Handbook of ICU Therapy

Cover
Half-title
Title page
Copyright information
Table of contents
Contributors
Preface to the third edition
Section 1 : Basic principles
	Chapter 1: Oxygen delivery, cardiac function and monitoring
		Oxygen delivery
		Oxygen consumption
		Venous oxygen saturation
		Cardiac function
			Cardiac output
			Heart rate
			Stroke volume
			Ejection fraction
		Preload
		Afterload
		Compliance
		Contractility
		The right and left ventricles: similar but different
		Monitoring
		Oxygen saturation monitoring (pulse oximetry)
		Noninvasive blood pressure monitoring
		Direct arterial blood pressure measurement
		Central venous pressure (CVP) monitoring
		Other ways to assess cardiac function and intravascular volume
			Pulse pressure variation (PPV)
			Echocardiogram
		Pulmonary artery catheters
		References
	Chapter 2 Shock
		Pathophysiology
		Types of shock
			The shock cycle
		Clinical presentation
		Monitoring
			General
			Serial lactate concentrations
			Central venous cannulation
		Management of shock
			Timing
			Airway, oxygenation and ventilation
			Circulatory support
		Anaphylactic shock
		References
	Chapter 3 Oxygen therapy
		Physiology and pathology
		Delivery devices
			Nasal cannulae
			Simple face masks
			Venturi masks
			Non-rebreathing masks
			Tracheostomy masks
			Continuous positive airway pressure (CPAP) masks
		Oxygen therapy in specific illnesses
			Chronic obstructive pulmonary disease (COPD)
			Acute coronary syndromes
			Acute stroke
			Shock
			Cardiac arrest
		Hazards of oxygen therapy
			Central nervous system (CNS)
			Ocular
			Pulmonary
			Drug-induced potentiation of pulmonary oxygen toxicity
		Permissive hypoxemia
		Key points
		References
	Chapter 4 Central venous access
		Indications
		Insertion sites
		Catheter characteristics
		Insertion technique
		Complications of CVCs
			Mechanical CVC complications
				Catheter misplacement
			Arterial puncture and hematoma
			Pneumothorax
		Thrombotic CVC complications
			Catheter-related thrombosis
		Infectious CVC complications
			Catheter-related infections
			Microbiology of CRBSI
			Diagnosis of CRBSI
			Management of CRBSI
			Prevention of CRBSI
		Summary
		References
	Chapter 5 Fluid therapy in ICU
		Body fluid compartments
		Fluid balance
			Intake
			Output
		Types of fluids
			Crystalloids
				Saline
				Balanced (or "physiologic") crystalloid solutions
				Saline versus "balanced" crystalloid solutions
				Glucose and glucose/salines
		Colloids
			Albumin
			Gelatins
			Dextrans
			Starches (Hydroxyethyl starches, HES)
		Positive fluid balance, or liberal versus restrictive fluids
		Surviving Sepsis Guidelines
		Additional practical points
		References
	Chapter 6 Anemia and blood transfusion
		Epidemiology and etiology of anemia in adult intensive care units
		Physiologic effects of anemia
		The role of anemia in morbidity and mortality
		Management of anemia in the critically ill
			Prevention
		Transfusion in critically ill patients
		Effect of transfusion on oxygen transport
		Harmful effects of blood transfusion
			Infectious complications of RBC transfusion
			Noninfectious complications of RBC transfusion
			Transfusion-related acute lung injury (TRALI)
			Transfusion-related immune modulation (TRIM)
			Age of blood
		Effect of RBC transfusion on outcome
		Indications for transfusion
			Ischemic heart disease
			Septic shock
			Neuro-critical care
		A practical approach to RBC transfusion
		References
	Chapter 7 Coagulation problems in the critically ill
		Epidemiology of coagulation abnormalities in critically ill patients
			Abnormalities in platelet count
			Abnormalities in global coagulation assays
			Other coagulation abnormalities
