Bongard Frederic , Darryl Sue. Diagnosis and Treatment Critical Care

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INDEX

867

imaging studies, 148

inhalational, 379–380

microbiologic etiology, 380

pathophysiology, 379–380

prevention, 381

treatment, 381

Nuclear scintigraphy, 138

in acalculous cholecystitis, 183, 183f

in acute calculous cholecystitis, 182

in acute renal failure, 184, 318

in intraabdominal abscess, 178

Nutrition. See also Malnutrition

in acute pancreatitis, 349

in acute renal failure, 332–333

after thermal burn injury. See Thermal burn injury,

nutritional support

assessment of needs, 4t, 126

changes during critical illness, 117–118

enteral. See Enteral nutrition

general considerations, 4t

macronutrients, 123t

micronutrients, 123t

outcome predictors, 119–121, 120t, 121f

status indicators, 118–119

total parenteral nutrition (TPN)

after thermal burn injury, 745

catheter placement, 128–129

catheter-related infection in, 129

central route, 128

in diabetes, 134

vs. enteral nutrition, 126–127

formulas for, 128t, 129

hyperphosphatemia in, 46

indications, 127t

lean body mass loss during, 118

ordering, 129–130

peripheral route, 128, 130

in pregnancy, 805–806

in vascular surgery patients, 651–652

vitamins and minerals, 122–125, 122t. See also specific

vitamins and minerals

Obesity, 89, 286, 287

Obesity-hypoventilation syndrome, 311, 313

Obstruction, bowel

large, 169, 170, 173f, 354–355

small

clinical features, 352–353, 353f

differential diagnosis, 353–354

essentials of diagnosis, 351

general considerations, 352

imaging studies, 169–170, 171f,

172f, 353

pathophysiology, 169, 352

postoperative, 700

treatment, 354

Obstructive sleep apnea, 273, 310–313

Obstructive uropathy, 184–185, 185f

Obturator sign, 698

Octreotide

for diarrhea in carcinoid tumors, 358

for enteric fistulas, 700

for variceal bleeding, 709, 717

Ocular injury

chemical, 749–750

thermal, 743

Oculocephalic reflex, 660

Ogilvie’s syndrome (colonic ileus), 172,

355–356

Oil of wintergreen, 773

Olanzapine, 435

Omega-3 fatty acids, 127

Omeprazole, 316t

Oncology patient. See Cancer

Opioid(s)

in cardiogenic shock, 243

cardiovascular effects, 98

commonly used, 111t, 112–113. See also specific drugs

epidural and intrathecal, 104–105

intravenous, 104

pharmacology, 111t, 112–113

poisoning/overdose, 759–760

respiratory effects, 100

uses, 112–113

withdrawal, 760

Opioid agonist-antagonists, 113

Opioid antagonists, 113–114

Orellanien, 781t

Orelline, 781t, 782

Organ donation, 219

Organ transplant recipient, 343, 374–375. See also

Renal transplant recipient

Organic osmolytes, 32

Organophosphate poisoning, 783–785

Oscillometry, for blood pressure monitoring,

190

Osler-Weber-Rendu syndrome, 542

Osmolality, 22

Osmolar gap, 778t

Osmotic demyelination syndrome, 27

Osmotic diarrhea, 358t

Osteoclast-activating factor, 457

Overdose. See Poisoning/overdose

Oxacillin, 89t

Oxandrolone, 135, 748

Oxygen delivery, 252–253

Oxygen therapy

for ARDS, 302

complications, 259–260

for COPD exacerbation, 291

delivery devices, 258–259, 259t

inspired oxygen concentration, 257–258,

258f

for obst

ructive sleep apnea, 312–313

oxygen saturation and oxygen content,

257, 257f

and P(

-a)

, 257

for status asthmaticus, 537

Oxygen uptake (V

), 206, 224

Oxyhemoglobin dissociation curve, 257f

Oxytocin, for postpartum hemorrhage, 818



INDEX

868

Pacemakers, cardiac

after acute myocardial infarction, 511

imaging studies, 143

malfunction, 492–493

age-related changes, 445t

in respiratory failure, 247, 250–251

Pain, 103–104

Pain management

for burn excision and wound debridement, 106

for cardioversion, 106

opioids for. See Opioid(s)

