOMITANS, CARDIOBACTERIUM HOMINIS, EIKENELLA CORRODENS, AND KINGELLA KINGAE - p. 759 762. CULTURE-NEGATIVE NATIVE VALVE ENDOCARDITIS - p. 759 763. ANTIMICROBIAL THERAPY FOR PROSTHETIC VALVE ENDOCARDITIS - p. 759 764. PROSTHETIC VALVE ENDOCARDITIS SECONDARY TO STAPHYLOCOCCI - p. 759 765. PROSTHETIC VALVE ENDOCARDITIS SECONDARY TO STREPTOCOCCI - p. 759 766. PROSTHETIC VALVE ENDOCARDITIS SECONDARY TO OTHER ORGANISMS - p. 760 767. CULTURE-NEGATIVE PROSTHETIC VALVE ENDOCARDITIS - p. 760 768. PARTIAL ORAL TREATMENT FOR ENDOCARDITIS TRIAL - p. 760 769. SUPPORTIVE CARE AND MONITORING - p. 760 770. ROLE OF SURGERY - p. 760 771. ANTIMICROBIAL THERAPY FOR CARDIOVASCULAR IMPLANTABLE ELECTRONIC DEVICE INFECTIONS - p. 763 772. SUMMARY - p. 764 773. Chapter 77: Interactive Multiple Choice Question - p. 767 774. Chapter 78 Infections Associated With Vascular Catheters - p. 768 775. INTRODUCTION - p. 768 776. PATHOGENESIS OF CATHETER-RELATED INFECTIONS - p. 768 777. DIAGNOSIS OF CATHETER-RELATED INFECTION - p. 768 778. CATHETER-ASSOCIATED INFECTIONS - p. 772 779. Chapter 78: Interactive Multiple Choice Question - p. 775 780. Chapter 79 Urinary Tract Infections - p. 775 781. INTRODUCTION - p. 775 782. THE PATHOPHYSIOLOGY OF URINARY TRACT INFECTIONS - p. 775 783. HOST DEFENSE MECHANISMS AGAINST URINARY TRACT INFECTIONS - p. 776 784. SEVERE URINARY TRACT INFECTIONS - p. 777 785. IMAGING PROCEDURES FOR THE DIAGNOSIS OF URINARY TRACT INFECTIONS - p. 778 786. MEDICAL MANAGEMENT OF URINARY TRACT INFECTIONS - p. 779 787. PREVENTIVE MEASURES AGAINST URINARY TRACT INFECTIONS IN THE ICU SETTING - p. 779 788. THE PROBLEM OF CANDIDURIA - p. 782 789. TREATMENT OF GENITOURINARY CANDIDIASIS - p. 783 790. Chapter 79: Interactive Multiple Choice Question - p. 785 791. Chapter 80 Central Nervous System Infections - p. 785 792. INTRODUCTION - p. 785 793. GENERAL CLINICAL APPROACH - p. 785 794. ACUTE BACTERIAL MENINGITIS - p. 785 795. ENCEPHALITIS - p. 790 796. BRAIN ABSCESS - p. 793 797. PARAMENINGEAL FOCI - p. 793 798. Chapter 80: Interactive Multiple Choice Question - p. 795 799. Chapter 81 Tuberculosis - p. 796 800. INTRODUCTION - p. 796 801. PATHOGENESIS - p. 796 802. CLINICAL MANIFESTATIONS - p. 796 803. DIAGNOSIS - p. 798 804. TREATMENT - p. 800 805. INFECTION CONTROL AND RESPIRATORY ISOLATION - p. 802 806. Chapter 81: Interactive Multiple Choice Question - p. 803 807. Chapter 82 Serious Epidemic Viral Pneumonias - p. 804 808. INTRODUCTION - p. 804 809. SEASONAL RESPIRATORY VIRUSES - p. 808 810. OTHER HUMAN VIRUSES RESULTING IN PNEUMONIA - p. 812 811. NOVEL ZOONOTIC VIRUSES - p. 813 812. Chapter 82: Interactive Multiple Choice Question - p. 815 813. Chapter 83 COVID-19: Presentation, Treatment, and Course of Severe Acute Respiratory Syndrome Coronavirus 2 Infection in the Intensive Care Unit - p. 815 814. ORIGINS - p. 815 815. VIROLOGY - p. 816 816. IMMUNOLOGY - p. 816 817. CLINICAL PRESENTATION - p. 817 818. CLINICAL COURSE - p. 817 819. ISSUES RELATED TO ICU CARE - p. 819 820. OPPORTUNISTIC INFECTIONS AFTER COVID-19 INFECTION - p. 819 821. MANAGEMENT - p. 819 822. LATE SEQUELAE AND “LONG COVID” - p. 820 823. Chapter 83: Interactive Multiple Choice Question - p. 821 824. Chapter 84 Critical Care of Patients Infected With Ebola Virus - p. 822 825. INTRODUCTION - p. 822 826. EPIDEMIOLOGY AND PATHOGENESIS - p. 822 827. CLINICAL PRESENTATION - p. 822 828. INFECTION CONTROL AND OTHER SAFETY CONSIDERATIONS - p. 823 829. CRITICAL CARE MANAGEMENT - p. 824 830. SPECIFIC THERAPIES - p. 825 831. ETHICAL CONSIDERATIONS - p. 825 832. Chapter 84: Interactive Multiple Choice Question - p. 825 833. Chapter 85 Botulism - p. 826 834. INTRODUCTION - p. 826 835. PATHOGENESIS - p. 826 836. EPIDEMIOLOGY - p. 826 837. CLINICAL MANIFESTATIONS - p. 827 838. DIAGNOSIS - p. 827 839. DIFFERENTIAL DIAGNOSIS - p. 827 840. TREATMENT - p. 827 841. Chapter 85: Interactive Multiple Choice Question - p. 828 842. Chapter 86 Tetanus - p. 829 843. INTRODUCTION - p. 829 844. PATHOGENESIS - p. 829 845. EPIDEMIOLOGY - p. 829 846. CLINICAL MANIFESTATIONS - p. 829 847. DIAGNOSIS - p. 830 848. TREATMENT - p. 830 849. Chapter 86: Interactive Multiple Choice Question - p. 831 850. SECTION 9 Hematologic and Oncologic Problems in the Intensive Care Unit - p. 832 851. Chapter 87 Disorders of Hemostasis in Critically Ill Patients - p. 832 852. INTRODUCTION - p. 832 853. NORMAL HEMOSTASIS - p. 832 854. APPROACH TO THE BLEEDING PATIENT - p. 833 855. LABORATORY ASSAYS OF PRIMARY AND SECONDARY HEMOSTASIS - p. 834 856. CONGENITAL DISORDERS OF HEMOSTASIS - p. 835 857. RARE CONGENITAL COAGULATION DISORDERS - p. 838 858. ACQUIRED COAGULATION DISORDERS - p. 840 859. ACQUIRED PLATELET DISORDERS/DYSFUNCTION - p. 844 860. OTHER ACQUIRED BLEEDING DISORDERS - p. 845 861. Chapter 87: Interactive Multiple Choice Question - p. 847 862. Chapter 88 Transfusion Therapy: Blood Components and Transfusion Complications - p. 848 863. INTRODUCTION - p. 848 864. BLOOD COMPONENT THERAPY - p. 848 865. COMPLICATIONS OF TRANSFUSION - p. 852 866. Chapter 88: Interactive Multiple Choice Question - p. 856 867. Chapter 89 Anemia in the Critical Care Setting - p. 856 868. INTRODUCTION - p. 856 869. HEMOLYTIC ANEMIAS - p. 859 870. MICROANGIOPATHIC HEMOLYTIC ANEMIA - p. 862 871. HEMOGLOBINOPATHIES - p. 864 872. CONCLUSIONS - p. 869 873. Chapter 89: Interactive Multiple Choice Question - p. 870 874. Chapter 90 Thrombocytopenia - p. 871 875. INTRODUCTION - p. 871 876. INITIAL EVALUATION - p. 871 877. IMMEDIATE THERAPY—PLATELET TRANSFUSION - p. 872 878. CAUSES OF THROMBOCYTOPENIA - p. 872 879. Chapter 90: Interactive Multiple Choice Question - p. 881 880. Chapter 91 Venous Thromboembolism and Associated Prothrombotic Disorders in the Intensive Care Unit - p. 882 881. INCIDENCE - p. 882 882. RISK FACTORS - p. 882 883. PATHOPHYSIOLOGY - p. 889 884. PREVENTION - p. 889 885. DIAGNOSIS - p. 890 886. TREATMENT - p. 895 887. SPECIAL THERAPEUTIC CONSIDERATIONS - p. 900 888. SEQUELAE OF VENOUS THROMBOEMBOLISM - p. 900 889. Chapter 91: Interactive Multiple Choice Question - p. 906 890. Chapter 92 Antithrombotic Pharmacotherapy - p. 906 891. INTRODUCTION - p. 906 892. ANTIPLATELET PHARMACOTHERAPY - p. 906 893. FIBRINOLYTIC THERAPY - p. 925 894. Chapter 92: Interactive Multiple Choice Question - p. 928 895. Chapter 93 Critical Care of Patients with Hematologic Malignancies - p. 928 896. INTRODUCTION - p. 929 897. OVERVIEW OF HEMATOLOGIC MALIGNANCIES - p. 929 898. DISEASE AND TREATMENT-RELATED COMPLICATIONS - p. 931 899. Chapter 93: Interactive Multiple Choice Question - p. 939 900. Chapter 94 Oncologic Emergencies - p. 940 901. INTRODUCTION - p. 940 902. SUPERIOR VENA CAVA SYNDROME - p. 940 903. CARDIAC TAMPONADE - p. 942 904. MALIGNANT EPIDURAL CORD COMPRESSION - p. 943 905. HYPERCALCEMIA - p. 944 906. LEUKOSTASIS - p. 946 907. ONCOLOGIC THERAPEUTICS - p. 946 908. TUMOR LYSIS SYNDROME - p. 946 909. CYTOKINE RELEASE SYNDROME AND NEUROTOXICITY FROM CHIMERIC ANTIGEN RECEPTOR–T CELL THERAPY - p. 950 910. Chapter 94: Interactive Multiple Choice Question - p. 952 911. Chapter 95 Therapeutic Apheresis: Technical Considerations and Indications in Critical Care - p. 952 912. TECHNICAL RATIONALE AND INSTRUMENTS - p. 952 913. PHYSIOLOGICAL PRINCIPLES - p. 953 914. VASCULAR ACCESS FOR THERAPEUTIC APHERESIS - p. 954 915. ANTICOAGULATION AND FLUID REPLACEMENT - p. 955 916. LIMITATIONS AND POTENTIAL ADVERSE EVENTS - p. 956 917. INDICATIONS FOR THE CRITICALLY ILL - p. 956 918. APHERESIS CONSULTATION - p. 962 919. Chapter 95: Interactive Multiple Choice Question - p. 963 920. SECTION 10 Pharmacology, Overdoses and Poisonings - p. 964 921. Chapter 96 General Considerations in the Evaluation and Treatment of Poisoning - p. 964 922. INTRODUCTION - p. 964 923. EPIDEMIOLOGY - p. 965 924. PHARMACOLOGICAL CONCEPTS - p. 965 925. CLINICAL CONSIDERATIONS - p. 966 926. Chapter 96: Interactive Multiple Choice Question - p. 981 927. Chapter 97 Acetaminophen Poisoning - p. 981 928. INTRODUCTION - p. 981 929. PHARMACOLOGY - p. 981 930. TOXICOLOGY - p. 981 931. CLINICAL MANIFESTATIONS - p. 983 932. DIAGNOSTIC EVALUATION - p. 983 933. MANAGEMENT - p. 984 934. GASTROINTESTINAL DECONTAMINATION - p. 985 935. ANTIDOTAL TREATMENT - p. 985 936. SUPPORTIVE CARE - p. 986 937. SPECIAL CONSIDERATIONS - p. 986 938. ACUTE OVERDOSE BY PEDIATRIC PATIENTS - p. 986 939. ACUTE OVERDOSE DURING PREGNANCY - p. 986 940. ACUTE OVERDOSE OF EXTENDED-RELEASE ACETAMINOPHEN - p. 986 941. CHRONIC OVERDOSE - p. 987 942. LATE TREATMENT - p. 987 943. MASSIVE ACETAMINOPHEN OVERDOSE TREATMENT - p. 987 944. SHORT-COURSE ORAL TREATMENT - p. 987 945. PROGNOSIS AND OUTCOME - p. 987 946. Chapter 97: Interactive Multiple Choice Question - p. 989 947. Chapter 98 Alcohols and Glycol Poisoning - p. 989 948. INTRODUCTION - p. 989 949. ETHANOL - p. 989 950. ALCOHOLIC KETOACIDOSIS - p. 990 951. ETHYLENE GLYCOL AND METHANOL - p. 993 952. ISOPROPANOL - p. 999 953. PROPYLENE GLYCOL - p. 1000 954. DIETHYLENE GLYCOL - p. 1001 955. Chapter 98: Interactive Multiple Choice Question - p. 1003 956. Chapter 99 Amphetamines - p. 1004 957. INTRODUCTION - p. 1004 958. PHARMACOLOGY - p. 1005 959. CLINICAL PRESENTATION - p. 1005 960. DIAGNOSTIC EVALUATION - p. 1007 961. MANAGEMENT - p. 1008 962. Chapter 99: Interactive Multiple Choice Question - p. 1011 963. Chapter 100 Antiarrhythmic Agents - p. 1011 964. INTRODUCTION - p. 1011 965. PHARMACOLOGY - p. 1011 966. CLINICAL PRESENTATION - p. 1013 967. DIAGNOSTIC EVALUATION - p. 1014 968. MANAGEMENT - p. 1014 969. INDIVIDUAL AGENTS - p. 1015 970. Chapter 100: Interactive Multiple Choice Question - p. 1020 971. Chapter 101 Anticholinergic Poisoning - p. 1021 972. INTRODUCTION - p. 1021 973. EPIDEMIOLOGY AND SOURCES - p. 1021 974. PHARMACOLOGY - p. 1021 975. CLINICAL PRESENTATION - p. 1021 976. MANAGEMENT - p. 1021 977. Chapter 101: Interactive Multiple Choice Question - p. 1024 978. Chapter 102 Anticonvulsant Poisoning - p. 1024 979. INTRODUCTION - p. 1024 980. PHENYTOIN - p. 1025 981. VALPROIC ACID - p. 1026 982. CARBAMAZEPINE - p. 1028 983. NEWER ANTICONVULSANTS - p. 1030 984. Chapter 102: Interactive Multiple Choice Question - p. 1033 985. Chapter 103 Antidepressant Poisoning - p. 1033 986. INTRODUCTION - p. 1034 987. HISTORY - p. 1034 988. TYPES OF ANTIDEPRESSANTS - p. 1034 989. PHARMACOLOGY - p. 1034 990. PHARMACOKINETICS - p. 1037 991. CLINICAL TOXICITY - p. 1037 992. DIAGNOSTIC EVALUATION - p. 1040 993. MANAGEMENT - p. 1040 994. Chapter 103: Interactive Multiple Choice Question - p. 1044 995. Chapter 104 Antipsychotic Poisoning - p. 1045 996. PHARMACOLOGY - p. 1045 997. CLINICAL TOXICITY - p. 1051 998. DIAGNOSTIC EVALUATION - p. 1052 999. MANAGEMENT - p. 1053 1000. Chapter 104: Interactive Multiple Choice Question - p. 1055 1001. Chapter 105 β-Blocker Poisoning - p. 1056 1002. INTRODUCTION - p. 1056 1003. PHARMACOLOGY - p. 1056 1004. CLINICAL TOXICITY - p. 1056 1005. DIAGNOSTIC EVALUATION - p. 1058 1006. MANAGEMENT - p. 1058 1007. Chapter 105: Interactive Multiple Choice Question - p. 1060 1008. Chapter 106 Calcium Channel Blocker Poisoning - p. 1060 1009. INTRODUCTION - p. 1060 1010. PHARMACOLOGY - p. 1061 1011. PHYSIOLOGY AND PATHOPHYSIOLOGY - p. 1061 1012. CLINICAL MANIFESTATIONS - p. 1061 1013. DIFFERENTIAL DIAGNOSIS - p. 1062 1014. MANAGEMENT - p. 1062 1015. EXTRACORPOREAL THERAPIES - p. 1065 1016. Chapter 106: Interactive Multiple Choice Question - p. 1066 1017. Chapter 107 Cardiac Glycoside Poisoning - p. 1067 1018. INTRODUCTION - p. 1067 1019. PHARMACOLOGY - p. 1067 1020. CLINICAL PRESENTATION - p. 1067 1021. DIAGNOSTIC EVALUATION - p. 1067 1022. MANAGEMENT - p. 1068 1023. Chapter 107: Interactive Multiple Choice Question - p. 1070 1024. Chapter 108 Cholinergic Poisoning - p. 1071 1025. INTRODUCTION - p. 1071 1026. PHARMACOLOGY - p. 1071 1027. CLINICAL MANIFESTATIONS - p. 1071 1028. DIAGNOSTIC EVALUATION - p. 1073 1029. MANAGEMENT - p. 1074 1030. NERVE AGENTS USED IN WARFARE - p. 1075 1031. Chapter 108: Interactive Multiple Choice Question - p. 1076 1032. Chapter 109 Cocaine Poisoning - p. 1077 1033. INTRODUCTION - p. 1077 1034. PHARMACOLOGY - p. 1077 1035. CLINICAL PRESENTATION - p. 1077 1036. DIAGNOSTIC EVALUATION - p. 1078 1037. MANAGEMENT - p. 1079 1038. Chapter 109: Interactive Multiple Choice Question - p. 1082 1039. Chapter 110 Corrosives Poisoning - p. 1083 1040. INTRODUCTION - p. 1083 1041. PATHOPHYSIOLOGY - p. 1083 1042. CLINICAL MANIFESTATIONS - p. 1083 1043. DIAGNOSTIC EVALUATION - p. 1084 1044. MANAGEMENT - p. 1085 1045. Chapter 110: Interactive Multiple Choice Question - p. 1087 1046. Chapter 111 Heavy Metal Poisoning - p. 1088 1047. INTRODUCTION - p. 1088 1048. ARSENIC - p. 1088 1049. ARSINE GAS - p. 1092 1050. LEAD - p. 1093 1051. MERCURY - p. 1097 1052. Chapter 111: Interactive Multiple Choice Question - p. 1101 1053. Chapter 112 Hydrocarbon Poisoning - p. 1102 1054. INTRODUCTION - p. 1102 1055. ALIPHATIC HYDROCARBONS - p. 1102 1056. HALOGENATED HYDROCARBONS - p. 1104 1057. AROMATIC HYDROCARBONS - p. 1105 1058. TERPENES - p. 1106 1059. Chapter 112: Interactive Multiple Choice Question - p. 1107 1060. Chapter 113 Hydrofluoric Acid Poisoning - p. 1108 1061. INTRODUCTION - p. 1108 1062. MECHANISM OF ACTION - p. 1108 1063. DERMAL EXPOSURE - p. 1108 1064. OCULAR EXPOSURE - p. 1109 1065. INHALATION - p. 1109 1066. INGESTION - p. 1109 1067. Chapter 113: Interactive Multiple Choice Question - p. 1110 1068. Chapter 114 Iron Poisoning - p. 1110 1069. INTRODUCTION - p. 1110 1070. PHARMACOLOGY - p. 1110 1071. CLINICAL TOXICITY - p. 1111 1072. DIAGNOSTIC EVALUATION - p. 1112 1073. MANAGEMENT - p. 1112 1074. Chapter 114: Interactive Multiple Choice Question - p. 1114 1075. Chapter 115 Isoniazid Poisoning - p. 1115 1076. INTRODUCTION - p. 1115 1077. PHARMACOLOGY - p. 1115 1078. CLINICAL PRESENTATION - p. 1116 1079. DIAGNOSTIC EVALUATION - p. 1116 1080. MANAGEMENT - p. 1117 1081. Chapter 115: Interactive Multiple Choice Question - p. 1118 1082. Chapter 116 Lithium Poisoning - p. 1119 1083. INTRODUCTION - p. 1119 1084. PHARMACOLOGY - p. 1119 1085. CLINICAL MANIFESTATIONS - p. 1120 1086. DIAGNOSTIC EVALUATION - p. 1121 1087. MANAGEMENT - p. 1122 1088. SUMMARY - p. 1123 1089. Chapter 116: Interactive Multiple Choice Question - p. 1124 1090. Chapter 117 Methylxanthine Poisoning - p. 1124 1091. INTRODUCTION - p. 1125 1092. PHARMACOLOGY - p. 1125 1093. CLINICAL TOXICITY - p. 1127 1094. DIAGNOSTIC EVALUATION - p. 1128 1095. MANAGEMENT - p. 1128 1096. CAFFEINE - p. 1129 1097. Chapter 117: Interactive Multiple Choice Question - p. 1131 1098. Chapter 118 Opioid Poisoning - p. 1131 1099. INTRODUCTION - p. 1131 1100. PHARMACODYNAMICS - p. 1131 1101. PHARMACOKINETICS - p. 1132 1102. PHARMACOLOGICAL HIGHLIGHTS OF INDIVIDUAL OPIOIDS - p. 1132 1103. CLINICAL PRESENTATION IN OVERDOSE - p. 1135 1104. TOXICITY FEATURES OF SPECIFIC AGENTS FOLLOWING OVERDOSE - p. 1136 1105. DIAGNOSTIC EVALUATION AND DIFFERENTIAL - p. 1136 1106. MANAGEMENT OF OPIOID OVERDOSE - p. 1138 1107. Chapter 118: Interactive Multiple Choice Question - p. 1139 1108. Chapter 119 Pesticide-Herbicide Poisoning - p. 1140 1109. INTRODUCTION - p. 1140 1110. ORGANOCHLORINES - p. 1140 1111. PYRETHROIDS - p. 1143 1112. ANTICOAGULANTS - p. 1144 1113. STRYCHNINE - p. 1145 1114. SODIUM MONOFLUOROACETATE - p. 1146 1115. ALUMINUM AND ZINC PHOSPHIDES - p. 1146 1116. METHYL BROMIDE - p. 1147 1117. N,N-DIETHYL-M-TOLUAMIDE - p. 1148 1118. PENTACHLOROPHENOL - p. 1149 1119. PARAQUAT - p. 1149 1120. DIQUAT - p. 1151 1121. CHLOROPHENOXY HERBICIDES - p. 1151 1122. CHLORATE SALTS - p. 1152 1123. Chapter 119: Interactive Multiple Choice Question - p. 1154 1124. Chapter 120 Phencyclidine and Hallucinogen Poisoning - p. 1154 1125. PHENCYCLIDINE - p. 1155 1126. HALLUCINOGENS - p. 1158 1127. Chapter 120: Interactive Multiple Choice Question - p. 1160 1128. Chapter 121 Salicylate and Other Nonsteroidal Anti-inflammatory Drug Poisoning - p. 1161 1129. INTRODUCTION - p. 1161 1130. PHARMACOLOGY - p. 1161 1131. CLINICAL TOXICITY - p. 1163 1132. DIAGNOSTIC EVALUATION - p. 1164 1133. MANAGEMENT - p. 1165 1134. Chapter 121: Interactive Multiple Choice Question - p. 1169 1135. Chapter 122 Sedative-Hypnotic Agent Poisoning - p. 1169 1136. INTRODUCTION - p. 1169 1137. BENZODIAZEPINES - p. 1169 1138. BARBITURATES - p. 1171 1139. NONBENZODIAZEPINE, NONBARBITURATE SEDATIVE-HYPNOTICS - p. 1173 1140. Chapter 122: Interactive Multiple Choice Question - p. 1177 1141. Chapter 123 Terrestrial Envenomations - p. 1177 1142. INTRODUCTION - p. 1178 1143. SNAKE ENVENOMATION - p. 1178 1144. SPIDER ENVENOMATION - p. 1184 1145. SCORPION ENVENOMATION - p. 1186 1146. CONCLUSION - p. 1188 1147. Chapter 123: Interactive Multiple Choice Question - p. 1189 1148. Chapter 124 Therapeutic Agents for Overdoses and Poisonings - p. 1190 1149. INTRODUCTION - p. 1190 1150. Chapter 125 Withdrawal Syndromes - p. 1210 1151. INTRODUCTION - p. 1210 1152. ETHANOL WITHDRAWAL - p. 1211 1153. BENZODIAZEPINE WITHDRAWAL - p. 1215 1154. γ-HYDROXYBUTYRATE WITHDRAWAL - p. 1216 1155. BACLOFEN WITHDRAWAL - p. 1216 1156. OPIOID WITHDRAWAL - p. 1217 1157. NICOTINE WITHDRAWAL - p. 1219 1158. STIMULANT WITHDRAWAL - p. 1219 1159. Chapter 125: Interactive Multiple Choice Question - p. 1221 1160. VOLUME 2 - p. 1222 1161. SECTION 11 CRITICAL CARE CONSEQUENCES OF WEAPONS (AGENTS) OF MASS DESTRUCTION - p. 1222 1162. Chapter 126 Planning and Organization for Emergency Mass Critical Care - p. 1222 1163. HOSPITAL AND COMMUNITY DISASTER RESPONSE - p. 1222 1164. CRITICAL CARE IN DISASTERS - p. 1224 1165. CRISIS STANDARDS OF CARE AND CRITICAL CARE TRIAGE - p. 1227 1166. SUMMARY - p. 1228 1167. Chapter 126: Interactive Multiple Choice Question - p. 1229 1168. Chapter 127 Chemical Agents of Mass Destruction - p. 1229 1169. INTRODUCTION - p. 1229 1170. HISTORY - p. 1230 1171. DETECTION AND DECONTAMINATION - p. 1230 1172. CLASSIFICATION OF CHEMICAL AGENTS - p. 1232 1173. SUMMARY - p. 1238 1174. DECLARATION - p. 1238 1175. Chapter 127: Interactive Multiple Choice Question - p. 1239 1176. Chapter 128 The Management of Acute Radiation Casualties - p. 1239 1177. INTRODUCTION - p. 1240 1178. TYPES OF RADIATION EMERGENCIES - p. 1240 1179. BASIC RADIATION PHYSICS - p. 1240 1180. RADIATION DOSES - p. 1242 1181. OVERVIEW OF RADIATION CASUALTIES - p. 1242 1182. ACUTE RADIATION SYNDROME AND SUBSYNDROMES - p. 1242 1183. PHASES - p. 1243 1184. DECONTAMINATION - p. 1244 1185. ACUTE RADIATION ILLNESS AND TRAUMA - p. 1246 1186. MANAGEMENT SUMMARY - p. 1247 1187. Chapter 128: Interactive Multiple Choice Question - p. 1249 1188. Chapter 129 Critical Care Consequences of Weapons (or Agents) of Mass Destruction—Biological Agents of Mass Destruction - p. 1249 1189. INTRODUCTION - p. 1249 1190. SMALLPOX - p. 1250 1191. ANTHRAX - p. 1254 1192. TULAREMIA - p. 1259 1193. PLAGUE - p. 1261 1194. BOTULINUM TOXIN - p. 1266 1195. RICIN - p. 1268 1196. Chapter 129: Interactive Multiple Choice Question - p. 1272 1197. SECTION 12 ICU DESIGN, ORGANIZATION, OPERATION AND OUTCOME MEASURES - p. 1273 1198. Chapter 130 Intensive Care Unit Design: Current Standards and Future Trends - p. 1273 1199. INTRODUCTION - p. 1273 1200. THE ICU DESIGN PROCESS - p. 1273 1201. THE ICU PATIENT ROOM - p. 1274 1202. CENTRAL SUPPORT AREAS - p. 1279 1203. ICU INFORMATICS - p. 1281 1204. FUTURE TRENDS - p. 1283 1205. CONCLUSIONS - p. 1284 1206. Chapter 130: Interactive Multiple Choice Question - p. 1285 1207. Chapter 131 Intensive Care Unit Organization and Management - p. 1285 1208. INTRODUCTION - p. 1285 1209. ICU ORGANIZATION - p. 1286 1210. ROLE OF THE ICU DIRECTOR - p. 1287 1211. ICU PROVIDER STAFFING - p. 1287 1212. ICU TELEMEDICINE - p. 1288 1213. PHYSICIAN HUMAN RESOURCE ISSUES - p. 1288 1214. MULTIDISCIPLINARY MODELS: ADVANCED PRACTITIONERS - p. 1289 1215. BUDGET AND PROFESSIONAL REIMBURSEMENT ISSUES - p. 1289 1216. MONITORING CLINICAL CARE - p. 1290 1217. CRITICAL CARE OUTREACH SERVICE AND EARLY WARNING SYSTEMS - p. 1291 1218. OPERATIONAL ISSUES - p. 1291 1219. QUALITY IMPROVEMENT INITIATIVES - p. 1291 1220. SUMMARY - p. 1291 1221. Chapter 131: Interactive Multiple Choice Question - p. 1294 1222. Chapter 132 Critical Care Information Systems (Systems of Engagement and Insight): Structure, Function, and Future - p. 1295 1223. INTRODUCTION - p. 1295 1224. SYSTEMS OF RECORD (CORE EMR) AND SYSTEMS OF ENGAGEMENT (CRITICAL CARE INFORMATION SYSTEMS) - p. 1296 1225. TELE-ICU SYSTEMS - p. 1297 1226. ON-DEMAND/CONSULTATIVE TELEMEDICINE - p. 1297 1227. VIGILANCE TELEMEDICINE/REMOTE PATIENT MONITORING - p. 1297 1228. SYSTEMS OF INSIGHT (DECISION SUPPORT AND ANALYTICS SYSTEMS IN CRITICAL CARE) - p. 1298 1229. PREDICTIVE ANALYTICS - p. 1298 1230. ADVANCES OF DATA VISUALIZATION - p. 1300 1231. GOING FORWARD - p. 1301 1232. ANALYTICAL REPOSITORIES AND REPORTING TOOLS - p. 1302 1233. RISK ADJUSTMENT MODELS FOR COMPARING ICU OUTCOMES - p. 1303 1234. Chapter 132: Interactive Multiple Choice Question - p. 1304 1235. Chapter 133 Defining and Measuring Patient Safety in the Critical Care Unit - p. 1305 1236. INTRODUCTION - p. 1305 1237. SAFETY LESSONS FROM OTHER INDUSTRIES - p. 1305 1238. DEFINITIONS - p. 1305 1239. MEASUREMENT OF SAFETY IN THE INTENSIVE CARE UNIT - p. 1306 1240. INCIDENT REPORTING - p. 1306 1241. TARGETED MONITORING - p. 1307 1242. DISCHARGE DATA - p. 1307 1243. PROCESS OF CARE MEASUREMENT - p. 1307 1244. INTENSIVE CARE UNIT AUDITS - p. 1307 1245. TRIGGER TOOLS - p. 1308 1246. LIMITATIONS OF EXISTING METRICS AND THEIR APPLICATIONS - p. 1308 1247. INTENSIVE CARE UNIT ORGANIZATION - p. 1308 1248. 