Bongard Frederic , Darryl Sue. Diagnosis and Treatment Critical Care

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INDEX

847

Arrhythmias, cardiac

in acute myocardial infarction, 509–510

atrial. See Atrial arrhythmias

AV block, 492

in digitalis toxicity, 770

drug-induced, 95

heart block, 491–492

in hemodialysis, 338

in hyperkalemia, 40

in hypokalemia, 36

in hypomagnesemia, 49

postoperative, 518–520, 530, 533

during pregnancy, 494

with pulmonary artery catheter placement,

198–199

sinus bradyarrhythmias, 492

ventricular. See Ventricular arrhythmias

Arsenic poisoning, 670

Arterial insufficiency. See Acute arterial insufficiency

Arterial oxygen content (CaO

), 223–224

Arteriography, bronchial, 544

Artificial airway. See Endotracheal intubation

Ascending cholangitis, 405, 406t

Ascites, 20, 718–719, 718t

Aspergillus/aspergillosis, 605, 738

Aspiration, 97, 300

Aspiration pneumonia, 149–150, 150f, 380. See also

Nosocomial pneumonia

Aspirin

for acute arterial insufficiency, 636

adverse effects, 124t

antiplatelet effects, 823

clinical benefits, 823

nutrient deficiencies caused by, 124t

pharmacology, 822

in pregnancy, 838

resistance to, 823

for ST-segment elevation myocardial infarction,

507, 509

for stroke, 674, 676

for unstable angina or non-STEMI, 503, 505t

Asplenia, 375

Asthma, 152, 534, 538. See also Status asthmaticus

Atelectasis, 145–146, 145f

Atenolol

for myocardial ischemia, 501

for ST-segment elevation myocardial infarction, 509

for unstable angina or non-STEMI, 503

Atlanto-occipital dislocation, 694. See also Cervical spinal

cord injuries

Atovaquone, 602

Atracurium, 107t, 108, 264

Atrial arrhythmias

in acute myocardial infarction, 509–510

atrial fibrillation, 487–488

atrial flutter, 487

atrial tachycardia, 487

AV nodal or reentrant tachycardia, 486–487

general considerations, 486

multifocal atrial tachycardia, 488

postoperative, 520

Atropine

for beta-blocker overdose, 768

for calcium channel blocker overdose, 768

for heart block, 511

for organophosphate poisoning, 784

Auto-PEEP, 268, 293–294

Autonomy, 215, 217

AV block, 492

Axis fractures, 694–695. See also Cervical spinal cord injuries

Azathioprine, 623

Azithromycin, 378

Azole antifungals, 93t

Babesiosis, transfusion-associated, 82t

Back pain, with suspected malignancy, 455t

Bacterial infections. See Infection(s)