Pamidronate, 56, 461

Pancreatic abscess, 179, 180, 372t

Pancreatic infections/necrosis, 347, 405

Pancreatic insufficiency, 357

Pancreatitis, acute

alcohol consumption and, 345

clinical features, 346–348, 347t

complications, 350

essentials of diagnosis, 345

general considerations, 345–346

in HIV disease, 600

hypocalcemia in, 53

imaging studies, 179–181, 180f, 181f, 346–347

nutritional support in, 131

pathophysiology, 179, 346

postoperative, 345

treatment, 181, 348–350

Pancuronium, 107t, 108, 264

Pancytopenia (post-chemotherapy), 7t

Pantothenic acid, 122t

age-related changes, 444

in oxygen therapy, 257, 257f

in respiratory failure, 247

Papillary muscle rupture, 512

Paracentesis, 22, 718–719

Paralytic ileus. See Ileus

Paranasal sinusitis, 400, 401t

Paraquat poisoning, 327t, 328

Parasitic infections, 82t, 677–678

Parathyroid hormone (PTH), 52, 54, 457, 458f

Parathyroid hormone–related peptide (PTHrP),

55, 457

Parenteral nutrition. See Nutrition

Parkinson’s disease, 283

Parkland formula, 731t

Paroxysmal depolarization shift, 662

Partial seizures, 663, 663t. See also Seizures

Parvovirus B19, 81t

Patient-controlled analgesia (PCA), 104

Patient’s bill of rights, 215, 216t

PCWP (pulmonary capillary wedge pressure), 197–198, 236

Peak airway pressure, 268

PEEP (positive end-expiratory pressure), 302–304, 303f

Pelvic inflammatory disease, 406t

Pemphigus vulgaris, 623

Penicillamine, 124t

Penicillins, 315t, 376t

Pentamidine, 315t, 595, 601–602

Pentasaccharide analogues. See Fondaparinux

Pentobarbital, 666, 685

Peptic ulcer disease, 706–709. See also Upper gastrointestinal bleeding

Percutaneous pyelography, 317

Pericardial effusions, 478. See also Cardiac tamponade

Pericardial tamponade. See Cardiac tamponade

Pericarditis, 512

Periodic lung recruitment, 309

Periorbital cellulitis, 400, 401t

Peripheral nerve stimulator, 109

Peripherally inserted central venous catheter (PICC), 384

Peritoneal dialysis

access, 339

advantages, 338

capabilities, 339

complications, 339–340, 339t

disadvantages, 338–339

urea clearance and protein losses, 334t

Peritoneal lavage

in acute abdomen, 699

in acute pancreatitis, 349

in pregnancy, 820

Peritonitis

dialysis-related, 339t, 340

primary/spontaneous, 372t, 403–404, 406t

secondary, 372t, 405, 406t

tertiary, 405, 406t

Permissive hypercapnia, 305

Personality disorders, 433

PGD

, 232t

PGE

, 232t

PGF

, 232t

Pharmacodynamics, 88

Pharmacokinetics, 88

absorption, 88

distribution, 89–90

drug clearance, 90–91, 90t, 91t

in elderly patients, 446

parameters, 88

Pharmacotherapy. See Drug(s); specific drugs

Phencyclidine (PCP) intoxication, 762–763

Phenindione, 316t

Phenobarbital

as anticonvulsant, 665, 665t

drug interactions, 93t

nutrient deficiencies caused by, 124t

therapeutic ranges, 92t

Phenol, 749

Phenothiazines, 124t

Phenylephrine, 241

Phenytoin

as anticonvulsant, 665, 665t, 688

drug interactions, 93t

hypersensitivity syndrome, 618–619

nephrotoxicity, 316t

nutrient deficiencies caused by, 124t

protein binding, 89, 89t

therapeutic ranges, 92, 92t

Phlebostatic axis, 193, 193f

Phlegmasia alba dolens, 642

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INDEX

869

Phlegmasia cerulea dolens, 642

Phosphodiesterase III inhibitors, 532, 825

Phosphorus

daily requirements, 123t

factors affecting balance, 43

functions, 42

imbalances. See Hyperphosphatemia; Hypophosphatemia

laboratory studies, 43

replacement therapy, 45, 124–125

after liver resection, 721

for diabetic ketoacidosis, 590–591, 591t

for hypercalcemia of malignancy, 460t

Pigment nephropathy, 326–327, 326t

PIOPED (Prospective Investigation of Pulmonary Embolism

Diagnosis), 549, 551t

Pipecuronium, 107t, 109

Placenta, 817, 819

Plasma exchange therapy, 77

Plasma osmolality, 22

Plasma transfusion. See also Transfusion therapy

indications, 72t, 77, 416t

products available, 72t, 75–76, 76t

requirements, 77

Plasminogen, 410t

Plasminogen activator inhibitor, 410t

Platelet(s)

