Bongard Frederic , Darryl Sue. Diagnosis and Treatment Critical Care

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INDEX

857

Fibrinogen concentrate, 76t, 416t

Fibrinogen deficiency, 413–414t, 416t

Fibrinolysis, 410t, 411t, 412

Fibrinolytic therapy. See Thrombolytic therapy

Fick method, cardiac output measurement, 200–201

First-degree burns, 728, 730t. See also Thermal burn injury

Flail chest, 286, 287

Flecainide, 487, 496

Flexion teardrop fractures, 695. See also Cervical

spinal cord injuries

Fluconazole, 377, 389, 604

Fluid flux, 223

Fluid management

in acute renal failure, 320, 330–331

in ARDS, 308

in elderly patients, 446–447

in hypercalcemia of malignancy, 460

in tumor lysis syndrome, 462

Fluid replacement

for acute adrenal insufficiency, 575

for diabetic ketoacidosis, 589, 592

for hypernatremia, 32–33

for hypovolemia, 17–19, 18t, 19t

Fluid resuscitation

in acute pancreatitis, 348

in cardiac compressive shock, 246

in cardiogenic shock, 243, 511

in electrical burn injury, 750

in hypovolemic shock, 227–229, 228t

in lower gastrointestinal bleeding, 710–711

in neurogenic shock, 241

in sepsis, 361–362

in septic shock, 235–236, 238

in thermal burn injury, 730–734, 731t, 732t

in upper gastrointestinal bleeding, 704–705

Fluid volume, 14. See also Hypervolemia; Hypovolemia

Flumazenil, 755

Fluoroquinolones, 93t

Fluoxetine, 438

Focal segmental glomerulosclerosis, 329

Folate, 122

Folic acid, 122t

Fomepizole, 779

Fondaparinux, 831

in coronary heart disease, 504

for deep venous thrombosis prophylaxis, 559, 560t, 645

for heparin-induced thrombocytopenia, 829t

Foscarnet, 315t

Fosphenytoin, 665, 665t

Fournier’s gangrene, 407

Fractional excretion of sodium (FE

), 316

Fractional excretion of urea (FE

), 316

Frank-Starling curve, 471, 471f

Frostbite, 791–793

Functional residual capacity, 99

Fungal pneumonia, in HIV disease, 604–605

Furosemide

for ascites, 718

for heart failure, 471, 472, 510

for hypercalcemia, 56

for hypercalcemia of malignancy, 460t

for hypervolemia, 21

for hyponatremia, 28

for oliguria, 330

protein binding, 89t

for pulmonary edema in pregnancy, 814–815

Gallium nitrate, 56, 460t

Gallstone ileus, 352

Ganciclovir, 315t

Gastric lavage, 755–756, 755t, 757

Gastrointestinal dialysis, 756

Gastrointestinal tract

bleeding

lower

causes, 711, 711t

diagnosis, 711–712

essentials of diagnosis, 710

general considerations, 710

initial approach, resuscitation, and risk stratification,

710–711

treatment, 712–713, 712f, 713f

upper

causes, 705–706, 705t

clinical features, 703, 716

differential diagnosis, 716

essentials of diagnosis, 703, 716

general considerations, 6t, 703, 716

initial evaluation, 6t, 703–704, 704t

preventive treatment, 3, 427–428

resuscitation, 704–705

risk stratification, 705

treatment

after failed endoscopic therapy, 708–709, 708f, 709–710

algorithm, 705f

peptic ulcer disease, 707–709, 707t

reminders, 6t

variceal bleeding, 709–710, 717

complications

in renal transplant recipients, 343

in thermal burn injury, 743

dysfunction indicators, 234t

fistulas

in acute pancreatitis, 350

nutritional support in, 131

risk factors, 700

treatment, 700

ileus. See Ileus

obstructions. See Large bowel obstruction; Small bowel

obstruction

perforation. See Pneumoperitoneum

thermal burn injury response, 725–726

Gastroparesis, 597

Gentamicin, 92t, 339t

Gitelman’s syndrome, 36, 49, 65

Glasgow Coma Scale (GCS), 11, 11t, 684, 684t

Glomerular filtration rate (GFR), 314–315

Glomerulonephritis, 94t, 322t

postinfectious, 323

Glucagon, 244, 768

Glucocorticoids. See Corticosteroids

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INDEX

858

Glucose, 123t, 576. See also Hyperglycemia; Hypoglycemia

Glycoprotein IIb/IIIa receptor inhibitors

for acute arterial insufficiency, 636

benefits, 824

characteristics, 825

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

Goiter, 567

Goodpasture’s syndrome, 327–328, 541

Graft-versus-host disease, 83t, 85, 611–612

Granulocyte transfusion, 72t, 78

Grey Turner’s sign, 346

Growth hormone, for burn injuries in children, 135

Guillain-Barré syndrome, 283, 668–669

HAART (highly active retroviral therapy), 599–600

Haemophilus influenzae, 376t

Haloperidol, 89t, 114, 435

Head and neck infections, 400, 401t

Head injury

clinical features, 684–685, 684t

essentials of diagnosis, 680

general considerations, 680

ICU monitoring, 684–685

imaging studies, 681f

nutritional support in, 132

primary injuries, 680–682, 681f

secondary injuries, 682–684, 682t, 683f

treatment, 685–686

Health care agent, 217

Heart block, 491–492, 511

Heart failure

acute renal failure in, 319, 320, 327t

after acute myocardial infarction, 510

causes, 467–468

clinical features, 468–469

differential diagnosis, 470

electrocardiography, 469

essentials of diagnosis, 467

general considerations, 467–468

hepatic dysfunction in, 91

hyperkalemia in, 40

hyperthyroidism and, 567

hypervolemia treatment in, 22

imaging studies, 469–470

indicators, 234t

in infective endocarditis, 368

nutritional support in, 130–131

pulmonary edema in, 158–159, 158f

treatment, 470–473

Heat cramps, 786

Heat exhaustion, 786

Heat rash (miliaria), 610

Heat stroke, 786–788

Helicobacter pylori, 706, 708

Helicopter transport, 209t, 210

Helium-oxygen inhalation, 539–540

