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Core Topics in Critical Care Medicine

Details

  • 91 b/w illus. 105 colour illus.
  • Page extent: 408 pages
  • Size: 246 x 189 mm
  • Weight: 1.2 kg

Library of Congress

  • Dewey number: 616.028
  • Dewey version: 22
  • LC Classification: RC86.7 .C667 2010
  • LC Subject headings:
    • Critical care medicine
    • Critical Care--methods

Library of Congress Record

Hardback

 (ISBN-13: 9780521897747)

Core Topics in Critical Care Medicine
Cambridge University Press
9780521897747 - Core Topics in Critical Care Medicine - Edited by Fang Gao Smith and Joyce Yeung
Frontmatter/Prelims

Core Topics in Critical Care Medicine


Core Topics in Critical Care Medicine

Edited by

Fang Gao Smith

Professor in Anaesthesia, Critical Care Medicine and Pain, Academic Department of Anaesthesia, Critical Care and Pain, Heart of England NHS Foundation Trust, Clinical Trials Unit, University of Warwick, UK

Joyce Yeung

Anaesthetic Specialist Registrar, Warwickshire Rotation, West Midlands Deanery and Research Fellow, Academic Department of Anaesthesia, Critical Care and Pain, Heart of England NHS Foundation Trust, UK


CAMBRIDGE UNIVERSITY PRESS
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Published in the United States of America by Cambridge University Press, New York

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Information on this title: www.cambridge.org/9780521897747

© F. Gao Smith and J. Yeung 2010

This publication is in copyright. Subject to statutory exception and to the provisions of relevant collective licensing agreements, no reproduction of any part may take place without the written permission of Cambridge University Press.

First published 2010

Printed in the United Kingdom at the University Press, Cambridge

A catalogue record for this publication is available from the British Library

ISBN 978-0-521-89774-7 Hardback

Cambridge University Press has no responsibility for the persistence or accuracy of URLs for external or third-party Internet websites referred to in this publication, and does not guarantee that any content on such websites is, or will remain, accurate or appropriate.

Every effort has been made in preparing this publication to provide accurate and up-to-date information which is in accord with accepted standards and practice at the time of publication. Although case histories are drawn from actual cases, every effort has been made to disguise the identities of the individuals involved. Nevertheless, the authors, editors and publishers can make no warranties that the information contained herein is totally free from error, not least because clinical standards are constantly changing through research and regulation. The authors, editors and publishers therefore disclaim all liability for direct or consequential damages resulting from the use of material contained in this publication. Readers are strongly advised to pay careful attention to information provided by the manufacturer of any drugs or equipment that they plan to use.