24/7 COVERAGE BY AN INTENSIVIST - p. 1308 1249. INTENSIVIST-TO-PATIENT RATIOS - p. 1308 1250. INTENSIVISTS OUTSIDE THE WALLS OF THE ICU - p. 1309 1251. NONINTENSIVIST PROVIDERS IN THE ICU - p. 1309 1252. ALTERNATIVE STRATEGIES FOR DELIVERING CRITICAL CARE - p. 1309 1253. PHYSICIAN TRAINING AND DEVELOPMENT OF A CULTURE OF SAFETY - p. 1309 1254. REGULATION AND GOVERNMENT IMPACT ON PATIENT SAFETY - p. 1310 1255. CONCLUSIONS - p. 1311 1256. Chapter 133: Interactive Multiple Choice Question - p. 1313 1257. Chapter 134 Assessing the Impact of Critical Care: Outcomes Research and Methodologies in the Current Era - p. 1314 1258. INTRODUCTION - p. 1314 1259. OUTCOMES IN CRITICAL CARE RESEARCH - p. 1314 1260. METHODS IN OUTCOMES RESEARCH - p. 1318 1261. CONCLUSIONS - p. 1322 1262. Chapter 134: Interactive Multiple Choice Question - p. 1324 1263. Chapter 135 Blockchain Technology and Medical Device Security in the Intensive Care Unit - p. 1325 1264. INTRODUCTION - p. 1325 1265. BLOCKCHAIN DEFINED - p. 1325 1266. PROSPECTIVE ROLE(S) FOR ICU DIAGNOSIS AND PATIENT MANAGEMENT - p. 1326 1267. USE OF REAL-WORLD EVIDENCE TO SUPPORT MEDICAL PRODUCT DEVELOPMENT AND REGULATORY DECISION-MAKING IMPORTANCE TO FDA - p. 1327 1268. KEY MEASURES OF SECURITY AND SAFETY - p. 1327 1269. BLOCKCHAINS IN HEALTH CARE/CURRENT SCOPE OF PRACTICE - p. 1328 1270. THOUGHTS ON BLOCKCHAIN EVALUATION - p. 1329 1271. SUMMARY AND CONCLUSIONS - p. 1329 1272. Chapter 135: Interactive Multiple Choice Question - p. 1329 1273. SECTION 13 ENDOCRINE PROBLEMS IN THE INTENSIVE CARE UNIT - p. 1330 1274. Chapter 136 Management of Hyperglycemia in Critically Ill Patients - p. 1330 1275. INTRODUCTION - p. 1330 1276. ETIOLOGY AND PATHOPHYSIOLOGY - p. 1330 1277. DIAGNOSIS OF HYPERGLYCEMIA FOR THE INTENSIVE CARE UNIT PATIENT - p. 1331 1278. TREATMENT OF CRITICALLY ILL PATIENTS WITH PREEXISTING DIABETES - p. 1331 1279. SURGERY IN THE CRITICALLY ILL PATIENT WITH DIABETES - p. 1334 1280. PITFALLS IN THE CARE OF THE CRITICALLY ILL PATIENT WITH HYPERGLYCEMIA - p. 1335 1281. CONCLUSIONS - p. 1336 1282. Chapter 136: Interactive Multiple Choice Question - p. 1337 1283. Chapter 137 Diabetic Comas: Ketoacidosis and Hyperosmolar Hyperglycemic State - p. 1338 1284. INTRODUCTION - p. 1338 1285. DIABETIC KETOACIDOSIS - p. 1338 1286. HYPERGLYCEMIC HYPEROSMOLAR SYNDROME - p. 1344 1287. CONCLUSIONS - p. 1347 1288. Chapter 137: Interactive Multiple Choice Question - p. 1349 1289. Chapter 138 Hypoglycemia - p. 1350 1290. DEFINITION OF HYPOGLYCEMIA - p. 1350 1291. SYMPTOMS AND SIGNS OF HYPOGLYCEMIA - p. 1350 1292. NORMAL GLUCOSE REGULATORY PHYSIOLOGY - p. 1350 1293. CLASSIFICATION OF HYPOGLYCEMIA - p. 1351 1294. DIFFERENTIAL DIAGNOSIS OF HYPOGLYCEMIA - p. 1352 1295. LABORATORY DIAGNOSIS OF HYPOGLYCEMIA - p. 1358 1296. MANAGEMENT OF HYPOGLYCEMIA - p. 1359 1297. PREVENTION OF HYPOGLYCEMIA IN THE ICU - p. 1360 1298. CONCLUSION - p. 1360 1299. Chapter 138: Interactive Multiple Choice Question - p. 1364 1300. Chapter 139 Hypoadrenal Crisis and the Stress Management of the Patient on Chronic Steroid Therapy - p. 1365 1301. INTRODUCTION - p. 1365 1302. ETIOLOGY - p. 1365 1303. DIAGNOSIS: CLINICAL PRESENTATION AND DIAGNOSTIC WORKUP - p. 1366 1304. DIAGNOSTIC WORKUP - p. 1366 1305. TREATMENT - p. 1367 1306. GLUCOCORTICOID USE FOR STRESSED PATIENTS ON GLUCOCORTICOID TREATMENT - p. 1367 1307. CRITICAL ILLNESS–RELATED CORTICOSTEROID INSUFFICIENCY - p. 1367 1308. Chapter 139: Interactive Multiple Choice Question - p. 1368 1309. Chapter 140 Disorders of Mineral Metabolism - p. 1368 1310. CALCIUM DISORDERS - p. 1369 1311. MAGNESIUM DISORDERS - p. 1372 1312. PHOSPHORUS DISORDERS - p. 1373 1313. Chapter 140: Interactive Multiple Choice Question - p. 1374 1314. Chapter 141 Severe Hyperthyroidism - p. 1375 1315. INTRODUCTION - p. 1375 1316. RISK FACTORS - p. 1375 1317. CLINICAL MANIFESTATIONS - p. 1375 1318. DIAGNOSIS AND DIFFERENTIAL DIAGNOSIS - p. 1375 1319. TREATMENT - p. 1376 1320. CONCLUSIONS - p. 1377 1321. Chapter 141: Interactive Multiple Choice Question - p. 1378 1322. Chapter 142 Myxedema Coma - p. 1378 1323. INTRODUCTION - p. 1378 1324. ETIOLOGY AND PATHOPHYSIOLOGY - p. 1378 1325. CLINICAL MANIFESTATIONS - p. 1379 1326. DIAGNOSIS AND DIFFERENTIAL DIAGNOSIS - p. 1379 1327. TREATMENT - p. 1379 1328. Chapter 142: Interactive Multiple Choice Question - p. 1382 1329. Chapter 143 Nonthyroidal Illness Syndrome (Sick Euthyroid Syndrome) in the Intensive Care Unit - p. 1382 1330. INTRODUCTION - p. 1382 1331. NORMAL THYROID HORMONE ECONOMY - p. 1383 1332. THYROID HORMONE ECONOMY WITH CRITICAL ILLNESS - p. 1384 1333. ALTERATIONS OF THYROID FUNCTION IN SPECIFIC CRITICAL ILLNESSES - p. 1388 1334. MANAGEMENT OF THE CRITICALLY ILL PATIENT WITH ABNORMAL THYROID FUNCTION TESTS - p. 1389 1335. TREATMENT OF THE SICK EUTHYROID SYNDROME WITH THYROID HORMONE - p. 1391 1336. SUMMARY - p. 1393 1337. Chapter 143: Interactive Multiple Choice Question - p. 1396 1338. SECTION 14 NEUROLOGIC PROBLEMS IN THE INTENSIVE CARE UNIT - p. 1397 1339. Chapter 144 An Approach to Neurologic Problems in the Intensive Care Unit - p. 1397 1340. INTRODUCTION - p. 1397 1341. INDICATIONS FOR NEUROLOGIC CONSULTATION IN THE INTENSIVE CARE UNIT - p. 1397 1342. PROGNOSTIC AND ETHICAL CONSIDERATIONS - p. 1399 1343. Chapter 144: Interactive Multiple Choice Question - p. 1400 1344. Chapter 145 Evaluating the Patient With Altered Consciousness in the Intensive Care Unit - p. 1400 1345. ALTERED STATES OF CONSCIOUSNESS - p. 1401 1346. BEDSIDE EVALUATION OF THE COMATOSE PATIENT - p. 1408 1347. INTERPRETATION OF THE NEUROLOGIC EXAMINATION - p. 1411 1348. ANCILLARY TESTS - p. 1411 1349. INITIATION OF EMERGENCY TREATMENT - p. 1412 1350. PROGNOSTICATION - p. 1412 1351. CONCLUSION - p. 1414 1352. Chapter 145: Interactive Multiple Choice Question - p. 1415 1353. Chapter 146 Metabolic Encephalopathy - p. 1416 1354. INTRODUCTION - p. 1416 1355. EVALUATION - p. 1416 1356. ETIOLOGY - p. 1419 1357. CONCLUSIONS - p. 1423 1358. Chapter 146: Interactive Multiple Choice Question - p. 1424 1359. Chapter 147 Mental Status Dysfunction in the Intensive Care Unit: Postoperative Cognitive Impairment - p. 1424 1360. INTRODUCTION - p. 1424 1361. MENTAL STATUS EXAMINATION IN THE INTENSIVE CARE UNIT - p. 1425 1362. MENTAL STATUS DYSFUNCTION IN THE INTENSIVE CARE UNIT - p. 1426 1363. RISK FACTORS - p. 1427 1364. INTERVENTIONS - p. 1427 1365. SUMMARY - p. 1428 1366. Chapter 147: Interactive Multiple Choice Question - p. 1428 1367. Chapter 148 Generalized Anoxia/Ischemia of the Nervous System - p. 1429 1368. INTRODUCTION - p. 1429 1369. PATHOGENESIS - p. 1429 1370. DIAGNOSIS - p. 1429 1371. CLINICAL COURSE AND PROGNOSIS - p. 1429 1372. TREATMENT - p. 1430 1373. SUMMARY - p. 1431 1374. Chapter 148: Interactive Multiple Choice Question - p. 1432 1375. Chapter 149 Cerebrovascular Diseases - p. 1432 1376. INTRODUCTION - p. 1432 1377. ISCHEMIC CEREBROVASCULAR DISEASE - p. 1432 1378. INTRACEREBRAL HEMORRHAGE - p. 1438 1379. Chapter 149: Interactive Multiple Choice Question - p. 1442 1380. Chapter 150 Subarachnoid Hemorrhage - p. 1443 1381. INTRODUCTION - p. 1443 1382. EPIDEMIOLOGY - p. 1443 1383. PATHOGENESIS - p. 1443 1384. CLINICAL PRESENTATION - p. 1444 1385. CLINICAL AND RADIOLOGIC GRADING - p. 1444 1386. DIAGNOSTIC EVALUATION - p. 1444 1387. ANEURYSM MANAGEMENT - p. 1445 1388. NEUROLOGICAL COMPLICATIONS - p. 1445 1389. GENERAL ICU MANAGEMENT - p. 1447 1390. HIGH-VOLUME SAH CENTERS - p. 1448 1391. Chapter 150: Interactive Multiple Choice Question - p. 1449 1392. Chapter 151 Status Epilepticus - p. 1449 1393. INTRODUCTION - p. 1449 1394. ETIOLOGY - p. 1450 1395. PROGNOSIS AND SEQUELAE OF STATUS EPILEPTICUS - p. 1450 1396. SYSTEMIC COMPLICATIONS - p. 1451 1397. DIAGNOSIS - p. 1451 1398. INITIAL ASSESSMENT - p. 1452 1399. MEDICAL MANAGEMENT - p. 1452 1400. CONCLUSIONS - p. 1456 1401. Chapter 151: Interactive Multiple Choice Question - p. 1457 1402. Chapter 152 Guillain-Barré Syndrome - p. 1457 1403. INTRODUCTION - p. 1457 1404. DIAGNOSIS - p. 1457 1405. DIFFERENTIAL DIAGNOSIS - p. 1459 1406. PATHOGENESIS - p. 1461 1407. PATHOLOGY - p. 1461 1408. NATURAL HISTORY - p. 1462 1409. MANAGEMENT - p. 1462 1410. OUTCOME AND PROGNOSTIC FACTORS - p. 1464 1411. SUMMARY - p. 1465 1412. Chapter 152: Interactive Multiple Choice Question - p. 1466 1413. Chapter 153 Myasthenia Gravis in the Intensive Care Unit - p. 1467 1414. INTRODUCTION - p. 1467 1415. PATHOGENESIS - p. 1467 1416. EPIDEMIOLOGY - p. 1467 1417. CLINICAL SPECTRUM - p. 1467 1418. DIAGNOSTIC STUDIES - p. 1467 1419. MISCELLANEOUS STUDIES - p. 1468 1420. CRITICAL CARE OF THE MYASTHENIC PATIENT - p. 1469 1421. THERAPY FOR MYASTHENIC CRISIS - p. 1469 1422. BIOLOGICAL THERAPIES - p. 1472 1423. PERIOPERATIVE MANAGEMENT OF THE MYASTHENIC PATIENT - p. 1473 1424. CONCLUSION - p. 1474 1425. Chapter 153: Interactive Multiple Choice Question - p. 1475 1426. Chapter 154 Newly Acquired Weakness in the Intensive Care Unit: Critical Illness Myopathy and Neuropathy - p. 1475 1427. INTRODUCTION - p. 1475 1428. CRITICAL ILLNESS MYOPATHY - p. 1475 1429. CRITICAL ILLNESS POLYNEUROPATHY - p. 1477 1430. THE DIAGNOSTIC CHALLENGE: DISTINGUISHING CRITICAL ILLNESS MYOPATHY FROM CRITICAL ILLNESS POLYNEUROPATHY - p. 1478 1431. Chapter 154: Interactive Multiple Choice Question - p. 1478 1432. Chapter 155 Neuro-oncological Problems in the Intensive Care Unit - p. 1479 1433. INTRODUCTION - p. 1479 1434. ELEVATED INTRACRANIAL PRESSURE - p. 1479 1435. HYDROCEPHALUS - p. 1483 1436. SEIZURES - p. 1485 1437. POSTOPERATIVE COMPLICATIONS - p. 1486 1438. SPINAL TUMORS - p. 1488 1439. SYSTEMIC COMPLICATIONS - p. 1489 1440. END-OF-LIFE IN THE ICU - p. 1489 1441. Chapter 155: Interactive Multiple Choice Question - p. 1491 1442. Chapter 156 Miscellaneous Neurological Problems in the Intensive Care Unit - p. 1491 1443. INTRODUCTION - p. 1491 1444. SUICIDAL HANGING - p. 1491 1445. ELECTRICAL INJURIES - p. 1492 1446. CARBON MONOXIDE POISONING - p. 1494 1447. DECOMPRESSION SICKNESS - p. 1495 1448. CEREBRAL FAT EMBOLISM SYNDROME - p. 1495 1449. SINGULTUS (HICCUPS) - p. 1496 1450. COMPRESSION NEUROPATHIES - p. 1497 1451. Chapter 156: Interactive Multiple Choice Question - p. 1498 1452. SECTION 15 PSYCHIATRIC ISSUES IN THE INTENSIVE CARE UNIT - p. 1499 1453. Chapter 157 Diagnosis and Treatment of Agitation and Delirium in the Intensive Care Unit Patient - p. 1499 1454. INTRODUCTION - p. 1499 1455. TERMS - p. 1499 1456. OTHER CAUSES OF AGITATION - p. 1504 1457. NONPHARMACOLOGICAL TREATMENT OF AGITATION - p. 1505 1458. LONG-TERM SEQUELAE - p. 1505 1459. CONCLUSION - p. 1506 1460. Chapter 157: Interactive Multiple Choice Question - p. 1507 1461. Chapter 158 Diagnosis and Treatment of Anxiety in the Intensive Care Unit Patient - p. 1508 1462. PHYSIOLOGICAL EXPRESSIONS OF ANXIETY - p. 1508 1463. MEDICAL CAUSES OF ANXIETY - p. 1508 1464. SCENARIOS IN WHICH ANXIETY SIGNIFICANTLY AFFECTS OUTCOMES OF MEDICAL ILLNESS - p. 1509 1465. ANXIETY DISORDERS SPECIFIC TO THE INTENSIVE CARE UNIT - p. 1511 1466. TREATMENT OF ANXIETY DURING AN INTENSIVE CARE UNIT STAY - p. 1512 1467. CONCLUSIONS - p. 1513 1468. Chapter 158: Interactive Multiple Choice Question - p. 1515 1469. Chapter 159 Diagnosis and Treatment of Depression in the Intensive Care Unit Patient - p. 1516 1470. INTRODUCTION - p. 1516 1471. DIAGNOSIS OF DEPRESSION - p. 1516 1472. DIFFERENTIAL DIAGNOSIS OF DEPRESSION - p. 1517 1473. LABORATORY EVALUATION OF DEPRESSION - p. 1519 1474. TREATMENT OF DEPRESSION - p. 1521 1475. SUMMARY - p. 1531 1476. Chapter 159: Interactive Multiple Choice Question - p. 1533 1477. Chapter 160 Managing the Suicidal Patient in the Intensive Care Unit - p. 1534 1478. INTRODUCTION - p. 1534 1479. EPIDEMIOLOGY OF SUICIDE - p. 1534 1480. RISK AND PROTECTIVE FACTORS - p. 1534 1481. PARASUICIDE - p. 1535 1482. TREATMENT OF THE SUICIDAL PATIENT - p. 1535 1483. CONCLUSIONS - p. 1536 1484. Chapter 160: Interactive Multiple Choice Question - p. 1536 1485. Chapter 161 Problematic Behaviors of Patients, Family, and Staff in the Intensive Care Unit - p. 1537 1486. INTRODUCTION - p. 1537 1487. APPROACH TO PROBLEMATIC BEHAVIORS - p. 1537 1488. COMMON PATTERNS OF PROBLEMATIC BEHAVIOR - p. 1538 1489. COMMUNICATION WITH FAMILIES - p. 1541 1490. CONCLUSION - p. 1542 1491. Chapter 161: Interactive Multiple Choice Question - p. 1543 1492. Chapter 162 Recognition and Management of Staff Stress in the Intensive Care Unit - p. 1543 1493. INTRODUCTION - p. 1543 1494. STRESS - p. 1543 1495. BURNOUT SYNDROME - p. 1544 1496. STRESS AND BURNOUT IN HEALTH CARE PROFESSIONALS - p. 1544 1497. STRESS AND BURNOUT AMONG INTENSIVISTS - p. 1545 1498. STRESS AND BURNOUT AMONG INTENSIVE CARE UNIT NURSES - p. 1545 1499. STAFF STRESS AND BURNOUT DURING COVID-19 IN THE INTENSIVE CARE UNIT - p. 1546 1500. MANAGEMENT OF STAFF STRESS AND BURNOUT IN THE INTENSIVE CARE UNIT - p. 1546 1501. CONCLUSIONS - p. 1546 1502. Chapter 162: Interactive Multiple Choice Question - p. 1547 1503. SECTION 16 Pulmonary Problems in the Intensive Care Unit - p. 1548 1504. Chapter 163 Acute Respiratory Failure Due to Acute Respiratory Distress Syndrome and Pulmonary Edema - p. 1548 1505. INTRODUCTION - p. 1548 1506. DEFINITION - p. 1548 1507. HISTOPATHOLOGY - p. 1549 1508. RADIOGRAPHIC FINDINGS - p. 1550 1509. EPIDEMIOLOGY - p. 1551 1510. PATHOGENESIS - p. 1551 1511. PATHOPHYSIOLOGY - p. 1552 1512. MANAGEMENT - p. 1553 1513. PROSPECTIVE FUTURE THERAPIES - p. 1559 1514. PROGNOSIS AND OUTCOMES - p. 1559 1515. CONCLUSIONS - p. 1562 1516. Chapter 163: Interactive Multiple Choice Question - p. 1565 1517. Chapter 164 Acute Respiratory Failure in Pregnancy - p. 1566 1518. INTRODUCTION - p. 1566 1519. CAUSES OF ACUTE RESPIRATORY FAILURE - p. 1569 1520. DIAGNOSTIC TESTING - p. 1573 1521. TREATMENT - p. 1574 1522. PREVENTION - p. 1579 1523. Chapter 164: Interactive Multiple Choice Question - p. 1581 1524. Chapter 165 Extrapulmonary Causes of Respiratory Failure - p. 1582 1525. INTRODUCTION - p. 1582 1526. PATHOPHYSIOLOGY - p. 1582 1527. DIAGNOSIS - p. 1582 1528. DIFFERENTIAL DIAGNOSIS - p. 1591 1529. TREATMENT - p. 1591 1530. Chapter 165: Interactive Multiple Choice Question - p. 1592 1531. Chapter 166 Invasive Mechanical Ventilation and Extracorporeal Life support for Respiratory Failure - p. 1593 1532. INTRODUCTION - p. 1593 1533. MODES OF MECHANICAL VENTILATION - p. 1593 1534. Chapter 166: Interactive Multiple Choice Question - p. 1611 1535. Chapter 167 Mechanical Ventilation—Part II: Noninvasive Mechanical Ventilation for the Adult Hospitalized Patient - p. 1611 1536. INTRODUCTION - p. 1611 1537. TERMINOLOGY - p. 1612 1538. WHY NONINVASIVE MECHANICAL VENTILATION - p. 1612 1539. UTILIZATION AND EPIDEMIOLOGY - p. 1612 1540. INDICATIONS FOR ACUTE APPLICATIONS OF NONINVASIVE VENTILATION - p. 1613 1541. WEAKER INDICATIONS—NONINVASIVE VENTILATION IS AN OPTION - p. 1614 1542. SELECTION GUIDELINES FOR NONINVASIVE VENTILATION IN ACUTE RESPIRATORY FAILURE - p. 1617 1543. TECHNIQUES AND EQUIPMENT FOR NONINVASIVE VENTILATION - p. 1618 1544. MONITORING - p. 1622 1545. SUMMARY AND RECOMMENDATIONS - p. 1625 1546. Chapter 167: Interactive Multiple Choice Question - p. 1628 1547. Chapter 168 Discontinuation of Mechanical Ventilation - p. 1629 1548. INTRODUCTION - p. 1629 1549. UNDERSTANDING THE PROBLEM - p. 1629 1550. PREDICTING SUCCESSFUL DISCONTINUATION - p. 1630 1551. POSTEXTUBATION MANAGEMENT AND RESPIRATORY SUPPORT - p. 1633 1552. COMBINATION OF HIGH-FLOW NASAL CANNULA OXYGEN AND NONINVASIVE POSITIVE PRESSURE VENTILATION - p. 1634 1553. MANAGING DISCONTINUATION FAILURE - p. 1634 1554. Chapter 168: Interactive Multiple Choice Question - p. 1638 1555. Chapter 169 Respiratory Adjunctive Therapies - p. 1639 1556. INTRODUCTION - p. 1639 1557. AEROSOL THERAPY - p. 1639 1558. LUNG-EXPANSION TECHNIQUES - p. 1644 1559. AIRWAY CLEARANCE - p. 1644 1560. ADMINISTRATION OF MEDICAL GASES - p. 1647 1561. CONTINUOUS POSITIVE AIRWAY PRESSURE FOR SLEEP-RELATED BREATHING DISORDERS - p. 1650 1562. COMMUNICATION ALTERNATIVES FOR THE PATIENT WITH AN ARTIFICIAL AIRWAY - p. 1651 1563. Chapter 169: Interactive Multiple Choice Question - p. 1654 1564. Chapter 170 Aspiration - p. 1654 1565. INTRODUCTION - p. 1654 1566. NORMAL DEFENSES AGAINST ASPIRATION AND THE MANNER IN WHICH THEY MAY FAIL - p. 1654 1567. PREVALENCE OF ASPIRATION AMONG THE CRITICALLY ILL - p. 1656 1568. DIAGNOSIS OF AN ASPIRATION SYNDROME - p. 1656 1569. DIFFERENTIAL DIAGNOSIS AND TREATMENT - p. 1657 1570. Chapter 170: Interactive Multiple Choice Question - p. 1660 1571. Chapter 171 Drowning - p. 1660 1572. INTRODUCTION - p. 1660 1573. ETIOLOGY AND PATHOGENESIS - p. 1660 1574. LACK OF LIFE JACKETS AND POOL FENCING - p. 1661 1575. PATHOPHYSIOLOGY - p. 1661 1576. DIAGNOSIS AND CLINICAL PRESENTATION - p. 1663 1577. THERAPIES - p. 1664 1578. CONCLUSIONS - p. 1665 1579. Chapter 171: Interactive Multiple Choice Question - p. 1666 1580. Chapter 172 Acute Exacerbation of Asthma - p. 1666 1581. INTRODUCTION - p. 1666 1582. EPIDEMIOLOGY - p. 1667 