HELLP syndrome, 809

Hematemesis, 703. See also Gastrointestinal tract, bleeding

Hematochezia, 703, 710. See also Gastrointestinal tract, bleeding

Hematogenous pneumonia, 380. See also Nosocomial pneumonia

Hematologic system

dysfunction indicators, 234t

in pregnancy, 803

thermal burn injury response, 726

Hematoma

after cardiac catheterization, 482

intracranial, 681, 681f

mediastinal, 140f

Hemodialysis

advantages, 336

anticoagulation for, 337

complications, 338

disadvantages, 336

drug dosing during, 336

drugs removed by, 91, 91t

effectiveness, 336–337

for hyperkalemia, 42

indications, 334–336

for poisoning

principles, 757, 757t

salicylates, 775, 775t

theophylline, 777t

serum albumin in, 120, 121f

stopping, 336

urea clearance and protein losses, 334t

vascular access, 337, 343

Hemodynamic calculations, 201t

Hemoglobin saturation (%Sat Hb), 198

Hemolysis, 326–327, 326t

Hemolytic anemia, 73

Hemolytic transfusion reactions, 79–80

Hemolytic uremic syndrome, 324, 325

Hemoperfusion, 757, 757t, 777, 777t

Hemophilia A, 412

Hemophilia B, 412

Hemoptysis

clinical features, 542

essentials of diagnosis, 540

general considerations, 540

imaging studies, 542–543

pathophysiology and pathogenesis, 540–542, 541t

prognostic signs, 534t

treatment, 543–545

Hemorrhage

in acute pancreatitis, 350

gastrointestinal, 427–428. See also Gastrointestinal tract,

bleeding

in hemodialysis, 338

in hepar

in ther

apy, 828

postpartum, 816–818

in thrombolytic therapy, 837–838

in warfarin therapy, 834

Hemostasis

laboratory tests, 409, 411–412, 411t

normal, 409, 410t

preoperative evaluation, 428–429, 429t

Henderson-Hasselbalch equation, 57

Heparin. See Low-molecular-weight heparin; Unfractionated

heparin

Heparin-induced thrombocytopenia, 522, 557, 645, 828–829, 829t

Heparinoids, 829t, 831–832

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INDEX

859

Hepatic abscess, 372t

Hepatic encephalopathy, 131, 715–716

Hepatic failure

causes, 714, 715t

clinical features, 714–715, 715t

coma in, 661t

drug clearance in, 91, 91t

drug-induced, 94–95, 95t

essentials of diagnosis, 714

general considerations, 714

indicators, 234t

predictors of poor outcome, 716t

in thermal burn injury, 726

treatment, 715–716

Hepatic steatosis, 599

Hepatitis

A, 81t

alcoholic, 131

B, 81t

C, 81t

G, 81t

Hepatorenal syndrome, 328, 719–720

Hereditary angioedema, 564, 565

Herpes zoster, 626–627

Hetastarch, 229

Highly active retroviral therapy (HAART), 599–600

Histamine H2 antagonists, 240, 563, 565

Histoplasma capsulatum, 604–605

Hospital-acquired pneumonia. See Nosocomial pneumonia

Howell-Jolly bodies, 375

HTLV-1, 81t

HTLV-2, 81t

Human immunodeficiency virus (HIV) disease

acute renal failure in, 329, 329t

CNS disorders, 607

complications of antiretroviral therapy

hyperglycemia and other metabolic disorders, 600

lactic acidosis and hepatic steatosis, 599

cryptococcal meningitis in, 408

overview, 598–599

pulmonary complications

bacterial pneumonia, 603–604

fungal pneumonia, 604–605

Kaposi sarcoma, 605

Pneumocystis pneumonia, 598, 601–602

respiratory failure, 600–601

tuberculosis, 602–603

sepsis in, 605–607

thyroid function in, 579

transfusion-associated, 81t

Hunt and Hess grades, subarachnoid hemorrhage, 687, 687t

Hydralazine

for aortic dissection, 485, 517

for heart failure after acute myocardial infarction, 510

for hypertensive crisis, 481

nutrient deficiencies caused by, 124t

for preeclampsia, 808

protein binding, 89t

Hydrocarbons, cutaneous injury from, 749

Hydrocephalus, 678

Hydrochloric acid, 66

Hydrochlorothiazide, 471

Hydrocortisone

for anaphylaxis, 563

for biphasic anaphylaxis prevention, 240

for myxedema coma, 571, 571t

in total parenteral nutrition solution, 128

Hydrofluoric acid, 749

Hydronephrosis, 184–185, 185f

Hyperbaric oxygen therapy, 371

Hyperbilirubinemia, after liver resection, 721

Hypercalcemia

in acute renal failure, 332

clinical features, 55

essentials of diagnosis, 54

general considerations, 54

of malignancy

clinical features, 457–459

differential diagnosis, 459, 460t

essentials of diagnosis, 457

pathogenesis, 457, 458f, 459t

treatment, 459–461, 460t

pathophysiology, 54–55

risk factors, 54t

treatment, 55–56

Hypercapnia, 249, 249t. See also Acute respiratory failure,

hypercapnic

Hyperchloremic metabolic acidosis, 60

Hyperemia, 723

Hyperglycemia

antiretroviral therapy-related, 599

coma in, 661t

in critical illness, 133–135, 398, 594–595

in diabetic ketoacidosis, 582–583, 582f, 585, 587–588, 661t

hyponatremia and, 25

in malignancy, 464

postoperative, 398

in septic shock, 235, 237

Hyperglycemic hyperosmolar nonketotic coma, 593

Hyperkalemia

in acute renal failure, 314, 331–332

clinical features, 40, 41f

in diabetic ketoacidosis, 591t

drug-induced, 95

essentials of diagnosis, 39, 41f

general considerations, 39

pathophysiology, 39–40

in rhabdomyolysis, 327

transfusion-related, 83t

treatment, 41–42

in tumor lysis syndrome, 462

Hypermagnesemia

clinical features, 51

essentials of diagnosis, 50

gener

al considerations, 50

pathophysiology, 50–51

treatment, 51

Hypermetabolism, after thermal burn injury, 743–744,

747–748

Hypernatremia

clinical features, 30–32, 31f

coma in, 661t

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INDEX

860

Hypernatremia (Cont.):