Bacterial translocation, 701

Bacteroides fragilis, 376t

Balloon tamponade, 717

Band ligation, 709, 717

Barbiturates, 111. See also specific drugs

Barium enema, 355

Barotrauma, 166–167, 276

Bartter’s syndrome, 36

Battle’s sign, 680

Bence Jones proteins, 317

Beneficence, 215

Benzodiazepines. See also specific drugs

commonly used, 110t

drug interactions, 93t

in mechanical ventilation, 264

pharmacology, 110–111

for seizures, 755

uses, 110–111

for withdrawal syndromes, 435

Beta-adrenergic agonists

for acute respiratory failure, 260–261, 291, 307

adverse effects, 261, 536

for beta-blocker overdose, 768

in pregnancy, 814, 816

for status asthmaticus, 537

Beta-adrenergic blockers

adverse effects, 497

for aortic dissection, 485, 517

for AV nodal reentrant tachycardias, 486

in burn injuries, 135–136, 748

in cardiogenic shock, 243

for heart failure, 468, 473

for hypertensive crisis, 481–482

for myocardial ischemia, 501

poisoning/overdose, 767–768

for postoperative arrhythmias prophylaxis and treatment, 518, 519

for postoperative hypertension, 654

for ST-segment elevation myocardial infarction, 508, 509

for thyroid storm, 568t, 569

for unstable angina or non-STEMI, 503, 505t

Beta-lactams, resistance to, 376t

Betaxolol, 501

Bicarbonate, 125t. See also Sodium bicarbonate

Bicarbonate–carbon dioxide buffering system, 57



INDEX

848

Biliary tract infection, 405, 406t

Biobrane, 738–739

Biologic dressings, 738

Biotin, 122t

Bismuth subsalicylate, 358

Bisphosphonates, 56, 459, 460t, 461

Bivalirudin

for acute arterial insufficiency, 636–637, 637t

for heparin-induced thrombocytopenia, 829, 829t

mechanisms of action, 831

Black widow spider bite, 796–797

Bladder obstruction, 321–322

Bleeding. See also Hemorrhage; Hemostasis

acute

platelet transfusion for, 74

red blood cell transfusion for, 73

lower gastrointestinal. See Gastrointestinal tract, bleeding

postoperative

clinical features, 522–524

differential diagnosis, 524

essentials of diagnosis, 520

etiology, 429t, 521–522

general considerations, 520

preoperative screening, 428–430, 429t

treatment, 524

posttraumatic, 430

upper gastrointestinal. See Gastrointestinal tract, bleeding

Bleeding disorders

acquired

coagulation disorders, 417–420, 420t

platelet dysfunction, 423–424

approach to, 427, 428t

gastrointestinal hemorrhage, 427–428

inherited

coagulation disorders, 412, 413–414t, 415–417, 416t

platelet dysfunction, 422–423, 422t

perioperative screening and management, 428–430, 429t

thrombocytopenia, 132, 425–427, 426t

Bleeding time, 411t

Blood components. See Transfusion therapy

Blood gases, 204, 235

Blood pressure monitoring

clinical applications, 192–193, 193f

general considerations, 188–189, 189f

invasive techniques, 190–192, 191f, 192f

noninvasive techniques, 189–190

Blood substitutes, 86

Body osmolality, 22

Body surface area (BSA), 728, 728f, 729f

Bohr equation, 203

Bone marrow transplantation, 132

Botulism

clinical features, 393–394, 671

controversies and unresolved issues, 394

differential diagnosis, 283, 394, 394t

essentials of diagnosis, 392, 671

general considerations, 283, 392–393, 671

treatment, 394, 671

Bowel irrigation, 756–757

Bowel ischemia. See Acute mesenteric ischemia

Bowel necrosis, 46

Bowel obstruction. See Large bowel obstruction; Small bowel

obstruction

Bowel perforation. See Pneumoperitoneum

Brain abscess, 678

Brain death, 662

Brain trauma. See Head injury

Brain tumors, 688–690

Bromocriptine, for neuroleptic malignant syndrome, 672

Bronchial arteriography, 544

Bronchial artery embolization, 544–545

Bronchodilators

for acute respiratory failure, 260–263

in pregnancy, 816

for status asthmaticus, 537

Bronchopneumonia, 147

Bronchoscopy

in acute respiratory failure, 265

in hemoptysis, 543

in inhalation injury, 740

in Pneumocystis pneumonia, 601

Brown recluse spider bite, 796–797

Brown-Séquard syndrome, 693

Bullous eruptions, drug-related, 613–614, 614t

Bupivacaine, 105–106, 106t

Buprenorphine, 113

Bupropion, 438

Burn center, referral guidelines, 723, 724t

Burn injury

chemical, 749–750

electrical, 750–751, 799

thermal. See Thermal burn injury

rns

excision and grafting

controversies and unresolved issues, 747

skin substitutes and biologic dressings, 738–739

technique, 738

infection

clinical features, 737, 737t

essentials of diagnosis, 736

fungal, 738

general considerations, 736–737, 736f

staging, 737t

treatment, 737–738

wound care

debridement, 735

dressings, 736

escharotomy and fasciotomy, 106, 734–735,

734f

topical antimicrobial therapy, 735–736

Butorphanol, 113

esterase inhibitor concentrate, 76t

CABG (coronary artery bypass grafting), 504, 505t

Calcitonin, 56, 460, 460t

Calcium, 51–52, 123t. See also Hypercalcemia; Hypocalcemia

Calcium channel blockers

after acute myocardial infarction, 509

in aortic dissection, 485

for heart failure, 473

in hypertensive crisis, 482

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INDEX

849

for myocardial ischemia, 501–502

poisoning/overdose, 767–768

toxicity, 497

Calcium chloride, 41, 51, 768

Calcium gluconate, 41, 51

Caloric oculovestibular response, 660

Cancer

antithrombotic therapy in, 840

complications

cachexia, 132

hypercalcemia, 457–461, 458f, 459t, 460t

hyperglycemia, 464

hypocalcemia, 461

hypoglycemia, 464

hypokalemia, 464

hyponatremia, 463

hypophosphatemia, 464

increased intracranial pressure, 454–456

lactic acidosis, 464–465

pancytopenia (post-chemotherapy), 7t

spinal cord compression, 451–454

superior vena cava syndrome, 465–466