1583. PATHOPHYSIOLOGY - p. 1667 1584. DIFFERENTIAL DIAGNOSIS - p. 1668 1585. ASSESSMENT - p. 1668 1586. THERAPEUTIC AGENTS - p. 1670 1587. MANAGEMENT - p. 1672 1588. MANAGEMENT OF SEVERE RESPIRATORY FAILURE - p. 1674 1589. Chapter 172: Interactive Multiple Choice Question - p. 1678 1590. Chapter 173 Critical Care of Acute Exacerbations of Chronic Obstructive Pulmonary Disease - p. 1679 1591. INTRODUCTION - p. 1679 1592. RISK FACTORS FOR ACUTE EXACERBATION OF CHRONIC OBSTRUCTIVE PULMONARY DISEASE - p. 1679 1593. PATHOPHYSIOLOGY - p. 1679 1594. SEVERITY SCORING - p. 1680 1595. ANTIBIOTICS AND BIOMARKERS - p. 1680 1596. MANAGEMENT - p. 1680 1597. EXTRACORPOREAL LIFE SUPPORT, EXTRACORPOREAL CARBON DIOXIDE REMOVAL - p. 1684 1598. Chapter 173: Interactive Multiple Choice Question - p. 1686 1599. Chapter 174 Pulmonary Hypertension in the Intensive Care Unit - p. 1687 1600. INTRODUCTION - p. 1687 1601. CLASSIFICATION/ETIOLOGY - p. 1687 1602. PHYSIOLOGY OF THE PULMONARY CIRCULATION AND RIGHT VENTRICLE - p. 1688 1603. PATHOLOGY AND PATHOGENESIS - p. 1689 1604. DIAGNOSIS - p. 1689 1605. TREATMENT - p. 1690 1606. Chapter 174: Interactive Multiple Choice Question - p. 1693 1607. Chapter 175 Managing Hemoptysis - p. 1694 1608. INTRODUCTION - p. 1694 1609. ETIOLOGY - p. 1694 1610. PATHOGENESIS - p. 1695 1611. DIAGNOSIS - p. 1697 1612. DIFFERENTIAL DIAGNOSIS - p. 1700 1613. TREATMENT - p. 1700 1614. Chapter 175: Interactive Multiple Choice Question - p. 1703 1615. Chapter 176 Pleural Diseases of the Critically Ill Patient - p. 1704 1616. INTRODUCTION - p. 1704 1617. RADIOLOGIC SIGNS OF PLEURAL DISEASE - p. 1704 1618. PLEURAL FLUID - p. 1704 1619. PNEUMOTHORAX - p. 1706 1620. EVALUATION OF THE PATIENT WITH A PLEURAL EFFUSION - p. 1706 1621. PLEURAL EFFUSIONS OF THE CRITICALLY ILL - p. 1707 1622. PNEUMOTHORAX - p. 1714 1623. BRONCHOPLEURAL FISTULA - p. 1716 1624. Chapter 176: Interactive Multiple Choice Question - p. 1719 1625. Chapter 177 Gas Embolism Syndromes - p. 1720 1626. INTRODUCTION - p. 1720 1627. VENOUS GAS EMBOLISM - p. 1720 1628. ARTERIAL GAS EMBOLISM - p. 1725 1629. DECOMPRESSION SICKNESS - p. 1727 1630. Chapter 177: Interactive Multiple Choice Question - p. 1733 1631. Chapter 178 Acute Inhalational Injuries - p. 1733 1632. INTRODUCTION - p. 1734 1633. ASPHYXIANT GASES - p. 1734 1634. IRRITANT GASES - p. 1740 1635. SMOKE - p. 1743 1636. VAPORS - p. 1744 1637. LONG-TERM COMPLICATIONS OF ACUTE INHALATION INJURY - p. 1746 1638. Chapter 178: Interactive Multiple Choice Question - p. 1749 1639. Chapter 179 Chest Radiographic Examination - p. 1750 1640. INTRODUCTION - p. 1750 1641. EVALUATION OF TUBES AND CATHETERS - p. 1750 1642. EVALUATION OF THE LUNG PARENCHYMA - p. 1756 1643. ABNORMALITIES OF THE PLEURA, MEDIASTINUM, AND DIAPHRAGM - p. 1761 1644. CARDIAC ABNORMALITIES - p. 1765 1645. TRAUMA - p. 1766 1646. PULMONARY THROMBOEMBOLISM AND INFARCTION - p. 1770 1647. EXTRAPULMONARY STRUCTURES - p. 1771 1648. Chapter 179: Interactive Multiple Choice Question - p. 1772 1649. Chapter 180 Severe Upper Airway Infections - p. 1772 1650. INTRODUCTION - p. 1773 1651. SINUSITIS - p. 1773 1652. SPHENOID SINUSITIS - p. 1774 1653. OTOGENIC INFECTIONS - p. 1774 1654. SUPRAGLOTTITIS (EPIGLOTTITIS) - p. 1775 1655. INFECTIONS OF THE DEEP SPACES OF THE NECK - p. 1779 1656. Chapter 180: Interactive Multiple Choice Question - p. 1785 1657. Chapter 181 Acute Infectious Pneumonia - p. 1786 1658. INTRODUCTION - p. 1786 1659. TYPES OF PNEUMONIA ENCOUNTERED IN THE INTENSIVE CARE UNIT - p. 1787 1660. PATHOGENESIS OF PNEUMONIA - p. 1790 1661. ETIOLOGY OF PNEUMONIA - p. 1792 1662. CLINICAL FEATURES OF PNEUMONIA - p. 1794 1663. DIAGNOSTIC APPROACH TO THE PATIENT WITH SEVERE PNEUMONIA - p. 1795 1664. THERAPY - p. 1800 1665. STRATEGIES FOR PREVENTION OF PNEUMONIA - p. 1807 1666. Chapter 181: Interactive Multiple Choice Question - p. 1813 1667. Chapter 182 Interventional Pulmonary in the Intensive Care Unit - p. 1814 1668. INTRODUCTION - p. 1814 1669. AIRWAY PROCEDURES - p. 1815 1670. CONCLUSIONS - p. 1826 1671. Chapter 182: Interactive Multiple Choice Question - p. 1827 1672. Chapter 183 Sleep Issues in the Intensive Care Unit Setting - p. 1828 1673. INTRODUCTION - p. 1828 1674. OVERVIEW OF NORMAL ADULT SLEEP - p. 1828 1675. SLEEP IN THE INTENSIVE CARE UNIT - p. 1829 1676. CONSEQUENCES OF DISRUPTED SLEEP IN THE ICU - p. 1834 1677. METHODS TO IMPROVE SLEEP IN THE INTENSIVE CARE UNIT - p. 1834 1678. Chapter 183: Interactive Multiple Choice Question - p. 1839 1679. Chapter 184 Disorders of Temperature Control, Part I: Hypothermia - p. 1840 1680. INTRODUCTION - p. 1840 1681. NORMAL PHYSIOLOGY OF TEMPERATURE REGULATION - p. 1840 1682. UNINTENTIONAL HYPOTHERMIA - p. 1841 1683. IATROGENIC HYPOTHERMIA - p. 1847 1684. INTENTIONAL HYPOTHERMIA - p. 1849 1685. Chapter 184: Interactive Multiple Choice Question - p. 1852 1686. Chapter 185 Disorders of Temperature Control, Part II: Hyperthermia - p. 1853 1687. INTRODUCTION - p. 1853 1688. HEAT STROKE - p. 1853 1689. MALIGNANT HYPERTHERMIA - p. 1856 1690. NEUROLEPTIC MALIGNANT SYNDROME - p. 1858 1691. DRUG-INDUCED HYPERTHERMIA - p. 1861 1692. HYPERTHERMIA AND FEVER CONTROL AFTER BRAIN INJURY - p. 1863 1693. Chapter 185: Interactive Multiple Choice Question - p. 1866 1694. SECTION 17 CARDIOVASCULAR PROBLEMS AND CORONARY CARE - p. 1867 1695. Chapter 186 Evolution of the Modern Cardiovascular Intensive Care Unit - p. 1867 1696. INTRODUCTION - p. 1867 1697. FROM CORONARY TO INTENSIVE CARE - p. 1867 1698. UNDERSTANDING THE NEEDS OF TODAY’S CICU - p. 1869 1699. CONCLUSIONS - p. 1871 1700. Chapter 186: Interactive Multiple Choice Question - p. 1872 1701. Chapter 187 Unstable Angina/Non–ST-Segment Elevation Myocardial Infarction, the Non–ST-Elevation Acute Coronary Syndromes - p. 1872 1702. INTRODUCTION - p. 1872 1703. DEFINITION - p. 1873 1704. PATHOPHYSIOLOGY - p. 1873 1705. CLINICAL PRESENTATION AND DIAGNOSIS - p. 1874 1706. RISK STRATIFICATION - p. 1875 1707. MEDICAL THERAPIES - p. 1876 1708. TREATMENT STRATEGIES AND INTERVENTIONS - p. 1881 1709. CONCLUSIONS - p. 1882 1710. Chapter 187: Interactive Multiple Choice Question - p. 1885 1711. Chapter 188 ST-Segment Elevation Myocardial Infarction - p. 1886 1712. INTRODUCTION - p. 1886 1713. PATHOPHYSIOLOGY - p. 1886 1714. DIAGNOSIS AND RISK ASSESSMENT - p. 1887 1715. REPERFUSION THERAPY - p. 1888 1716. ADJUNCTIVE ANTIPLATELET AND ANTITHROMBOTIC THERAPY - p. 1896 1717. ANTI-ISCHEMIC THERAPY - p. 1898 1718. ARRHYTHMIAS COMPLICATING ST ELEVATION MYOCARDIAL INFARCTION - p. 1900 1719. TRANSITION TO DISCHARGE - p. 1902 1720. Chapter 188: Interactive Multiple Choice Question - p. 1904 1721. Chapter 189 Mechanical Complications of Myocardial Infarction - p. 1904 1722. INTRODUCTION - p. 1904 1723. MECHANICAL COMPLICATIONS INVOLVING MYOCARDIAL RUPTURE - p. 1905 1724. MECHANICAL COMPLICATIONS OF ACUTE MYOCARDIAL INFARCTION WITHOUT RUPTURE - p. 1908 1725. SUMMARY OF RECOMMENDATIONS BASED ON PROFESSIONAL GUIDELINES - p. 1909 1726. Chapter 189: Interactive Multiple Choice Question - p. 1911 1727. Chapter 190 Management of Acute Decompensated Heart Failure - p. 1911 1728. DEFINITION/EPIDEMIOLOGY - p. 1911 1729. PREDICTORS OF PROGNOSIS - p. 1912 1730. ASSESSMENT OF CONGESTION IN ADHF - p. 1913 1731. PHARMACOLOGICAL MANAGEMENT OF ADHF - p. 1913 1732. TRAJECTORY OF ADHF HOSPITAL COURSE - p. 1918 1733. INTENSIVE CARE MANAGEMENT OF ADVANCED ACUTE DECOMPENSATED HEART FAILURE - p. 1919 1734. CONCLUSIONS - p. 1921 1735. Chapter 190: Interactive Multiple Choice Question - p. 1923 1736. Chapter 191 Pharmacological Management of Shock and Hypotension - p. 1924 1737. INTRODUCTION - p. 1924 1738. GENERAL APPROACH TO THE HYPOTENSIVE PATIENT IN THE CARDIAC INTENSIVE CARE UNIT - p. 1924 1739. ADRENERGIC RECEPTOR PHYSIOLOGY - p. 1925 1740. COMMONLY USED VASOPRESSORS AND POSITIVE INOTROPES - p. 1925 1741. CHOOSING AN AGENT - p. 1933 1742. CLINICAL USE OF VASOACTIVE DRUGS - p. 1938 1743. Chapter 191: Interactive Multiple Choice Question - p. 1940 1744. Chapter 192 Mechanical Circulatory Support for Cardiogenic Shock - p. 1940 1745. INTRODUCTION - p. 1941 1746. RATIONALE FOR MCS - p. 1941 1747. INDICATIONS AND CONTRAINDICATIONS FOR TEMPORARY MCS - p. 1941 1748. EPIDEMIOLOGY OF TEMPORARY MCS - p. 1942 1749. AVAILABLE TEMPORARY MCS DEVICES - p. 1942 1750. GENERAL PRINCIPLES OF PATIENT AND DEVICE SELECTION AND TIMING OF DEVICE DEPLOYMENT - p. 1949 1751. CONSIDERATIONS FOR MCS DEVICE SELECTION - p. 1950 1752. COMPLICATIONS OF MECHANICAL CIRCULATORY SUPPORT - p. 1952 1753. MONITORING AND MITIGATING THE RISK OF MCS-RELATED COMPLICATIONS - p. 1953 1754. WEANING MCS - p. 1954 1755. LONG-TERM MCS - p. 1955 1756. SUMMARY - p. 1956 1757. Chapter 192: Interactive Multiple Choice Question - p. 1958 1758. Chapter 193 Valvular Heart Disease - p. 1958 1759. INTRODUCTION - p. 1958 1760. AORTIC STENOSIS - p. 1959 1761. CARDIAC CT - p. 1962 1762. AORTIC REGURGITATION - p. 1964 1763. MITRAL STENOSIS - p. 1966 1764. MITRAL REGURGITATION - p. 1968 1765. TRICUSPID REGURGITATION - p. 1971 1766. PROSTHETIC VALVE DYSFUNCTION - p. 1971 1767. Chapter 193: Interactive Multiple Choice Question - p. 1976 1768. Chapter 194 Acute Aortic Syndromes - p. 1976 1769. INTRODUCTION - p. 1976 1770. AORTIC DISSECTION - p. 1976 1771. CLASSIC AORTIC DISSECTION - p. 1978 1772. INTRAMURAL HEMATOMA - p. 1984 1773. EXPANDING AORTIC ANEURYSM AND RUPTURE - p. 1987 1774. ANEURYSMS OF THE THORACIC AORTA - p. 1988 1775. ANEURYSMS OF THE ABDOMINAL AORTA - p. 1990 1776. SUMMARY OF SELECTED RECOMMENDATIONS BASED ON PROFESSIONAL SOCIETY GUIDELINES - p. 1991 1777. Chapter 194: Interactive Multiple Choice Question - p. 1993 1778. Chapter 195 Management of the Cardiac Arrest Survivor - p. 1994 1779. THE ROLE OF CORONARY ANGIOGRAPHY - p. 1994 1780. HEMODYNAMIC TARGETS - p. 1995 1781. TEMPERATURE CONTROL AFTER CARDIAC ARREST - p. 1995 1782. NEUROLOGICAL PROGNOSTICATION - p. 1998 1783. LONG-TERM RECOVERY - p. 2000 1784. CONCLUSION - p. 2002 1785. Chapter 195: Interactive Multiple Choice Question - p. 2003 1786. Chapter 196 Management of Common Arrhythmias in the Intensive Care Unit - p. 2004 1787. INTRODUCTION - p. 2004 1788. SECTION I: VENTRICULAR ARRHYTHMIAS - p. 2004 1789. SECTION II: SUPRAVENTRICULAR TACHYCARDIA - p. 2012 1790. SECTION III: BRADYARRHYTHMIAS - p. 2018 1791. SUMMARY - p. 2020 1792. Chapter 196: Interactive Multiple Choice Question - p. 2020 1793. Chapter 197 Management of Cardiac Devices in the ICU - p. 2021 1794. INTRODUCTION - p. 2021 1795. GENERAL DEVICE MANAGEMENT - p. 2021 1796. DEVICE-SPECIFIC CONSIDERATIONS - p. 2029 1797. Chapter 197: Interactive Multiple Choice Question - p. 2032 1798. SECTION 18 RENAL PROBLEMS IN THE INTENSIVE CARE UNIT - p. 2033 1799. Chapter 198 Metabolic Acidosis and Metabolic Alkalosis - p. 2033 1800. INTRODUCTION - p. 2033 1801. METABOLIC ACIDOSIS - p. 2034 1802. METABOLIC ALKALOSIS - p. 2040 1803. Chapter 198: Interactive Multiple Choice Question - p. 2043 1804. Chapter 199 Disorders of Plasma Sodium and Plasma Potassium - p. 2044 1805. DISORDERS OF PLASMA SODIUM - p. 2044 1806. RELATIONSHIP BETWEEN PLASMA NA+ AND PLASMA OSMOLALITY - p. 2044 1807. REGULATION OF PLASMA OSMOLALITY - p. 2045 1808. REGULATION OF ANTIDIURETIC HORMONE - p. 2045 1809. HYPONATREMIA - p. 2046 1810. RENAL HYPOPERFUSION-INDUCED HYPONATREMIA - p. 2046 1811. DIURETIC-INDUCED HYPONATREMIA - p. 2046 1812. ADVANCED CHRONIC KIDNEY DISEASE - p. 2047 1813. ENDOCRINE DEFICIENCY - p. 2047 1814. SYNDROME OF INAPPROPRIATE ANTIDIURETIC HORMONE SECRETION - p. 2047 1815. CEREBRAL SALT WASTING - p. 2048 1816. REDUCED SOLUTE INTAKE - p. 2048 1817. PRIMARY POLYDIPSIA - p. 2048 1818. HYPONATREMIA WITHOUT HYPOOSMOLALITY - p. 2048 1819. SYMPTOMS OF HYPOOSMOLALITY - p. 2049 1820. DIAGNOSIS OF HYPONATREMIA - p. 2049 1821. TREATMENT OF HYPONATREMIA - p. 2050 1822. EFFECTS OF POTASSIUM - p. 2050 1823. RISK OF OSMOTIC DEMYELINATION - p. 2050 1824. RECOMMENDATIONS - p. 2051 1825. UREA - p. 2052 1826. ADH-V2 ANTAGONISTS - p. 2052 1827. TREATMENT OF HYPONATREMIA IN EDEMATOUS STATES - p. 2052 1828. CONGESTIVE HEART FAILURE - p. 2052 1829. LIVER DISEASE - p. 2052 1830. HYPERNATREMIA - p. 2053 1831. ETIOLOGY OF HYPERNATREMIA - p. 2053 1832. FREE WATER LOSS - p. 2053 1833. WATER LOSS INTO CELLS - p. 2054 1834. SODIUM OVERLOAD - p. 2054 1835. SYMPTOMS OF HYPERNATREMIA - p. 2054 1836. DIAGNOSIS OF HYPERNATREMIA AND POLYURIC DISORDERS - p. 2054 1837. DIAGNOSIS OF POLYURIC STATES AND DIABETES INSIPIDUS - p. 2054 1838. TREATMENT OF HYPERNATREMIA - p. 2056 1839. RATE OF CORRECTION - p. 2056 1840. TREATMENT OF DIABETES INSIPIDUS - p. 2056 1841. CENTRAL DIABETES INSIPIDUS - p. 2056 1842. NEPHROGENIC DIABETES INSIPIDUS - p. 2056 1843. DISORDERS OF PLASMA POTASSIUM - p. 2057 1844. NORMAL POTASSIUM HOMEOSTASIS - p. 2057 1845. TRANSCELLULAR POTASSIUM SHIFTS - p. 2057 1846. RENAL REGULATION OF POTASSIUM EXCRETION - p. 2057 1847. HYPOKALEMIA - p. 2058 1848. CAUSES OF HYPOKALEMIA - p. 2058 1849. HYPOTHERMIA - p. 2059 1850. CLINICAL MANIFESTATIONS - p. 2061 1851. DIAGNOSIS - p. 2061 1852. URINARY POTASSIUM - p. 2061 1853. TREATMENT - p. 2061 1854. POTASSIUM DEFICIT - p. 2062 1855. POTASSIUM PREPARATIONS - p. 2062 1856. MILD-TO-MODERATE POTASSIUM DEPLETION - p. 2062 1857. SEVERE HYPOKALEMIA - p. 2062 1858. HYPERKALEMIA - p. 2063 1859. ETIOLOGY - p. 2063 1860. INCREASED POTASSIUM RELEASE FROM CELLS. - p. 2063 1861. REDUCED URINARY POTASSIUM EXCRETION - p. 2064 1862. CLINICAL MANIFESTATIONS - p. 2066 1863. TREATMENT - p. 2066 1864. Chapter 199: Interactive Multiple Choice Question - p. 2068 1865. Chapter 200 Acute Kidney Injury in the Intensive Care Unit - p. 2069 1866. OVERVIEW OF ACUTE KIDNEY INJURY - p. 2069 1867. CLINICAL SYNDROMES ASSOCIATED WITH AKI IN THE INTENSIVE CARE UNIT SETTING - p. 2073 1868. DIAGNOSIS OF ACUTE KIDNEY INJURY - p. 2083 1869. COMPLICATIONS AND TREATMENT OF ACUTE KIDNEY INJURY - p. 2084 1870. Chapter 200: Interactive Multiple Choice Question - p. 2091 1871. Chapter 201 Renal Replacement Therapy for the Critically Ill - p. 2092 1872. INTRODUCTION - p. 2092 1873. PRINCIPLES OF SOLUTE CLEARANCE AND FLUID REMOVAL BY DIALYTIC TECHNIQUES - p. 2092 1874. OVERVIEW OF DIALYSIS MODALITIES - p. 2093 1875. TECHNICAL CONSIDERATIONS FOR RENAL REPLACEMENT THERAPY - p. 2096 1876. INDICATIONS FOR AND TIMING OF INITIATION OF RENAL REPLACEMENT THERAPY - p. 2098 1877. MODALITY SELECTION - p. 2102 1878. COMPLICATIONS OF RRT - p. 2104 1879. Chapter 201: Interactive Multiple Choice Question - p. 2106 1880. Chapter 202 Ultrasonography for the Evaluation of the Urinary System - p. 2106 1881. EQUIPMENT - p. 2106 1882. SCANNING TECHNIQUE FOR THE KIDNEY - p. 2106 1883. ULTRASONOGRAPHIC ANATOMY OF THE KIDNEY - p. 2107 1884. SCANNING TECHNIQUES FOR IMAGING THE BLADDER - p. 2107 1885. CLINICAL APPLICATION OF ULTRASONOGRAPHY OF THE URINARY SYSTEM - p. 2108 1886. LIMITATIONS OF ULTRASONOGRAPHY FOR EVALUATION OF AKI - p. 2109 1887. Chapter 202: Interactive Multiple Choice Question - p. 2109 1888. Chapter 203 Drug Dosing in Renal and Hepatic Failure: A Pharmacokinetic Approach to the Critically Ill Patient - p. 2109 1889. INTRODUCTION - p. 2110 1890. PHARMACOKINETIC AND PHARMACODYNAMIC PRINCIPLES - p. 2110 1891. PHARMACOKINETIC CONCEPTS - p. 2111 1892. RENAL DRUG EXCRETION - p. 2112 1893. PHARMACOKINETIC CHANGES AMONG CRITICALLY ILL PATIENTS WITH RENAL DYSFUNCTION - p. 2113 1894. ASSESSING RENAL FUNCTION - p. 2114 1895. DIALYSIS - p. 2114 1896. PHARMACOKINETIC CHANGES OF CRITICALLY ILL PATIENTS WITH HEPATIC FAILURE - p. 2114 1897. Chapter 203: Interactive Multiple Choice Question - p. 2129 1898. SECTION 19 Gastrointestinal Disease Problems in the Intensive Care Unit - p. 2130 1899. Chapter 204 Gastrointestinal Bleeding - p. 2130 1900. INTRODUCTION - p. 2130 1901. INITIAL EVALUATION AND RESUSCITATION - p. 2130 1902. FURTHER EVALUATION AND MANAGEMENT - p. 2131 1903. DIAGNOSTIC EVALUATION - p. 2131 1904. THERAPEUTIC PROCEDURES FOR HEMOSTASIS - p. 2133 1905. SPECIFIC BLEEDING LESIONS - p. 2134 1906. Chapter 204: Interactive Multiple Choice Question - p. 2137 1907. Chapter 205 Stress Ulcer and Acid Peptic Disease - p. 2138 1908. INTRODUCTION - p. 2138 1909. CLINICAL CHARACTERISTICS AND PRESENTATION - p. 2138 1910. RISK FACTORS - p. 2138 1911. PATHOPHYSIOLOGY - p. 2139 1912. PROPHYLAXIS - p. 2140 1913. REGIMENS FOR PROPHYLAXIS - p. 2140 1914. COMPLICATIONS OF PROPHYLAXIS - p. 2141 1915. IMPACT ON MORTALITY AND RISK-BENEFIT ANALYSIS - p. 2141 1916. INAPPROPRIATE USE OF STRESS ULCER PROPHYLAXIS - p. 2141 1917. MANAGEMENT OF STRESS-RELATED AND ACID PEPTIC GI BLEEDING - p. 2142 1918. CONCLUSIONS - p. 2142 1919. Chapter 205: Interactive Multiple Choice Question - p. 2143 1920. Chapter 206 Nausea and Vomiting - p. 2144 1921. INTRODUCTION - p. 2144 1922. PATHOPHYSIOLOGY - p. 2144 1923. EVALUATION AND DIAGNOSTIC APPROACH - p. 2149 1924. TREATMENT APPROACH TO NAUSEA AND VOMITING IN THE ICU - p. 2150 1925. CONCLUSIONS - p. 2151 1926. Chapter 206: Interactive Multiple Choice Question - p. 2152 1927. Chapter 207 Gastrointestinal Motility of the Critically Ill Patient - p. 2153 1928. INTRODUCTION - p. 2153 1929. ESOPHAGEAL DISORDERS: GASTROESOPHAGEAL REFLUX DISEASE - p. 2153 1930. GASTRIC DISORDERS: DELAYED GASTRIC EMPTYING AND GASTROPARESIS - p. 2154 1931. SMALL BOWEL DISORDERS: ILEUS - p. 2155 1932. COLONIC DISORDERS: ACUTE COLONIC PSEUDO-OBSTRUCTION (OGILVIE SYNDROME) - p. 2157 1933. SUMMARY - p. 2158 1934. Chapter 207: Interactive Multiple Choice Question - p. 2160 1935. Chapter 208 Hepatic Dysfunction and Liver Failure - p. 2160 1936. INTRODUCTION - p. 2160 1937. ACUTE LIVER FAILURE - p. 2160 1938. SYSTEMIC MANIFESTATIONS AND MANAGEMENT - p. 2163 1939. CEREBRAL EDEMA - p. 2163 1940. HEPATIC DYSFUNCTION AMONG CRITICALLY ILL PATIENTS - p. 2165 1941. HEPATIC DYSFUNCTION DUE TO CHRONIC LIVER DISEASE AND CIRRHOSIS - p. 2166 1942. HEPATIC HYDROTHORAX - p. 2168 1943. HYPONATREMIA - p. 2168 1944. Chapter 208: Interactive Multiple Choice Question - p. 2171 1945. Chapter 209 Severe and Complicated Biliary Tract Disease - p. 2171 1946. INTRODUCTION - p. 2171 1947. DIAGNOSTIC EVALUATION - p. 2172 1948. BILIARY TRACT DISORDERS ENCOUNTERED IN THE INTENSIVE CARE UNIT - p. 2173 1949. Chapter 209: Interactive Multiple Choice Question - p. 2175 1950. Chapter 210 Acute Pancreatitis - p. 2176 1951. INTRODUCTION - p. 2176 1952. ETIOLOGY AND PATHOPHYSIOLOGY - p. 2176 1953. POST-ERCP PANCREATITIS - p. 2178 1954. CLINICAL PRESENTATION - p. 2178 1955. LABORATORY TESTS AND RADIOLOGIC EXAMINATIONS - p. 2179 1956. DIFFERENTIAL DIAGNOSIS - p. 2180 1957. PROGNOSIS - p. 2180 1958. TREATMENT OF ACUTE PANCREATITIS - p. 2180 1959. LOCAL COMPLICATIONS OF PANCREATITIS - p. 2181 1960. CONCLUSIONS - p. 2183 1961. Chapter 210: Interactive Multiple Choice Question - p. 2184 1962. Chapter 211 Diarrhea and Constipation - p. 2185 1963. DIARRHEA IN THE ICU - p. 2185 1964. ETIOLOGY - p. 2185 1965. DIAGNOSIS - p. 2188 1966. MANAGEMENT - p. 2189 1967. CONCLUSIONS - p. 2190 1968. CONSTIPATION IN THE ICU - p. 2190 1969. DRUG-INDUCED CONSTIPATION - p. 2191 1970. MECHANICAL FACTORS - p. 2191 1971. PHYSIOLOGIC FACTORS - p. 2191 1972. DIETARY FACTORS - p. 2191 1973. PREVENTION OF CONSTIPATION AMONG CRITICALLY ILL PATIENTS - p. 2192 1974. Chapter 211: Interactive Multiple Choice Question - p. 2192 1975. Chapter 212 Fulminant Colitis and Toxic Megacolon - p. 2193 1976. INTRODUCTION - p. 2193 1977. PREDISPOSING FACTORS - p. 2193 1978. CLINICAL FEATURES - p. 2194 1979. MANAGEMENT - p. 2194 1980. Chapter 212: Interactive Multiple Choice Question - p. 2198 1981. SECTION 20 METABOLISM AND NUTRITION - p. 2199 1982. Chapter 213 Nutritional Therapy in the Critically Ill Patient - p. 2199 1983. INTRODUCTION - p. 2199 1984. WHAT IS MALNUTRITION AND HOW DO WE RECOGNIZE IT? - p. 2199 1985. HOW MUCH SHOULD YOU FEED? - p. 2200 1986. WHICH ROUTE OF ADMINISTRATION SHOULD BE CHOSEN? - p. 2201 1987. HOW DO YOU PREVENT COMPLICATIONS AND MAXIMIZE BENEFITS? - p. 2202 1988. WHAT IS THE IMPORTANCE OF PROVIDING SPECIAL KEY NUTRIENTS? - p. 2202 1989. NUTRITIONAL MANAGEMENT FOR CRITICALLY ILL PATIENTS WITH CORONAVIRUS DISEASE 2019 - p. 2203 1990. Chapter 213: Interactive Multiple Choice Question - p. 2203 1991. Chapter 214 Parenteral and Enteral Nutrition in the Intensive Care Unit - p. 2204 1992. INTRODUCTION - p. 2204 1993. CLINICAL CONSEQUENCES OF DELAYING NUTRITIONAL SUPPORT - p. 2205 1994. IDENTIFYING PATIENTS IN NEED OF NUTRITIONAL SUPPORT - p. 2206 1995. NUTRITIONAL REQUIREMENTS - p. 2207 1996. DIFFERENCES BETWEEN ENTERAL AND PARENTERAL NUTRITION - p. 2211 1997. MONITORING PARAMETERS FOR NUTRITIONAL SUPPORT - p. 2216 1998. CONCLUSIONS - p. 2217 1999. Chapter 214: Interactive Multiple Choice Question - p. 2219 2000. Chapter 215 Disease-Specific Nutrition - p. 2219 2001. INTRODUCTION - p. 2219 2002. RENAL FAILURE - p. 2219 2003. LIVER FAILURE - p. 2222 2004. PULMONARY FAILURE - p. 2225 2005. Chapter 215: Interactive Multiple Choice Question - p. 2230 2006. Appendix CALCULATIONS COMMONLY USED IN CRITICAL CARE - p. 2231 2007. Index - p. I-1