in diabetes insipidus. See Diabetes insipidus

essentials of diagnosis, 29, 31f

general considerations, 6t, 29

pathophysiology, 29–30, 30t

with polyuria, 32

treatment, 6t, 32–33

without polyuria, 32

Hyperparathyroidism, 459, 459t, 460t

Hyperphosphatemia

in acute renal failure, 332

clinical features, 46–47, 46t

essentials of diagnosis, 45

general considerations, 46

treatment, 47

in tumor lysis syndrome, 462

Hypertension

in cocaine intoxication, 764

intracranial. See Intracranial hypertension

in pregnancy. See Preeclampsia-eclampsia

in renal transplant recipients, 344

in sympathomimetic poisoning/overdose, 761

Hypertensive crisis, 480–482

Hyperthermia

in cocaine intoxication, 764

in heat stroke, 787

in sympathomimetic poisoning/overdose, 761

Hyperthyroidism. See Thyroid storm

Hypertonic saline

for fluid resuscitation in burn injury, 731–732, 731t

for hyponatremia, 28

for hypovolemic shock, 228–229

Hypertriglyceridemia, 587, 745

Hyperuricemia, in tumor lysis syndrome, 462

Hyperuricosuria, in tumor lysis syndrome, 462

Hypervolemia

clinical features, 20

essentials of diagnosis, 19

general considerations, 14

with hyponatremia, 28

pathophysiology, 19–20, 20t

treatment, 20–22

Hypoalbuminemia, 76t, 119–121,

120t, 121f

Hypocalcemia

in acute renal failure, 332

clinical features, 53

essentials of diagnosis, 52

general considerations, 52–53

with hyperphosphatemia, 47

with hypomagnesemia, 49, 50, 53

in malignant disease, 461

pathophysiology, 53

in rhabdomyolysis, 53, 327

risk factors, 52t

transfusion-related, 83t

treatment, 53–54

Hypoglycemia

coma in, 661t

in diabetic patients with acute illness, 595–596, 595t, 596t

in malignancy, 464

Hypokalemia

clinical features, 36–38, 37f

in diabetic ketoacidosis, 590, 591t

differential diagnosis, 464

drug-induced, 95, 124t

essentials of diagnosis, 35, 37f

general considerations, 35

in malignancy, 464

pathophysiology, 35–36

treatment, 38–39, 50

Hypomagnesemia

acute myocardial infarction and, 49

clinical features, 49

drug-induced, 124t

general considerations, 48

hypocalcemia and, 49, 53

hypokalemia and, 36, 49

pathophysiology, 48–49, 48t

in total parenteral nutrition, 124

treatment, 49–50

Hyponatremia

in acute adrenal insufficiency, 572

in acute renal failure, 331

clinical features, 25–26, 26f

coma in, 661t

differential diagnosis, 463

drug-induced, 95, 124t

essentials of diagnosis, 24, 26f

general considerations, 6t, 24

in malignancy, 463

pathophysiology, 24–25, 24t

treatment, 6t, 27–29, 463

Hyponatremic encephalopathy,

25, 27

poparathyroidism, 53

Hypophosphatemia

clinical features, 44–45, 44t

in diabetic ketoacidosis, 590–591, 591t

drug-induced, 124, 124t

essentials of diagnosis, 43

general considerations, 43

in malignancy, 464

pathophysiology, 43–44

physiologic effects, 44, 124

in total parenteral nutrition, 124

treatment, 45, 124–125

Hyporeninemic hypoaldosteronism, 597

Hypotension

general considerations, 6t

in hemodialysis, 338

in theophylline poisoning, 776

treatment, 6t

Hypothermia

anesthesia and, 100–101

blood gases in, 253, 790

with cardiopulmonary bypass,

527–529

clinical features, 787–790

controversies and unresolved issues, 791

differential diagnosis, 790

essentials of diagnosis, 788



INDEX

861

general considerations, 788–789

prognosis, 791

transfusion-related, 83t

treatment, 790–791

Hypothyroidism. See Myxedema coma

Hypovolemia. See also Hypovolemic shock

clinical features, 16–17, 223t

with decreased extracellular volume, 15, 15t

definition, 14, 15

in diabetic ketoacidosis, 583–584, 583t

differential diagnosis, 17

essentials of diagnosis, 15

ICU monitoring, 17

with increased or normal extracellular volume, 15t, 16

pathophysiology, 15–16, 15t, 223t

treatment, 17–19, 18t, 19t

Hypovolemic shock

cardiovascular effects, 222–223

cellular and immunologic effects, 224–225

clinical features, 223t, 225–226

controversies and unresolved issues, 230

differential diagnosis, 226, 227t

essentials of diagnosis, 222

gastrointestinal effects, 225

general considerations, 222

hematologic and thrombotic effects, 225

metabolic effects, 223–224

neuroendocrine effects, 224

neurologic effects, 225

pathophysiology, 223t

renal effects, 225

treatment

blood transfusion, 230

colloids, 229

crystalloids, 227–229, 228t

general principles, 226–227

Hypoxemia, 250, 250t. See also Acute respiratory failure,

hypoxemic

in hemodialysis, 338

refractory, 298, 298f

Hypoxia, 250, 661t

Ibotenic acid, 781t

Ibuprofen, 316t

Ibutilide, 487

Ifosfamide, 315t

IgG, 76t

Ileus