tumor lysis syndrome, 46, 462

thyroid function in, 579

Candida albicans, 388, 610

Candida glabrata, 388

Candida krusei, 388

Candida parapsilosis, 388

Candida tropicalis, 388

Candidiasis, 388–389

oral (thrush), 610–611

Candiduria, 383

CAPD (chronic ambulatory peritoneal dialysis),

334t, 343

Capnography, 203–204

Captopril, 510

Carbapenems, 376–377

Carbon dioxide output (V

), 206

Carboprost tromethamine, for postpartum hemorrhage, 818

Cardiac catheterization

for acute myocardial infarction, 507

complications, 482–483

in heart failure, 470

Cardiac compressive shock, 227t, 245–246

Cardiac index, 201t

Cardiac output

during fluid resuscitation for burn

injury, 732

general considerations, 199–200

in heart failure, 468

measurement methods, 200–201, 201t

during mechanical ventilation, 276

in normal heart, 468

in respiratory failure, 252

Cardiac pacemakers. See Pacemakers

Cardiac tamponade

clinical features, 478–479

essentials of diagnosis, 478

general considerations, 478

imaging studies, 479–480, 479f

postoperative, 531

pulmonary capillary wedge pressure in, 198

surgical evaluation, 533

treatment, 480

Cardiac troponins, in pulmonary embolism, 550

Cardiogenic shock

after acute myocardial infarction, 510–511

causes, 242t

clinical features, 242–243

differential diagnosis, 227t, 243

essentials of diagnosis, 242

general considerations, 242

prognosis, 245

stages, 242

treatment, 243–245, 470, 471–472, 511

Cardiomyopathy, peripartum, 814

Cardiopulmonary bypass

adverse effects, 528–529

circuit-related complications, 527

coagulation parameters, 527

cross-clamp time and hypothermia, 527

fluid and drug administration during, 417

general considerations, 525–527, 526f

platelet dysfunction and, 424

Cardiopulmonary resuscitation, in pregnancy, 806

Cardiothoracic surgery. See also Cardiopulmonary bypass

arrhythmias after, 518–520

bleeding after. See Bleeding, postoperative

cardiac insufficiency after, 529–533

hypercoagulability after, 522–525

Cardiovascular system

age-related changes, 443–444, 444t

in pregnancy, 802

thermal burn injury response, 724–725

Cardioversion, 106, 519–520

Carotid endarterectomy, 655, 676

Caspofungin, 378

Catheter–associated infections

intravenous. See Intravenous catheter–associated infections

urinary. See Urinary catheter–associated infections

CAVD (continuous arteriovenous hemodialysis and

hemodiafiltration), 334t, 341

CAVH (continuous arteriovenous hemofiltration), 334t,

340–341

Cavitary pneumonia, 147, 148f

Cecal volvulus, 173f

Cefazolin, 339t

Cefepime, 376

Ceftriaxone, 89t

Celecoxib, 316t

Cellulitis, 407, 408t

Central cord syndrome, 693

Central nervous system

dysfunction indicators, 234t

head injury. See Head injury

infections, 677–679

spinal cord, 692f

compression. See Spinal cord compression

disorders/trauma, 132, 283. See also Cervical spinal cord

injuries

thermal burn injury response, 726

tumors, 688–690



INDEX

850

Central venous catheters

clinical applications, 193–195, 194f, 195f

complications, 140–141, 140f, 195. See also Intravenous

catheter–associated infections

for contrast injection, 139

imaging studies, 140–141, 140f

positioning, 140

for potassium administration, 38

Central venous pressure (CVP), 193–195, 194f, 195f

Cephalosporins, 315t, 376

Cerebral contusion, 681

Cerebral edema, 592, 714

Cerebrospinal fluid (CSF), 678–679

Cervical spinal cord injuries

clinical features, 691–693, 692f, 693t

essentials of diagnosis, 690

general considerations, 690–691

imaging studies, 693

pathophysiology, 691

treatment, 693–695

Cesarean section, 806–807, 820

Chagas’ disease, transfusion-associated, 82t

Charcoal, for poisonings, 756, 756t

Chemical burn injury

hydrocarbons, 749

hydrofluoric acid, 749

inhalation of aerosolized chemicals, 749

initial care, 749

ocular injury, 749–750

pathophysiology, 749

phenol, 749

Chest percussion, 265

Chest physiotherapy, 264–265

Chest radiographs, 137

in acute myocardial infarction, 506

in aortic dissection, 516

in ARDS, 160–161, 161f, 301

in aspiration pneumonia, 150, 150f

in asthma, 152

in atelectasis, 145–146, 145f, 146f

in cardiac compressive shock, 245–246

of cardiac pacemakers, 143

in cardiac tamponade, 479

in cardiogenic shock, 243

of central venous catheters, 140, 140f

in COPD, 151, 151f, 291

of endotracheal tubes, 139–140, 256

in heart failure, 469

in infective endocarditis, 368

of nasogastric tubes, 143, 143f

in neuromuscular disease with respiratory failure, 284

in pleural effusions, 162–163

in Pneumocystis pneumonia, 601

in pneumonia, 147–148, 148f

in pneumothorax, 165–166, 165f, 166f

of pulmonary artery catheters, 141, 142f, 196–197

in pulmonary edema, 158–159, 158f

in pulmonary embolism, 153, 154, 550

routine daily, 144

in status asthmaticus, 536

in tuberculosis, 603

Chest tube output, postoperative, 522

Chest wall compliance, 205, 267, 267f

Chest wall disorders. See Thoracic wall disorders

Child-Turcotte-Pugh classification, surgical risk in cirrhosis, 720, 720t

Chlordiazepoxide, 89t

Chloride, 123t, 125t

Cholecystectomy, 349–350

Cholecystitis

acalculous, 182–184, 183f, 655

calculous, 181–182, 182f

clinical features, 701

diagnosis, 701

emphysematous, 375

risk factors, 701

treatment, 183–184

Cholesterol embolization, 325

Cholestyramine, 124t, 769

Cholinergics. poisoning/overdose, 753t

Chromium, 123t

Chronic ambulatory peritoneal dialysis (CAPD), 334t, 343

Chronic anemia, 71–72

Chronic bronchitis, 288. See also Chronic obstructive

pulmonary disease

Chronic obstructive pulmonary disease (COPD)