		Mechanisms of coagulopathy
			Coagulation system and inflammation
			Coagulation system and immunity
			Coagulation system and vascular homeostasis
			Coagulation system and tissue remodeling
		Coagulation abnormalities in critically ill patients
			Thrombocytopenia
				Diagnostic approach to thrombocytopenia in critically ill patients
			Prolonged coagulation times
				Diagnostic approach to prolonged coagulation times in critically ill patients
			Disseminated intravascular coagulation (DIC)
			Other coagulation abnormalities
				Platelet function defects
				Hyperfibrinolysis (primary)
		Principles of management of patients with coagulation abnormalities
			Platelet abnormalities
			Coagulation factor deficiencies
		Conclusions
		References
	Chapter 8 Airway management in critically ill patients
		Introduction
		Airway assessment and documentation
		Optimization
		Rapid sequence induction and intubation (RSII)
		Controversies in RSII
		Awake intubation
		Adjunct devices
		Failed or unanticipated difficult airway
		Surgical airway
		Post-intubation management
		Reducing complications in intubation
		The Fourth National Audit Project of the Royal College of Anesthesists and Difficult Airway Society (NAP4)
		Conclusion
		References
	Chapter 9 Noninvasive mechanical ventilation
		Choosing an interface
			Nasal mask
			Full-face mask
			Total face mask
			Helmet
		Initiating NIPPV
		Selecting and adjusting CPAP pressure
		Selecting and adjusting the IPAP pressure
		NIPPV for acute exacerbation of COPD
		NIPPV for acute cardiogenic pulmonary edema
		NIPPV for pneumonia
		NIPPV for ARDS
		NIPPV for immunocompromised patients
		NIPPV as an adjunct to weaning
		References
	Chapter 10 Nutrition
		Introduction
		Reasons for feeding the critically ill patient
		Nutritional status
		Assessment of nutritional status
		Early or late feeding
		Nutritional composition
			Energy and protein requirements
			Composition of nonprotein calories
			Other nutritional requirements
		Oral feeding
		Enteral nutrition
			Complications of enteral nutrition
		Parenteral nutrition
		Hyperglycemia
		Nutrition in acute respiratory failure
		Novel nutritional substrates
			Fish oil
			Glutamine
			Arginine
			Fiber, pro- and prebiotics
		Summary
		References
	Chapter 11 Electrolyte and metabolic acid-base problems
		Metabolic acidosis
			Definition
			Approach to metabolic acidosis
			Causes
				Anion gap metabolic acidosis
				Nonanion-gap MA
					Renal and extrarenal causes
			Acid-base analysis
			Treatment
		Metabolic alkalosis
			Definition
			Pathophysiology
			Clinical features
			Investigations
			Treatment
				Chloride-responsive alkalosis
				Chloride-resistant alkalosis
		Disorders of sodium and water balance
			Overview
			Key hormones
		Hyponatremia
			Definition
			Pathophysiology
			Causes/classification
				Hypovolemic hyponatremia
				Euvolemic hyponatremia
				Hypervolemic hyponatremia
			Clinical presentation
			Management
				Work-up
				Treatment
					Acute hyponatremia (rapid development of hyponatremia in 48 hours)
					Chronic hyponatremia (development of hyponatremia in >48 hours)
		Hypernatremia
			Definition
			Pathophysiology
			Clinical presentation
			Causes/classification
				Hypovolemic hypernatremia
				Euvolemic hypernatremia
				Hypervolemic hypernatremia
			Management
				Work-up (see Figure 11.2)
					Treatment
		Disorders of potassium [10-13]
		Hypokalemia
			Overview
			Pathophysiology
			Causes
				Increased loss
				Transcellular shift
			Clinical features
			Diagnosis
			Treatment
		Hyperkalemia
			Overview
			Causes
			Clinical features
			Diagnosis
			Treatment
				Stabilize cardiac membrane
				Potassium shift into cells