clinical features, 356

colonic/pseudo-obstruction (Ogilvie’s syndrome), 172,

355–356, 701

controversies and unresolved issues, 356

differential diagnosis, 354, 356

essentials of diagnosis, 355

gallstone, 352

general considerations, 355–356

imaging studies, 170, 172, 174f, 356

pathophysiology, 172

prognosis, 356

treatment, 356

Imaging studies. See also specific conditions

for central venous catheters, 140–141, 140f

chest radiographs. See Chest radiographs

computed tomography. See Computed tomography

contrast agents for, 138–139

for endotracheal and tracheostomy tubes, 139–140

in intraaortic balloon counterpulsation, 141–142

magnetic resonance imaging. See Magnetic

resonance imaging

for nasogastric tubes, 143–144, 143f

nuclear scintigraphy. See Nuclear scintigraphy

for pulmonary artery catheters, 141, 142f

for thoracostomy tubes, 144

ultrasound. See Ultrasound

Imipenem, 376–377

Immobility, 449–450

Immune-enhancing diet, 134

Immune serum globulin, 76t

Immunologic system

dysfunction indicators, 234t

thermal burn injury response, 726–727

Immunosuppressive agents

for acute glomerulonephritis, 323

nephrotoxicity, 315t

Impedance plethysmography, 548, 643

Incentive spirometry, 265

Indinavir, 315t

Indomethacin, 316t

fection(s). See also Sepsis

in ARDS, 307

in asplenic patients, 375

botulism. See Botulism

candidiasis. See Candidiasis

central nervous system, 676–679

Clostridium difficile–associated diarrhea, 386–387

endocarditis. See Infective endocarditis

intraabdominal. See Intraabdominal infections/abscess

intravenous catheter–associated. See Intravenous

catheter–associated infections

meningococcemia, 628–629

in neutropenic patient, 374

in organ transplant recipients, 343, 374–375

in patients on chronic corticosteroid therapy, 375

in patients with diabetes mellitus, 375

pneumonia. See Pneumonia

Rocky Mountain spotted fever, 629

rubeola, 627–628

soft tissue. See Necrotizing fasciitis

surgical. See Surgical infections

tetanus. See Tetanus

thyroid function in, 578

toxic shock syndrome, 630–631

transfusion-associated, 81t

urinary catheter–associated. See Urinary catheter–associated

infections

urinary tract. See Urinary tract infections

varicella-zoster virus, 626–627

vascular graft, 655

Infection control, 9, 391–392, 741

Inflammatory response, 225

Informed consent, 79



INDEX

862

Inhalation injury

clinical features, 740

controversies and unresolved issues, 746–747

essentials of diagnosis, 739

general considerations, 739–740

prognosis, 741

treatment, 740–741

Inhalational pneumonia, 379–380. See also Nosocomial pneumonia

Injury Severity Score (ISS), 12

Inspiratory airway pressure, 205

Inspiratory capacity, 281

Insulin

for diabetic ketoacidosis, 589–590

for hyperkalemia, 42

hypophosphatemia following administration, 43, 45

management in diabetic patients with acute illness, 595–596

for tight glycemic control in ICU patients, 133–135, 398,

594–595

Insulin resistance

after severe injury, 117–118

decrease during acute illness, 595

in diabetic ketoacidosis, 581–582, 582t

metabolic stress syndrome and, 135–136

Integra, 739

Intensive care unit (ICU). See also Critical care

data display, 3

decision making in

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

infection control, 9

monitoring techniques, 3

airway CO

, 203–204

blood pressure. See Blood pressure monitoring

cardiac output. See Cardiac output

central venous catheters. See Central venous catheters

electrocardiography. See Electrocardiography

pulmonary artery catheters. See Pulmonary artery catheters

pulse oximetry, 201–202

respiratory mechanics, 204–205

respired gas analysis, 206–207

transcutaneous blood gases, 204

outcomes and alternatives, 10

patient care recommendations, 2t, 4–7t

problem-oriented medical record in, 2–3

protocols, practice guidelines, and order sets, 8–9

psychosocial needs of patients, 7

quality assurance, 9

staff issues

burnout, 10

communication, 10

controversies and unresolved issues, 441

education and errors, 9–10

intervention, 441

problem identification, 440–441

self-esteem, 440

supportive and preventive care, 3

Interfacility transport. See Transport, interfacility

Interferon, 315t

Interleukin-2, 315t

Intermittent mandatory ventilation (IMV), 270t, 272, 279. See also

Mechanical ventilation

Intermittent positive-pressure breathing, 265

International normalized ratio (INR), 409

Interstitial nephritis, 94t, 322t, 323–324. See also Renal failure, acute

Interstitial pneumonia, 147

Intestinal ischemia. See Acute mesenteric ischemia