acut

e r

espiratory failure in

clinical features, 290–291, 290t

differential diagnosis, 291

essentials of diagnosis, 288

general considerations, 5t, 288–289

noninvasive ventilatory support for, 273

pathophysiology, 289

treatment

antibiotics, 292–293

anticholinergics, 291–292

beta-adrenergic agonists, 291

corticosteroids, 292

mechanical ventilation, 274t, 293–294, 294f

oxygen, 291

reminders, 5t

respiratory stimulants and depressants, 294–295

theophylline, 292

definition, 288

imaging studies, 150–152, 151f, 291

nutritional support in, 130

Churg-Strauss syndrome, 327t

Cidofovir, 315t

Cimetidine

adverse effects, 240

for angioedema, 565

drug interactions, 93t

nephrotoxicity, 316t

Ciprofloxacin, 315t, 377

Circulation, Respiration, Abdomen, Motor, Speech (CRAMS) Scale,

11–12, 12t

Cirrhosis

ascites in, 717–719

definition, 714

hepatorenal syndrome in, 719–720

liver resection in, 720–721

preoperative assessment and perioperative management, 720, 720t

variceal bleeding in. See Variceal bleeding



INDEX

851

Cisatracurium, 107t, 108

Cisplatin, 124t, 315t

Citrate, 337

Clarithromycin, 378

Clindamycin

for Pneumocystis pneumonia, 602

protein binding, 89t

resistance to, 376t

Clonidine, 358, 720

Clopidogrel

for acute arterial insufficiency, 636

antiplatelet effects, 824

nephrotoxicity, 316t

pharmacology, 823–824

side effects, 824

vs. ticlopidine, 824t

for unstable angina or non-STEMI, 503, 504, 505t

Clostridium botulinum, 392. See also Botulism

Clostridium difficile–associated diarrhea, 386–387

Coagulation

acquired disorders

clinical features, 419–420, 420t

differential diagnosis, 420

essentials of diagnosis, 417

general considerations, 417–418

pathophysiology, 418–419

treatment, 420–421

inherited disorders

clinical features, 413–414t, 415

controversies and unresolved issues, 417

differential diagnosis, 415

essentials of diagnosis, 412

general considerations, 412

treatment, 415–417, 416t

laboratory tests, 409, 411–412, 411t

Coagulation factors, 410t, 418

Cocaine abstinence syndrome, 763

Cocaine toxicity, 763–764

Coccidioidomycosis, 678

Coccoides immitis, 604–605

Cockroft-Gault equation, 90

Cofactors, 410t

Cognitive Test for Delirium, 432

Colitis, 175–176, 176f, 711

Colloid solutions

for hypovolemia, 18, 18t

for hypovolemic shock, 229, 230

for septic shock, 236

Colonoscopy, 711–712

Coma

brain death in, 662

clinical features

history, 658–659

level of consciousness, 659

localization of brain lesions, 659, 659t

motor systems, 660

oculomotor system, 660

pupillary and ophthalmoscopic evaluation, 659–660, 660t

respiratory and circulatory changes, 660

differential diagnosis, 661–662

drug-induced, 660t

general considerations, 658

hyperglycemic hyperosmolar nonketotic, 593

metabolic, 661, 661t

pathophysiology, 658

in primary brain injury, 661–662

toxic, 661

treatment, 662

Common-mode voltage, 188

Community-acquired pneumonia. See also Pneumonia

clinical features, 363–364, 364t

differential diagnosis, 364

essentials of diagnosis, 362

general considerations, 363

microbiologic etiology, 363, 364t

treatment, 364–365, 365t

Compartment syndrome

abdominal, 701

intraabdominal, 733

Compassion fatigue, 220

Complement activation, 232

Complex partial seizure, 663, 663t. See also Seizures

Compression ultrasonography, 548, 555t

Computed tomography (CT), 138

in acalculous cholecystitis, 183

in acute calculous cholecystitis, 182, 182f

in acute mesenteric ischemia, 174–175, 175f, 649

in acute pancreatitis, 180, 180f, 181f, 346–347

in acute renal failure, 317

in acute respiratory distress syndrome, 161, 164f

in aortic dissection, 485, 485f

in ascites, 718

in asthma,

153

in back pain with suspected malignancy, 455t

in bowel obstruction, 170, 172f

in cervical spine injuries, 693

in chronic obstructive pulmonary disease, 152

in colitis, 176, 176f

in head trauma, 684

in heart failure, 159, 470

in increased intracranial pressure due to malignancy,

456

in intraabdominal abscess, 178, 178f, 373

in obstructive uropathy, 184, 185f

in pancreatic necrosis, 347–348

in pleural effusion, 164, 164f

in pneumonia, 148–149, 149f

in pneumoperitoneum, 168, 169f

in pulmonary embolism, 153, 155, 155f, 553–554

in renal colic, 185, 185f

in septic pulmonary emboli, 157, 157f

in spinal cord compression, 453

in stroke, 674, 675f

in subarachnoid hemorrhage, 687

in surgical infections, 398

in urinary tract infection, 185

Concussion, 681

Confidentiality, in interfacility transport, 210–211

Congenital heart disease, 494, 530

Congestive heart failure. See Heart failure

Conivaptan, 29, 463

Contact dermatitis, 609



INDEX

852

Continuous arteriovenous hemodialysis and hemodiafiltration

(CAVD), 334t, 341

Continuous arteriovenous hemofiltration (CAVH), 334t,

340–341

Continuous positive airway pressure (CPAP)

for ARDS, 302–304, 303f

nasal, 273, 312

for obstructive sleep apnea, 312

Continuous renal replacement therapy (CRRT)