acquired dysfunction, 423–424

in hemostasis, 410t

inherited dysfunction, 422–423, 422t

inhibitors. See Antiplatelet agents

laboratory tests, 411t, 412

in pregnancy, 803

transfusion, 72t, 74–75, 76t, 424. See also Transfusion therapy

Plethysmography, 190, 635, 643

Pleural effusions, 161–164, 164f

Plicamycin, 56, 460t

Pneumocystis pneumonia (PCP), in HIV disease, 598, 601–602

Pneumomediastinum, 166–167

Pneumonectomy, 402

Pneumonia

acute renal failure in, 327t

after thermal burn injury, 742

community-acquired

clinical features, 363–364, 364t

differential diagnosis, 364

essentials of diagnosis, 362

general considerations, 363

microbiologic etiology, 363, 364t

treatment, 364–365, 365t

in HIV disease

bacterial, 603–604

fungal, 604–605

Pneumocystis, 598, 601–602

imaging studies, 146–149, 148f, 149f

nosocomial. See Nosocomial pneumonia

nutritional support in, 130

ventilator-associated. See Ventilator-associated pneumonia

Pneumoperitoneum, 167–168, 168f, 169f

Pneumothorax

with central venous catheter placement, 141

iatrogenic, 165

imaging studies, 164–166, 165f, 166f

with pulmonary artery catheter placement, 198

tension, 165–166, 166f

-a)