				Removal of potassium
		Disorders of calcium [14-17]
			Overview
		Hypocalcemia
			Definition
			Pathophysiology in the critically ill
			Causes
			Clinical manifestations
			Management
		Hypercalcemia
			Definition
			Causes
			Clinical manifestations
			Diagnosis (investigations)
			Treatment
		Disorders of magnesium [18-19]
			Overview
			Pathophysiology
		Hypomagnesemia
			Definition
			Causes
				Impaired intestinal absorption
				Increased renal excretion
				Miscellaneous
			Clinical features
			Diagnosis
			Treatment
				Severe magnesium deficiency i.e. Mg 0.5 mmol/L
				Less severe magnesium deficiency
		Hypermagnesemia
			Definition
			Causes
				Increased magnesium load
				Renal insufficiency
			Clinical features
			Treatment
		Disorders of phosphorus [20-23]
			Overview
			Pathophysiology
		Hypophosphatemia
			Definition
			Causes
			Clinical manifestations
			Treatment
		Hyperphosphatemia
			Definition
			Causes
			Clinical features
			Treatment
		References
	Chapter 12 Principles of IPPV and care of the ventilated patient
		Care of the ventilated patient
			General issues
			Specific issues
				Deep-vein thrombosis prophylaxis
				Pressure area care
				Eye care
		Daily assessment and management planning
		Airway management
		The role of chest X-rays
		Principles of ventilatory support
			Indications
			Contraindications to IPPV
		Physiological effects of IPPV
			Cardiovascular effects
			Respiratory effects
			Other systemic consequences of IPPV
		Beneficial effects
		Limitations of IPPV
		Goals of ventilatory support
		Initial ventilator settings
		Ventilator-induced lung injury (VILI)
			Barotrauma
			Volume trauma or volutrauma
		Ventilator care bundles
		References
	Chapter 13 Modes of ventilation and ventilator strategies
		Modes of mechanical ventilation
		Inspiratory breath characteristics
			Trigger
			Limit/target
			Cycle
		Controlled modes of ventilation
			Volume control ventilation (VCV)
			Pressure control ventilation (PCV)
			High-frequency oscillatory ventilation (HFOV)
		Assisted modes of ventilation
			Assist control ventilation (ACV)
			Pressure support ventilation (PSV)
			Airway pressure release ventilation (APRV)
			Proportional assist ventilation (PAV)
			Neurally adjusted ventilatory assist (NAVA)
			Positive end-expiratory pressure (PEEP)
		Ventilatory strategies
			Low tidal volume ventilation
			Positive end-expiratory pressure
			High-frequency oscillatory ventilation (HFOV)
		References
	Chapter 14 Discontinuing mechanical ventilation
		Introduction
		Discontinuing ventilation versus extubation
			Readiness to discontinue ventilation
			Readiness for extubation
		Predictors
		Spontaneous breathing trials
		SBTs versus other weaning techniques
		Protocols
		The impact of sedation
		Early mobilization
		Use of noninvasive ventilation in weaning
		Weaning failures
		Extubation failures
		The role and timing of tracheostomy in weaning
		Decannulation
		References
	Chapter 15 Vasoactive drugs
		Structure of the autonomic nervous system
			Neurotransmitters
		Receptor physiology
			Adrenoreceptors
			Alpha receptors
			Beta receptors
			Receptor activity
			Agonism versus antagonism
			Dopaminergic receptors
		Catecholamine metabolism
		Vasopressors
			Norepinephrine
			Phenylephrine
			Ephedrine
			Vasopressin
		Complications of vasopressors
		Inotropic agents (inodilators)
			Dobutamine
			Milrinone
			Isoproterenol
		Mixed agents
			Epinephrine
			Dopamine
			Adverse effects of dopamine
			"Renal-dose" dopamine
			Dopexamine
		Hypotensive agents
			Directly acting vasodilators
				Nitroglycerin (NTG)
				Hydralazine
				Sodium nitroprusside
			Adrenergic receptor antagonists
				Labetalol
				Esmolol
				Phentolamine