Intestinal pseudo-obstruction. See Ileus, colonic ileus/pseudo-obstruction

Intraabdominal compartment syndrome, 733

Intraabdominal infections/abscess

clinical features, 373

essentials of diagnosis, 372

general considerations, 372

imaging studies, 177–179, 178f, 373

microbiologic etiology, 372–373, 372t

pathophysiology, 372t, 403–405, 700

postoperative, 699, 700

treatment, 373, 399, 405

types, 403–404

Intraaortic balloon counterpulsation, 11, 141–142

Intracellular space, 14

Intracranial hematoma, 681, 681f

Intracranial hypertension

in acute hepatic failure, 715–716

due to malignancy

clinical features, 455–456

differential diagnosis, 456

essentials of diagnosis, 454

general considerations, 455

imaging studies, 456

treatment, 456

in head injury

pathophysiology, 682–683, 683f

treatment, 685

Intraperitoneal abscess, 372t

Intrathoracic pressure, 205

Intravenous catheter–associated infections

in central venous catheters, 195

clinical features, 384–385

controversies and unresolved issues, 385–386

differential diagnosis, 385

essentials of diagnosis, 384

general considerations, 384

microbiologic etiology, 384

pathophysiology, 384

prevention, 385–386, 400

in total parenteral nutrition, 129

treatment, 385, 401t

Intravenous immunoglobulin (IVIG), 76t, 316t, 427

Intravenous pyelography, 317, 322

Intrinsic PEEP, 268, 293–294

Inverse-ratio ventilation (IRV), 271

Iodide, for thyroid storm, 569

Iodinated contrast agents

adverse reactions, 138–139

central venous catheters for injection, 139

histamine-mediated reactions, 483

nephrotoxicity, 189, 316t, 318, 483

Iodinated glycerol, 265



INDEX

863

Ion trapping, 757

Ipecac, 755, 757

Ipodate sodium, for thyroid storm, 568–569, 568t

Ipratropium bromide, 261–262, 292, 537

Iris lesions, 615

Iron, 83t, 125

Iron deficiency anemia, 132

Isoniazid, 124t, 603

Isopropyl alcohol poisoning, 62, 779–780

Isoproterenol, 244

Isosorbide dinitrate

for heart failure after acute myocardial infarction, 510

for myocardial ischemia, 500–501

for unstable angina or non-STEMI, 503–504

Isotretinoin, 624

ISS (Injury Severity Score), 12

Itraconazole, 377

Jefferson fracture of the atlas, 694. See also

Cervical spinal cord injuries

Justice, 215

Kaposi sarcoma, 605

Kerley lines, 158, 158f

Kernohan’s notch phenomenon, 684

Ketamine, 106, 114

Ketorolac, 316t

Ketorolac tromethamine, 106

Ketosis, in diabetic ketoacidosis, 583, 588–589

Kidney, 445, 725

failure. See Renal failure, acute

transplantation. See Renal transplant recipient

King’s College Criteria, outcome in acute hepatic failure, 716t

Koplik’s spots, 627

Kussmaul’s sign, 245

Kyphosis, 286

Labetalol

for aortic dissection, 517

for hypertensive crisis, 481

for postoperative hypertension, 654

for preeclampsia, 808

Labor and delivery, 802, 806–807. See also Pregnancy

Lactase deficiency, 357

Lactic acidosis, 61–62, 61t, 464–465, 599

Large bowel obstruction, 169, 170, 173f, 354–355

Laryngeal mask airway (LMA), 102

Laryngoedema, 97

Laryngospasm, 97

Laxatives, nutrient deficiencies caused by, 124t

Lead poisoning, 670

Left ventricular end-diastolic pressure (LVEDP), 198

Legal issues, in interfacility transport, 210

Legionella, 363

Lepirudin

for acute arterial insufficiency, 636–637, 637t

for heparin-induced thrombocytopenia, 645, 829t

mechanisms of action, 831

Leukocytoclastic vasculitis, 620–621, 620t

Leukotriene inhibitors, 264

Leukotriene receptor antagonists, 264

Leuven study, 594

Levalbuterol, 260

Levetiracetam, 665

Levothyroxine (T

), for myxedema coma, 571, 571t

Lidocaine

in acute myocardial infarction, 508

adverse effects, 489, 496

for pain management, 105

pharmacology, 105, 106t, 496

for premature ventricular contractions, 489

therapeutic ranges, 92t

for ventricular tachycardia, 491

Life support, withholding and withdrawing,

218–219

Life-threatening hemoptysis, 543, 543t. See also Hemoptysis

Lightning injury, 798–800

Limb ischemia. See Acute arterial insufficiency

Linezolid, 376t, 378

Lipids, 123t, 127, 129

Listeria monocytogenes, 678

Lithium, 316t, 568t, 569

Liver disease. See also Hepatic failure

coagulation disorders in, 418

thyroid function in, 578

treatment of bleeding in, 420–421

Liver resection, 720–721

Liver transplantation, 716, 720

Living will, 217

Local anesthetics, 98, 105–106, 106t. See also specific drugs

Loperamide, 358

Lorazepam

as anticonvulsant, 665, 665t

for anxiety, 440

pharmacology, 110–111, 110t

protein binding, 89t

side effects, 111

uses, 110

for withdrawal syndromes, 435

Low-molecular-weight heparin (LMWH)