advantages, 340

anticoagulation for, 341–342

continuous arteriovenous hemodialysis and hemodiafiltration, 341

continuous arteriovenous hemofiltration, 340–341

continuous venovenous hemodialysis or hemofiltration, 341

continuous venovenous hemofiltration, 341

disadvantages, 340

hemoaccess, 341

predilution, 342

replacement fluids and dialysate, 342

slow continuous ultrafiltration, 341

types, 340

urea clearance and protein losses, 334t

Continuous venovenous hemodialysis or hemofiltration

(CVVHD/F), 334t, 341

Continuous venovenous hemofiltration (CVVH), 334t, 341

Contrast agents. See Iodinated contrast agents

Contrast nephropathy, 139, 316t, 318, 483

Contrast venography, 643

Contrecoup injury, 681

COPD. See Chronic obstructive pulmonary disease

Copper, 123t, 125

Coprine, 781, 781t, 782

Cor pulmonale, 21

Corneal injury, after thermal burn injury, 743

Coronary angiography, 500, 505t

Coronary angioplasty, 504, 508

Coronary artery bypass grafting (CABG), 504, 505t

Coronary heart disease

anticoagulant therapy in, 827t

myocardial ischemia, 499–502

physiologic considerations, 498–499

postoperative management, 653–654

preoperative risk assessment, 652–653

Cortical necrosis, 326. See also Renal failure, acute

Cortical vein thrombosis, 678

Corticosteroids

for acute adrenal insufficiency, 574–575, 575t

for acute respiratory failure, 263, 292, 307

adverse effects, 28, 263, 538

for angioedema, 565

for hypercalcemia, 56

for hypercalcemia of malignancy, 459, 460, 460t

for increased intracranial pressure due to malignancy, 456

indications, 76t

infections in patients on chronic therapy, 375

muscle weakness and, 282

for myxedema coma, 571, 571t

nutrient deficiencies caused by, 124t

for pemphigus vulgaris, 623

as platelet transfusion alternative, 76t

for Pneumocystis pneumonia, 602

in pregnancy, 816

in sepsis, 362, 701

for septic shock, 237

for spinal cord compression, 453–454

for status asthmaticus, 537–538, 816

for thyroid storm, 568t, 569

Cortisol, 224

Cortrosyn stimulation test, 237

Cough

in hemoptysis, 544

inadequate, in neuromuscular disorders, 281

Coup injury, 681

CPAP. See Continuous positive airway pressure

CRAMS (Circulation, Respiration, Abdomen, Motor, Speech) Scale,

11–12, 12t

Creatinine, 314–315

Creatinine clearance, 317, 445

Critical care. See also Intensive care unit

early identification of problems, 1–2

limits of, 78

recent developments, 2t

scoring systems, 10–12, 11t, 12t

Critical illness myopathy, 282, 669

Critical illness polyneuropathy, 282, 669

Crotalidae, 795–796

CRRT. See Continuous renal replacement therapy

Cryoglobulinemia in, 324–325

Cryoprecipitate, 77–78, 416t, 424

Cryptococcosis, 678

cryptococcal meningitis, in HIV disease, 608

cryptococcal pneumonia, in HIV disease, 604

Crystalloid solutions

excessive administration, 228

for hypovolemia, 17–18, 18t

for hypovolemic shock, 227–229, 228t, 230

for septic shock, 236

CT. See Computed tomography

ullen’s sign, 346

Cushing’s syndrome, 464

Cutaneous disorders

candidiasis, 610–611

contact dermatitis, 609

drug reactions

erythema multiforme, 615–616, 615t

morbilliform, urticarial, and bullous, 612–614, 613t, 614t

phenytoin hypersensitivity syndrome, 618–619

Stevens-Johnson syndrome, 616–618

toxic epidermal necrolysis, 616–618

exfoliative erythroderma, 614t, 625–626, 625t

generalized pustular psoriasis, 624

graft-versus-host disease, 611–612

miliaria (heat rash), 610

pemphigus vulgaris, 623

purpura

causes, 614t, 619, 619t

in disseminated vascular coagulation, 622. See also

Disseminated intravascular coagulation

general considerations, 619

in leukocytoclastic vasculitis, 620–621, 620t, 621t

CVP (central venous pressure), 193–195, 194f, 195f

CVVH (continuous venovenous hemofiltration), 334t, 341



INDEX

853

CVVHD/F (continuous venovenous hemodialysis or

hemofiltration), 334t, 341

Cyclodextrin, 110

Cyclooxygenase inhibitors, 822–823. See also Aspirin

Cyclooxygenase pathway, 231–232, 231f

Cyclopeptide (mushroom) poisoning, 780, 781, 781t

Cyclosporine, 93t, 315t

Cysticercosis, 677

Cytochrome P450 (CYP), 82t, 93–94, 446

Cytokines, 231, 297

Cytomegalovirus, 81t

Daclizumab, 315t

Dalteparin, 644, 645t. See also Low-molecular-weight heparin

Damping coefficient, 190–192, 191f

Danaparoid, 829t, 831–832

Dantrolene, 116, 672

Dapsone, 315t, 602

Daptomycin, 378

D-dimer test, 411t, 550, 555t

Dead space:tidal volume ratio (VD/VT), 248, 249f

DeBakey classification, aortic dissection, 515

Debridement, of burn wounds, 735

Decision making, in intensive care unit

assessment of patient capacity, 216

health care professional’s role, 219–220

medicolegal aspects, 217

shared, 217

surrogates for, 216–217

withholding and withdrawing treatment,

218–219

Deep venous thrombosis