		Summary and general points
		References
	Chapter 16 Optimizing antimicrobial therapy in the ICU
		Introduction
		Approach to infection in the critically ill patient
		Principles of antimicrobial therapy
			Determining the spectrum of coverage
			Understanding pharmacokinetics and pharmacodynamics
		Establishing and maintaining antimicrobial activity through appropriate dosing
			Special populations
		Minimizing drug toxicity
		Administering timely antimicrobial therapy
		Reassessing for effect
		Summary
		References
	Chapter 17 Sedation, analgesia and neuromuscular blockade
		Introduction
		Sedation
			Control of stress and anxiety
			Control of intracranial pressure
			Control of seizures and spasms
			Safe transport
			Compliance with procedures
			Facilitate/tolerate controlled ventilation
			Promote a more natural sleep pattern
			Agitation and delirium
			Reduction of metabolic and hormonal response to critical illness
		Sedative agents
		Analgesia
			Analgesic agents
		Management of sedation and analgesia
		Measuring sedation
			Subjective techniques
			Objective techniques
		Muscular relaxation
			Neuromuscular blocking agents
				Suxamethonium (succinylcholine)
				Atracurium
				Cis-atracurium
				Vecuronium
				Rocuronium
				Pancuronium
		Monitoring neuromuscular blockade
		References
	Chapter 18 Continuous renal replacement therapy
		Renal replacement therapy (RRT)
		Hemoltration (CRRT)
		Hemodialysis
		Advantages of CRRT
		Indications for starting RRT
		Timing of CRRT
		Efcacy of CRRT
		Practicalities
			Initial settings
			Filters (membranes)
			Replacement uid
				Pre-dilution:
				Post-dilution:
			Buffers
			Vascular access
				Veno-venous mode
				Arterio-venous mode
		Anticoagulation
			Anticoagulant free
			Continuous pre-filter unfractionated heparin infusion
			Low-molecular-weight heparin
			Regional anticoagulation
			Citrate
			Prostacyclin
		Drug removal
		Intensity of CRRT in the ICU
		The controversy: CRRT or IRT?
		High-volume hemoltration?
		Fluid and electrolyte control
		Septic shock, multiorgan failure and RRT
		Advances in technology
		References
	Chapter 19 Chronic critical illness
		Definition
		Outcomes
		Reducing the risk of progressing to PMV
		Care models
		Management strategies in CCI
			Ventilator support and weaning [22,23]
			Nutritional support [30-32]
			Cognitive care [12,33]
			Physiotherapy [34,35]
			Patient communication [37,38]
		Palliative care
		End-of-life care
		References
	Chapter 20 Recognizing and responding to the deteriorating patient
		Introduction
		Background
		Making the case for rapid response systems
		Clinical research
		The afferent limb
		The efferent limb
		Interventions
		End-of-life care
		MET syndromes and standard operating procedures
			Decreased level of consciousness
		ICU outreach post-discharge from critical care
		Measuring impact of rapid response systems
			Outcomes measures
			Process measures
			Balancing measures
		Audit
		Training requirements
		Considerations for the set-up of a service
		Controversies
		References
	Chapter 21 ICU rehabilitation
		Intensive-care-acquired weakness
		Definition and mechanisms of ICU-AW
		Diagnosis of ICU-AW
		Assessment of strength and function
			Strength tests (other than MRC)
			Functional tests
			Rehabilitation in the ICU
			Rehabilitation interventions
				In-bed exercises
				Out-of-bed exercises
		Neurocognitive interventions
		Resources
		The future
		References
	Chapter 22 Palliative care, withholding and withdrawal of life support in the intensive care unit
		Introduction
		Palliative care
		Definitions
		Models for integrating palliative care into ICU care provision
		Key components of palliative care in ICU [14]