advantages, 830

complications, 831

for deep venous thrombosis/pulmonary embolism

prophylaxis, 559–561, 560t, 644

treatment, 556, 645, 646t

in hemodialysis, 337

indications, 830–831

mechanisms of action, 829–830

in pregnancy, 838, 839t

vs. unfractionated heparin, 830t

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

Lugol’s solution, for thyroid storm, 568t, 569

Lung abscess, 147–148, 148f

Lung cancer, 541

Lung compliance

anesthesia and, 99

in ARDS, 298–299, 299f

in mechanical ventilation, 267–268, 267f

monitoring, 205



INDEX

864

Lung-protective strategy, mechanical ventilation, 304–306, 304t, 305f

Lyme disease, transfusion-associated, 81t

Macrolides, 376t, 378

Mafenide burn cream, 735, 737

Magnesium

in acute renal failure, 332

in body fluids, 125t

daily requirements, 123t

distribution, 47, 125t

excretion, 47–48

functions, 47, 48

imbalances. See Hypermagnesemia; Hypomagnesemia

intake, 47

losses, 124

normal levels, 124

replacement therapy, 50

Magnesium sulfate

for acute myocardial infarction, 509

for acute respiratory failure, 262–263

adverse effects, 263

for seizure prophylaxis/treatment in preeclampsia-eclampsia,

808, 809

for status asthmaticus, 537

Magnetic resonance imaging (MRI), 138

in back pain with suspected malignancy, 455t

in increased intracranial pressure due to malignancy, 456

in spinal cord compression, 452–453

Malaria, transfusion-associated, 82t

Malignant hypertension, 480–482

Malignant hyperthermia, 115–116, 116t

Malnutrition. See also Nutrition

delayed hypersensitivity in, 121

drug-induced nutrient deficiencies, 124t

in elderly patients, 447

infection risk and, 398

laboratory findings, 121

lean body mass loss in, 121–122

new treatment strategies

albumin, 135

anabolic steroids, 135

beta-adrenergic blockade, 135–136

growth hormone, 135

insulin, 134–135

nutritional support in, 130

symptoms and signs, 121

thyroid function in, 578

treatment in specific diseases

acute hepatic porphyria, 134

burns, 133

cancer, 132

cardiopulmonary disorders, 130–131

diabetes mellitus, 133–134

gastrointestinal disorders, 131

hematologic disorders, 132

hypoalbuminemia, 130

immune-enhancing diet, 134

renal disorders, 132

sepsis and multiple organ failure syndrome, 133

stroke, 133

trauma, 132–133

wound dehiscence and healing, 133

vitamins and minerals, 123–125. See also specific vitamins

and minerals

Manganese, 123t

Mannitol

for acute arterial insufficiency, 636

for increased intracranial pressure in brain tumor, 689

nephrotoxicity, 315t

for oliguria, 330

for pigment nephropathy, 327

Massive hemoptysis, 542. See also Hemoptysis

Massive pulmonary embolism, 547. See also Pulmonary embolism

Maximum expiratory airway pressure, 205

Maximum inspiratory airway pressure, 205

Mean airway pressure, 268

Mean arterial pressure (MAP), 189

Measles (rubeola), 627–628

Mechanical ventilation

airway pressure-release, 270t, 272

for ARDS, 304–307, 304t, 305f

central venous pressure in, 195f

complications, 275–277, 275t

for COPD exacerbations, 274t, 293–294, 294f

expiratory phase, 269

in inhalation injury, 740–741

inspiratory phase, 269

during interfacility transport, 212

methods

airway pressure-release ventilation, 272

comparison, 270t

extracorporeal membrane oxygenation, 274

high-frequency ventilation, 274

intermittent mandatory ventilation, 272

noninvasive negative-pressure, 272–273

noninvasive positive-pressure. See Noninvasive

positive-pressure ventilation

pressure-controlled ventilation, 271

pressure-support ventilation, 271–272