in cancer patients, 840

clinical features, 547–548, 642–643

controversies and unresolved issues, 561

diagnostic approach, 548

differential diagnosis, 643t

essentials of diagnosis, 545, 640

general considerations, 545–546, 640–641

imaging studies, 548, 643

pathophysiology and pathogenesis, 546, 641–642, 641f

postthrombotic syndrome, 647

in pregnancy, 647, 804

prevention, 559–561, 560t, 640t, 643–645. See also

Antithrombotic therapy

risk factors, 822t

risk stratification, 640, 640t

treatment

anticoagulation, 554–557, 555t, 645

inferior vena cava interruption, 558–559, 647

operative embolectomy, 647

supportive care, 559, 645

thrombolytic therapy, 557–558, 645–647

upper extremity, 642, 642t

Defibrinating agents, 832

Delirium

causes, 433–434, 434t, 447t

clinical features, 432–433

controversies and unresolved issues, 436

differential diagnosis, 433

drug-induced, 434t

in elderly patients, 447–448, 447t

essentials of diagnosis, 431

general considerations, 431

pathophysiology, 431–432

risk factors, 447t

treatment, 434–436

Delta agent, transfusion-associated, 81t

Demeclocycline, for hyponatremia, 463

Dementia, 433

Depression, 433, 436–438

Dermatologic problems. See Cutaneous disorders

Desmopressin (DDAVP)

for acquired coagulation disorders, 421

indications, 76t

for inherited coagulation disorders,

415, 416t

for platelet dysfunction, 423, 424, 425

for postoperative bleeding, 524

Dexamethasone, 568t. See also Corticosteroids

Dexmedetomidine, 435–436

Dextrans

for acute arterial insufficiency, 636

for deep venous thrombosis prophylaxis, 644

for hypovolemic shock, 229

platelet function and, 423, 825

Dextroamphetamine, 437–438

Dextrose, in total parenteral nutrition, 129

Diabet

es insipidus

ain tumor and, 689

central, 30, 30t

clinical features, 32

diagnosis, 31f, 32

nephrogenic, 30t

treatment, 33

Diabetes mellitus

complications in acute illness

diabetic ketoacidosis. See Diabetic ketoacidosis

gastroparesis, 597

hyperglycemia, 594–595

hyperglycemic hyperosmolar nonketotic coma, 593

hypoglycemia, 595–596, 595t, 596t

hyporeninemic hypoaldosteronism, 597

retinal, 597

infections in, 375

new-onset in ICU patients, 134–135

nutritional support in, 133–134

thyroid function in, 578

Diabetic foot infections, 407, 408t

Diabetic ketoacidosis

clinical features, 584–587, 585t, 586t

complications, 591–592, 591t

controversies and unresolved issues

acute respiratory distress syndrome, 591–592

cerebral edema, 591

fluid replacement, 591

differential diagnosis, 587

essentials of diagnosis, 581

general considerations, 5t, 581

hypophosphatemia during treatment, 43

metabolic acidosis in, 61, 61t



INDEX

854

Diabetic ketoacidosis (Cont.):

pathophysiology, 581–584, 582f, 582t, 583t

potassium supplementation in, 39

precipitating factors, 584, 585t

treatment

algorithm, 588f

bicarbonate, 590

correction of hyperglycemia, 587–588, 588t

correction of ketosis, 588–589

fluid replacement, 589

initial, 587t

insulin, 589–590

monitoring, 587

phosphate replacement, 590–591, 591t

potassium replacement, 590

reminders, 5t

Dialysis. See also Continuous renal replacement therapy;

Hemodialysis; Peritoneal dialysis

drug dosing during, 336

indications, 334–336

stopping, 336

types, 334t

Diaphragm, 100, 283

Diarrhea

classification, 358, 358t

Clostridium difficile–associated, 386–387

definition, 357

diagnosis, 358

pathophysiology, 358

treatment, 358

Diazepam

as anticonvulsant, 665, 665t

pharmacology, 110, 110t

protein binding, 89t

side effects, 110

uses, 110

Diclofenac, 316t

Diffuse axonal injury, 682

Digoxin

for atrial fibrillation, 487, 509–510

for cardiogenic shock, 244

for heart failure after acute myocardial infarction, 510

pharmacology, 495

therapeutic ranges, 92t

toxicity, 495–496

clinical features, 769

controversies and unresolved issues, 771

differential diagnosis, 769

essentials of diagnosis, 768

general considerations, 768–769

predisposing factors, 769t

treatment, 769–771, 770t

Digoxin immune Fab, 495–496, 770–771, 770t

Dihydropyridines, 501

Diltiazem

after acute myocardial infarction, 509

for atrial fibrillation, 487, 510

for AV nodal reentrant tachycardias, 486

contraindications, 502

for myocardial ischemia, 502

Dilute Russell viper venom time, 411t

Diphenhydramine, 240, 563, 565

Diphenoxylate with atropine, 358

Dipyridamole, 652–653, 825

Disopyramide, 316t

Disseminated intravascular coagulation (DIC)

acute renal failure in, 324, 325

causes, 418, 419t

clinical features, 622

coagulation factor consumption in, 418

controversies and unresolved issues, 421–422

essentials of diagnosis, 622

in heat stroke, 787

pathophysiology, 622

postoperative, 429, 429t

treatment, 421, 622

Distributive shock. See Anaphylactic shock; Neurogenic shock;