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Covering both the theoretical and practical aspects of critical care,Irwin & Rippe’s Intensive Care Medicine, Ninth Edition, provides state-of-the-art, evidence-based knowledge for specialty physicians and non-physicians practicing in the adult intensive care environment. Drs. Craig M. Lilly, Walter A. Boyle, and Richard S. Irwin, along with a team of expert contributing authors and education expert, William F. Kelly, offer authoritative, comprehensive guidance from an interprofessional, collaborative, educational, and scholarly perspective, encompassing all adult critical care specialties.
1. INTRODUCTION - p. 1 2. COMPETENCE - p. 2 3. CONCLUSIONS - p. 3 4. Chapter 1: Interactive Multiple Choice Question - p. 4 5. Chapter 2 Anesthesia for Bedside Procedures - p. 4 6. INTRODUCTION - p. 4 7. COMMON PAIN MANAGEMENT PROBLEMS IN ICU PATIENTS - p. 4 8. CHARACTERISTICS OF SPECIFIC AGENTS USED FOR BEDSIDE PROCEDURES - p. 6 9. NEUROMUSCULAR BLOCKING AGENTS - p. 10 10. PRACTICAL CONSIDERATIONS - p. 10 11. CONCLUSIONS - p. 10 12. Chapter 2: Interactive Multiple Choice Question - p. 11 13. Chapter 3 Management of Pain in the Critically Ill - p. 11 14. INTRODUCTION - p. 11 15. PHYSIOLOGICAL EFFECTS OF ACUTE PAIN - p. 12 16. EVALUATION OF PAIN AND SEDATION IN THE ICU PATIENT - p. 12 17. SUBJECTIVE PAIN ASSESSMENT - p. 12 18. OBJECTIVE PAIN ASSESSMENT - p. 12 19. FORMULATION OF A TREATMENT PLAN - p. 13 20. CHARACTER AND SITE - p. 13 21. MEDICAL MANAGEMENT OF PAIN FOR THE ICU PATIENT - p. 13 22. NONPHARMACOLOGIC TREATMENTS - p. 13 23. PHARMACOLOGIC TREATMENTS - p. 14 24. ACETAMINOPHEN—PARACETAMOL - p. 14 25. OPIOIDS - p. 14 26. ADJUVANT MEDICATIONS - p. 17 27. REGIONAL ANALGESIA TECHNIQUES - p. 18 28. NERVE BLOCKS FOR THORACIC AND ABDOMINAL WALL - p. 18 29. CONCLUSION - p. 20 30. Chapter 3: Interactive Multiple Choice Question - p. 22 31. Chapter 4 Therapeutic Paralysis - p. 22 32. INTRODUCTION - p. 22 33. PHARMACOLOGY OF NEUROMUSCULAR BLOCKING AGENTS - p. 23 34. THE NICOTINIC ACETYLCHOLINE RECEPTOR - p. 23 35. DEPOLARIZING NEUROMUSCULAR BLOCKERS - p. 23 36. NONDEPOLARIZING NMBAS - p. 23 37. REVERSAL AGENTS - p. 25 38. DRUG INTERACTIONS - p. 25 39. MONITORING OF NMBAS - p. 26 40. ADVERSE EFFECTS OF DEPOLARIZING AND NONDEPOLARIZING NMBAS IN CRITICALLY ILL PATIENTS - p. 26 41. INTENSIVE CARE UNIT–ACQUIRED WEAKNESS - p. 27 42. SUMMARY AND RECOMMENDATIONS - p. 28 43. Chapter 4: Interactive Multiple Choice Question - p. 29 44. Chapter 5 Cerebrospinal Fluid Aspiration - p. 29 45. INTRODUCTION - p. 29 46. CEREBROSPINAL FLUID ACCESS - p. 30 47. TECHNIQUES OF CEREBROSPINAL FLUID ACCESS - p. 32 48. SUMMARY - p. 38 49. Chapter 5: Interactive Multiple Choice Question - p. 38 50. Chapter 6 Central Venous Catheters - p. 38 51. INTRODUCTION - p. 39 52. INDICATIONS AND SITE SELECTION - p. 39 53. GENERAL CONSIDERATIONS - p. 40 54. ROUTES OF CENTRAL VENOUS CANNULATION - p. 42 55. Chapter 6: Interactive Multiple Choice Question - p. 53 56. Chapter 7 Arterial Line Placement and Care - p. 54 57. INTRODUCTION - p. 54 58. INDICATIONS FOR ARTERIAL CANNULATION - p. 54 59. EQUIPMENT, MONITORING, TECHNIQUES, AND SOURCES OF ERROR - p. 55 60. TECHNIQUE OF ARTERIAL CANNULATION - p. 57 61. COMPLICATIONS OF ARTERIAL CANNULATION - p. 61 62. RECOMMENDATIONS - p. 63 63. Chapter 7: Interactive Multiple Choice Question - p. 64 64. Chapter 8 Airway Management and Endotracheal Intubation - p. 64 65. INTRODUCTION - p. 64 66. CONCISE ANATOMY - p. 64 67. EMERGENCY AIRWAY MANAGEMENT - p. 66 68. INDICATIONS FOR INTUBATION - p. 67 69. EQUIPMENT FOR INTUBATION - p. 69 70. ANESTHESIA BEFORE INTUBATION - p. 71 71. TECHNIQUES OF INTUBATION - p. 73 72. COMPLICATIONS OF ENDOTRACHEAL INTUBATION - p. 78 73. EXTUBATION - p. 79 74. Chapter 8: Interactive Multiple Choice Question - p. 81 75. Chapter 9 Tracheostomy - p. 82 76. INTRODUCTION - p. 82 77. INDICATIONS - p. 82 78. CONTRAINDICATIONS - p. 82 79. TIMING OF TRACHEOSTOMY - p. 83 80. PROCEDURES - p. 83 81. TRACHEOSTOMY PROCEDURES FOR THE INTENSIVE CARE UNIT - p. 84 82. TUBES AND CANNULAS - p. 86 83. POSTOPERATIVE CARE - p. 86 84. COMPLICATIONS - p. 87 85. CONCLUSIONS - p. 90 86. Chapter 9: Interactive Multiple Choice Question - p. 91 87. Chapter 10 Bronchoscopy - p. 91 88. INTRODUCTION - p. 92 89. GENERAL CONSIDERATIONS - p. 92 90. COMMON DIAGNOSTIC INDICATIONS - p. 92 91. THERAPEUTIC INDICATIONS - p. 93 92. COMPLICATIONS - p. 94 93. CONTRAINDICATIONS - p. 94 94. PROCEDURE - p. 95 95. Chapter 10: Interactive Multiple Choice Question - p. 96 96. Chapter 11 Lung Ultrasonography - p. 97 97. INTRODUCTION - p. 97 98. BASIC PRINCIPLES OF LUS - p. 97 99. MACHINE REQUIREMENTS - p. 97 100. PERFORMANCE OF LUS - p. 97 101. IMAGING PATTERNS IN LUS - p. 97 102. NORMAL ANATOMY - p. 97 103. FINDINGS OF LUS - p. 98 104. PATTERN ANALYSIS OF LUS - p. 99 105. CLINICAL APPLICATIONS OF LUS - p. 99 106. LUS AND COVID-19 - p. 100 107. TRANSESOPHAGEAL LUNG ULTRASONOGRAPHY - p. 100 108. SUMMARY - p. 101 109. Chapter 11: Interactive Multiple Choice Question - p. 102 110. Chapter 12 Thoracentesis - p. 102 111. INTRODUCTION - p. 103 112. INDICATIONS - p. 103 113. CONTRAINDICATIONS - p. 103 114. COMPLICATIONS - p. 104 115. THORACENTESIS PROCEDURE - p. 105 116. PROCEDURE - p. 106 117. INTERPRETATION OF PLEURAL FLUID ANALYSIS - p. 108 118. CLINICAL APPROACH TO EFFUSION DRAINAGE AND FURTHER MANAGEMENT - p. 110 119. Chapter 12: Interactive Multiple Choice Question - p. 111 120. Chapter 13 Chest Tube Insertion and Care - p. 111 121. INTRODUCTION - p. 111 122. PLEURAL ANATOMY AND PHYSIOLOGY - p. 111 123. CHEST TUBE PLACEMENT - p. 111 124. CONTRAINDICATIONS - p. 113 125. TECHNIQUE - p. 114 126. COMPLICATIONS - p. 116 127. CHEST TUBE MANAGEMENT AND CARE - p. 117 128. CHEST TUBE REMOVAL - p. 117 129. RELATED SYSTEMS - p. 117 130. SUMMARY - p. 118 131. Chapter 13: Interactive Multiple Choice Question - p. 118 132. Chapter 14 Cardiopulmonary Resuscitation - p. 119 133. INTRODUCTION - p. 119 134. EFFICACY - p. 119 135. EXPERIMENTAL AND ALTERNATIVE TECHNIQUES OF CARDIOPULMONARY RESUSCITATION - p. 120 136. INFECTIOUS DISEASES AND CARDIOPULMONARY RESUSCITATION - p. 120 137. STANDARD PROCEDURES AND TEAM EFFORT - p. 120 138. BASIC LIFE SUPPORT FOR ADULTS WITH AN UNOBSTRUCTED AIRWAY - p. 121 139. PEDIATRIC RESUSCITATION - p. 123 140. OBSTRUCTED AIRWAY - p. 123 141. ADVANCED CARDIAC LIFE SUPPORT OF ADULTS - p. 125 142. DRUG THERAPIES - p. 128 143. CLINICAL SETTINGS - p. 131 144. CONCLUSIONS - p. 133 145. Chapter 14: Interactive Multiple Choice Question - p. 134 146. Chapter 15 Cardioversion and Defibrillation - p. 135 147. INTRODUCTION - p. 135 148. PHYSIOLOGY OF ARRHYTHMIA AND SHOCK - p. 135 149. INDICATIONS AND CONTRAINDICATIONS - p. 135 150. CLINICAL COMPETENCE - p. 135 151. Chapter 15: Interactive Multiple Choice Question - p. 140 152. Chapter 16 Critical Care Echocardiography - p. 140 153. INTRODUCTION - p. 140 154. BASIC CRITICAL CARE ECHOCARDIOGRAPHY - p. 141 155. ADVANCED CRITICAL CARE ECHOCARDIOGRAPHY - p. 145 156. Chapter 16: Interactive Multiple Choice Question - p. 146 157. Chapter 17 Pericardiocentesis - p. 146 158. INTRODUCTION - p. 146 159. INDICATIONS FOR PERICARDIOCENTESIS - p. 146 160. ANATOMY - p. 147 161. PROCEDURE - p. 147 162. SHORT-TERM AND LONG-TERM MANAGEMENT - p. 151 163. UTILITY OF ULTRASONOGRAPHY FOR MANAGEMENT OF PERICARDIAL EFFUSION - p. 152 164. SPECIAL CIRCUMSTANCES - p. 153 165. SUMMARY - p. 154 166. Chapter 17: Interactive Multiple Choice Question - p. 154 167. Chapter 18 Temporary Cardiac Pacing - p. 155 168. INTRODUCTION - p. 155 169. INDICATIONS FOR TEMPORARY CARDIAC PACING - p. 155 170. ATRIOVENTRICULAR BLOCK - p. 156 171. DIAGNOSIS OF RAPID RHYTHMS - p. 157 172. ACUTE MYOCARDIAL INFARCTION - p. 157 173. EQUIPMENT AVAILABLE FOR TEMPORARY PACING - p. 157 174. CHOICE OF PACING MODE - p. 158 175. PROCEDURE TO ESTABLISH TEMPORARY PACING - p. 159 176. COMPLICATIONS OF TEMPORARY PACING - p. 160 177. Chapter 18: Interactive Multiple Choice Question - p. 160 178. Chapter 19 Pulmonary Artery Catheters - p. 161 179. INTRODUCTION - p. 161 180. PHYSIOLOGIC RATIONALE FOR USE OF PULMONARY ARTERY CATHETER - p. 161 181. CONTROVERSIES REGARDING USE OF PULMONARY ARTERY CATHETER - p. 161 182. INDICATIONS FOR USE OF PULMONARY ARTERY CATHETER - p. 161 183. CONTRAINDICATIONS TO PULMONARY ARTERY CATHETERS - p. 161 184. CATHETER FEATURES AND EVOLUTION - p. 162 185. INSERTION TECHNIQUES - p. 163 186. PHYSIOLOGIC DATA - p. 167 187. CLINICAL APPLICATIONS OF THE PULMONARY ARTERY CATHETER - p. 170 188. COMPLICATIONS - p. 170 189. GUIDELINES FOR SAFE USE OF PULMONARY ARTERY CATHETERS - p. 173 190. SUMMARY - p. 174 191. Chapter 19: Interactive Multiple Choice Question - p. 175 192. Chapter 20 Gastrointestinal Endoscopy - p. 176 193. INTRODUCTION - p. 176 194. PATIENT SELECTION - p. 176 195. PREPROCEDURAL CARE - p. 179 196. INTRAPROCEDURAL CARE - p. 179 197. POSTPROCEDURAL CARE - p. 181 198. FUTURE DIRECTIONS - p. 182 199. Chapter 20: Interactive Multiple Choice Question - p. 183 200. Chapter 21 Endoscopic Placement of Feeding Tubes - p. 183 201. INDICATIONS FOR ENTERAL FEEDING - p. 183 202. ACCESS TO THE GASTROINTESTINAL TRACT - p. 183 203. TECHNIQUES - p. 184 204. SURGICAL PROCEDURES - p. 186 205. DELIVERING THE TUBE-FEEDING FORMULA - p. 187 206. MEDICATIONS - p. 188 207. COMPLICATIONS - p. 188 208. Chapter 21: Interactive Multiple Choice Question - p. 189 209. Chapter 22 Gastroesophageal Balloon Tamponade for Acute Variceal Hemorrhage - p. 190 210. INTRODUCTION - p. 190 211. ACUTE VARICEAL HEMORRHAGE OVERVIEW - p. 190 212. ROLE OF BALLOON TAMPONADE FOR THE MANAGEMENT OF ACUTE VARICEAL HEMORRHAGE - p. 190 213. CONTRAINDICATIONS TO BALLOON TAMPONADE - p. 190 214. PRACTICAL CONSIDERATIONS - p. 191 215. BALLOON TUBE INSERTION TECHNIQUE - p. 191 216. COMPLICATIONS AND ALTERNATIVES - p. 194 217. Chapter 22: Interactive Multiple Choice Question - p. 195 218. Chapter 23 Paracentesis and Diagnostic Peritoneal Lavage - p. 195 219. ABDOMINAL PARACENTESIS - p. 195 220. DIAGNOSTIC PERITONEAL LAVAGE - p. 200 221. DIAGNOSTIC PERITONEAL ASPIRATION - p. 200 222. Chapter 23: Interactive Multiple Choice Question - p. 204 223. Chapter 24 Interventional Radiology: Percutaneous Drainage Techniques - p. 204 224. INTRODUCTION - p. 204 225. GENERAL AIMS - p. 204 226. INDICATIONS - p. 204 227. CONTRAINDICATIONS - p. 205 228. RISKS, BENEFITS, AND ALTERNATIVES - p. 205 229. PREPROCEDURE PREPARATION - p. 206 230. IMAGING GUIDANCE - p. 207 231. ANESTHESIA AND MONITORING - p. 208 232. THERAPEUTIC CATHETER DRAINAGE - p. 208 233. CATHETER SELECTION, FIXATION, AND REMOVAL - p. 209 234. DIAGNOSTIC OR THERAPEUTIC ASPIRATION - p. 209 235. PROCEDURE - p. 209 236. SPECIAL SITUATIONS - p. 210 237. SUMMARY - p. 211 238. Chapter 24: Interactive Multiple Choice Question - p. 211 239. Chapter 25 Percutaneous Suprapubic Cystostomy - p. 212 240. INTRODUCTION - p. 212 241. URETHRAL CATHETERIZATION - p. 212 242. SUPRAPUBIC CATHETER CARE - p. 214 243. COMPLICATIONS - p. 214 244. UTILITY OF ULTRASONOGRAPHY FOR PERCUTANEOUS CYSTOSTOMY AND URETHRAL CATHETERIZATION - p. 215 245. Chapter 25: Interactive Multiple Choice Question - p. 216 246. Chapter 26 Aspiration of the Knee and Synovial Fluid Analysis - p. 216 247. INTRODUCTION - p. 216 248. INDICATIONS - p. 216 249. CONTRAINDICATIONS - p. 217 250. COMPLICATIONS - p. 217 251. TECHNIQUE - p. 218 252. UTILITY OF ULTRASONOGRAPHY FOR KNEE JOINT ASPIRATION - p. 219 253. SYNOVIAL FLUID ANALYSIS - p. 219 254. GROSS EXAMINATION - p. 220 255. CELL COUNT AND DIFFERENTIAL - p. 220 256. CRYSTALS - p. 220 257. GRAM STAIN AND CULTURE - p. 221 258. Chapter 26: Interactive Multiple Choice Question - p. 221 259. SECTION 2 MINIMALLY INVASIVE MONITORING - p. 222 260. Chapter 27 Routine Monitoring of Critically Ill Patients - p. 222 261. INTRODUCTION - p. 222 262. MONITORING SYSTEMS - p. 222 263. TEMPERATURE MONITORING - p. 222 264. ARTERIAL BLOOD PRESSURE MONITORING - p. 224 265. ELECTROCARDIOGRAPHIC MONITORING - p. 227 266. RESPIRATORY MONITORING - p. 228 267. NONINVASIVE TISSUE PERFUSION MONITORING - p. 232 268. Chapter 27: Interactive Multiple Choice Question - p. 236 269. Chapter 28 Minimally Invasive Hemodynamic Monitoring - p. 236 270. INTRODUCTION - p. 237 271. CARDIAC OUTPUT - p. 237 272. FUTURE DIRECTIONS - p. 243 273. OXYGEN DELIVERY AND TISSUE PERFUSION - p. 243 274. PRACTICE RECOMMENDATIONS - p. 246 275. Chapter 28: Interactive Multiple Choice Question - p. 248 276. Chapter 29 Respiratory Monitoring During Mechanical Ventilation - p. 248 277. INTRODUCTION - p. 249 278. GAS EXCHANGE - p. 249 279. RESPIRATORY MECHANICS - p. 251 280. PATIENT VENTILATOR INTERACTION - p. 257 281. SUMMARY - p. 260 282. Chapter 29: Interactive Multiple Choice Question - p. 261 283. Chapter 30 Neurologic Multimodal Monitoring - p. 261 284. GOALS OF BRAIN MONITORING - p. 262 285. CEREBRAL ISCHEMIA - p. 262 286. TECHNIQUES OF NEUROLOGIC MONITORING - p. 264 287. MULTIMODAL MONITORING STRATEGIES - p. 276 288. Chapter 30: Interactive Multiple Choice Question - p. 278 289. Chapter 31 Role of Tele-Critical Care in the Health Care System - p. 279 290. INTRODUCTION - p. 279 291. TECHNOLOGICAL AND ORGANIZATIONAL SOLUTIONS - p. 281 292. DATA AND OUTCOMES - p. 283 293. SUMMARY - p. 286 294. Chapter 31: Interactive Multiple Choice Question - p. 287 295. SECTION 3 PALLIATIVE CARE AND ETHICAL ISSUES IN THE INTENSIVE CARE UNIT - p. 288 296. Chapter 32 Palliative Care in the ICU - p. 288 297. INTRODUCTION - p. 288 298. MODELS OF ICU PALLIATIVE CARE DELIVERY - p. 289 299. CLINICAL TRIGGERS FOR ICU PALLIATIVE CARE - p. 290 300. BARRIERS TO PALLIATIVE CARE IN THE ICU - p. 290 301. ELEMENTS TO SUCCESSFUL INTEGRATION OF PALLIATIVE CARE IN THE ICU - p. 291 302. PALLIATIVE CARE QUALITY IMPROVEMENT - p. 291 303. SUMMARY - p. 292 304. Chapter 32: Interactive Multiple Choice Question - p. 293 305. Chapter 33 Effective Communication and Ethical Decision-Making in the ICU - p. 293 306. INTRODUCTION - p. 293 307. FAMILY MEETINGS AND GOALS OF CARE DISCUSSIONS - p. 294 308. Chapter 33: Interactive Multiple Choice Question - p. 308 309. Chapter 34 Managing Symptoms in Critically Ill Patients - p. 308 310. INTRODUCTION - p. 308 311. PAIN MANAGEMENT IN PALLIATIVE CARE - p. 308 312. GENERAL PRINCIPLES - p. 308 313. PEARLS FOR CLINICAL PRACTICE - p. 310 314. MANAGEMENT OF DYSPNEA - p. 310 315. INTERVENTIONS OF UNKNOWN EFFICACY - p. 312 316. GASTROINTESTINAL SYMPTOMS: CONSTIPATION, NAUSEA, AND VOMITING - p. 312 317. PSYCHIATRIC SYMPTOMS: DELIRIUM, ANXIETY, AND DEPRESSION - p. 315 318. Chapter 34: Interactive Multiple Choice Question - p. 321 319. Chapter 35 Being With Suffering: Addressing Existential and Spiritual Distress - p. 321 320. INTRODUCTION - p. 321 321. DEFINITIONS - p. 322 322. RELIGIOUS TRADITIONS AT THE END OF LIFE - p. 322 323. IMPACT OF RELIGIOSITY ON END-OF-LIFE DECISIONS - p. 323 324. DIAGNOSIS OF EXISTENTIAL SUFFERING AND LOSS OF PERSONHOOD - p. 323 325. ADDRESSING EXISTENTIAL AND SPIRITUAL DISTRESS: USE OF AN INTERDISCIPLINARY TEAM - p. 324 326. HOPE AND RESILIENCY—RESTORATION OF PERSONHOOD - p. 325 327. IMPACT OF MEDICAL DECISIONS ON GRIEF AND BEREAVEMENT - p. 325 328. SELF-CARE AND MORAL DISTRESS - p. 326 329. SUMMARY - p. 326 330. Chapter 35: Interactive Multiple Choice Question - p. 327 331. SECTION 4 SHOCK, TRAUMA AND SEPSIS MANAGEMENT - p. 328 332. Chapter 36 Resuscitation From Shock Following Hemorrhage - p. 328 333. INTRODUCTION - p. 328 334. PHYSIOLOGICAL RESPONSES TO HEMORRHAGE - p. 328 335. SHOCK RECOGNITION - p. 330 336. HEMORRHAGE CONTROL - p. 333 337. HISTORY OF HEMORRHAGIC SHOCK RESUSCITATION - p. 333 338. INITIAL RESUSCITATION - p. 334 339. ONGOING RESUSCITATION - p. 335 340. SUMMARY - p. 339 341. Chapter 36: Interactive Multiple Choice Question - p. 341 342. Chapter 37 Trauma Systems - p. 341 343. INTRODUCTION - p. 342 344. TRAUMA CENTER DESIGNATION AND VERIFICATION - p. 342 345. TRAUMA SCORING SYSTEMS - p. 342 346. PREHOSPITAL CARE - p. 343 347. IN-HOSPITAL CARE - p. 343 348. POSTHOSPITAL CARE - p. 345 349. DISASTER AND EMERGENCY PREPAREDNESS - p. 346 350. SPECIAL CONSIDERATIONS - p. 346 351. SUMMARY - p. 346 352. Chapter 37: Interactive Multiple Choice Question - p. 347 353. Chapter 38 Management of Sepsis - p. 347 354. INTRODUCTION - p. 348 355. DEFINITIONS - p. 348 356. PATHOGENS AND SITES OF INFECTION - p. 348 357. PATHOPHYSIOLOGY OF SEPSIS - p. 348 358. COMPLICATIONS ASSOCIATED WITH SEPSIS - p. 350 359. CLINICAL FEATURES AND DIAGNOSIS OF SEPSIS - p. 350 360. MANAGEMENT OF SEPSIS - p. 351 361. CONCLUSIONS - p. 356 362. Chapter 38: Interactive Multiple Choice Question - p. 358 363. Chapter 39 Multiple Organ Dysfunction Syndrome - p. 358 364. INTRODUCTION - p. 358 365. ETIOLOGY - p. 358 366. DIAGNOSTIC CRITERIA AND SCORING SYSTEMS - p. 359 367. MECHANISMS OF MULTIPLE ORGAN DYSFUNCTION SYNDROME - p. 359 368. CURRENT MANAGEMENT CONSIDERATIONS - p. 360 369. PROGNOSIS AND ICU LENGTH OF STAY - p. 361 370. SUMMARY - p. 362 371. Chapter 39: Interactive Multiple Choice Question - p. 363 372. Chapter 40 Traumatic Brain Injury - p. 363 373. INTRODUCTION - p. 363 374. TRAUMA BAY AND INITIAL CRITICAL CARE - p. 363 375. REVERSAL OF ANTICOAGULATION - p. 364 376. SURGICAL THERAPIES FOR TRAUMATIC BRAIN INJURY - p. 365 377. NEUROLOGICAL CRITICAL CARE - p. 365 378. CEREBRAL PERFUSION PRESSURE AND THE LUND CONCEPT - p. 366 379. TEMPERATURE MANAGEMENT - p. 366 380. INDUCED COMA - p. 367 381. SYSTEMIC CRITICAL CARE - p. 