Contents

List of contributors
vii
Foreword by Julian Bion
ix
Preface
xi
Acknowledgements
xii
List of abbreviations
xiii
Section I Specific features of critical care medicine
1
1         Recognition of critical illness
Edwin Mitchell
1
2         Advanced airway management
Isma Quasim
6
3         Patient admission and discharge
Santhana Kannan
16
4         Transfer of the critically ill
Gavin Perkins
21
5         Scoring systems and outcome
Roger Stedman
27
6         Information management in critical care
Roger Stedman
34
7         Haemodynamics monitoring
Anil Kumar and Joyce Yeung
40
8         Critical care imaging modalities
Frances Aitchison
49
9         Vasoactive drugs
Mamta Patel
58
10        Nutrition
Yasser Tolba
66
11        Pain control
Edwin Mitchell
72
12        Sedation
Joyce Yeung
77
13        Ethics
John Bleasdale
85
14        Organ donation
Angeline Simons and Joyce Yeung
91
Section IISystemic disorders and management
99
15        Sepsis
Yasser Tolba and David Thickett
99
16        Multiple organ failure
Zahid Khan
108
17        Immunosuppressed patients
Tara Quasim
116
18        Principles of antibiotics use
Edwin Mitchell
124
19        Fluid and electrolyte disorders
Prasad Bheemasenachar
130
20        Acid–base abnormalities
Prasad Bheemasenachar
148
21        Post-operative critical care
Prasad Bheemasenachar
159
22        Post-resuscitation care
Gavin Perkins
170
Section IIIOrgan dysfunction and management
177
23        Bleeding and clotting disorders
Nick Murphy
177
24        Acute coronary syndromes
Harjot Singh and Tony Whitehouse
185
25        Cardiac arrhythmias
Khai Ping Ng and George Pulikal
194
26        Acute heart failure
Harjot Singh and Tony Whitehouse
202
27        Mechanical ventilation
Bill Tunnicliffe
212
28        Failure of ventilation
Darshan Pandit and Joyce Yeung
226
29        Failure of oxygenation
Darshan Pandit and Joyce Yeung
232
30        Respiratory weaning
Darshan Pandit
241
31        Non-invasive ventilation
David Thickett
246
32        Unconventional strategies for respiratory support
Bill Tunnicliffe
251
33        Acute gastrointestinal bleeding and perforation
Mamta Patel and Richard Skone
257
34        Severe acute pancreatitis
Andrew Burtenshaw and Neil Crooks
266
35        Poisoning
Zahid Khan
275
36        Liver failure
Nick Murphy and Joyce Yeung
284
37        Acute renal failure
Andrew Burtenshaw
292
38        Renal replacement therapy
Andrew Burtenshaw
299
39        Status epilepticus
Joyce Yeung
306
40        Abnormal levels of consciousness
Anil Kumar
312
41        Meningitis and encephalitis
Nick Sherwood
319
42        Traumatic brain injury
Randeep Mullhi and Sandeep Walia
325
43        Trauma and burns
Catherine Snelson
334
44        Eclampsia and pre-eclampsia
John Clift
342
45        Obstetric emergencies in the ICU
John Clift and Elinor Powell
349
46        Paediatric emergencies
Nageena Hussain and Joyce Yeung
360
Section IVExaminations
369
47        Core areas required for UK/European Diploma examinations
Zahid Khan
369
48        Examples of mock MCQs and viva questions
Zahid Khan
374
Index
380

Contributors

Frances Aitchison

Consultant Radiologist
Birmingham City Hospital
West Midlands Critical Care Research Network
Birmingham, UK

Prasad Bheemasenachar

Consultant Intensivist
Birmingham Heartlands Hospital
West Midlands Critical Care Research Network
Birmingham, UK

John Bleasdale

Consultant Intensivist
Birmingham City Hospital
West Midlands Critical Care Research Network
Birmingham, UK

Andrew Burtenshaw

Consultant Intensivist
Worcestershire Royal Hospital
West Midlands Critical Care Research Network
Worcester, UK

John Clift

Consultant Anaesthetist
Birmingham City Hospital
West Midlands Critical Care Research Network
Birmingham, UK

Neil Crooks

Anaesthetic Specialist Registrar
Birmingham Heartlands Hospital
West Midlands Critical Care Research Network
Birmingham, UK

Fang Gao Smith

Professor in Critical Care Medicine
Birmingham Heartlands Hospital
West Midlands Critical Care Research Network
Birmingham, UK

Nageena Hussain

Anaesthetic Specialist Registrar
University Hospital Coventry and Warwickshire
West Midlands Critical Care Research Network
Birmingham, UK

Santhana Kannan

Consultant Intensivist
Birmingham City Hospital
West Midlands Critical Care Research Network
Birmingham, UK

Zahid Khan

Consultant Intensivist
Birmingham City Hospital
West Midlands Critical Care Research Network
Birmingham, UK

Anil Kumar

Anaesthetic Specialist Registrar
University Hospital Coventry and Warwickshire
West Midlands Critical Care Research Network
Birmingham, UK

Edwin Mitchell

Consultant Intensivist
Birmingham City Hospital
West Midlands Critical Care Research Network
Birmingham, UK

Randeep Mullhi

Anaesthetic Specialist Registrar
University Hospital Birmingham
West Midlands Critical Care Research Network
Birmingham, UK

Nick Murphy

Consultant Intensivist
University Hospital Birmingham
West Midlands Critical Care Research Network
Birmingham, UK

Darshan Pandit

Consultant Intensivist
Russell Hall Hospital
West Midlands Critical Care Research Network
Dudley, UK

Mamta Patel

Consultant Intensivist
Birmingham City Hospital
West Midlands Critical Care Research Network
Birmingham, UK


Gavin Perkins

Associate Clinical Professor in Critical Care Medicine
Birmingham Heartlands Hospital
West Midlands Critical Care Research Network
Birmingham, UK

Khai Ping Ng

Medical Specialist Registrar
Birmingham Heartlands Hospital
West Midlands Critical Care Research Network
Birmingham, UK