			Framework for ethical decision-making
			Conducting a goal-setting meeting
			Goals of care and care plans, decision-making process
				Prior to the meeting
				During the meeting
				After the meeting
		A practical approach to initiating the palliative approach in ICU
			Cultural change in ICU practice
		Withholding and withdrawal of life support [29]
			Communication
			Documentation
			Withdrawal of life support protocol
		References
Section 2 : Specific problems
	Chapter 23: The injured patient in the ICU
		Epidemiology
		Assessment and initial trauma management
		Airway
			C-spine injury
		Breathing
		Circulation
			Hypovolemic/hypotensive resuscitation
			Blood product ratios and massive transfusion
			Tranexamic acid
			Hemorrhagic sources of shock
			Nonhemorrhagic sources of shock
				Cardiac
			Neurogenic shock (distributive)
			Tension pneumothorax (obstructive)
			Emergency department (resuscitative) thoracotomy
		Disability
		Exposure
		Advanced assessment
			Point-of-care ultrasonography (e-FAST)
			Computed tomography (CT)
		Intraoperative management
			Damage-control surgery
			External fixation and angiography
			Timing of long-bone fracture fixation
		Post-operative care and ongoing resuscitation
			Damage-control resuscitation
				Physiologic endpoints of resuscitation
				Balanced blood product resuscitation (1:1:1)
				Active rewarming
				Guided vasopressor and inotrope therapy
		Abdominal compartment syndrome
		Sedation and analgesia
		Antibiotic therapy
		Early enteral nutrition
		Early mobilization
		Thromboembolic prophylaxis
		Outcome
		References
	Chapter 24 Neurotrauma
		Introduction
		Traumatic brain injury
			General considerations
			Initial assessment and resuscitation
			Intensive care management
			Overview of neuromonitoring
			Management of ICP/CPP
			Hyperosmolar therapy
			Fluid therapy, feeding and glycemic control
			Temperature control
			Other rescue strategies
		Spinal-cord injury
			Neurological injury
			Respiratory effects
			Cardiovascular effects
			Other intensive care considerations
				Genito-urinary effects
				Gastrointestinal system
				Hematological system
				Other effects
			Rehabilitation
		References
	Chapter 25 Acute coronary syndromes
		Epidemiology
		The spectrum of ACS
		Clinical presentation
		Diagnosis of ACS
		Management
			Anti-ischemic therapy
			Statin therapy
			Antithrombotic therapy
			Anticoagulation
			Early risk stratification
			Reperfusion therapy
		Complications of MI
			Pericardial complications
			Arrhythmic complications
		Perioperative management of ACS
			Elective noncardiac surgery after percutaneous coronary intervention
			Management of perioperative myocardial infarction
		References
	Chapter 26 Heart failure
		Classification of AHF
		Characteristics of patients admitted with AHF
		Etiology of AHF
			Cardiac causes
			Noncardiac causes
		Diagnosis of AHF
			Laboratory testing
			Natriuretic peptides
			Troponin
			Electrocardiography
			Chest radiography
			Echocardiography
			Coronary angiography
			Acute heart failure score
			PRIDE acute heart failure score:
		Management of AHF
			Diuretics and ultrafiltration
			Vasodilators
			Oxygenation and ventilatory support
			Inotropes
			Mechanical circulatory support (MCS)
		Transition to chronic care
		References
	Chapter 27 Arrhythmias
		Introduction
		Arrhythmogenesis
			Re-entry
			Abnormal automaticity and triggered activity
		Tachyarrhythmias
			Supraventricular arrhythmias
				Atrial fibrillation and atrial flutter
			Paroxysmal supraventricular tachycardia
			Ventricular arrhythmias
				Ventricular tachycardia
				Torsades de pointes (TdP)
		Bradyarrhythmias
		Summary
		References