367 382. SPECIALTY INJURY SUBTYPES - p. 368 383. LONG-TERM OUTCOMES - p. 368 384. Chapter 40: Interactive Multiple Choice Question - p. 371 385. Chapter 41 Spinal Cord Trauma - p. 371 386. INTRODUCTION - p. 371 387. ANATOMY - p. 371 388. SPINAL COLUMN: CLASSIFICATION OF INJURY AND ASSESSMENT OF SPINAL STABILITY - p. 372 389. TREATMENT - p. 378 390. Chapter 41: Interactive Multiple Choice Question - p. 381 391. Chapter 42 Thoracic and Cardiac Trauma - p. 381 392. INTRODUCTION - p. 381 393. INDICATIONS FOR URGENT SURGICAL INTERVENTION - p. 381 394. DIAGNOSTICS - p. 382 395. SPECIFIC INJURIES - p. 384 396. UTILITY OF ULTRASONOGRAPHY FOR EVALUATION OF THORACIC AND CARDIAC TRAUMA - p. 391 397. SUMMARY - p. 392 398. Chapter 42: Interactive Multiple Choice Question - p. 394 399. Chapter 43 Critical Care of the Patient With Abdominal Trauma - p. 394 400. INTRODUCTION - p. 394 401. ICU ADMISSION - p. 394 402. NONOPERATIVE MANAGEMENT - p. 394 403. BLUNT TRAUMA - p. 395 404. PENETRATING INJURY - p. 397 405. MISSED INJURIES - p. 397 406. ABDOMINAL COMPARTMENT SYNDROME - p. 398 407. DAMAGE CONTROL RESUSCITATION - p. 399 408. SUMMARY - p. 400 409. Chapter 43: Interactive Multiple Choice Question - p. 402 410. Chapter 44 Orthopedic Injury - p. 402 411. EPIDEMIOLOGY - p. 402 412. OPEN FRACTURES - p. 402 413. PELVIC FRACTURES - p. 404 414. LONG BONE FRACTURES - p. 407 415. COMPARTMENT SYNDROMES - p. 409 416. OTHER SEQUELAE OF ORTHOPEDIC TRAUMA - p. 411 417. SCAPULOTHORACIC DISSOCIATION - p. 413 418. Chapter 44: Interactive Multiple Choice Question - p. 416 419. Chapter 45 Burn Management - p. 417 420. DEFINITION AND GENERAL CONSIDERATIONS - p. 417 421. BURN SHOCK - p. 418 422. CARDIOVASCULAR RESPONSE - p. 418 423. INHALATIONAL INJURY - p. 419 424. METABOLIC AND NUTRITIONAL CONSIDERATIONS - p. 419 425. BURN WOUND SEPSIS - p. 419 426. SURGICAL CONSIDERATIONS - p. 420 427. TOPICAL WOUND CARE - p. 420 428. SPECIFIC INJURIES - p. 420 429. PSYCHIATRIC AND ANALGESIC CONSIDERATIONS - p. 421 430. Chapter 45: Interactive Multiple Choice Question - p. 422 431. SECTION 5 Surgical Problems In The Intensive Care Unit - p. 423 432. Chapter 46 Surgeon and Intensivist Collaboration in the Care of the ICU Patient - p. 423 433. INTRODUCTION - p. 423 434. DEFINITION OF ICU MODELS AND LEVELS OF CARE - p. 423 435. COMMUNICATION AMONG ICU TEAM MEMBERS - p. 424 436. METHODS FOR ACHIEVING AND MAINTAINING ICU TEAM CONSENSUS - p. 424 437. SUMMARY - p. 425 438. Chapter 46: Interactive Multiple Choice Question - p. 426 439. Chapter 47 Surgical Infections in the Intensive Care Unit - p. 427 440. INTRODUCTION - p. 427 441. PATHOGENESIS - p. 427 442. DIAGNOSIS - p. 428 443. THERAPY - p. 428 444. PROGNOSIS - p. 429 445. Chapter 47: Interactive Multiple Choice Question - p. 429 446. Chapter 48 Care of the Patient with Necrotizing Fasciitis - p. 430 447. INTRODUCTION - p. 430 448. EPIDEMIOLOGY AND RISK FACTORS - p. 430 449. ETIOLOGIES - p. 430 450. PATHOPHYSIOLOGY - p. 430 451. CLASSIFICATION - p. 431 452. SIGNS AND SYMPTOMS - p. 432 453. DIAGNOSTICS - p. 432 454. TREATMENT - p. 433 455. SUMMARY - p. 434 456. Chapter 48: Interactive Multiple Choice Question - p. 434 457. Chapter 49 The ICU Management of Patients Undergoing Major Surgery for Gastrointestinal Cancers - p. 435 458. INTRODUCTION - p. 435 459. PANCREATIC RESECTION - p. 435 460. ESOPHAGEAL RESECTION - p. 436 461. GASTRIC RESECTION - p. 438 462. COLORECTAL RESECTION - p. 438 463. EMERGING ADVANCES - p. 439 464. Chapter 49: Interactive Multiple Choice Question - p. 440 465. Chapter 50 The ICU Approach to the Acute Abdomen - p. 440 466. INTRODUCTION - p. 440 467. EPIDEMIOLOGY - p. 440 468. HISTORY - p. 441 469. PHYSICAL EXAMINATION - p. 441 470. IMAGING - p. 442 471. SPECIFIC CAUSES OF ABDOMINAL PAIN - p. 442 472. SPECIAL POPULATIONS - p. 443 473. MANAGEMENT - p. 443 474. CONCLUSIONS - p. 443 475. Chapter 50: Interactive Multiple Choice Question - p. 443 476. Chapter 51 Abdominal Compartment Syndrome - p. 444 477. INTRODUCTION - p. 444 478. INCIDENCE - p. 444 479. MEASUREMENT OF INTRA-ABDOMINAL PRESSURE - p. 444 480. PHYSIOLOGY - p. 444 481. ABDOMINAL COMPARTMENT SYNDROME - p. 445 482. TREATMENT OPTIONS - p. 446 483. PREVENTION - p. 447 484. SUMMARY - p. 447 485. Chapter 51: Interactive Multiple Choice Question - p. 448 486. Chapter 52 Management of the Obstetrical Patient in the Intensive Care Setting - p. 448 487. INTRODUCTION - p. 448 488. MATERNAL PHYSIOLOGIC ADAPTATIONS TO PREGNANCY - p. 448 489. DIAGNOSTIC RADIATION EXPOSURE - p. 449 490. MEDICATIONS AND PREGNANCY - p. 450 491. SPECIFIC PREGNANCY DISORDERS - p. 451 492. Chapter 52: Interactive Multiple Choice Question - p. 454 493. Chapter 53 Acute Limb Ischemia in the ICU Population - p. 454 494. INTRODUCTION - p. 454 495. ETIOLOGY - p. 454 496. EVALUATION AND DIAGNOSIS OF ACUTE LIMB ISCHEMIA IN THE ICU POPULATION - p. 455 497. TREATMENT OF ACUTE LIMB ISCHEMIA IN THE ICU POPULATION - p. 455 498. OPEN SURGICAL REVASCULARIZATION - p. 456 499. ENDOVASCULAR ANGIOGRAPHY AND THROMBOLYSIS - p. 456 500. POSTOPERATIVE CARE - p. 457 501. MANAGEMENT OF ISCHEMIA-REPERFUSION INJURY AND RHABDOMYOLYSIS - p. 457 502. COMPARTMENT SYNDROME - p. 458 503. UPPER EXTREMITY ACUTE LIMB ISCHEMIA - p. 458 504. RECOMMENDATIONS - p. 458 505. Chapter 53: Interactive Multiple Choice Question - p. 459 506. Chapter 54 Palliative Surgery in the Intensive Care Unit - p. 459 507. INTRODUCTION - p. 459 508. CURRENT STATUS OF PALLIATIVE SURGERY - p. 459 509. MANAGEMENT OF COMMON PALLIATIVE SURGERY CONSULTATIONS - p. 461 510. BENEFITS OF EARLY PALLIATIVE CARE CONSULTS - p. 465 511. SUMMARY - p. 465 512. Chapter 54: Interactive Multiple Choice Question - p. 466 513. SECTION 6 TRANSPLANTATION - p. 467 514. Chapter 55 Management of the Organ Donor - p. 467 515. INTRODUCTION - p. 467 516. DONOR CLASSIFICATION BASED ON THE CRITERIA USED FOR DETERMINATION OF DEATH - p. 468 517. CURRENT STATUS OF SOLID-ORGAN TRANSPLANTATION - p. 469 518. CURRENT STATUS OF ORGAN DONATION - p. 470 519. OTHER OPTIONS TO INCREASE ORGAN AVAILABILITY - p. 471 520. REGULATION AND ORGANIZATION OF ORGAN PROCUREMENT AND ALLOCATION - p. 472 521. LEGAL ASPECTS OF ORGAN DONATION AND BRAIN DEATH - p. 472 522. ORGAN DONATION PROCESS - p. 475 523. PERIOPERATIVE CRITICAL CARE OF THE BRAIN-DEAD ORGAN DONOR - p. 479 524. PERIOPERATIVE CRITICAL CARE OF THE DCD ORGAN DONOR - p. 487 525. Chapter 55: Interactive Multiple Choice Question - p. 490 526. Chapter 56 Critical Care Problems in Kidney Recipients - p. 491 527. INTRODUCTION - p. 491 528. PRETRANSPLANT EVALUATION - p. 491 529. PERIOPERATIVE CARE - p. 492 530. CRITICAL EVALUATION OF DYSFUNCTIONAL GRAFTS - p. 492 531. NONRENAL POSTTRANSPLANTATION COMPLICATIONS - p. 494 532. CURRENT CHALLENGES IN KIDNEY TRANSPLANTATION - p. 498 533. Chapter 56: Interactive Multiple Choice Question - p. 500 534. Chapter 57 Critical Care of Liver Transplant Recipients and Live Liver Donors - p. 501 535. INTRODUCTION - p. 501 536. ORGAN ALLOCATION AND DISPARITY - p. 501 537. CAUSES OF LIVER FAILURE AND LIVER TRANSPLANT CANDIDATE SELECTION - p. 502 538. INTRAOPERATIVE MANAGEMENT - p. 504 539. POSTOPERATIVE MANAGEMENT - p. 505 540. POSTTRANSPLANT SURGICAL COMPLICATIONS - p. 507 541. POSTTRANSPLANTATION MEDICAL COMPLICATIONS - p. 509 542. CARE OF THE LIVING LIVER DONOR - p. 512 543. SUMMARY - p. 513 544. Chapter 57: Interactive Multiple Choice Question - p. 515 545. Chapter 58 Critical Care of the Lung Transplant Recipient - p. 515 546. INTRODUCTION - p. 515 547. INDICATIONS - p. 516 548. GUIDELINES FOR RECIPIENT SELECTION - p. 516 549. DONOR ALLOCATION AND SELECTION - p. 518 550. SURGICAL TECHNIQUES - p. 519 551. GENERAL POSTOPERATIVE MANAGEMENT - p. 519 552. IMMUNOSUPPRESSION - p. 519 553. POSTOPERATIVE COMPLICATIONS - p. 520 554. ICU OUTCOMES - p. 527 555. SUMMARY - p. 527 556. Chapter 58: Interactive Multiple Choice Question - p. 529 557. Chapter 59 Critical Care Problems in Heart and Heart-Lung Transplant Recipients - p. 530 558. INTRODUCTION - p. 530 559. HEART TRANSPLANTATION - p. 530 560. POSTOPERATIVE CARE - p. 533 561. POSTTRANSPLANT LYMPHOPROLIFERATIVE DISEASE - p. 536 562. HEART-LUNG TRANSPLANTATION - p. 536 563. POSTOPERATIVE CARE - p. 537 564. CONCLUSION - p. 537 565. Chapter 59: Interactive Multiple Choice Question - p. 538 566. Chapter 60 Care of the Pancreas Transplant Recipient - p. 538 567. INTRODUCTION - p. 538 568. TECHNICAL ASPECTS OF PANCREAS TRANSPLANTATION - p. 540 569. PRETRANSPLANT EVALUATION - p. 540 570. CONTRAINDICATIONS - p. 541 571. DONOR SELECTION - p. 541 572. IMMUNOLOGY - p. 541 573. ANESTHETIC CONSIDERATIONS FOR THE RECIPIENT - p. 541 574. INTRAOPERATIVE TECHNIQUES - p. 542 575. POSTOPERATIVE CARE - p. 543 576. SURGICAL COMPLICATIONS - p. 544 577. SUMMARY - p. 551 578. Chapter 60: Interactive Multiple Choice Question - p. 553 579. Chapter 61 Critical Care of Intestinal Transplant Recipients - p. 553 580. INTRODUCTION - p. 553 581. SUMMARY - p. 560 582. Chapter 61: Interactive Multiple Choice Question - p. 561 583. Chapter 62 Immunosuppression in Solid-Organ Transplantation - p. 562 584. INTRODUCTION - p. 562 585. IMMUNOSUPPRESSIVE STRATEGIES - p. 562 586. PHARMACOLOGIC AGENTS - p. 563 587. ANTIPROLIFERATIVE AGENTS - p. 564 588. BIOLOGIC IMMUNOSUPPRESSION - p. 566 589. ATGAM - p. 566 590. TREATMENT OF ACUTE REJECTION - p. 567 591. SUMMARY - p. 567 592. Chapter 62: Interactive Multiple Choice Question - p. 569 593. Chapter 63 Hematopoietic Cell Transplantation - p. 569 594. GENERAL PRINCIPLES - p. 570 595. TRANSPLANT-RELATED COMPLICATIONS - p. 571 596. COMPLICATIONS OF T CELL THERAPIES - p. 583 597. Chapter 63: Interactive Multiple Choice Question - p. 586 598. Chapter 64 Management of Graft-vs-Host Disease, Infection, Malignancy, and Rejection in Transplant Recipients - p. 586 599. INTRODUCTION - p. 587 600. GRAFT-VS-HOST DISEASE - p. 587 601. INFECTIONS - p. 588 602. MALIGNANCY - p. 594 603. REJECTION - p. 596 604. SUMMARY - p. 601 605. Chapter 64: Interactive Multiple Choice Question - p. 605 606. SECTION 7 RHEUMATOLOGIC, IMMUNOLOGIC, AND DERMATOLOGIC DISEASES IN THE INTENSIVE CARE UNIT - p. 606 607. Chapter 65 Rheumatologic Diseases in the Intensive Care Unit - p. 606 608. ACUTE RHEUMATIC DISEASES IN THE INTENSIVE CARE SETTING - p. 606 609. ASPECTS OF RHEUMATIC DISEASES COMPLICATING INTENSIVE CARE PROCEDURES - p. 611 610. RHEUMATOID ARTHRITIS - p. 612 611. SYSTEMIC LUPUS ERYTHEMATOSUS - p. 615 612. ANTIPHOSPHOLIPID SYNDROME - p. 622 613. SYSTEMIC SCLEROSIS - p. 623 614. IDIOPATHIC INFLAMMATORY MYOPATHIES - p. 626 615. Chapter 65: Interactive Multiple Choice Question - p. 630 616. Chapter 66 Vasculitis in the Intensive Care Unit - p. 631 617. INTRODUCTION - p. 631 618. POLYARTERITIS NODOSA - p. 631 619. MICROSCOPIC POLYANGIITIS - p. 632 620. CRYOGLOBULINEMIC VASCULITIS - p. 633 621. DRUG-INDUCED VASCULITIS - p. 635 622. CNS VASCULITIS - p. 635 623. OTHER VASCULITIDES - p. 636 624. CHOLESTEROL EMBOLISM - p. 636 625. TREATMENT STRATEGIES IN UNDIFFERENTIATED RHEUMATIC DISEASES PRESENTING WITH CRITICAL ILLNESS AND RELAPSE OR WORSENING KNOWN RHEUMATIC DISEASE - p. 636 626. Chapter 66: Interactive Multiple Choice Question - p. 638 627. Chapter 67 Therapeutics in Immune-Mediated Rheumatic Diseases - p. 639 628. INTRODUCTION - p. 639 629. NONSTEROIDAL ANTI-INFLAMMATORY DRUGS - p. 639 630. CORTICOSTEROID THERAPY - p. 639 631. DISEASE-MODIFYING ANTIRHEUMATIC DRUGS - p. 640 632. BIOLOGIC MODIFIERS - p. 642 633. INTRAVENOUS IMMUNOGLOBULIN - p. 646 634. DMARDS, BIOLOGICS, AND PREGNANCY - p. 646 635. SUMMARY - p. 647 636. Chapter 67: Interactive Multiple Choice Question - p. 647 637. Chapter 68 Anaphylaxis - p. 648 638. PATHOPHYSIOLOGY OF ANAPHYLACTIC REACTIONS - p. 648 639. CLINICAL AND LABORATORY FEATURES - p. 650 640. DIAGNOSIS AND DIFFERENTIAL DIAGNOSIS OF ANAPHYLAXIS - p. 650 641. CLINICAL COURSE OF ANAPHYLACTIC REACTIONS - p. 652 642. TREATMENT OF ANAPHYLAXIS - p. 652 643. PREVENTION OF ANAPHYLACTIC REACTIONS - p. 653 644. MANAGEMENT OF ANAPHYLAXIS TO SPECIFIC AGENTS AND PRECIPITANTS - p. 654 645. Chapter 68: Interactive Multiple Choice Question - p. 660 646. Chapter 69 Dermatology in the Intensive Care Unit - p. 661 647. INTRODUCTION - p. 661 648. DRUG ERUPTIONS - p. 661 649. INFECTIONS - p. 667 650. BLISTERING DISEASES - p. 672 651. VASCULAR DISORDERS - p. 674 652. AUTOIMMUNE SKIN DISEASE - p. 678 653. SUMMARY - p. 681 654. Chapter 69: Interactive Multiple Choice Question - p. 682 655. SECTION 8 INFECTIOUS DISEASE PROBLEMS IN THE INTENSIVE CARE UNIT - p. 683 656. Chapter 70 Approach to Fever for the ICU Patient - p. 683 657. APPROACH TO THE FEBRILE PATIENT - p. 683 658. ETIOLOGY OF FEVER IN THE INTENSIVE CARE PATIENT - p. 683 659. DIAGNOSTIC CONSIDERATIONS - p. 685 660. TREATMENT CONSIDERATIONS - p. 686 661. Chapter 70: Interactive Multiple Choice Question - p. 689 662. Chapter 71 Prevention and Control of Health Care–Acquired Infections in the Intensive Care Unit - p. 690 663. INTRODUCTION - p. 690 664. EPIDEMIOLOGY OF HEALTH CARE–ACQUIRED ICU INFECTIONS - p. 690 665. MICROBIOLOGY OF ICU INFECTIONS - p. 690 666. RISK FACTORS - p. 691 667. PREVENTIVE AND CONTROL MEASURES - p. 691 668. SELECTED HEALTH CARE–ACQUIRED PATHOGENS - p. 694 669. Chapter 71: Interactive Multiple Choice Question - p. 697 670. Chapter 72 Use of Antimicrobials in the Treatment of Infection in the Critically Ill Patient - p. 697 671. INTRODUCTION - p. 697 672. PENICILLINS - p. 697 673. CEPHALOSPORINS - p. 698 674. CARBAPENEMS - p. 701 675. AZTREONAM - p. 701 676. AMINOGLYCOSIDES - p. 701 677. FLUOROQUINOLONES - p. 703 678. VANCOMYCIN - p. 704 679. LIPOGLYCOPEPTIDES - p. 705 680. THERAPY OF ANAEROBIC INFECTIONS - p. 705 681. MACROLIDES - p. 705 682. OXAZOLIDINONES - p. 706 683. TETRACYCLINES - p. 706 684. THERAPY OF FUNGAL INFECTIONS - p. 707 685. TRIAZOLES - p. 708 686. ECHINOCANDINS - p. 709 687. THERAPY OF VIRAL INFECTIONS - p. 709 688. Chapter 72: Interactive Multiple Choice Question - p. 712 689. Chapter 73 Life-Threatening Community-Acquired Bacterial and Parasitic Infections - p. 713 690. INTRODUCTION - p. 713 691. TOXIC SHOCK SYNDROMES - p. 713 692. MENINGOCOCCEMIA - p. 715 693. INTRODUCTION - p. 715 694. OVERWHELMING POST-SPLENECTOMY INFECTION - p. 716 695. INTRODUCTION - p. 716 696. MALARIA - p. 717 697. INTRODUCTION - p. 717 698. TICK-BORNE ILLNESSES - p. 719 699. INTRODUCTION - p. 719 700. MISCELLANEOUS INFECTIOUS DISEASES - p. 720 701. Chapter 73: Interactive Multiple Choice Question - p. 722 702. Chapter 74 Acute Infection in the Non–HIV-Infected Immunocompromised Host - p. 722 703. INTRODUCTION - p. 722 704. SPECIFIC DISEASES WITH ASSOCIATED IMMUNOCOMPROMISE AND ASSOCIATED INFECTIONS - p. 723 705. DIAGNOSTIC APPROACH TO FEVER IN IMMUNOCOMPROMISED PATIENTS - p. 726 706. APPROACH TO SPECIFIC INFECTIOUS DISEASE PRESENTATIONS - p. 726 707. Chapter 74: Interactive Multiple Choice Question - p. 731 708. Chapter 75 Intensive Care of Patients With HIV Infection - p. 732 709. INTRODUCTION - p. 732 710. REASONS FOR INTENSIVE CARE UNIT ADMISSION - p. 732 711. PULMONARY DISORDERS - p. 733 712. CENTRAL NERVOUS SYSTEM DISORDERS - p. 734 713. HEPATIC DISORDERS - p. 735 714. IMMUNE RECONSTITUTION DISORDERS - p. 735 715. OTHER CRITICAL ILLNESSES - p. 735 716. TOXIC EFFECTS OF ANTIRETROVIRAL THERAPY - p. 735 717. MANAGEMENT OF ANTIRETROVIRAL AND PROPHYLACTIC AGENTS - p. 736 718. PREDICTORS OF OUTCOMES - p. 737 719. RISK TO HEALTH CARE WORKERS AND POSTEXPOSURE PROPHYLAXIS - p. 737 720. SUMMARY - p. 738 721. Chapter 75: Interactive Multiple Choice Question - p. 739 722. Chapter 76 Infectious Complications of Persons Who Inject Drugs - p. 740 723. INTRODUCTION - p. 740 724. FEVER - p. 740 725. BACTEREMIA - p. 740 726. SOFT-TISSUE INFECTIONS - p. 741 727. PERIPHERAL VASCULAR INFECTIONS - p. 741 728. ENDOCARDITIS - p. 741 729. SKELETAL INFECTIONS - p. 743 730. SYSTEMIC SYNDROMES WITH SPORE-FORMING BACTERIA - p. 743 731. HUMAN IMMUNODEFICIENCY VIRUS INFECTION - p. 743 732. VIRAL HEPATITIS - p. 744 733. PULMONARY DISEASE AND TUBERCULOSIS - p. 744 734. DISSEMINATED CANDIDIASIS - p. 744 735. OCULAR INFECTIONS - p. 745 736. CENTRAL NERVOUS SYSTEM INFECTIONS - p. 745 737. Chapter 76: Interactive Multiple Choice Question - p. 746 738. Chapter 77 Infective Endocarditis and Infections of Intracardiac Prosthetic Devices - p. 746 739. INTRODUCTION - p. 747 740. ETIOLOGY - p. 747 741. PATHOPHYSIOLOGY - p. 749 742. DIAGNOSIS - p. 750 743. CRITERIA - p. 750 744. HISTORY - p. 751 745. PHYSICAL EXAMINATION - p. 751 746. LABORATORY TESTS - p. 752 747. OTHER DIAGNOSTIC TESTS - p. 753 748. DIFFERENTIAL DIAGNOSIS - p. 754 749. INFECTIONS OF CARDIOVASCULAR IMPLANTABLE ELECTRONIC DEVICES: PACEMAKERS, AUTOMATIC IMPLANTABLE CARDIOVERTER DEFIBRILLATORS, AND VENTRICULAR ASSIST DEVICES - p. 755 750. TREATMENT - p. 756 751. EMPIRIC ANTIBIOTICS - p. 756 752. ANTIMICROBIAL THERAPY - p. 756 753. VALVE SURGERY - p. 756 754. TIMING OF VALVE SURGERY - p. 756 755. PREVENTION OF RECURRENT INFECTIVE ENDOCARDITIS - p. 757 756. RECURRENT INFECTIVE ENDOCARDITIS IN PEOPLE WHO INJECT DRUGS - p. 757 757. ANTIMICROBIAL THERAPY FOR LEFT-SIDED NATIVE VALVE ENDOCARDITIS - p. 757 758. NATIVE VALVE ENDOCARDITIS SECONDARY TO STAPHYLOCOCCI - p. 757 759. NATIVE VALVE ENDOCARDITIS SECONDARY TO STREPTOCOCCI - p. 758 760. NATIVE VALVE ENDOCARDITIS SECONDARY TO ENTEROCOCCI - p. 758 761. NATIVE VALVE ENDOCARDITIS SECONDARY TO HAEMOPHILUS SP, AGGREGATIBACTER ACTINOMYCETEMCOMITANS, CARDIOBACTERIUM HOMINIS, EIKENELLA CORRODENS, AND KINGELLA KINGAE - p. 759 762. CULTURE-NEGATIVE NATIVE VALVE ENDOCARDITIS - p. 759 763. ANTIMICROBIAL THERAPY FOR PROSTHETIC VALVE ENDOCARDITIS - p. 759 764. PROSTHETIC VALVE ENDOCARDITIS SECONDARY TO STAPHYLOCOCCI - p. 759 765. PROSTHETIC VALVE ENDOCARDITIS SECONDARY TO STREPTOCOCCI - p. 759 766. PROSTHETIC VALVE ENDOCARDITIS SECONDARY TO OTHER ORGANISMS - p. 760 767. CULTURE-NEGATIVE PROSTHETIC VALVE ENDOCARDITIS - p. 760 768. PARTIAL ORAL TREATMENT FOR ENDOCARDITIS TRIAL - p. 760 769. SUPPORTIVE CARE AND MONITORING - p. 760 770. ROLE OF SURGERY - p. 760 771. ANTIMICROBIAL THERAPY FOR CARDIOVASCULAR IMPLANTABLE ELECTRONIC DEVICE INFECTIONS - p. 763 772. SUMMARY - p. 764 773. Chapter 77: Interactive Multiple Choice Question - p. 767 774. Chapter 78 Infections Associated With Vascular Catheters - p. 768 775. INTRODUCTION - p. 768 776. PATHOGENESIS OF CATHETER-RELATED INFECTIONS - p. 768 777. DIAGNOSIS OF CATHETER-RELATED INFECTION - p. 768 778. CATHETER-ASSOCIATED INFECTIONS - p. 772 779. Chapter 78: Interactive Multiple Choice Question - p. 775 780. Chapter 79 Urinary Tract Infections - p. 775 781. INTRODUCTION - p. 775 782. THE PATHOPHYSIOLOGY OF URINARY TRACT INFECTIONS - p. 775 783. HOST DEFENSE MECHANISMS AGAINST URINARY TRACT INFECTIONS - p. 776 784. SEVERE URINARY TRACT INFECTIONS - p. 777 785. IMAGING PROCEDURES FOR THE DIAGNOSIS OF URINARY TRACT INFECTIONS - p. 778 786. MEDICAL MANAGEMENT OF URINARY TRACT INFECTIONS - p. 779 787. PREVENTIVE MEASURES AGAINST URINARY TRACT INFECTIONS IN THE ICU SETTING - p. 779 788. THE PROBLEM OF CANDIDURIA - p. 782 789. TREATMENT OF GENITOURINARY CANDIDIASIS - p. 783 790. Chapter 79: Interactive Multiple Choice Question - p. 785 791. Chapter 80 Central Nervous System Infections - p. 785 792. INTRODUCTION - p. 785 793. GENERAL CLINICAL APPROACH - p. 785 794. ACUTE BACTERIAL MENINGITIS - p. 785 795. ENCEPHALITIS - p. 790 796. BRAIN ABSCESS - p. 793 797. PARAMENINGEAL FOCI - p. 793 798. Chapter 80: Interactive Multiple Choice Question - p. 795 799. Chapter 81 Tuberculosis - p. 796 800. INTRODUCTION - p. 796 801. PATHOGENESIS - p. 796 802. CLINICAL MANIFESTATIONS - p. 796 803. DIAGNOSIS - p. 798 804. TREATMENT - p. 800 805. INFECTION CONTROL AND RESPIRATORY ISOLATION - p. 802 806. Chapter 81: Interactive Multiple Choice Question - p. 803 807. Chapter 82 Serious Epidemic Viral Pneumonias - p. 804 808. INTRODUCTION - p. 804 809. SEASONAL RESPIRATORY VIRUSES - p. 808 810. OTHER HUMAN VIRUSES RESULTING IN PNEUMONIA - p. 812 811. NOVEL ZOONOTIC VIRUSES - p. 813 812. Chapter 82: Interactive Multiple Choice Question - p. 815 813. Chapter 83 COVID-19: Presentation, Treatment, and Course of Severe Acute Respiratory Syndrome Coronavirus 2 Infection in the Intensive Care Unit - p. 815 814. ORIGINS - p. 815 815. VIROLOGY - p. 816 816. IMMUNOLOGY - p. 816 817. CLINICAL PRESENTATION - p. 817 818. CLINICAL COURSE - p. 817 819. ISSUES RELATED TO ICU CARE - p. 819 820. OPPORTUNISTIC INFECTIONS AFTER COVID-19 INFECTION - p. 819 821. MANAGEMENT - p. 819 822. LATE SEQUELAE AND “LONG COVID” - p. 820 823. Chapter 83: Interactive Multiple Choice Question - p. 821 824. Chapter 84 Critical Care of Patients Infected With Ebola Virus - p. 822 825. INTRODUCTION - p. 822 826. EPIDEMIOLOGY AND PATHOGENESIS - p. 822 827. CLINICAL PRESENTATION - p. 822 828. INFECTION CONTROL AND OTHER SAFETY CONSIDERATIONS - p. 823 829. CRITICAL CARE MANAGEMENT - p. 824 830. SPECIFIC THERAPIES - p. 825 831. ETHICAL CONSIDERATIONS - p. 825 832. Chapter 84: Interactive Multiple Choice Question - p. 825 833. Chapter 85 Botulism - p. 826 834. INTRODUCTION - p. 826 835. PATHOGENESIS - p. 826 836. EPIDEMIOLOGY - p. 826 837. CLINICAL MANIFESTATIONS - p. 827 838. DIAGNOSIS - p. 827 839. DIFFERENTIAL DIAGNOSIS - p. 827 840. TREATMENT - p. 827 841. Chapter 85: Interactive Multiple Choice Question - p. 828 842. Chapter 86 Tetanus - p. 829 843. INTRODUCTION - p. 829 844. PATHOGENESIS - p. 829 845. EPIDEMIOLOGY - p. 829 846. CLINICAL MANIFESTATIONS - p. 829 847. DIAGNOSIS - p. 830 848. TREATMENT - p. 830 849. Chapter 86: Interactive Multiple Choice Question - p. 831 850. SECTION 9 Hematologic and Oncologic Problems in the Intensive Care Unit - p. 832 851. Chapter 87 Disorders of Hemostasis in Critically Ill Patients - p. 832 852. INTRODUCTION - p. 832 853. NORMAL HEMOSTASIS - p. 832 854. APPROACH TO THE BLEEDING PATIENT - p. 833 855. LABORATORY ASSAYS OF PRIMARY AND SECONDARY HEMOSTASIS - p. 834 856. CONGENITAL DISORDERS OF HEMOSTASIS - p. 835 857. RARE CONGENITAL COAGULATION DISORDERS - p. 838 858. ACQUIRED COAGULATION DISORDERS - p. 840 859. ACQUIRED PLATELET DISORDERS/DYSFUNCTION - p. 844 860. OTHER ACQUIRED BLEEDING DISORDERS - p. 845 861. Chapter 87: Interactive Multiple Choice Question - p. 847 862. Chapter 88 Transfusion Therapy: Blood Components and Transfusion Complications - p. 848 863. INTRODUCTION - p. 848 864. BLOOD COMPONENT THERAPY - p. 848 865. COMPLICATIONS OF TRANSFUSION - p. 852 866. Chapter 88: Interactive Multiple Choice Question - p. 856 867. Chapter 89 Anemia in the Critical Care Setting - p. 856 868. INTRODUCTION - p. 856 869. HEMOLYTIC ANEMIAS - p. 859 870. MICROANGIOPATHIC HEMOLYTIC ANEMIA - p. 862 871. HEMOGLOBINOPATHIES - p. 864 872. CONCLUSIONS - p. 869 873. Chapter 89: Interactive Multiple Choice Question - p. 870 874. Chapter 90 Thrombocytopenia - p. 871 875. INTRODUCTION - p. 871 876. INITIAL EVALUATION - p. 871 877. IMMEDIATE THERAPY—PLATELET TRANSFUSION - p. 872 878. CAUSES OF THROMBOCYTOPENIA - p. 872 879. Chapter 90: Interactive Multiple Choice Question - p. 881 880. Chapter 91 Venous Thromboembolism and Associated Prothrombotic Disorders in the Intensive Care Unit - p. 882 881. INCIDENCE - p. 882 882. RISK FACTORS - p. 882 883. PATHOPHYSIOLOGY - p. 889 884. PREVENTION - p. 889 885. DIAGNOSIS - p. 890 886. TREATMENT - p. 895 887. SPECIAL THERAPEUTIC CONSIDERATIONS - p. 900 888. SEQUELAE OF VENOUS THROMBOEMBOLISM - p. 900 889. Chapter 91: Interactive Multiple Choice Question - p. 906 890. Chapter 92 Antithrombotic Pharmacotherapy - p. 906 891. INTRODUCTION - p. 906 892. ANTIPLATELET PHARMACOTHERAPY - p. 906 893. FIBRINOLYTIC THERAPY - p. 925 894. Chapter 92: Interactive Multiple Choice Question - p. 928 895. Chapter 93 Critical Care of Patients with Hematologic Malignancies - p. 928 896. INTRODUCTION - p. 929 897. OVERVIEW OF HEMATOLOGIC MALIGNANCIES - p. 929 898. DISEASE AND TREATMENT-RELATED COMPLICATIONS - p. 931 899. Chapter 93: Interactive Multiple Choice Question - p. 939 900. Chapter 94 Oncologic Emergencies - p. 940 901. INTRODUCTION - p. 940 902. SUPERIOR VENA CAVA SYNDROME - p. 940 903. CARDIAC TAMPONADE - p. 942 904. MALIGNANT EPIDURAL CORD COMPRESSION - p. 943 905. HYPERCALCEMIA - p. 944 906. LEUKOSTASIS - p. 946 907. ONCOLOGIC THERAPEUTICS - p. 946 908. TUMOR LYSIS SYNDROME - p. 946 909. CYTOKINE RELEASE SYNDROME AND NEUROTOXICITY FROM CHIMERIC ANTIGEN RECEPTOR–T CELL THERAPY - p. 950 910. Chapter 94: Interactive Multiple Choice Question - p. 952 911. Chapter 95 Therapeutic Apheresis: Technical Considerations and Indications in Critical Care - p. 952 912. TECHNICAL RATIONALE AND INSTRUMENTS - p. 952 913. PHYSIOLOGICAL PRINCIPLES - p. 953 914. VASCULAR ACCESS FOR THERAPEUTIC APHERESIS - p. 954 915. ANTICOAGULATION AND FLUID REPLACEMENT - p. 955 916. LIMITATIONS AND POTENTIAL ADVERSE EVENTS - p. 956 917. INDICATIONS FOR THE CRITICALLY ILL - p. 956 918. APHERESIS CONSULTATION - p. 962 919. Chapter 95: Interactive Multiple Choice Question - p. 963 920. SECTION 10 Pharmacology, Overdoses and Poisonings - p. 964 921. Chapter 96 General Considerations in the Evaluation and Treatment of Poisoning - p. 964 922. INTRODUCTION - p. 964 923. EPIDEMIOLOGY - p. 965 924. PHARMACOLOGICAL CONCEPTS - p. 965 925. CLINICAL CONSIDERATIONS - p. 966 926. Chapter 96: Interactive Multiple Choice Question - p. 981 927. Chapter 97 Acetaminophen Poisoning - p. 981 928. INTRODUCTION - p. 981 929. PHARMACOLOGY - p. 981 930. TOXICOLOGY - p. 981 931. CLINICAL MANIFESTATIONS - p. 983 932. DIAGNOSTIC EVALUATION - p. 983 933. MANAGEMENT - p. 984 934. GASTROINTESTINAL DECONTAMINATION - p. 985 935. ANTIDOTAL TREATMENT - p. 985 936. SUPPORTIVE CARE - p. 986 937. SPECIAL CONSIDERATIONS - p. 986 938. ACUTE OVERDOSE BY PEDIATRIC PATIENTS - p. 986 939. ACUTE OVERDOSE DURING PREGNANCY - p. 986 940. ACUTE OVERDOSE OF EXTENDED-RELEASE ACETAMINOPHEN - p. 986 941. CHRONIC OVERDOSE - p. 987 942. LATE TREATMENT - p. 987 943. MASSIVE ACETAMINOPHEN OVERDOSE TREATMENT - p. 987 944. SHORT-COURSE ORAL TREATMENT - p. 987 945. PROGNOSIS AND OUTCOME - p. 987 946. Chapter 97: Interactive Multiple Choice Question - p. 989 947. Chapter 98 Alcohols and Glycol Poisoning - p. 989 948. INTRODUCTION - p. 989 949. ETHANOL - p. 989 950. ALCOHOLIC KETOACIDOSIS - p. 990 951. ETHYLENE GLYCOL AND METHANOL - p. 993 952. ISOPROPANOL - p. 999 953. PROPYLENE GLYCOL - p. 1000 954. DIETHYLENE GLYCOL - p. 1001 955. Chapter 98: Interactive Multiple Choice Question - p. 1003 956. Chapter 99 Amphetamines - p. 1004 957. INTRODUCTION - p. 1004 958. PHARMACOLOGY - p. 1005 959. CLINICAL PRESENTATION - p. 1005 960. DIAGNOSTIC EVALUATION - p. 1007 961. MANAGEMENT - p. 1008 962. Chapter 99: Interactive Multiple Choice Question - p. 1011 963. Chapter 100 Antiarrhythmic Agents - p. 1011 964. INTRODUCTION - p. 1011 965. PHARMACOLOGY - p. 1011 966. CLINICAL PRESENTATION - p. 1013 967. DIAGNOSTIC EVALUATION - p. 1014 968. MANAGEMENT - p. 1014 969. INDIVIDUAL AGENTS - p. 1015 970. Chapter 100: Interactive Multiple Choice Question - p. 1020 971. Chapter 101 Anticholinergic Poisoning - p. 1021 972. INTRODUCTION - p. 1021 973. EPIDEMIOLOGY AND SOURCES - p. 1021 974. PHARMACOLOGY - p. 1021 975. CLINICAL PRESENTATION - p. 1021 976. MANAGEMENT - p. 1021 977. Chapter 101: Interactive Multiple Choice Question - p. 1024 978. Chapter 102 Anticonvulsant Poisoning - p. 1024 979. INTRODUCTION - p. 1024 980. PHENYTOIN - p. 1025 981. VALPROIC ACID - p. 1026 982. CARBAMAZEPINE - p. 1028 983. NEWER ANTICONVULSANTS - p. 1030 984. Chapter 102: Interactive Multiple Choice Question - p. 1033 985. Chapter 103 Antidepressant Poisoning - p. 1033 986. INTRODUCTION - p. 1034 987. HISTORY - p. 1034 988. TYPES OF ANTIDEPRESSANTS - p. 1034 989. PHARMACOLOGY - p. 1034 990. PHARMACOKINETICS - p. 1037 991. CLINICAL TOXICITY - p. 1037 992. DIAGNOSTIC EVALUATION - p. 1040 993. MANAGEMENT - p. 1040 994. Chapter 103: Interactive Multiple Choice Question - p. 1044 995. Chapter 104 Antipsychotic Poisoning - p. 1045 996. PHARMACOLOGY - p. 1045 997. CLINICAL TOXICITY - p. 1051 998. DIAGNOSTIC EVALUATION - p. 1052 999. MANAGEMENT - p. 1053 1000. Chapter 104: Interactive Multiple Choice Question - p. 1055 1001. Chapter 105 β-Blocker Poisoning - p. 1056 1002. INTRODUCTION - p. 1056 1003. PHARMACOLOGY - p. 1056 1004. CLINICAL TOXICITY - p. 1056 1005. DIAGNOSTIC EVALUATION - p. 1058 1006. MANAGEMENT - p. 1058 1007. Chapter 105: Interactive Multiple Choice Question - p. 1060 1008. Chapter 106 Calcium Channel Blocker Poisoning - p. 1060 1009. INTRODUCTION - p. 1060 1010. PHARMACOLOGY - p. 1061 1011. PHYSIOLOGY AND PATHOPHYSIOLOGY - p. 1061 1012. CLINICAL MANIFESTATIONS - p. 1061 1013. DIFFERENTIAL DIAGNOSIS - p. 1062 1014. MANAGEMENT - p. 1062 1015. EXTRACORPOREAL THERAPIES - p. 1065 1016. Chapter 106: Interactive Multiple Choice Question - p. 1066 1017. Chapter 107 Cardiac Glycoside Poisoning - p. 1067 1018. INTRODUCTION - p. 1067 1019. PHARMACOLOGY - p. 1067 1020. CLINICAL PRESENTATION - p. 1067 1021. DIAGNOSTIC EVALUATION - p. 1067 1022. MANAGEMENT - p. 1068 1023. Chapter 107: Interactive Multiple Choice Question - p. 1070 1024. Chapter 108 Cholinergic Poisoning - p. 1071 1025. INTRODUCTION - p. 1071 1026. PHARMACOLOGY - p. 1071 1027. CLINICAL MANIFESTATIONS - p. 1071 1028. DIAGNOSTIC EVALUATION - p. 1073 1029. MANAGEMENT - p. 1074 1030. NERVE AGENTS USED IN WARFARE - p. 1075 1031. Chapter 108: Interactive Multiple Choice Question - p. 1076 1032. Chapter 109 Cocaine Poisoning - p. 1077 1033. INTRODUCTION - p. 1077 1034. PHARMACOLOGY - p. 1077 1035. CLINICAL PRESENTATION - p. 1077 1036. DIAGNOSTIC EVALUATION - p. 1078 1037. MANAGEMENT - p. 1079 1038. Chapter 109: Interactive Multiple Choice Question - p. 1082 1039. Chapter 110 Corrosives Poisoning - p. 1083 1040. INTRODUCTION - p. 1083 1041. PATHOPHYSIOLOGY - p. 1083 1042. CLINICAL MANIFESTATIONS - p. 1083 1043. DIAGNOSTIC EVALUATION - p. 1084 1044. MANAGEMENT - p. 1085 1045. Chapter 110: Interactive Multiple Choice Question - p. 1087 1046. Chapter 111 Heavy Metal Poisoning - p. 1088 1047. INTRODUCTION - p. 1088 1048. ARSENIC - p. 1088 1049. ARSINE GAS - p. 1092 1050. LEAD - p. 1093 1051. MERCURY - p. 1097 1052. Chapter 111: Interactive Multiple Choice Question - p. 1101 1053. Chapter 112 Hydrocarbon Poisoning - p. 1102 1054. INTRODUCTION - p. 1102 1055. ALIPHATIC HYDROCARBONS - p. 1102 1056. HALOGENATED HYDROCARBONS - p. 1104 1057. AROMATIC HYDROCARBONS - p. 1105 1058. TERPENES - p. 1106 1059. Chapter 112: Interactive Multiple Choice Question - p. 1107 1060. Chapter 113 Hydrofluoric Acid Poisoning - p. 1108 1061. INTRODUCTION - p. 1108 1062. MECHANISM OF ACTION - p. 1108 1063. DERMAL EXPOSURE - p. 1108 1064. OCULAR EXPOSURE - p. 1109 1065. INHALATION - p. 1109 1066. INGESTION - p. 1109 1067. Chapter 113: Interactive Multiple Choice Question - p. 1110 1068. Chapter 114 Iron Poisoning - p. 1110 1069. INTRODUCTION - p. 1110 1070. PHARMACOLOGY - p. 1110 1071. CLINICAL TOXICITY - p. 1111 1072. DIAGNOSTIC EVALUATION - p. 1112 1073. MANAGEMENT - p. 1112 1074. Chapter 114: Interactive Multiple Choice Question - p. 1114 1075. Chapter 115 Isoniazid Poisoning - p. 1115 1076. INTRODUCTION - p. 1115 1077. PHARMACOLOGY - p. 1115 1078. CLINICAL PRESENTATION - p. 1116 1079. DIAGNOSTIC EVALUATION - p. 1116 1080. MANAGEMENT - p. 1117 1081. Chapter 115: Interactive Multiple Choice Question - p. 1118 1082. Chapter 116 Lithium Poisoning - p. 1119 1083. INTRODUCTION - p. 1119 1084. PHARMACOLOGY - p. 1119 1085. CLINICAL MANIFESTATIONS - p. 1120 1086. DIAGNOSTIC EVALUATION - p. 1121 1087. MANAGEMENT - p. 1122 1088. SUMMARY - p. 1123 1089. Chapter 116: Interactive Multiple Choice Question - p. 1124 1090. Chapter 117 Methylxanthine Poisoning - p. 1124 1091. INTRODUCTION - p. 1125 1092. PHARMACOLOGY - p. 1125 1093. CLINICAL TOXICITY - p. 1127 1094. DIAGNOSTIC EVALUATION - p. 1128 1095. MANAGEMENT - p. 1128 1096. CAFFEINE - p. 1129 1097. Chapter 117: Interactive Multiple Choice Question - p. 1131 1098. Chapter 118 Opioid Poisoning - p. 1131 1099. INTRODUCTION - p. 1131 1100. PHARMACODYNAMICS - p. 1131 1101. PHARMACOKINETICS - p. 1132 1102. PHARMACOLOGICAL HIGHLIGHTS OF INDIVIDUAL OPIOIDS - p. 1132 1103. CLINICAL PRESENTATION IN OVERDOSE - p. 1135 1104. TOXICITY FEATURES OF SPECIFIC AGENTS FOLLOWING OVERDOSE - p. 1136 1105. DIAGNOSTIC EVALUATION AND DIFFERENTIAL - p. 1136 1106. MANAGEMENT OF OPIOID OVERDOSE - p. 1138 1107. Chapter 118: Interactive Multiple Choice Question - p. 1139 1108. Chapter 119 Pesticide-Herbicide Poisoning - p. 1140 1109. INTRODUCTION - p. 1140 1110. ORGANOCHLORINES - p. 1140 1111. PYRETHROIDS - p. 1143 1112. ANTICOAGULANTS - p. 1144 1113. STRYCHNINE - p. 1145 1114. SODIUM MONOFLUOROACETATE - p. 1146 1115. ALUMINUM AND ZINC PHOSPHIDES - p. 1146 1116. METHYL BROMIDE - p. 1147 1117. N,N-DIETHYL-M-TOLUAMIDE - p. 1148 1118. PENTACHLOROPHENOL - p. 1149 1119. PARAQUAT - p. 1149 1120. DIQUAT - p. 1151 1121. CHLOROPHENOXY HERBICIDES - p. 1151 1122. CHLORATE SALTS - p. 1152 1123. Chapter 119: Interactive Multiple Choice Question - p. 1154 1124. Chapter 120 Phencyclidine and Hallucinogen Poisoning - p. 1154 1125. PHENCYCLIDINE - p. 1155 1126. HALLUCINOGENS - p. 1158 1127. Chapter 120: Interactive Multiple Choice Question - p. 1160 1128. Chapter 121 Salicylate and Other Nonsteroidal Anti-inflammatory Drug Poisoning - p. 1161 1129. INTRODUCTION - p. 1161 1130. PHARMACOLOGY - p. 1161 1131. CLINICAL TOXICITY - p. 1163 1132. DIAGNOSTIC EVALUATION - p. 1164 1133. MANAGEMENT - p. 1165 1134. Chapter 121: Interactive Multiple Choice Question - p. 1169 1135. Chapter 122 Sedative-Hypnotic Agent Poisoning - p. 1169 1136. INTRODUCTION - p. 1169 1137. BENZODIAZEPINES - p. 1169 1138. BARBITURATES - p. 1171 1139. NONBENZODIAZEPINE, NONBARBITURATE SEDATIVE-HYPNOTICS - p. 1173 1140. Chapter 122: Interactive Multiple Choice Question - p. 1177 1141. Chapter 123 Terrestrial Envenomations - p. 1177 1142. INTRODUCTION - p. 1178 1143. SNAKE ENVENOMATION - p. 1178 1144. SPIDER ENVENOMATION - p. 1184 1145. SCORPION ENVENOMATION - p. 1186 1146. CONCLUSION - p. 1188 1147. Chapter 123: Interactive Multiple Choice Question - p. 1189 1148. Chapter 124 Therapeutic Agents for Overdoses and Poisonings - p. 1190 1149. INTRODUCTION - p. 1190 1150. Chapter 125 Withdrawal Syndromes - p. 1210 1151. INTRODUCTION - p. 1210 1152. ETHANOL WITHDRAWAL - p. 1211 1153. BENZODIAZEPINE WITHDRAWAL - p. 1215 1154. γ-HYDROXYBUTYRATE WITHDRAWAL - p. 1216 1155. BACLOFEN WITHDRAWAL - p. 1216 1156. OPIOID WITHDRAWAL - p. 1217 1157. NICOTINE WITHDRAWAL - p. 1219 1158. STIMULANT WITHDRAWAL - p. 1219 1159. Chapter 125: Interactive Multiple Choice Question - p. 1221 1160. VOLUME 2 - p. 1222 1161. SECTION 11 CRITICAL CARE CONSEQUENCES OF WEAPONS (AGENTS) OF MASS DESTRUCTION - p. 1222 1162. Chapter 126 Planning and Organization for Emergency Mass Critical Care - p. 1222 1163. HOSPITAL AND COMMUNITY DISASTER RESPONSE - p. 1222 1164. CRITICAL CARE IN DISASTERS - p. 1224 1165. CRISIS STANDARDS OF CARE AND CRITICAL CARE TRIAGE - p. 1227 1166. SUMMARY - p. 1228 1167. Chapter 126: Interactive Multiple Choice Question - p. 1229 1168. Chapter 127 Chemical Agents of Mass Destruction - p. 1229 1169. INTRODUCTION - p. 1229 1170. HISTORY - p. 1230 1171. DETECTION AND DECONTAMINATION - p. 1230 1172. CLASSIFICATION OF CHEMICAL AGENTS - p. 1232 1173. SUMMARY - p. 1238 1174. DECLARATION - p. 1238 1175. Chapter 127: Interactive Multiple Choice Question - p. 1239 1176. Chapter 128 The Management of Acute Radiation Casualties - p. 1239 1177. INTRODUCTION - p. 1240 1178. TYPES OF RADIATION EMERGENCIES - p. 1240 1179. BASIC RADIATION PHYSICS - p. 1240 1180. RADIATION DOSES - p. 1242 1181. OVERVIEW OF RADIATION CASUALTIES - p. 1242 1182. ACUTE RADIATION SYNDROME AND SUBSYNDROMES - p. 1242 1183. PHASES - p. 1243 1184. DECONTAMINATION - p. 1244 1185. ACUTE RADIATION ILLNESS AND TRAUMA - p. 1246 1186. MANAGEMENT SUMMARY - p. 1247 1187. Chapter 128: Interactive Multiple Choice Question - p. 1249 1188. Chapter 129 Critical Care Consequences of Weapons (or Agents) of Mass Destruction—Biological Agents of Mass Destruction - p. 1249 1189. INTRODUCTION - p. 1249 1190. SMALLPOX - p. 1250 1191. ANTHRAX - p. 1254 1192. TULAREMIA - p. 1259 1193. PLAGUE - p. 1261 1194. BOTULINUM TOXIN - p. 1266 1195. RICIN - p. 1268 1196. Chapter 129: Interactive Multiple Choice Question - p. 1272 1197. SECTION 12 ICU DESIGN, ORGANIZATION, OPERATION AND OUTCOME MEASURES - p. 1273 1198. Chapter 130 Intensive Care Unit Design: Current Standards and Future Trends - p. 1273 1199. INTRODUCTION - p. 1273 1200. THE ICU DESIGN PROCESS - p. 1273 1201. THE ICU PATIENT ROOM - p. 1274 1202. CENTRAL SUPPORT AREAS - p. 1279 1203. ICU INFORMATICS - p. 1281 1204. FUTURE TRENDS - p. 1283 1205. CONCLUSIONS - p. 1284 1206. Chapter 130: Interactive Multiple Choice Question - p. 1285 1207. Chapter 131 Intensive Care Unit Organization and Management - p. 1285 1208. INTRODUCTION - p. 1285 1209. ICU ORGANIZATION - p. 1286 1210. ROLE OF THE ICU DIRECTOR - p. 1287 1211. ICU PROVIDER STAFFING - p. 1287 1212. ICU TELEMEDICINE - p. 1288 1213. PHYSICIAN HUMAN RESOURCE ISSUES - p. 1288 1214. MULTIDISCIPLINARY MODELS: ADVANCED PRACTITIONERS - p. 1289 1215. BUDGET AND PROFESSIONAL REIMBURSEMENT ISSUES - p. 1289 1216. MONITORING CLINICAL CARE - p. 1290 1217. CRITICAL CARE OUTREACH SERVICE AND EARLY WARNING SYSTEMS - p. 1291 1218. OPERATIONAL ISSUES - p. 1291 1219. QUALITY IMPROVEMENT INITIATIVES - p. 1291 1220. SUMMARY - p. 1291 1221. Chapter 131: Interactive Multiple Choice Question - p. 1294 1222. Chapter 132 Critical Care Information Systems (Systems of Engagement and Insight): Structure, Function, and Future - p. 1295 1223. INTRODUCTION - p. 1295 1224. SYSTEMS OF RECORD (CORE EMR) AND SYSTEMS OF ENGAGEMENT (CRITICAL CARE INFORMATION SYSTEMS) - p. 1296 1225. TELE-ICU SYSTEMS - p. 1297 1226. ON-DEMAND/CONSULTATIVE TELEMEDICINE - p. 1297 1227. VIGILANCE TELEMEDICINE/REMOTE PATIENT MONITORING - p. 1297 1228. SYSTEMS OF INSIGHT (DECISION SUPPORT AND ANALYTICS SYSTEMS IN CRITICAL CARE) - p. 1298 1229. PREDICTIVE ANALYTICS - p. 1298 1230. ADVANCES OF DATA VISUALIZATION - p. 1300 1231. GOING FORWARD - p. 1301 1232. ANALYTICAL REPOSITORIES AND REPORTING TOOLS - p. 1302 1233. RISK ADJUSTMENT MODELS FOR COMPARING ICU OUTCOMES - p. 1303 1234. Chapter 132: Interactive Multiple Choice Question - p. 1304 1235. Chapter 133 Defining and Measuring Patient Safety in the Critical Care Unit - p. 1305 1236. INTRODUCTION - p. 1305 1237. SAFETY LESSONS FROM OTHER INDUSTRIES - p. 1305 1238. DEFINITIONS - p. 1305 1239. MEASUREMENT OF SAFETY IN THE INTENSIVE CARE UNIT - p. 1306 1240. INCIDENT REPORTING - p. 1306 1241. TARGETED MONITORING - p. 1307 1242. DISCHARGE DATA - p. 1307 1243. PROCESS OF CARE MEASUREMENT - p. 1307 1244. INTENSIVE CARE UNIT AUDITS - p. 1307 1245. TRIGGER TOOLS - p. 1308 1246. LIMITATIONS OF EXISTING METRICS AND THEIR APPLICATIONS - p. 1308 1247. INTENSIVE CARE UNIT ORGANIZATION - p. 1308 1248. 