Septic shock

Diuretics

in ARDS, 307

for ascites, 718

for heart failure, 471, 472, 473, 510

in hypercalcemia, 55

for hypernatremia, 33

for hypervolemia, 21–22

hypocalcemia and, 53

hypokalemia and, 36, 39

metabolic alkalosis and, 64

nephrotoxicity, 315t

nutrient deficiencies caused by, 124t, 131

Diverticulosis, 711

Do not resuscitate/do not attempt resuscitation (DNR/DNAR)

orders, 218

Dobutamine

for calcium channel blocker overdose, 768

for cardiogenic shock, 243–244, 511

for septic shock, 236–237

Dobutamine stress echocardiography, 653

“Doll’s eye” reflex, 660

Dopamine

for anaphylactic shock, 240

for calcium channel blocker overdose, 768

for cardiogenic shock, 244, 472, 511

for septic shock, 236

Doppler ultrasound

in acute arterial insufficiency, 635t

for blood pressure monitoring, 190

for cardiac output measurement, 200

in deep venous thrombosis, 642–643

transcranial, 685, 687

Double product, 498

Doxacurium, 107t, 109

Drotrecogin alfa, 237–238, 362, 701

Drug(s). See also specific drugs

adverse effects

cardiac toxicity, 95

cutaneous reactions

erythema multiforme, 615–616, 615t

morbilliform, urticarial, and bullous, 612–614, 613t, 614t

phenytoin hypersensitivity syndrome, 618–619

Stevens-Johnson syndrome, 616–618

xic epidermal necrolysis, 616–618



INDEX

855

delirium, 434t

in elderly patients, 446

electrolyte abnormalities, 95

hepatotoxicity, 94–95, 95t

nephrotoxicity, 94, 94t, 315–316t

thyroid dysfunction, 579, 579t

clearance

hepatic dysfunction and, 91, 91t

renal dysfunction and, 90–91, 90t

distribution, 89–90, 89t

in elderly patients, 446

errors, 95–96

interactions

pharmaceutical, 93

pharmacodynamic, 92–93

pharmacokinetics, 93–94, 93t

in pregnancy, 804, 805t

therapeutic ranges, 92, 92t

withdrawal. See Withdrawal

Duchenne’s muscular dystrophy, 672–673

Duke criteria, infective endocarditis, 368, 369t

Dynamic hyperinflation, 268–269, 538–539

Dysfibrinogenemia, 413–414t

Echinocandins, 378

Echocardiography

in acute myocardial infarction, 506

in aortic dissection, 484–485, 484f, 516

in cardiac tamponade, 479–480, 479f

in cardiogenic shock, 243, 472

in heart failure, 469

in infective endocarditis, 368, 403, 477–478, 477f

Eclampsia, 809. See also Preeclampsia-eclampsia

Edema

in hypervolemia, 20

pulmonary. See Pulmonary edema

in thermal burn injury, 723–724

Edrophonium test, 670

Effective arterial volume, 15

Elapidae, 795–796

Elderly patients

clinical presentation of disease, 445–446

communication problems, 448–449

delirium, 447–448, 447t

drug therapy, 446

hydration and nutrition, 446–447

immobility, 449–450

physiologic changes

cardiac, 443–444, 444t

pulmonary, 444–445, 445t

renal, 445

Electric shock injury, 798–800, 799t

Electrical burn injury, 750–751, 799

Electrocardiography (ECG), 187–188, 188f

in acute myocardial infarction, 506

ambulatory, for preoperative risk assessment, 652

in cardiac tamponade, 479

in COPD, 291

in digitalis toxicity, 769

in heart failure, 469

in infective endocarditis, 368

in myocardial ischemia, 499–500

in pulmonary embolism, 550

Electroencephalography (EEG), 664, 678

Elimination half-life (t

1/2

), 88

Embolic stroke, 674. See also Stroke

Embolism

in acute mesenteric ischemia, 648

air, 141, 195, 199

amniotic fluid, 811

arterial. See Acute arterial insufficiency

pulmonary. See Pulmonary embolism

Embolization

in atrial fibrillation, 488

in infective endocarditis, 368

from prosthetic heart valves, 476

Emergency medical technician (EMT), 213

Emergency Treatment and Active Labor Act (EMTALA), 210

Emesis. See Vomiting

Emphysema, 288. See also Chronic obstructive pulmonary disease

Empyema, 147, 148–149, 149f, 402, 404t

Enalaprilat, 481

Encephalitis, viral, 677

Encephalopathy

hepatic, 131, 715–716

hyponatremic, 25, 27

End-tidal CO

monitoring, 203–204

End-tidal P

, 203

Endocarditis

after thermal burn injury, 742

clinical features, 367–368, 369t, 476–477

complications, 368

essentials of diagnosis, 367, 474

general considerations, 367, 403

imaging studies, 477, 477f

microbiologic etiology, 367, 403

modified Duke clinical criteria, 369t

pathophysiology, 367

in surgical patients, 403

treatment, 368–369, 404t, 477–478