	Chapter 28 The patient with sepsis
		Incidence and causes
		Terminology, definitions and conceptual challenges
		Organ dysfunction
		Clinical features and diagnosis
		Pathophysiology
		Management
			Initial resuscitation
			Fluid therapy
			Vasoactive medications
			Source control
			Antimicrobial therapy
			Blood products
			Nutrition
			Glucose control
			Renal replacement therapy
			Mechanical ventilation of sepsis-induced ARDS patients
			Corticosteroids
			Screening and infection prevention
			Supportive care
		Quality assurance in sepsis management
		Conclusions
		References
	Chapter 29 Acute kidney injury
		Incidence of AKI
		Causes of AKI
		Pathogenesis of AKI
		Impact and outcomes of AKI
		Diagnosis and assessment of AKI
		Prevention and treatment of AKI
			Fluid resuscitation
			Fluid type
			Vasopressor support
			Inotropic support
			Diuretics
			Glycemic control with intravenous insulin
		Syndromes associated with AKI
			Contrast nephropathy
			Abdominal compartment syndrome
			Tumor lysis syndrome
			Rhabdomyolysis
			AKI in liver disease
		Conclusions
		References
	Chapter 30 Acute lung injury and ARDS
		Definition of acute respiratory distress syndrome
		Diagnosis
		Pre-dispositions to ARDS
		Incidence
		Pathophysiology
		Clinical features
		Management
			Ventilation strategies
				The open lung concept
				Limiting lung volumes
				Lung recruitment
			Hypercapnia
		Adjuvant therapy
			Fluid restriction
			Prone positioning
			High-frequency oscillatory ventilation
			Inhaled nitric oxide
			Extracorporeal membrane oxygenation (ECMO)
			Drug therapies
				Neuromuscular blockers
				β2 agonists
				Steroids in ARDS
		Outcome
		References
	Chapter 31 The patient with gastrointestinal problems
		Gastrointestinal bleeding
			Upper GI bleeds
			Lower GI bleeds
		Management of gastrointestinal bleeding in the ICU
			General principles of management
			Stress-induced ulceration
			Gastroesophageal varices
			Medications
				Vasopressin and terlipressin
				Somatostatin and octreotide
			Infection and use of prophylactic antibiotics
			Endoscopic therapy
			Balloon tamponade
			Transjugular intrahepatic portosystemic shunt (TIPS)
			Surgery
		Ischemic colitis
		Clostridium difficile infection
			Diagnosis
			Medical management
			Surgical management
		Intra-abdominal hypertension (IAH) and abdominal compartment syndrome (ACS)
			Medical management of IAH/ACS [21,22]
			Surgical management of ACS [21,22]
		Acute pancreatitis
			Etiology
			Predicting severity of disease
			Management
			Current controversies in management
				Feeding
				Antibiotics
				The role of surgery
		Acute mesenteric ischemia
			Nonocclusive mesenteric ischemia (NOMI)
			Diagnosis
			Treatment
		Acute colonic pseudo-obstruction (Ogilvie's syndrome)
			Etiology
			Pathogenesis
			Clinical manifestations
			Diagnosis
			Laboratory evaluation
			Imaging
			Treatment
			General measures
			Pharmacologic agents
			Decompression
			Surgery
		References
	Chapter 32 The comatose patient: neurological aspects
		The approach to the acutely unresponsive patient
		Therapy
		Status epilepticus
		Anoxic-ischemic encephalopathy after cardiac arrest
		Prognostic determination of cardiac arrest survivors not treated with hypothermia [20]
		Prognostic determination after hypothermia
		Improving prognostic accuracy in the hypothermic era
		Some general statements regarding prognostic determination and discussions of level of care
		References
	Chapter 33 The obstetric patient in the ICU
		Introduction
		Changes in pregnancy
			Respiratory system
			Cardiovascular
			Renal
		Maternal critical care epidemiology
		Obstetric conditions resulting in ICU admission
			Pre-eclampsia and eclampsia