24/7 COVERAGE BY AN INTENSIVIST - p. 1308 1249. INTENSIVIST-TO-PATIENT RATIOS - p. 1308 1250. INTENSIVISTS OUTSIDE THE WALLS OF THE ICU - p. 1309 1251. NONINTENSIVIST PROVIDERS IN THE ICU - p. 1309 1252. ALTERNATIVE STRATEGIES FOR DELIVERING CRITICAL CARE - p. 1309 1253. PHYSICIAN TRAINING AND DEVELOPMENT OF A CULTURE OF SAFETY - p. 1309 1254. REGULATION AND GOVERNMENT IMPACT ON PATIENT SAFETY - p. 1310 1255. CONCLUSIONS - p. 1311 1256. Chapter 133: Interactive Multiple Choice Question - p. 1313 1257. Chapter 134 Assessing the Impact of Critical Care: Outcomes Research and Methodologies in the Current Era - p. 1314 1258. INTRODUCTION - p. 1314 1259. OUTCOMES IN CRITICAL CARE RESEARCH - p. 1314 1260. METHODS IN OUTCOMES RESEARCH - p. 1318 1261. CONCLUSIONS - p. 1322 1262. Chapter 134: Interactive Multiple Choice Question - p. 1324 1263. Chapter 135 Blockchain Technology and Medical Device Security in the Intensive Care Unit - p. 1325 1264. INTRODUCTION - p. 1325 1265. BLOCKCHAIN DEFINED - p. 1325 1266. PROSPECTIVE ROLE(S) FOR ICU DIAGNOSIS AND PATIENT MANAGEMENT - p. 1326 1267. USE OF REAL-WORLD EVIDENCE TO SUPPORT MEDICAL PRODUCT DEVELOPMENT AND REGULATORY DECISION-MAKING IMPORTANCE TO FDA - p. 1327 1268. KEY MEASURES OF SECURITY AND SAFETY - p. 1327 1269. BLOCKCHAINS IN HEALTH CARE/CURRENT SCOPE OF PRACTICE - p. 1328 1270. THOUGHTS ON BLOCKCHAIN EVALUATION - p. 1329 1271. SUMMARY AND CONCLUSIONS - p. 1329 1272. Chapter 135: Interactive Multiple Choice Question - p. 1329 1273. SECTION 13 ENDOCRINE PROBLEMS IN THE INTENSIVE CARE UNIT - p. 1330 1274. Chapter 136 Management of Hyperglycemia in Critically Ill Patients - p. 1330 1275. INTRODUCTION - p. 1330 1276. ETIOLOGY AND PATHOPHYSIOLOGY - p. 1330 1277. DIAGNOSIS OF HYPERGLYCEMIA FOR THE INTENSIVE CARE UNIT PATIENT - p. 1331 1278. TREATMENT OF CRITICALLY ILL PATIENTS WITH PREEXISTING DIABETES - p. 1331 1279. SURGERY IN THE CRITICALLY ILL PATIENT WITH DIABETES - p. 1334 1280. PITFALLS IN THE CARE OF THE CRITICALLY ILL PATIENT WITH HYPERGLYCEMIA - p. 1335 1281. CONCLUSIONS - p. 1336 1282. Chapter 136: Interactive Multiple Choice Question - p. 1337 1283. Chapter 137 Diabetic Comas: Ketoacidosis and Hyperosmolar Hyperglycemic State - p. 1338 1284. INTRODUCTION - p. 1338 1285. DIABETIC KETOACIDOSIS - p. 1338 1286. HYPERGLYCEMIC HYPEROSMOLAR SYNDROME - p. 1344 1287. CONCLUSIONS - p. 1347 1288. Chapter 137: Interactive Multiple Choice Question - p. 1349 1289. Chapter 138 Hypoglycemia - p. 1350 1290. DEFINITION OF HYPOGLYCEMIA - p. 1350 1291. SYMPTOMS AND SIGNS OF HYPOGLYCEMIA - p. 1350 1292. NORMAL GLUCOSE REGULATORY PHYSIOLOGY - p. 1350 1293. CLASSIFICATION OF HYPOGLYCEMIA - p. 1351 1294. DIFFERENTIAL DIAGNOSIS OF HYPOGLYCEMIA - p. 1352 1295. LABORATORY DIAGNOSIS OF HYPOGLYCEMIA - p. 1358 1296. MANAGEMENT OF HYPOGLYCEMIA - p. 1359 1297. PREVENTION OF HYPOGLYCEMIA IN THE ICU - p. 1360 1298. CONCLUSION - p. 1360 1299. Chapter 138: Interactive Multiple Choice Question - p. 1364 1300. Chapter 139 Hypoadrenal Crisis and the Stress Management of the Patient on Chronic Steroid Therapy - p. 1365 1301. INTRODUCTION - p. 1365 1302. ETIOLOGY - p. 1365 1303. DIAGNOSIS: CLINICAL PRESENTATION AND DIAGNOSTIC WORKUP - p. 1366 1304. DIAGNOSTIC WORKUP - p. 1366 1305. TREATMENT - p. 1367 1306. GLUCOCORTICOID USE FOR STRESSED PATIENTS ON GLUCOCORTICOID TREATMENT - p. 1367 1307. CRITICAL ILLNESS–RELATED CORTICOSTEROID INSUFFICIENCY - p. 1367 1308. Chapter 139: Interactive Multiple Choice Question - p. 1368 1309. Chapter 140 Disorders of Mineral Metabolism - p. 1368 1310. CALCIUM DISORDERS - p. 1369 1311. MAGNESIUM DISORDERS - p. 1372 1312. PHOSPHORUS DISORDERS - p. 1373 1313. Chapter 140: Interactive Multiple Choice Question - p. 1374 1314. Chapter 141 Severe Hyperthyroidism - p. 1375 1315. INTRODUCTION - p. 1375 1316. RISK FACTORS - p. 1375 1317. CLINICAL MANIFESTATIONS - p. 1375 1318. DIAGNOSIS AND DIFFERENTIAL DIAGNOSIS - p. 1375 1319. TREATMENT - p. 1376 1320. CONCLUSIONS - p. 1377 1321. Chapter 141: Interactive Multiple Choice Question - p. 1378 1322. Chapter 142 Myxedema Coma - p. 1378 1323. INTRODUCTION - p. 1378 1324. ETIOLOGY AND PATHOPHYSIOLOGY - p. 1378 1325. CLINICAL MANIFESTATIONS - p. 1379 1326. DIAGNOSIS AND DIFFERENTIAL DIAGNOSIS - p. 1379 1327. TREATMENT - p. 1379 1328. Chapter 142: Interactive Multiple Choice Question - p. 1382 1329. Chapter 143 Nonthyroidal Illness Syndrome (Sick Euthyroid Syndrome) in the Intensive Care Unit - p. 1382 1330. INTRODUCTION - p. 1382 1331. NORMAL THYROID HORMONE ECONOMY - p. 1383 1332. THYROID HORMONE ECONOMY WITH CRITICAL ILLNESS - p. 1384 1333. ALTERATIONS OF THYROID FUNCTION IN SPECIFIC CRITICAL ILLNESSES - p. 1388 1334. MANAGEMENT OF THE CRITICALLY ILL PATIENT WITH ABNORMAL THYROID FUNCTION TESTS - p. 1389 1335. TREATMENT OF THE SICK EUTHYROID SYNDROME WITH THYROID HORMONE - p. 1391 1336. SUMMARY - p. 1393 1337. Chapter 143: Interactive Multiple Choice Question - p. 1396 1338. SECTION 14 NEUROLOGIC PROBLEMS IN THE INTENSIVE CARE UNIT - p. 1397 1339. Chapter 144 An Approach to Neurologic Problems in the Intensive Care Unit - p. 1397 1340. INTRODUCTION - p. 1397 1341. INDICATIONS FOR NEUROLOGIC CONSULTATION IN THE INTENSIVE CARE UNIT - p. 1397 1342. PROGNOSTIC AND ETHICAL CONSIDERATIONS - p. 1399 1343. Chapter 144: Interactive Multiple Choice Question - p. 1400 1344. Chapter 145 Evaluating the Patient With Altered Consciousness in the Intensive Care Unit - p. 1400 1345. ALTERED STATES OF CONSCIOUSNESS - p. 1401 1346. BEDSIDE EVALUATION OF THE COMATOSE PATIENT - p. 1408 1347. INTERPRETATION OF THE NEUROLOGIC EXAMINATION - p. 1411 1348. ANCILLARY TESTS - p. 1411 1349. INITIATION OF EMERGENCY TREATMENT - p. 1412 1350. PROGNOSTICATION - p. 1412 1351. CONCLUSION - p. 1414 1352. Chapter 145: Interactive Multiple Choice Question - p. 1415 1353. Chapter 146 Metabolic Encephalopathy - p. 1416 1354. INTRODUCTION - p. 1416 1355. EVALUATION - p. 1416 1356. ETIOLOGY - p. 1419 1357. CONCLUSIONS - p. 1423 1358. Chapter 146: Interactive Multiple Choice Question - p. 1424 1359. Chapter 147 Mental Status Dysfunction in the Intensive Care Unit: Postoperative Cognitive Impairment - p. 1424 1360. INTRODUCTION - p. 1424 1361. MENTAL STATUS EXAMINATION IN THE INTENSIVE CARE UNIT - p. 1425 1362. MENTAL STATUS DYSFUNCTION IN THE INTENSIVE CARE UNIT - p. 1426 1363. RISK FACTORS - p. 1427 1364. INTERVENTIONS - p. 1427 1365. SUMMARY - p. 1428 1366. Chapter 147: Interactive Multiple Choice Question - p. 1428 1367. Chapter 148 Generalized Anoxia/Ischemia of the Nervous System - p. 1429 1368. INTRODUCTION - p. 1429 1369. PATHOGENESIS - p. 1429 1370. DIAGNOSIS - p. 1429 1371. CLINICAL COURSE AND PROGNOSIS - p. 1429 1372. TREATMENT - p. 1430 1373. SUMMARY - p. 1431 1374. Chapter 148: Interactive Multiple Choice Question - p. 1432 1375. Chapter 149 Cerebrovascular Diseases - p. 1432 1376. INTRODUCTION - p. 1432 1377. ISCHEMIC CEREBROVASCULAR DISEASE - p. 1432 1378. INTRACEREBRAL HEMORRHAGE - p. 1438 1379. Chapter 149: Interactive Multiple Choice Question - p. 1442 1380. Chapter 150 Subarachnoid Hemorrhage - p. 1443 1381. INTRODUCTION - p. 1443 1382. EPIDEMIOLOGY - p. 1443 1383. PATHOGENESIS - p. 1443 1384. CLINICAL PRESENTATION - p. 1444 1385. CLINICAL AND RADIOLOGIC GRADING - p. 1444 1386. DIAGNOSTIC EVALUATION - p. 1444 1387. ANEURYSM MANAGEMENT - p. 1445 1388. NEUROLOGICAL COMPLICATIONS - p. 1445 1389. GENERAL ICU MANAGEMENT - p. 1447 1390. HIGH-VOLUME SAH CENTERS - p. 1448 1391. Chapter 150: Interactive Multiple Choice Question - p. 1449 1392. Chapter 151 Status Epilepticus - p. 1449 1393. INTRODUCTION - p. 1449 1394. ETIOLOGY - p. 1450 1395. PROGNOSIS AND SEQUELAE OF STATUS EPILEPTICUS - p. 1450 1396. SYSTEMIC COMPLICATIONS - p. 1451 1397. DIAGNOSIS - p. 1451 1398. INITIAL ASSESSMENT - p. 1452 1399. MEDICAL MANAGEMENT - p. 1452 1400. CONCLUSIONS - p. 1456 1401. Chapter 151: Interactive Multiple Choice Question - p. 1457 1402. Chapter 152 Guillain-Barré Syndrome - p. 1457 1403. INTRODUCTION - p. 1457 1404. DIAGNOSIS - p. 1457 1405. DIFFERENTIAL DIAGNOSIS - p. 1459 1406. PATHOGENESIS - p. 1461 1407. PATHOLOGY - p. 1461 1408. NATURAL HISTORY - p. 1462 1409. MANAGEMENT - p. 1462 1410. OUTCOME AND PROGNOSTIC FACTORS - p. 1464 1411. SUMMARY - p. 1465 1412. Chapter 152: Interactive Multiple Choice Question - p. 1466 1413. Chapter 153 Myasthenia Gravis in the Intensive Care Unit - p. 1467 1414. INTRODUCTION - p. 1467 1415. PATHOGENESIS - p. 1467 1416. EPIDEMIOLOGY - p. 1467 1417. CLINICAL SPECTRUM - p. 1467 1418. DIAGNOSTIC STUDIES - p. 1467 1419. MISCELLANEOUS STUDIES - p. 1468 1420. CRITICAL CARE OF THE MYASTHENIC PATIENT - p. 1469 1421. THERAPY FOR MYASTHENIC CRISIS - p. 1469 1422. BIOLOGICAL THERAPIES - p. 1472 1423. PERIOPERATIVE MANAGEMENT OF THE MYASTHENIC PATIENT - p. 1473 1424. CONCLUSION - p. 1474 1425. Chapter 153: Interactive Multiple Choice Question - p. 1475 1426. Chapter 154 Newly Acquired Weakness in the Intensive Care Unit: Critical Illness Myopathy and Neuropathy - p. 1475 1427. INTRODUCTION - p. 1475 1428. CRITICAL ILLNESS MYOPATHY - p. 1475 1429. CRITICAL ILLNESS POLYNEUROPATHY - p. 1477 1430. THE DIAGNOSTIC CHALLENGE: DISTINGUISHING CRITICAL ILLNESS MYOPATHY FROM CRITICAL ILLNESS POLYNEUROPATHY - p. 1478 1431. Chapter 154: Interactive Multiple Choice Question - p. 1478 1432. Chapter 155 Neuro-oncological Problems in the Intensive Care Unit - p. 1479 1433. INTRODUCTION - p. 1479 1434. ELEVATED INTRACRANIAL PRESSURE - p. 1479 1435. HYDROCEPHALUS - p. 1483 1436. SEIZURES - p. 1485 1437. POSTOPERATIVE COMPLICATIONS - p. 1486 1438. SPINAL TUMORS - p. 1488 1439. SYSTEMIC COMPLICATIONS - p. 1489 1440. END-OF-LIFE IN THE ICU - p. 1489 1441. Chapter 155: Interactive Multiple Choice Question - p. 1491 1442. Chapter 156 Miscellaneous Neurological Problems in the Intensive Care Unit - p. 1491 1443. INTRODUCTION - p. 1491 1444. SUICIDAL HANGING - p. 1491 1445. ELECTRICAL INJURIES - p. 1492 1446. CARBON MONOXIDE POISONING - p. 1494 1447. DECOMPRESSION SICKNESS - p. 1495 1448. CEREBRAL FAT EMBOLISM SYNDROME - p. 1495 1449. SINGULTUS (HICCUPS) - p. 1496 1450. COMPRESSION NEUROPATHIES - p. 1497 1451. Chapter 156: Interactive Multiple Choice Question - p. 1498 1452. SECTION 15 PSYCHIATRIC ISSUES IN THE INTENSIVE CARE UNIT - p. 1499 1453. Chapter 157 Diagnosis and Treatment of Agitation and Delirium in the Intensive Care Unit Patient - p. 1499 1454. INTRODUCTION - p. 1499 1455. TERMS - p. 1499 1456. OTHER CAUSES OF AGITATION - p. 1504 1457. NONPHARMACOLOGICAL TREATMENT OF AGITATION - p. 1505 1458. LONG-TERM SEQUELAE - p. 1505 1459. CONCLUSION - p. 1506 1460. Chapter 157: Interactive Multiple Choice Question - p. 1507 1461. Chapter 158 Diagnosis and Treatment of Anxiety in the Intensive Care Unit Patient - p. 1508 1462. PHYSIOLOGICAL EXPRESSIONS OF ANXIETY - p. 1508 1463. MEDICAL CAUSES OF ANXIETY - p. 1508 1464. SCENARIOS IN WHICH ANXIETY SIGNIFICANTLY AFFECTS OUTCOMES OF MEDICAL ILLNESS - p. 1509 1465. ANXIETY DISORDERS SPECIFIC TO THE INTENSIVE CARE UNIT - p. 1511 1466. TREATMENT OF ANXIETY DURING AN INTENSIVE CARE UNIT STAY - p. 1512 1467. CONCLUSIONS - p. 1513 1468. Chapter 158: Interactive Multiple Choice Question - p. 1515 1469. Chapter 159 Diagnosis and Treatment of Depression in the Intensive Care Unit Patient - p. 1516 1470. INTRODUCTION - p. 1516 1471. DIAGNOSIS OF DEPRESSION - p. 1516 1472. DIFFERENTIAL DIAGNOSIS OF DEPRESSION - p. 1517 1473. LABORATORY EVALUATION OF DEPRESSION - p. 1519 1474. TREATMENT OF DEPRESSION - p. 1521 1475. SUMMARY - p. 1531 1476. Chapter 159: Interactive Multiple Choice Question - p. 1533 1477. Chapter 160 Managing the Suicidal Patient in the Intensive Care Unit - p. 1534 1478. INTRODUCTION - p. 1534 1479. EPIDEMIOLOGY OF SUICIDE - p. 1534 1480. RISK AND PROTECTIVE FACTORS - p. 1534 1481. PARASUICIDE - p. 1535 1482. TREATMENT OF THE SUICIDAL PATIENT - p. 1535 1483. CONCLUSIONS - p. 1536 1484. Chapter 160: Interactive Multiple Choice Question - p. 1536 1485. Chapter 161 Problematic Behaviors of Patients, Family, and Staff in the Intensive Care Unit - p. 1537 1486. INTRODUCTION - p. 1537 1487. APPROACH TO PROBLEMATIC BEHAVIORS - p. 1537 1488. COMMON PATTERNS OF PROBLEMATIC BEHAVIOR - p. 1538 1489. COMMUNICATION WITH FAMILIES - p. 1541 1490. CONCLUSION - p. 1542 1491. Chapter 161: Interactive Multiple Choice Question - p. 1543 1492. Chapter 162 Recognition and Management of Staff Stress in the Intensive Care Unit - p. 1543 1493. INTRODUCTION - p. 1543 1494. STRESS - p. 1543 1495. BURNOUT SYNDROME - p. 1544 1496. STRESS AND BURNOUT IN HEALTH CARE PROFESSIONALS - p. 1544 1497. STRESS AND BURNOUT AMONG INTENSIVISTS - p. 1545 1498. STRESS AND BURNOUT AMONG INTENSIVE CARE UNIT NURSES - p. 1545 1499. STAFF STRESS AND BURNOUT DURING COVID-19 IN THE INTENSIVE CARE UNIT - p. 1546 1500. MANAGEMENT OF STAFF STRESS AND BURNOUT IN THE INTENSIVE CARE UNIT - p. 1546 1501. CONCLUSIONS - p. 1546 1502. Chapter 162: Interactive Multiple Choice Question - p. 1547 1503. SECTION 16 Pulmonary Problems in the Intensive Care Unit - p. 1548 1504. Chapter 163 Acute Respiratory Failure Due to Acute Respiratory Distress Syndrome and Pulmonary Edema - p. 1548 1505. INTRODUCTION - p. 1548 1506. DEFINITION - p. 1548 1507. HISTOPATHOLOGY - p. 1549 1508. RADIOGRAPHIC FINDINGS - p. 1550 1509. EPIDEMIOLOGY - p. 1551 1510. PATHOGENESIS - p. 1551 1511. PATHOPHYSIOLOGY - p. 1552 1512. MANAGEMENT - p. 1553 1513. PROSPECTIVE FUTURE THERAPIES - p. 1559 1514. PROGNOSIS AND OUTCOMES - p. 1559 1515. CONCLUSIONS - p. 1562 1516. Chapter 163: Interactive Multiple Choice Question - p. 1565 1517. Chapter 164 Acute Respiratory Failure in Pregnancy - p. 1566 1518. INTRODUCTION - p. 1566 1519. CAUSES OF ACUTE RESPIRATORY FAILURE - p. 1569 1520. DIAGNOSTIC TESTING - p. 1573 1521. TREATMENT - p. 1574 1522. PREVENTION - p. 1579 1523. Chapter 164: Interactive Multiple Choice Question - p. 1581 1524. Chapter 165 Extrapulmonary Causes of Respiratory Failure - p. 1582 1525. INTRODUCTION - p. 1582 1526. PATHOPHYSIOLOGY - p. 1582 1527. DIAGNOSIS - p. 1582 1528. DIFFERENTIAL DIAGNOSIS - p. 1591 1529. TREATMENT - p. 1591 1530. Chapter 165: Interactive Multiple Choice Question - p. 1592 1531. Chapter 166 Invasive Mechanical Ventilation and Extracorporeal Life support for Respiratory Failure - p. 1593 1532. INTRODUCTION - p. 1593 1533. MODES OF MECHANICAL VENTILATION - p. 1593 1534. Chapter 166: Interactive Multiple Choice Question - p. 1611 1535. Chapter 167 Mechanical Ventilation—Part II: Noninvasive Mechanical Ventilation for the Adult Hospitalized Patient - p. 1611 1536. INTRODUCTION - p. 1611 1537. TERMINOLOGY - p. 1612 1538. WHY NONINVASIVE MECHANICAL VENTILATION - p. 1612 1539. UTILIZATION AND EPIDEMIOLOGY - p. 1612 1540. INDICATIONS FOR ACUTE APPLICATIONS OF NONINVASIVE VENTILATION - p. 1613 1541. WEAKER INDICATIONS—NONINVASIVE VENTILATION IS AN OPTION - p. 1614 1542. SELECTION GUIDELINES FOR NONINVASIVE VENTILATION IN ACUTE RESPIRATORY FAILURE - p. 1617 1543. TECHNIQUES AND EQUIPMENT FOR NONINVASIVE VENTILATION - p. 1618 1544. MONITORING - p. 1622 1545. SUMMARY AND RECOMMENDATIONS - p. 1625 1546. Chapter 167: Interactive Multiple Choice Question - p. 1628 1547. Chapter 168 Discontinuation of Mechanical Ventilation - p. 1629 1548. INTRODUCTION - p. 1629 1549. UNDERSTANDING THE PROBLEM - p. 1629 1550. PREDICTING SUCCESSFUL DISCONTINUATION - p. 1630 1551. POSTEXTUBATION MANAGEMENT AND RESPIRATORY SUPPORT - p. 1633 1552. COMBINATION OF HIGH-FLOW NASAL CANNULA OXYGEN AND NONINVASIVE POSITIVE PRESSURE VENTILATION - p. 1634 1553. MANAGING DISCONTINUATION FAILURE - p. 1634 1554. Chapter 168: Interactive Multiple Choice Question - p. 1638 1555. Chapter 169 Respiratory Adjunctive Therapies - p. 1639 1556. INTRODUCTION - p. 1639 1557. AEROSOL THERAPY - p. 1639 1558. LUNG-EXPANSION TECHNIQUES - p. 1644 1559. AIRWAY CLEARANCE - p. 1644 1560. ADMINISTRATION OF MEDICAL GASES - p. 1647 1561. CONTINUOUS POSITIVE AIRWAY PRESSURE FOR SLEEP-RELATED BREATHING DISORDERS - p. 1650 1562. COMMUNICATION ALTERNATIVES FOR THE PATIENT WITH AN ARTIFICIAL AIRWAY - p. 1651 1563. Chapter 169: Interactive Multiple Choice Question - p. 1654 1564. Chapter 170 Aspiration - p. 1654 1565. INTRODUCTION - p. 1654 1566. NORMAL DEFENSES AGAINST ASPIRATION AND THE MANNER IN WHICH THEY MAY FAIL - p. 1654 1567. PREVALENCE OF ASPIRATION AMONG THE CRITICALLY ILL - p. 1656 1568. DIAGNOSIS OF AN ASPIRATION SYNDROME - p. 1656 1569. DIFFERENTIAL DIAGNOSIS AND TREATMENT - p. 1657 1570. Chapter 170: Interactive Multiple Choice Question - p. 1660 1571. Chapter 171 Drowning - p. 1660 1572. INTRODUCTION - p. 1660 1573. ETIOLOGY AND PATHOGENESIS - p. 1660 1574. LACK OF LIFE JACKETS AND POOL FENCING - p. 1661 1575. PATHOPHYSIOLOGY - p. 1661 1576. DIAGNOSIS AND CLINICAL PRESENTATION - p. 1663 1577. THERAPIES - p. 1664 1578. CONCLUSIONS - p. 1665 1579. Chapter 171: Interactive Multiple Choice Question - p. 1666 1580. Chapter 172 Acute Exacerbation of Asthma - p. 1666 1581. INTRODUCTION - p. 1666 1582. EPIDEMIOLOGY - p. 1667 1583. PATHOPHYSIOLOGY - p. 1667 1584. DIFFERENTIAL DIAGNOSIS - p. 1668 1585. ASSESSMENT - p. 1668 1586. THERAPEUTIC AGENTS - p. 1670 1587. MANAGEMENT - p. 1672 1588. MANAGEMENT OF SEVERE RESPIRATORY FAILURE - p. 1674 1589. Chapter 172: Interactive Multiple Choice Question - p. 1678 1590. Chapter 173 Critical Care of Acute Exacerbations of Chronic Obstructive Pulmonary Disease - p. 1679 1591. INTRODUCTION - p. 1679 1592. RISK FACTORS FOR ACUTE EXACERBATION OF CHRONIC OBSTRUCTIVE PULMONARY DISEASE - p. 1679 1593. PATHOPHYSIOLOGY - p. 1679 1594. SEVERITY SCORING - p. 1680 1595. ANTIBIOTICS AND BIOMARKERS - p. 1680 1596. MANAGEMENT - p. 1680 1597. EXTRACORPOREAL LIFE SUPPORT, EXTRACORPOREAL CARBON DIOXIDE REMOVAL - p. 1684 1598. Chapter 173: Interactive Multiple Choice Question - p. 1686 1599. Chapter 174 Pulmonary Hypertension in the Intensive Care Unit - p. 1687 1600. INTRODUCTION - p. 1687 1601. CLASSIFICATION/ETIOLOGY - p. 1687 1602. PHYSIOLOGY OF THE PULMONARY CIRCULATION AND RIGHT VENTRICLE - p. 1688 1603. PATHOLOGY AND PATHOGENESIS - p. 1689 1604. DIAGNOSIS - p. 1689 1605. TREATMENT - p. 1690 1606. Chapter 174: Interactive Multiple Choice Question - p. 1693 1607. Chapter 175 Managing Hemoptysis - p. 1694 1608. INTRODUCTION - p. 1694 1609. ETIOLOGY - p. 1694 1610. PATHOGENESIS - p. 1695 1611. DIAGNOSIS - p. 1697 1612. DIFFERENTIAL DIAGNOSIS - p. 1700 1613. TREATMENT - p. 1700 1614. Chapter 175: Interactive Multiple Choice Question - p. 1703 1615. Chapter 176 Pleural Diseases of the Critically Ill Patient - p. 1704 1616. INTRODUCTION - p. 1704 1617. RADIOLOGIC SIGNS OF PLEURAL DISEASE - p. 1704 1618. PLEURAL FLUID - p. 1704 1619. PNEUMOTHORAX - p. 1706 1620. EVALUATION OF THE PATIENT WITH A PLEURAL EFFUSION - p. 1706 1621. PLEURAL EFFUSIONS OF THE CRITICALLY ILL - p. 1707 1622. PNEUMOTHORAX - p. 1714 