Coagulation Issues
The endothelium is a specialized organ that plays a central role in the regulation of clot formation (i.e., hemostasis) by presenting a nonthrombogenic surface to flowing blood and by enhancing…
Thyroid Disorders
TABLE 140.2 Commonly Used Drugs that Affect Thyroid Function THYROTOXICOSIS Clinical Presentation In the ICU, patients with thyrotoxicosis may have an atypical presentation, with tachyarrhythmias or central nervous system disturbance…
Multiple Organ Dysfunction Syndrome
PATHOPHYSIOLOGY MODS usually occurs in patients who exhibit signs of a generalized inflammatory response (systemic inflammatory response syndrome [SIRS]; Table 52.2) (1). Although SIRS is often the result of infection…
Cardiac Disease and Hypertensive Disorders in Pregnancy
Preeclampsia is defined by the maternal manifestations of hypertension and proteinuria occurring in the second half of pregnancy. The presentation and diagnostic features of preeclampsia are reviewed in Tables 78.2…
Lung Structure and Function
FIGURE 14.1 Named branches of the tracheobronchial tree, viewed from the front. (From Nunn JF. Applied Respiratory Physiology. 3rd ed. London: Butterworths; 1987, with permission.) The primary lobular terminal respiratory…
Blood Gas Analysis and Acid–Base Disorders
The pH, defined by Sorenson, is the negative log of the concentration of H+. Therefore, in neutral solution, the pH is 7. This is a very small concentration of [H+],…
Altered Consciousness and Coma in the Intensive Care Unit
CLINICAL EXAMINATION The neurologic coma examination, admittedly limited, is still able to offer several localizing clues. The examination includes an assessment of mental status as described earlier, brainstem reflex testing,…
Transfusion Therapy: When to Use It and How to Minimize It
TREATMENT Transfusion Decision-Making Transfusion based on sound physiologic principles and an understanding of relative risks and benefits should give maximal benefit to the patient, with efficient use of a valuable…
Shock: General
The most common inciting event in cardiogenic shock is an acute MI. Historically, once 40% of the myocardium has been irreversibly damaged, cardiogenic shock may result. From a mechanical perspective,…
Mesenteric Ischemia
FIGURE 131.1 Diagram of the collateral pathways for the mesenteric vessels. The celiac axis and superior mesenteric arteries communicate through the superior and inferior pancreaticoduodenal arteries, respectively. The superior and…