volume-present ventilation, 269–271

monitoring, 275, 275t

in muscular dystrophy, 673

neuromuscular blockade in, 107

in neuromuscular disease, 274t, 285

patient-ventilator system, 266

respiratory alkalosis and, 69–70

respiratory mechanics in, 267–269, 267f

in septic shock, 236

for status asthmaticus, 274t, 538–539

tidal volume monitoring, 204–205

variables in, 266t

ventilator capabilities, 269

weaning

methods, 278–279

physiologic assessment, 277, 277t

predictors of success, 277–278, 278t

Mediastinal hematoma, 140f

diastinitis, 402–403, 404t

acute necrotizing, 403

Medical director, intensive care unit, 8–10

Medical futility, 216



INDEX

865

Medication errors, 95–96

Medroxyprogesterone acetate, 313

Mee’s lines, 670

Melena, 703. See also Upper gastrointestinal bleeding

Mendelson’s syndrome, 150

Meningitis, 400, 401t, 608

viral, 677

Meningococcemia, 628–629

Meperidine, 111t, 112

Mepivacaine, 106t

Meropenem, 315t, 376–377

Metabolic acidosis

clinical features, 62

controversies and unresolved issues, 63–64

definition, 58

in diabetic ketoacidosis, 583, 585

differential diagnosis, 62–63

elevated anion gap, 61–62, 61t, 778, 778t

essentials of diagnosis, 60

expected response, 59t

general considerations, 60

normal anion gap, 60–61

relationship between pH and HCO

–

,59t

in septic shock, 235

treatment, 63

Metabolic alkalosis

clinical features, 65–66

definition, 58

differential diagnosis, 66

essentials of diagnosis, 64

expected response, 59t

general considerations, 64

pathophysiology, 64–65, 65t

relationship between pH and HCO

–

,59t

treatment, 66–67

Metabolism

changes during critical illness

acute-phase response, 117

catabolism and urine urea nitrogen, 118, 126

energy expenditure, 126

hormonal, 117–118

dysfunction indicators, 234t

in hypovolemic shock, 223–224

in septic shock, 233

Metaproterenol, 260

Methadone, 112

Methanol poisoning, 61t, 777–779, 778t, 779t

Methicillin-resistant Staphylococcus aureus (MRSA),

363, 390

Methimazole, for thyroid storm, 568, 568t

Methohexital, 106

Methotrexate, 315t

Methylergonovine, for postpartum hemorrhage, 818

Methylphenidate, 437

Methylprednisolone, 537–538, 565

Metoclopramide, 354, 356

Metolazone, 21, 471

Metoprolol

for myocardial ischemia, 501

for ST-segment elevation myocardial infarction, 508, 509

for unstable angina or non-STEMI, 503

Metronidazole, 387

Micafungin, 378

Midazolam, 89t, 110t, 111

Midline catheter, 384

Miliaria (heat rash), 610

Milk-alkali syndrome, 55, 64

Miller-Fisher syndrome, 669

Milrinone, for cardiogenic shock, 511

Mineralocorticoids, 575, 575t

Minute ventilation, 203, 248, 249f

Mitomycin, 315t

Mitral regurgitation, 198, 475

Mitral stenosis, 198, 475, 494

Mivacurium, 107t, 108–109

Mixed expired P

, 203

Mixed venous oxygen saturation (S

–

), 195, 198

Modified Brooke formula, 731t, 732

Modified fluid gelatin (MFG), 229

Mojave rattlesnake, 795

Molybdenum, 123t

Monitoring

in intensive care unit. See Intensive care unit, monitoring

during interfacility transport, 212

Monoclonal antibodies, 702

Monomethylhydrazine, 781t

Morbilliform eruptions, 612–614, 614t

Morphine

in acute myocardial infarction, 508

epidural, 104, 105

in patient-controlled analgesia, 104

pharmacology, 111t, 112

side effects, 98, 112

uses, 112

MRSA. See Methicillin-resistant Staphylococcus aureus

Mucolytics, 539

Mucormycosis, 591t, 592

rhinocerebral, 375

Multifocal atrial tachycardia, 488

Multiple organ system failure (multiple organ system

dysfunction syndrome)