1623. BRONCHOPLEURAL FISTULA - p. 1716 1624. Chapter 176: Interactive Multiple Choice Question - p. 1719 1625. Chapter 177 Gas Embolism Syndromes - p. 1720 1626. INTRODUCTION - p. 1720 1627. VENOUS GAS EMBOLISM - p. 1720 1628. ARTERIAL GAS EMBOLISM - p. 1725 1629. DECOMPRESSION SICKNESS - p. 1727 1630. Chapter 177: Interactive Multiple Choice Question - p. 1733 1631. Chapter 178 Acute Inhalational Injuries - p. 1733 1632. INTRODUCTION - p. 1734 1633. ASPHYXIANT GASES - p. 1734 1634. IRRITANT GASES - p. 1740 1635. SMOKE - p. 1743 1636. VAPORS - p. 1744 1637. LONG-TERM COMPLICATIONS OF ACUTE INHALATION INJURY - p. 1746 1638. Chapter 178: Interactive Multiple Choice Question - p. 1749 1639. Chapter 179 Chest Radiographic Examination - p. 1750 1640. INTRODUCTION - p. 1750 1641. EVALUATION OF TUBES AND CATHETERS - p. 1750 1642. EVALUATION OF THE LUNG PARENCHYMA - p. 1756 1643. ABNORMALITIES OF THE PLEURA, MEDIASTINUM, AND DIAPHRAGM - p. 1761 1644. CARDIAC ABNORMALITIES - p. 1765 1645. TRAUMA - p. 1766 1646. PULMONARY THROMBOEMBOLISM AND INFARCTION - p. 1770 1647. EXTRAPULMONARY STRUCTURES - p. 1771 1648. Chapter 179: Interactive Multiple Choice Question - p. 1772 1649. Chapter 180 Severe Upper Airway Infections - p. 1772 1650. INTRODUCTION - p. 1773 1651. SINUSITIS - p. 1773 1652. SPHENOID SINUSITIS - p. 1774 1653. OTOGENIC INFECTIONS - p. 1774 1654. SUPRAGLOTTITIS (EPIGLOTTITIS) - p. 1775 1655. INFECTIONS OF THE DEEP SPACES OF THE NECK - p. 1779 1656. Chapter 180: Interactive Multiple Choice Question - p. 1785 1657. Chapter 181 Acute Infectious Pneumonia - p. 1786 1658. INTRODUCTION - p. 1786 1659. TYPES OF PNEUMONIA ENCOUNTERED IN THE INTENSIVE CARE UNIT - p. 1787 1660. PATHOGENESIS OF PNEUMONIA - p. 1790 1661. ETIOLOGY OF PNEUMONIA - p. 1792 1662. CLINICAL FEATURES OF PNEUMONIA - p. 1794 1663. DIAGNOSTIC APPROACH TO THE PATIENT WITH SEVERE PNEUMONIA - p. 1795 1664. THERAPY - p. 1800 1665. STRATEGIES FOR PREVENTION OF PNEUMONIA - p. 1807 1666. Chapter 181: Interactive Multiple Choice Question - p. 1813 1667. Chapter 182 Interventional Pulmonary in the Intensive Care Unit - p. 1814 1668. INTRODUCTION - p. 1814 1669. AIRWAY PROCEDURES - p. 1815 1670. CONCLUSIONS - p. 1826 1671. Chapter 182: Interactive Multiple Choice Question - p. 1827 1672. Chapter 183 Sleep Issues in the Intensive Care Unit Setting - p. 1828 1673. INTRODUCTION - p. 1828 1674. OVERVIEW OF NORMAL ADULT SLEEP - p. 1828 1675. SLEEP IN THE INTENSIVE CARE UNIT - p. 1829 1676. CONSEQUENCES OF DISRUPTED SLEEP IN THE ICU - p. 1834 1677. METHODS TO IMPROVE SLEEP IN THE INTENSIVE CARE UNIT - p. 1834 1678. Chapter 183: Interactive Multiple Choice Question - p. 1839 1679. Chapter 184 Disorders of Temperature Control, Part I: Hypothermia - p. 1840 1680. INTRODUCTION - p. 1840 1681. NORMAL PHYSIOLOGY OF TEMPERATURE REGULATION - p. 1840 1682. UNINTENTIONAL HYPOTHERMIA - p. 1841 1683. IATROGENIC HYPOTHERMIA - p. 1847 1684. INTENTIONAL HYPOTHERMIA - p. 1849 1685. Chapter 184: Interactive Multiple Choice Question - p. 1852 1686. Chapter 185 Disorders of Temperature Control, Part II: Hyperthermia - p. 1853 1687. INTRODUCTION - p. 1853 1688. HEAT STROKE - p. 1853 1689. MALIGNANT HYPERTHERMIA - p. 1856 1690. NEUROLEPTIC MALIGNANT SYNDROME - p. 1858 1691. DRUG-INDUCED HYPERTHERMIA - p. 1861 1692. HYPERTHERMIA AND FEVER CONTROL AFTER BRAIN INJURY - p. 1863 1693. Chapter 185: Interactive Multiple Choice Question - p. 1866 1694. SECTION 17 CARDIOVASCULAR PROBLEMS AND CORONARY CARE - p. 1867 1695. Chapter 186 Evolution of the Modern Cardiovascular Intensive Care Unit - p. 1867 1696. INTRODUCTION - p. 1867 1697. FROM CORONARY TO INTENSIVE CARE - p. 1867 1698. UNDERSTANDING THE NEEDS OF TODAY’S CICU - p. 1869 1699. CONCLUSIONS - p. 1871 1700. Chapter 186: Interactive Multiple Choice Question - p. 1872 1701. Chapter 187 Unstable Angina/Non–ST-Segment Elevation Myocardial Infarction, the Non–ST-Elevation Acute Coronary Syndromes - p. 1872 1702. INTRODUCTION - p. 1872 1703. DEFINITION - p. 1873 1704. PATHOPHYSIOLOGY - p. 1873 1705. CLINICAL PRESENTATION AND DIAGNOSIS - p. 1874 1706. RISK STRATIFICATION - p. 1875 1707. MEDICAL THERAPIES - p. 1876 1708. TREATMENT STRATEGIES AND INTERVENTIONS - p. 1881 1709. CONCLUSIONS - p. 1882 1710. Chapter 187: Interactive Multiple Choice Question - p. 1885 1711. Chapter 188 ST-Segment Elevation Myocardial Infarction - p. 1886 1712. INTRODUCTION - p. 1886 1713. PATHOPHYSIOLOGY - p. 1886 1714. DIAGNOSIS AND RISK ASSESSMENT - p. 1887 1715. REPERFUSION THERAPY - p. 1888 1716. ADJUNCTIVE ANTIPLATELET AND ANTITHROMBOTIC THERAPY - p. 1896 1717. ANTI-ISCHEMIC THERAPY - p. 1898 1718. ARRHYTHMIAS COMPLICATING ST ELEVATION MYOCARDIAL INFARCTION - p. 1900 1719. TRANSITION TO DISCHARGE - p. 1902 1720. Chapter 188: Interactive Multiple Choice Question - p. 1904 1721. Chapter 189 Mechanical Complications of Myocardial Infarction - p. 1904 1722. INTRODUCTION - p. 1904 1723. MECHANICAL COMPLICATIONS INVOLVING MYOCARDIAL RUPTURE - p. 1905 1724. MECHANICAL COMPLICATIONS OF ACUTE MYOCARDIAL INFARCTION WITHOUT RUPTURE - p. 1908 1725. SUMMARY OF RECOMMENDATIONS BASED ON PROFESSIONAL GUIDELINES - p. 1909 1726. Chapter 189: Interactive Multiple Choice Question - p. 1911 1727. Chapter 190 Management of Acute Decompensated Heart Failure - p. 1911 1728. DEFINITION/EPIDEMIOLOGY - p. 1911 1729. PREDICTORS OF PROGNOSIS - p. 1912 1730. ASSESSMENT OF CONGESTION IN ADHF - p. 1913 1731. PHARMACOLOGICAL MANAGEMENT OF ADHF - p. 1913 1732. TRAJECTORY OF ADHF HOSPITAL COURSE - p. 1918 1733. INTENSIVE CARE MANAGEMENT OF ADVANCED ACUTE DECOMPENSATED HEART FAILURE - p. 1919 1734. CONCLUSIONS - p. 1921 1735. Chapter 190: Interactive Multiple Choice Question - p. 1923 1736. Chapter 191 Pharmacological Management of Shock and Hypotension - p. 1924 1737. INTRODUCTION - p. 1924 1738. GENERAL APPROACH TO THE HYPOTENSIVE PATIENT IN THE CARDIAC INTENSIVE CARE UNIT - p. 1924 1739. ADRENERGIC RECEPTOR PHYSIOLOGY - p. 1925 1740. COMMONLY USED VASOPRESSORS AND POSITIVE INOTROPES - p. 1925 1741. CHOOSING AN AGENT - p. 1933 1742. CLINICAL USE OF VASOACTIVE DRUGS - p. 1938 1743. Chapter 191: Interactive Multiple Choice Question - p. 1940 1744. Chapter 192 Mechanical Circulatory Support for Cardiogenic Shock - p. 1940 1745. INTRODUCTION - p. 1941 1746. RATIONALE FOR MCS - p. 1941 1747. INDICATIONS AND CONTRAINDICATIONS FOR TEMPORARY MCS - p. 1941 1748. EPIDEMIOLOGY OF TEMPORARY MCS - p. 1942 1749. AVAILABLE TEMPORARY MCS DEVICES - p. 1942 1750. GENERAL PRINCIPLES OF PATIENT AND DEVICE SELECTION AND TIMING OF DEVICE DEPLOYMENT - p. 1949 1751. CONSIDERATIONS FOR MCS DEVICE SELECTION - p. 1950 1752. COMPLICATIONS OF MECHANICAL CIRCULATORY SUPPORT - p. 1952 1753. MONITORING AND MITIGATING THE RISK OF MCS-RELATED COMPLICATIONS - p. 1953 1754. WEANING MCS - p. 1954 1755. LONG-TERM MCS - p. 1955 1756. SUMMARY - p. 1956 1757. Chapter 192: Interactive Multiple Choice Question - p. 1958 1758. Chapter 193 Valvular Heart Disease - p. 1958 1759. INTRODUCTION - p. 1958 1760. AORTIC STENOSIS - p. 1959 1761. CARDIAC CT - p. 1962 1762. AORTIC REGURGITATION - p. 1964 1763. MITRAL STENOSIS - p. 1966 1764. MITRAL REGURGITATION - p. 1968 1765. TRICUSPID REGURGITATION - p. 1971 1766. PROSTHETIC VALVE DYSFUNCTION - p. 1971 1767. Chapter 193: Interactive Multiple Choice Question - p. 1976 1768. Chapter 194 Acute Aortic Syndromes - p. 1976 1769. INTRODUCTION - p. 1976 1770. AORTIC DISSECTION - p. 1976 1771. CLASSIC AORTIC DISSECTION - p. 1978 1772. INTRAMURAL HEMATOMA - p. 1984 1773. EXPANDING AORTIC ANEURYSM AND RUPTURE - p. 1987 1774. ANEURYSMS OF THE THORACIC AORTA - p. 1988 1775. ANEURYSMS OF THE ABDOMINAL AORTA - p. 1990 1776. SUMMARY OF SELECTED RECOMMENDATIONS BASED ON PROFESSIONAL SOCIETY GUIDELINES - p. 1991 1777. Chapter 194: Interactive Multiple Choice Question - p. 1993 1778. Chapter 195 Management of the Cardiac Arrest Survivor - p. 1994 1779. THE ROLE OF CORONARY ANGIOGRAPHY - p. 1994 1780. HEMODYNAMIC TARGETS - p. 1995 1781. TEMPERATURE CONTROL AFTER CARDIAC ARREST - p. 1995 1782. NEUROLOGICAL PROGNOSTICATION - p. 1998 1783. LONG-TERM RECOVERY - p. 2000 1784. CONCLUSION - p. 2002 1785. Chapter 195: Interactive Multiple Choice Question - p. 2003 1786. Chapter 196 Management of Common Arrhythmias in the Intensive Care Unit - p. 2004 1787. INTRODUCTION - p. 2004 1788. SECTION I: VENTRICULAR ARRHYTHMIAS - p. 2004 1789. SECTION II: SUPRAVENTRICULAR TACHYCARDIA - p. 2012 1790. SECTION III: BRADYARRHYTHMIAS - p. 2018 1791. SUMMARY - p. 2020 1792. Chapter 196: Interactive Multiple Choice Question - p. 2020 1793. Chapter 197 Management of Cardiac Devices in the ICU - p. 2021 1794. INTRODUCTION - p. 2021 1795. GENERAL DEVICE MANAGEMENT - p. 2021 1796. DEVICE-SPECIFIC CONSIDERATIONS - p. 2029 1797. Chapter 197: Interactive Multiple Choice Question - p. 2032 1798. SECTION 18 RENAL PROBLEMS IN THE INTENSIVE CARE UNIT - p. 2033 1799. Chapter 198 Metabolic Acidosis and Metabolic Alkalosis - p. 2033 1800. INTRODUCTION - p. 2033 1801. METABOLIC ACIDOSIS - p. 2034 1802. METABOLIC ALKALOSIS - p. 2040 1803. Chapter 198: Interactive Multiple Choice Question - p. 2043 1804. Chapter 199 Disorders of Plasma Sodium and Plasma Potassium - p. 2044 1805. DISORDERS OF PLASMA SODIUM - p. 2044 1806. RELATIONSHIP BETWEEN PLASMA NA+ AND PLASMA OSMOLALITY - p. 2044 1807. REGULATION OF PLASMA OSMOLALITY - p. 2045 1808. REGULATION OF ANTIDIURETIC HORMONE - p. 2045 1809. HYPONATREMIA - p. 2046 1810. RENAL HYPOPERFUSION-INDUCED HYPONATREMIA - p. 2046 1811. DIURETIC-INDUCED HYPONATREMIA - p. 2046 1812. ADVANCED CHRONIC KIDNEY DISEASE - p. 2047 1813. ENDOCRINE DEFICIENCY - p. 2047 1814. SYNDROME OF INAPPROPRIATE ANTIDIURETIC HORMONE SECRETION - p. 2047 1815. CEREBRAL SALT WASTING - p. 2048 1816. REDUCED SOLUTE INTAKE - p. 2048 1817. PRIMARY POLYDIPSIA - p. 2048 1818. HYPONATREMIA WITHOUT HYPOOSMOLALITY - p. 2048 1819. SYMPTOMS OF HYPOOSMOLALITY - p. 2049 1820. DIAGNOSIS OF HYPONATREMIA - p. 2049 1821. TREATMENT OF HYPONATREMIA - p. 2050 1822. EFFECTS OF POTASSIUM - p. 2050 1823. RISK OF OSMOTIC DEMYELINATION - p. 2050 1824. RECOMMENDATIONS - p. 2051 1825. UREA - p. 2052 1826. ADH-V2 ANTAGONISTS - p. 2052 1827. TREATMENT OF HYPONATREMIA IN EDEMATOUS STATES - p. 2052 1828. CONGESTIVE HEART FAILURE - p. 2052 1829. LIVER DISEASE - p. 2052 1830. HYPERNATREMIA - p. 2053 1831. ETIOLOGY OF HYPERNATREMIA - p. 2053 1832. FREE WATER LOSS - p. 2053 1833. WATER LOSS INTO CELLS - p. 2054 1834. SODIUM OVERLOAD - p. 2054 1835. SYMPTOMS OF HYPERNATREMIA - p. 2054 1836. DIAGNOSIS OF HYPERNATREMIA AND POLYURIC DISORDERS - p. 2054 1837. DIAGNOSIS OF POLYURIC STATES AND DIABETES INSIPIDUS - p. 2054 1838. TREATMENT OF HYPERNATREMIA - p. 2056 1839. RATE OF CORRECTION - p. 2056 1840. TREATMENT OF DIABETES INSIPIDUS - p. 2056 1841. CENTRAL DIABETES INSIPIDUS - p. 2056 1842. NEPHROGENIC DIABETES INSIPIDUS - p. 2056 1843. DISORDERS OF PLASMA POTASSIUM - p. 2057 1844. NORMAL POTASSIUM HOMEOSTASIS - p. 2057 1845. TRANSCELLULAR POTASSIUM SHIFTS - p. 2057 1846. RENAL REGULATION OF POTASSIUM EXCRETION - p. 2057 1847. HYPOKALEMIA - p. 2058 1848. CAUSES OF HYPOKALEMIA - p. 2058 1849. HYPOTHERMIA - p. 2059 1850. CLINICAL MANIFESTATIONS - p. 2061 1851. DIAGNOSIS - p. 2061 1852. URINARY POTASSIUM - p. 2061 1853. TREATMENT - p. 2061 1854. POTASSIUM DEFICIT - p. 2062 1855. POTASSIUM PREPARATIONS - p. 2062 1856. MILD-TO-MODERATE POTASSIUM DEPLETION - p. 2062 1857. SEVERE HYPOKALEMIA - p. 2062 1858. HYPERKALEMIA - p. 2063 1859. ETIOLOGY - p. 2063 1860. INCREASED POTASSIUM RELEASE FROM CELLS. - p. 2063 1861. REDUCED URINARY POTASSIUM EXCRETION - p. 2064 1862. CLINICAL MANIFESTATIONS - p. 2066 1863. TREATMENT - p. 2066 1864. Chapter 199: Interactive Multiple Choice Question - p. 2068 1865. Chapter 200 Acute Kidney Injury in the Intensive Care Unit - p. 2069 1866. OVERVIEW OF ACUTE KIDNEY INJURY - p. 2069 1867. CLINICAL SYNDROMES ASSOCIATED WITH AKI IN THE INTENSIVE CARE UNIT SETTING - p. 2073 1868. DIAGNOSIS OF ACUTE KIDNEY INJURY - p. 2083 1869. COMPLICATIONS AND TREATMENT OF ACUTE KIDNEY INJURY - p. 2084 1870. Chapter 200: Interactive Multiple Choice Question - p. 2091 1871. Chapter 201 Renal Replacement Therapy for the Critically Ill - p. 2092 1872. INTRODUCTION - p. 2092 1873. PRINCIPLES OF SOLUTE CLEARANCE AND FLUID REMOVAL BY DIALYTIC TECHNIQUES - p. 2092 1874. OVERVIEW OF DIALYSIS MODALITIES - p. 2093 1875. TECHNICAL CONSIDERATIONS FOR RENAL REPLACEMENT THERAPY - p. 2096 1876. INDICATIONS FOR AND TIMING OF INITIATION OF RENAL REPLACEMENT THERAPY - p. 2098 1877. MODALITY SELECTION - p. 2102 1878. COMPLICATIONS OF RRT - p. 2104 1879. Chapter 201: Interactive Multiple Choice Question - p. 2106 1880. Chapter 202 Ultrasonography for the Evaluation of the Urinary System - p. 2106 1881. EQUIPMENT - p. 2106 1882. SCANNING TECHNIQUE FOR THE KIDNEY - p. 2106 1883. ULTRASONOGRAPHIC ANATOMY OF THE KIDNEY - p. 2107 1884. SCANNING TECHNIQUES FOR IMAGING THE BLADDER - p. 2107 1885. CLINICAL APPLICATION OF ULTRASONOGRAPHY OF THE URINARY SYSTEM - p. 2108 1886. LIMITATIONS OF ULTRASONOGRAPHY FOR EVALUATION OF AKI - p. 2109 1887. Chapter 202: Interactive Multiple Choice Question - p. 2109 1888. Chapter 203 Drug Dosing in Renal and Hepatic Failure: A Pharmacokinetic Approach to the Critically Ill Patient - p. 2109 1889. INTRODUCTION - p. 2110 1890. PHARMACOKINETIC AND PHARMACODYNAMIC PRINCIPLES - p. 2110 1891. PHARMACOKINETIC CONCEPTS - p. 2111 1892. RENAL DRUG EXCRETION - p. 2112 1893. PHARMACOKINETIC CHANGES AMONG CRITICALLY ILL PATIENTS WITH RENAL DYSFUNCTION - p. 2113 1894. ASSESSING RENAL FUNCTION - p. 2114 1895. DIALYSIS - p. 2114 1896. PHARMACOKINETIC CHANGES OF CRITICALLY ILL PATIENTS WITH HEPATIC FAILURE - p. 2114 1897. Chapter 203: Interactive Multiple Choice Question - p. 2129 1898. SECTION 19 Gastrointestinal Disease Problems in the Intensive Care Unit - p. 2130 1899. Chapter 204 Gastrointestinal Bleeding - p. 2130 1900. INTRODUCTION - p. 2130 1901. INITIAL EVALUATION AND RESUSCITATION - p. 2130 1902. FURTHER EVALUATION AND MANAGEMENT - p. 2131 1903. DIAGNOSTIC EVALUATION - p. 2131 1904. THERAPEUTIC PROCEDURES FOR HEMOSTASIS - p. 2133 1905. SPECIFIC BLEEDING LESIONS - p. 2134 1906. Chapter 204: Interactive Multiple Choice Question - p. 2137 1907. Chapter 205 Stress Ulcer and Acid Peptic Disease - p. 2138 1908. INTRODUCTION - p. 2138 1909. CLINICAL CHARACTERISTICS AND PRESENTATION - p. 2138 1910. RISK FACTORS - p. 2138 1911. PATHOPHYSIOLOGY - p. 2139 1912. PROPHYLAXIS - p. 2140 1913. REGIMENS FOR PROPHYLAXIS - p. 2140 1914. COMPLICATIONS OF PROPHYLAXIS - p. 2141 1915. IMPACT ON MORTALITY AND RISK-BENEFIT ANALYSIS - p. 2141 1916. INAPPROPRIATE USE OF STRESS ULCER PROPHYLAXIS - p. 2141 1917. MANAGEMENT OF STRESS-RELATED AND ACID PEPTIC GI BLEEDING - p. 2142 1918. CONCLUSIONS - p. 2142 1919. Chapter 205: Interactive Multiple Choice Question - p. 2143 1920. Chapter 206 Nausea and Vomiting - p. 2144 1921. INTRODUCTION - p. 2144 1922. PATHOPHYSIOLOGY - p. 2144 1923. EVALUATION AND DIAGNOSTIC APPROACH - p. 2149 1924. TREATMENT APPROACH TO NAUSEA AND VOMITING IN THE ICU - p. 2150 1925. CONCLUSIONS - p. 2151 1926. Chapter 206: Interactive Multiple Choice Question - p. 2152 1927. Chapter 207 Gastrointestinal Motility of the Critically Ill Patient - p. 2153 1928. INTRODUCTION - p. 2153 1929. ESOPHAGEAL DISORDERS: GASTROESOPHAGEAL REFLUX DISEASE - p. 2153 1930. GASTRIC DISORDERS: DELAYED GASTRIC EMPTYING AND GASTROPARESIS - p. 2154 1931. SMALL BOWEL DISORDERS: ILEUS - p. 2155 1932. COLONIC DISORDERS: ACUTE COLONIC PSEUDO-OBSTRUCTION (OGILVIE SYNDROME) - p. 2157 1933. SUMMARY - p. 2158 1934. Chapter 207: Interactive Multiple Choice Question - p. 2160 1935. Chapter 208 Hepatic Dysfunction and Liver Failure - p. 2160 1936. INTRODUCTION - p. 2160 1937. ACUTE LIVER FAILURE - p. 2160 1938. SYSTEMIC MANIFESTATIONS AND MANAGEMENT - p. 2163 1939. CEREBRAL EDEMA - p. 2163 1940. HEPATIC DYSFUNCTION AMONG CRITICALLY ILL PATIENTS - p. 2165 1941. HEPATIC DYSFUNCTION DUE TO CHRONIC LIVER DISEASE AND CIRRHOSIS - p. 2166 1942. HEPATIC HYDROTHORAX - p. 2168 1943. HYPONATREMIA - p. 2168 1944. Chapter 208: Interactive Multiple Choice Question - p. 2171 1945. Chapter 209 Severe and Complicated Biliary Tract Disease - p. 2171 1946. INTRODUCTION - p. 2171 1947. DIAGNOSTIC EVALUATION - p. 2172 1948. BILIARY TRACT DISORDERS ENCOUNTERED IN THE INTENSIVE CARE UNIT - p. 2173 1949. Chapter 209: Interactive Multiple Choice Question - p. 2175 1950. Chapter 210 Acute Pancreatitis - p. 2176 1951. INTRODUCTION - p. 2176 1952. ETIOLOGY AND PATHOPHYSIOLOGY - p. 2176 1953. POST-ERCP PANCREATITIS - p. 2178 1954. CLINICAL PRESENTATION - p. 2178 1955. LABORATORY TESTS AND RADIOLOGIC EXAMINATIONS - p. 2179 1956. DIFFERENTIAL DIAGNOSIS - p. 2180 1957. PROGNOSIS - p. 2180 1958. TREATMENT OF ACUTE PANCREATITIS - p. 2180 1959. LOCAL COMPLICATIONS OF PANCREATITIS - p. 2181 1960. CONCLUSIONS - p. 2183 1961. Chapter 210: Interactive Multiple Choice Question - p. 2184 1962. Chapter 211 Diarrhea and Constipation - p. 2185 1963. DIARRHEA IN THE ICU - p. 2185 1964. ETIOLOGY - p. 2185 1965. DIAGNOSIS - p. 2188 1966. MANAGEMENT - p. 2189 1967. CONCLUSIONS - p. 2190 1968. CONSTIPATION IN THE ICU - p. 2190 1969. DRUG-INDUCED CONSTIPATION - p. 2191 1970. MECHANICAL FACTORS - p. 2191 1971. PHYSIOLOGIC FACTORS - p. 2191 1972. DIETARY FACTORS - p. 2191 1973. PREVENTION OF CONSTIPATION AMONG CRITICALLY ILL PATIENTS - p. 2192 1974. Chapter 211: Interactive Multiple Choice Question - p. 2192 1975. Chapter 212 Fulminant Colitis and Toxic Megacolon - p. 2193 1976. INTRODUCTION - p. 2193 1977. PREDISPOSING FACTORS - p. 2193 1978. CLINICAL FEATURES - p. 2194 1979. MANAGEMENT - p. 2194 1980. Chapter 212: Interactive Multiple Choice Question - p. 2198 1981. SECTION 20 METABOLISM AND NUTRITION - p. 2199 1982. Chapter 213 Nutritional Therapy in the Critically Ill Patient - p. 2199 1983. INTRODUCTION - p. 2199 1984. WHAT IS MALNUTRITION AND HOW DO WE RECOGNIZE IT? - p. 2199 1985. HOW MUCH SHOULD YOU FEED? - p. 2200 1986. WHICH ROUTE OF ADMINISTRATION SHOULD BE CHOSEN? - p. 2201 1987. HOW DO YOU PREVENT COMPLICATIONS AND MAXIMIZE BENEFITS? - p. 2202 1988. WHAT IS THE IMPORTANCE OF PROVIDING SPECIAL KEY NUTRIENTS? - p. 2202 1989. NUTRITIONAL MANAGEMENT FOR CRITICALLY ILL PATIENTS WITH CORONAVIRUS DISEASE 2019 - p. 2203 1990. Chapter 213: Interactive Multiple Choice Question - p. 2203 1991. Chapter 214 Parenteral and Enteral Nutrition in the Intensive Care Unit - p. 2204 1992. INTRODUCTION - p. 2204 1993. CLINICAL CONSEQUENCES OF DELAYING NUTRITIONAL SUPPORT - p. 2205 1994. IDENTIFYING PATIENTS IN NEED OF NUTRITIONAL SUPPORT - p. 2206 1995. NUTRITIONAL REQUIREMENTS - p. 2207 1996. DIFFERENCES BETWEEN ENTERAL AND PARENTERAL NUTRITION - p. 2211 1997. MONITORING PARAMETERS FOR NUTRITIONAL SUPPORT - p. 2216 1998. CONCLUSIONS - p. 2217 1999. Chapter 214: Interactive Multiple Choice Question - p. 2219 2000. Chapter 215 Disease-Specific Nutrition - p. 2219 2001. INTRODUCTION - p. 2219 2002. RENAL FAILURE - p. 2219 2003. LIVER FAILURE - p. 2222 2004. PULMONARY FAILURE - p. 2225 2005. Chapter 215: Interactive Multiple Choice Question - p. 2230 2006. Appendix CALCULATIONS COMMONLY USED IN CRITICAL CARE - p. 2231 2007. Index - p. I-1
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