How Should Traumatic Brain Injury Be Managed?
The morbidity and mortality resulting from traumatic brain injury (TBI) stem not only from the primary brain damage caused by the initial impact but also from the secondary insults that…
CRITICAL CARE
Is It Really Necessary to Measure Intracranial Pressure in Brain-Injured Patients?
A search of the literature on the management of severe traumatic brain injury (sTBI) will reveal evidence-based guidelines and consensus-based recommendations supporting intracranial pressure (ICP) monitoring ( Table 61-1 )….
How Should Acid-Base Disorders Be Diagnosed and Managed?
Arterial blood gas (ABG) analysis, a core component of critical care monitoring, provides immediate information on the status of the patient’s respiratory system and whether a state of acidosis or…
What Is the Meaning of a High Lactate? What Are the Implications of Lactic Acidosis?
An imbalance of oxygen delivery and demand with resultant organ dysfunction is the hallmark of critical illness. Measuring oxygen delivery, recognizing tissue hypoperfusion, and monitoring the response to therapeutic interventions…
How Does One Rapidly and Correctly Identify Acute Kidney Injury?
Acute kidney injury (AKI) is a syndrome that is frequently and commonly observed among hospitalized and especially critically ill patients. The incidence of AKI varies based on the criteria used…
What Is the Role of Renal Replacement Therapy in the Intensive Care Unit?
The aim of this chapter is to review the evidence surrounding the use of renal replacement therapy (RRT) in the intensive care unit (ICU) setting. It examines the conventional indications…
How Does One Optimize Care in Patients at Risk for or Presenting with Acute Kidney Injury?
Acute kidney injury (AKI) is common in the intensive care unit (ICU) and is associated with poor outcomes. There is evidence that even minor short-term changes in serum creatinine (i.e.,…
Is Right Ventricular Failure Common in the Intensive Care Unit? How Should It Be Managed?
In 1616, William Harvey described the relationship of the right ventricle (RV) to the pulmonary circulation. For many years after that, this cardiac chamber has been underappreciated. Indeed, in 1943,…
How Does One Prevent or Treat Atrial Fibrillation in Postoperative Critically Ill Patients?
Supraventricular arrhythmias are the most common rhythm disturbance encountered in postsurgical patients. The incidence of postoperative atrial fibrillation may be as high as 50% after cardiac surgery, 40% after pneumonectomy,…
When Is Hypertension a True Crisis, and How Should It Be Managed in the Intensive Care Unit?
Systemic hypertension remains a global priority because it is common and serious. Hypertension affects approximately 1 billion people worldwide and is responsible for over 9 million deaths each year. It…