Elinor Powell

Anaesthetic Specialist Registrar/Research Fellow
Birmingham Heartlands Hospital
West Midlands Critical Care Research Network
Birmingham, UK

George Pulikal

Medical Specialist Registrar
Derriford Hospital
Plymouth, UK

Isma Quasim

Consultant Anaesthetist
Golden Jubilee Hospital
Scotland, UK

Tara Quasim

Senior Lecturer
Glasgow Royal Infirmary
Glasgow, UK

Nick Sherwood

Consultant Intensivist
Birmingham City Hospital
West Midlands Critical Care Research Network
Birmingham, UK

Angeline Simons

Medical Specialist Registrar
Birmingham Heartlands Hospital
West Midlands Critical Care Research Network
Birmingham, UK

Harjot Singh

Consultant Anaesthetist
University Hospital Birmingham
West Midlands Critical Care Research Network
Birmingham, UK

Richard Skone

Paediatric Intensive Care Registrar
Birmingham Children’s Hospital
Birmingham, UK

Catherine Snelson

Medical Specialist Registrar/Advanced Trainee in Intensive Care Medicine
Birmingham Heartlands Hospital
West Midlands Critical Care Research Network
Birmingham, UK

Roger Stedman

Consultant Intensivist
Birmingham Heartlands Hospital
West Midlands Critical Care Research Network
Birmingham, UK

David Thickett

Senior Lecturer in Respiratory Medicine
University Hospital Birmingham
West Midlands Critical Care Research Network
Birmingham, UK

Yasser Tolba

Consultant Intensivist
Birmingham Heartlands Hospital
West Midlands Critical Care Research Network
Birmingham, UK

Bill Tunnicliffe

Consultant Intensivist
University Hospital Birmingham
West Midlands Critical Care Research Network
Birmingham, UK

Sandeep Walia

Consultant Anaesthetist
University Hospital Birmingham
West Midlands Critical Care Research Network
Birmingham, UK

Tony Whitehouse

Consultant Intensivist
University Hospital Birmingham
West Midlands Critical Care Research Network
Birmingham, UK

Joyce Yeung

Anaesthetic Specialist Registrar/Research Fellow
Birmingham Heartlands Hospital
West Midlands Critical Care Research Network
Birmingham, UK


Foreword

The range of chapter titles in this concise and focussed textbook demonstrates how far intensive care medicine has travelled along the road from the first steps of providing co-located care for patients with a single disease – respiratory paralysis from polio – to becoming a speciality caring for patients with life-threatening disease of multiple organ systems. The outcome from the polio epidemics of the 1950s was transformed by the anaesthetist Professor Bjorn Ibsen, who reduced the mortality from 90% to 40% by combining laboratory science with applied physiology to change the way care was delivered – from iron lung respirator to positive pressure ventilation via a cuffed tracheostomy tube. The ‘power supply’ (medical students) was soon replaced by the development of mechanical ventilators, and the scientific innovation – arterial blood gas measurement – rapidly become a standard investigation in any acutely ill patient. Although polio has virtually disappeared, intensive care was retained by hospitals convinced of its apparent utility for supporting patients with an increasingly diverse mix of diseases. In the Western world at least, we now care for patients with a substantial chronic disease burden underlying their acute illness, and intensive care has increasingly come to resemble general medical practice with its accompanying ethical issues for individuals and for society. Indeed, Professor Henry Lassen’s data describing the polio epidemic (Lancet 1953) demonstrated that although the new technique of ventilatory management saved many lives, those who eventually died did so much later: intensive care has the capacity to delay, but not always prevent, death.

As a new multi-disciplinary speciality we have many challenges and opportunities ahead, from understanding the cellular mechanisms of organ dysfunction and sepsis to improving the reliability and safety of care delivered across multiple transitions in time, place and staff. The modern intensivist must combine many roles: compassionate clinician, scientist, educator and team leader amongst them. For those wishing to participate, the experience will be demanding and rewarding. This textbook provides a sound basis for that journey.

Professor Julian Bion MBBS FRCP FRCA MD
Professor of Intensive Care Medicine
University Department of Anaesthesia and Intensive Care Medicine
Royal College of Anaesthetists
Chair, Professional Standards Committee
Chair, European Board of Intensive Care Medicine




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