Endocrine problems

acute adrenal insufficiency. See Adrenal insufficiency, acute

diabetes mellitus. See Diabetes mellitus

sick euthyroid syndrome. See Sick euthyroid syndrome

in thermal burn injury, 726

thyroid storm. See Thyroid storm

Endorphins, 224

Endoscopy

for lower gastrointestinal bleeding, 712

for peptic ulcer bleeding, 707–708, 707t

for variceal bleeding, 709

Endothelium, in hemostasis, 410t

Endotoxin, 360

Endotracheal intubation

air leakage, 103

airway care, 255–256

complications, 256–257

general considerations, 102

imaging studies, 139–140

indications, 255t

nasotracheal vs. orotracheal, 255, 256



INDEX

856

Endotracheal intubation (Cont.):

neuromuscular blocking agents in, 102

risks and benefits, 254–255, 255t

time factors, 102

tube positioning, 103, 139–140, 256

tube size, 102

Enoxaparin. See also Low-molecular-weight heparin

for deep venous thrombosis prophylaxis, 644

for deep venous thrombosis treatment, 645t

for unstable angina or non-STEMI, 504, 505t

Enteral nutrition. See also Nasogastric tubes

after thermal burn injury, 745

feeding tube position, 127

formulas for, 127

lipids, 127

protein, 127

vs. total parenteral nutrition, 126–127

Enteric fistulas. See Gastrointestinal tract, fistulas

Enterobacteriaceae, 376t

Enterococcal infections, 376t, 389–390

Envenomation

marine life, 797–798

snakebite, 795–796

spider and scorpion bites/stings, 796–797

Environmental injuries

chemical burn injury, 749–750

electric shock and lightning injury, 750–751,

798–800

envenomation

marine life, 797–798

snakebite, 795–796

spider and scorpion bites, 796–797

frostbite, 791–793

heat stroke, 786–788

hypothermia. See Hypothermia

near-drowning, 793–794

radiation injury, 800–801

thermal burns. See Thermal burn injury

Epidural hematoma, 681, 681f

Epiglottitis, 153

Epinephrine

for anaphylactic shock, 240

for anaphylaxis, 563

for angioedema, 565

in hypovolemic shock, 224

for status asthmaticus, 537

Epstein-Barr virus, transfusion-associated, 81t

Eptifibatide, 504, 825

Erythema multiforme, 614t, 615–616, 615t

Erythromycin, 89t, 93t, 378

Erythropoietin, 76t, 85

Escharotomy, 106, 734–735, 734f

Escherichia coli

in dialysis-related peritonitis, 339t

in pancreatic necrosis, 348

in pyelonephritis in pregnancy, 812

Esmolol, 481, 517

Esophageal perforation, 402

Esophagogastric varices, 707, 716. See also Variceal bleeding

Estrogens, 76t, 124t

Ethacrynic acid, 89t

Ethambutol, 603

Ethanol, 778–779, 779t

Ethics

conflicts in, 216

in decision making, 216–217

institutional policies, 220, 220t

organ donation, 219

principles, 215–216

in withholding and withdrawing treatment, 218–219

Ethylene glycol poisoning, 61t, 62, 777–779, 778t

Etidocaine, 106t

Euglobulin lysis time, 411t

Exchange transfusion, 73

Exercise stress ECG, 500, 652

Exfoliative erythroderma, 614t, 625–626, 625t

Expectorants, 265

Expiratory airway pressure, 205

Extended-spectrum β-lactamases, 390–391

Extracellular space, 15

Extracorporeal membrane oxygenation, 274

Exudative diarrhea, 358t

Exudative pulmonary edema. See Acute respiratory

distress syndrome

Facet dislocation, 695. See also Cer

vical spinal cord injuries

actor II deficiency, 413–414t, 416t

Factor IX concentrates, 76t

Factor V deficiency, 413–414t, 416t

Factor VII concentrate, 76t

Factor VII deficiency, 413–414t, 416t

Factor VIII deficiency, 412, 413–414t, 416t

Factor IX deficiency, 412, 413–414t, 416t

Factor X deficiency, 413–414t, 416t

Factor XI

concentrate, 76t, 416t

deficiency, 413–414t, 416t

Factor XIII

concentrate, 76t

deficiency, 413–414t, 416t

in hemostasis, 410t

Famciclovir, for herpes zoster, 627

Fasciotomy, 735

Fear. See Anxiety and fear

Febrile-associated transfusion reaction (FATR), 83t

Feeding tubes. See Nasogastric tubes

Felodipine, 501

Fenoprofen, 316t

Fentanyl, 104–105, 111t, 112–113

Fetus

monitoring in pregnant ICU patient, 804, 820

radiation exposure, 804–805, 805t

traumatic injury, 818–820

Fever

new, in ICU patient, 379

noninfectious causes, 392t

recurrent or persistent, 7t

Fiberoptic bronchoscopy, 265. See also Bronchoscopy

Fibrin degradation products, 411t

Fibrin glue, 76t

Fibrinogen, 410t, 411t