in ARDS, 299–300

assessment, 234t

definition, 360

nutritional support in, 133

in septic shock, 233

Murphy sign, 698

Muscarine, 781t, 782

Muscimol, 781t

Muscle relaxants. See Neuromuscular blockade

Muscular dystrophies, 672–673

Mushroom poisoning, 780–783, 781t

Myasthenia gravis, 283, 670–671

Mycobacterium tuberculosis. See Tuberculosis

Mycotic aneurysm, 368

Myocardial depressant factor (MDF), 232–233

Myocardial infarction. See Acute myocardial

infarction

Myocardial ischemia (angina pectoris), 499–502

Myopathies, inflammatory, 671, 672

Myotonic dystrophy, 672–673

Myxedema coma, 570–572, 571t, 661t



INDEX

866

Nabumetone, 316t

Nafcillin, 89t

Naloxone, 113–114, 755

Naproxen, 316t

Narcotic analgesia/anesthesia. See Opioid(s)

Nasal continuous positive airway pressure (nasal CPAP), 273, 312

Nasogastric tubes, 143–144, 143f. See also Enteral nutrition

Near-drowning, 793–794

Necrosectomy, pancreatic, 350

Necrosis, pancreatic, 347–348

Necrotizing fasciitis

categories, 407

clinical features, 370–371, 630

differential diagnosis, 371

essentials of diagnosis, 370, 630

general considerations, 370, 630

microbiologic etiology, 370

pathophysiology, 370

prognosis, 371, 407

treatment, 371, 407, 408t, 630

Needle aspiration, pancreas, 348

Neisseria meningitidis, 628

Neostigmine, 701

Nephropathy, contrast-related, 139, 318, 483

Nesiritide, 471, 533

Neurogenic pulmonary edema, 284

Neurogenic shock, 227t, 241–242

Neuroleptic malignant syndrome, 433, 672

Neuromuscular blockade

in anesthesia, 101

commonly used agents, 107t, 108–109. See also specific drugs

complications, 108, 109

in endotracheal intubation, 102

indications, 106–107

in mechanical ventilation, 107, 264

monitoring, 109

respiratory effects, 101

reversal, 110

Neuromuscular disorders

botulism. See Botulism

controversies and unresolved issues, 673

critical illness myopathy, 282, 669

critical illness polyneuropathy, 282, 669

differential diagnosis, 673

Guillain-Barré syndrome, 283, 668–669

inflammatory myopathies, 671–672

muscular dystrophies, 672–673

myasthenia gravis, 283, 670–671

neuroleptic malignant syndrome, 433, 672

pathophysiology, 666–667, 666f

respiratory failure in, 274t

clinical features, 281–284, 282t

diseases causing, 667t

essentials of diagnosis, 280

general considerations, 280, 280t

pathophysiology, 280–281, 280t, 667, 668f

treatment, 284–285

spinal cord compression. See Spinal

cord compression

toxic neuropathies, 669–670

Neuropathy, toxic, 669–670

Neutropenia, 374

Niacin. See Vitamin B

Nifedipine, 89t, 501, 808

Nikolsky’s sign, 617, 623

Nitrates, 500–501, 503–504

Nitric oxide

for ARDS, 307

in heat stroke, 788

for perioperative low cardiac output, 532

for pulmonary hypertension, 473

in septic shock, 232

Nitrogen balance, in acute renal failure, 332–333

Nitrogen loss, after thermal burn injury, 745

Nitroglycerin

for acute myocardial infarction, 507, 508

for aortic dissection, 517

for cardiogenic shock, 243, 245, 472

for hypertensive crisis, 481

for variceal bleeding, 717

Nitroprusside

for aortic dissection, 485, 517

for cardiogenic shock, 244, 470, 472

for hypertensive crisis, 481

for septic shock, 237

toxicity, 244

No-reflow phenomenon, 634

Non-ST-segment-elevation myocardial infarction (non-STEMI),

502–504, 505t

Noncardiogenic pulmonary edema, 297. See also Acute respiratory

distress syndrome

Noninvasive positive-pressure ventilation (NiPPV), 273–274

after weaning from mechanical ventilation, 279

negative-pressure, 272–273

for acute respiratory failure in thoracic wall disorders, 287

for COPD exacerbations, 294

for heart failure, 471

for status asthmaticus, 540

negative-pressure, 272–273

positive-pressure, 273–274

Nonmaleficence, 215

Nonrebreathing mask, 258, 259t

Nonsteroidal anti-inflammatory drugs (NSAIDs)

antiplatelet effects, 822

gastroduodenal ulceration and, 706

nephrotoxicity, 316t

for pain management, 106

Norepinephrine

for anaphylactic shock, 240

for cardiogenic shock, 244

for neurogenic shock, 241

for septic shock, 237

Nortriptyline, 438

Nosocomial pneumonia

aspiration, 149–150, 150f, 380

clinical features, 380–381

definition, 146

differential diagnosis, 381

essentials of diagnosis, 379

general considerations, 379

hematogenous, 380