Analgesia, Sedation, and Therapeutic Paralysis KEY POINTS 1 Sedatives should be administered to achieve specific target levels of an objective sedation scale and for most patients, should be interrupted at…
Nutritional Assessment and Support 1 For patients with preexisting nutritional deficiencies, profound hypermetabolic states, or prolonged ICU stays, nutritional support is probably important. By contrast, for patients with normal nutritional…
Pharmacotherapy KEY POINTS 1 It is essential to review the medication list of every patient daily, preferably with a pharmacist specializing in critical care. 2 In choosing a cost-effective course…
Blood Conservation and Transfusion KEY POINTS 1 In hemodynamically stable, nonbleeding patients, reasonable target levels for hemoglobin are 7 to 9 gm/dL and greater than 20,000/mm3 for platelets. Higher levels…
Respiratory Monitoring KEY POINTS 1 Although pulse oximetry is an invaluable clinical tool, it provides a signal-averaged number, the output of which lags behind the actual physiologic value of interest….
Intensive Care Unit Imaging KEY POINTS 1 The value of a portable CXR is critically dependent on obtaining an appropriately penetrated, upright exposure in full inspiration. Consistency of technique from…
Weaning and Discontinuation of Mechanical Ventilation KEY POINTS 1 A continuing need for ventilator assistance may arise from oxygen desaturation of hemoglobin during spontaneous breathing, cardiovascular instability during machine withdrawal,…
Positive End-Expiratory and Continuous Positive Airway Pressure KEY POINTS 1 Adding positive end-expiratory pressure (PEEP) can help maintain patency of collapsed lung units or further distend those that are already…
Practical Problems and Complications of Mechanical Ventilation KEY POINTS 1 Impaired cardiac output is most likely to result from mechanical ventilation when intravascular volume is depleted, vascular reflexes are impaired,…
Indications and Options for Mechanical Ventilation KEY POINTS 1 Prime indications for initiating mechanical ventilation include inadequate alveolar ventilation, inadequate arterial oxygenation, excessive respiratory workload, and acute heart failure with…