			Features of severe pre-eclampsia
			Management of severe pre-eclampsia and eclampsia
			HELLP syndrome
			Venous thromboembolism (VTE)
				Diagnosis
				Treatment
			Amniotic fluid embolism (AFE)
			Major obstetric hemorrhage
				Management
					Pharmacological
					Surgical
					Radiological
		Nonobstetric complications
			Sepsis
			Respiratory infections
			Trauma
			Cardiopulmonary arrest
		The care of the parturient in critical care
		References
	Chapter 34 The critically ill asthmatic
		Incidence
		Pathophysiology
		Differential diagnosis
		Clinical examination
		Investigations
		Management
			Education
			Initial treatment
		Indications for ICU admission
		Noninvasive ventilation
		Indications for intubation
		Mechanical ventilation of the asthmatic patient
			Ventilation strategies in severe asthma [25]
		Oxygen
			Respiratory rate
			Inspiratory to expiratory ratio
			Tidal volumes
			Positive end-expiratory pressure (PEEP)
			Inspiratory flow
		Permissive hypercapnia
		Dynamic hyperinflation
		Additional medical therapies
			Intravenous magnesium sulfate
			Ketamine
			Heliox
			Volatile anesthetic agents
			Extracorporeal membrane oxygenation (ECMO)
		References
	Chapter 35 Endocrine problems in critical illness
		Hyperglycemic crises [1]
			Indications for admission to ICU
			Principles of treatment
			Fluid management
			Insulin
			Potassium
			Other issues
		Glycemic control in the ICU
		Corticosteroid use in the ICU
		References
	Chapter 36 The cardiac surgical patient in the ICU
		Structure of cardiac surgical critical care unit
		Pre-operative assessment
		Transfer of care
		Fast-track cardiac anesthesia
		Post-operative complications
			Bleeding
			Cardiac tamponade
			Cardiac arrest
			Arrhythmia
			Neurological complications
			Acute kidney injury
			Vasoplegic syndrome
		Special procedures
			Heart transplantation
			Ventricular assist devices
			Emerging surgical techniques
		References
	Chapter 37 Care of the organ donor
		Introduction
		Physiological changes associated with NDD
			Neurological
			Cardiovascular
			Pulmonary
			Endocrine
			Hypothermia
			Hepatic
			Coagulation
			Immunological
		Organ monitoring
		Investigations
		Therapeutic interventions
		Cardiovascular
			Hypotension
				Fluid therapy
				Vasoactive drug support
			Hypertension
		Endocrine
			Diabetes insipidus
			Anterior pituitary hormones
				Thyroid hormones
				Adrenal hormones
		Hyperglycemia
		Hypothermia
		Pulmonary
		Nutritional support
		Hematological support
		Summary
		References
	Chapter 38 The patient with cardiac arrest
		Classification
			Sudden cardiac arrest and asphyxial arrest
			Shockable and nonshockable rhythms
			Out-of-hospital and in-hospital cardiac arrest
			Expected death in critically ill patients
		Causes
			Hs
			Ts
		Prevention of in-hospital cardiac arrest
		Basic life support
			Adult BLS sequence
			Team resuscitation
			Alternative CPR techniques
			CPR devices
		Advanced life support
			Rhythm-based management
			Electrical therapies
			Monitoring and optimization of CPR quality
			Effective teamwork and leadership
			Drugs
			Advanced airway management
		Cardiac arrest in special circumstances
			Asthma
			Pulmonary embolism
			Hyperkalemia
			Cardiac arrest following cardiac surgery
			Cardiac arrest associated with pregnancy
		Post-resuscitation care
			Avoiding hyperoxia
			Induced hypothermia
			Acute coronary syndrome management
		Survival and neurologic outcomes
			Prognostication of neurological outcome
		Providing emotional support to the family
		Education and training
			Training intervals
			Improving communication skills
			Debriefing
		Quality improvement in resuscitation
		Further reading
		References
Index