, 257

Poisoning/overdose

diagnosis, 752–754, 753t, 754t

differential diagnosis, 754

serotonin syndrome in, 766–767

specific agents

acetaminophen, 771–773, 772f

antihypertensives, 767–768

arsenic, 670

cocaine, 763–764

digoxin. See Digoxin, toxicity

ethylene glycol, 61t, 62, 777–779, 778t

isopropyl alcohol, 62, 779–780

lead, 670

methanol, 61t, 777–779, 778t, 779t

mushrooms, 780–783, 781t

opioids, 759–760

organophosphates, 783–785

phencyclidine, 762–763

salicylates, 61t, 773–775, 774f, 775t

sedative-hypnotics, 753t, 757–758

sympathomimetics, 753t, 760–761

theophylline, 775–777, 777t

tricyclic antidepressants, 764–766

treatment

airway management, 754

control of seizures, 755

decontamination, 755–757, 755t, 756t

general measures, 754

hemodynamic support, 754–755

opioid and benzodiazepine antagonists, 755

Poliomyelitis, 283

Polymorphonuclear leukocytes, 297

Polymyxin B, 315t

Polyuria, in hypernatremia, 32

Pontine paramedian reticular formation, 660

Porphyria, acute hepatic, 134

Portal hypertension, 707. See also Variceal bleeding

Positive end-expiratory pressure (PEEP), 302–304, 303f

Posterior spinal cord syndrome, 693

Postphlebitic syndrome, 546

Postrenal renal failure, 321–322, 321t. See also

Renal failure, acute

Postthrombotic syndrome, 647

Posttransfusion purpura, 83t

Posttraumatic stress disorder (PTSD), 439

Potassium

in body fluids, 125t

daily requirements, 123t

extracellular-intracellular distribution, 34–35, 35t

imbalances. See Hyperkalemia; Hypokalemia

intake and output, 332t

plasma levels, 34

renal excretion, 34, 35t

replacement therapy, 38–39

supplementation in acute myocardial infarction, 509

total body, 34

Pralidoxime, for organophosphate poisoning, 784



INDEX

870

Praziquantel, for cysticercosis, 677

Prednisone. See also Corticosteroids

for angioedema, 565

for pemphigus vulgaris, 623

for status asthmaticus, 538

Preeclampsia-eclampsia, 807–809

Pregnancy

acute fatty liver of, 809–810

amniotic fluid embolism in, 811

anticoagulant therapy in, 827t, 838–839, 839t

asthma in, 538

cardiac arrhythmias during, 494

congenital heart disease during, 494

deep venous thrombosis in, 647, 804

diabetic ketoacidosis in, 582

general considerations for care in the ICU

cardiopulmonary resuscitation, 806

drugs, 804, 805t

imaging studies, 804–805, 805t

labor and delivery, 806–807

monitoring, 804

patient counseling, 806

position, 804

total parenteral nutrition, 805–806

HELLP syndrome in, 809

physiologic adaptation to

cardiovascular, 802

hematologic, 803

immune, 803–804

respiratory, 802–803, 803f

postpartum hemorrhage, 816–818

preeclampsia-eclampsia in, 807–809

pulmonary edema in, 813–815

pyelonephritis in, 811–812

septic abortion in, 813

status asthmaticus in, 815–816

trauma during, 818–820

valvular heart disease during, 493–494

warfarin use during, 835

Premature ventricular contractions (PVCs), 489

Prerenal renal failure, 319–321, 319t. See also Renal failure, acute

Pressure-controlled ventilation (PCV), 270t, 271. See also

Mechanical ventilation

Pressure-support ventilation (PSV), 270t, 271–272, 279. See also

Mechanical ventilation

Pressure ulcers (decubitus), prevention, 449–450

Pressure-volume (PV) curve

in ARDS, 299, 299f, 302–303, 303f, 309

positive end-expiratory pressure and, 302–303, 303f

Primaquine, 602

Problem-oriented medical record, 2–3

Procainamide

in acute myocardial infarction, 508

for atrial arrhythmias, 486

for atrial fibrillation, 487

therapeutic ranges, 92t

toxicity, 489, 496

for ventricular tachycardia, 491, 510

Procaine, 106t

Prochlorperazine, 89t

Procoagulant, 410t

Proenzymes, 410t

Progesterone, 124t

Prone positioning, in ARDS, 309

Propafenone, 487

Propofol, 114, 264

Proportionality, 216

Propranolol

for atrial fibrillation, 510

in burn injuries, 135–136

for ST-segment elevation myocardial infarction, 509

for thyroid storm, 568t, 569

Propylthiouracil, for thyroid storm, 568, 568t

Prospective Investigation of Pulmonary Embolism Diagnosis

(PIOPED), 549, 551t

Prostacyclin (PGI

), 232t, 337

Prosthetic heart valves, 475–476, 522–523

Protamine sulfate, 557, 828

Protamine sulfate test, 411t

Protein

daily requirements, 123t

in enteral nutrition, 127

requirements in thermal burn injury, 744–745

in total parenteral nutrition, 129

Protein binding, 89, 89t

Protein C, 410t

Protein S, 410t

Proteinuria, 317

Prothrombin time (PT), 409, 411t

Proton pump inhibitors, 708

Prourokinase, 637

Pseudo-obstruction, colonic, 172, 355–356, 701, See also Ileus

Pseudoaneurysm, pulmonary artery, 141

Pseudocysts, pancreatic, 179, 181, 350

Pseudomembranous colitis, 175

Pseudomonas aeruginosa

in community-acquired pneumonia, 363

in dialysis-related peritonitis, 339t

resistance issues, 376t

Psilocin, 781t

Psilocybin, 781t

Psoas sign, 698

Psoriasis, generalized pustular, 624

Psychiatric problems

anxiety and fear, 438–440

delirium, 431–436, 434t

depression, 436–438

Psychosis, vs. delirium, 433

PTH (parathyroid hormone), 52, 54, 457, 458f

PTHrP (parathyroid hormone–related peptide), 55, 457

Pulmonary angiography, 153, 156, 553–554

Pulmonary artery catheters

clinical applications

in acute myocardial infarction, 506–507

in heart failure, 470, 472

mixed venous oxygen saturation, 198

pressure measurements, 197–198

complications, 141, 142f, 198–199

general considerations, 6t, 196–197, 196f

imaging studies, 141, 142f

positioning, 196, 197f

Pulmonary artery pseudoaneurysm, 141



INDEX

871

Pulmonary artery rupture, 141, 199

Pulmonary capillary wedge pressure (PCWP), 197–198, 236

Pulmonary edema

cardiogenic vs. noncardiogenic, 159, 159f, 301, 301t. See also

Heart failure

in hypervolemia, 20

hypooncotic, nutritional support in, 130

imaging studies, 157–160, 158f, 159f

neurogenic, 285

noncardiogenic, 297. See also Acute respiratory distress syndrome

pathophysiology, 157–158

in preeclampsia, 808

in pregnancy, 813–815

Pulmonary embolism

acute renal failure in, 327t

clinical features, 548–550, 549t

diagnostic approach, 552f, 554

essentials of diagnosis, 545

general considerations, 545–546

imaging studies, 153–156, 155f, 550–554, 551t

pathophysiology and pathogenesis, 546–547

prevention, 559–561, 560t

septic, 156–157, 157f

treatment

anticoagulation, 554–557, 555t

inferior vena cava interruption, 558–559

pulmonary embolectomy, 559

supportive care, 559

thrombolytic therapy, 557–558, 837

Pulmonary function

age-related changes, 444–445

during fluid resuscitation for burn injury, 733

in pregnancy, 802–803, 803f

Pulmonary gas exchange, anesthetic effects, 100

Pulmonary hypertension, 473

Pulmonary infarction, 142f, 547

Pulmonary interstitial emphysema, 166–167

Pulmonary renal syndromes, 327–328, 327t

Pulmonary vascular resistance, 201t

Pulse oximetry, 201–202

Pulse pressure, 189

Pulse waveform analysis, 201

Pupillary response, in coma, 659–660, 660t

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

Purpura fulminans, 622

Pyelonephritis. See also Urinary tract infections

emphysematous, 366

Pyrazinamide, 603

Pyridostigmine, 670

Pyridoxine. See Vitamin B

Quality assurance, 9

Quinidine, 489, 496

Quinolones, 315t, 376t, 377

Quinupristin-dalfopristin, 376t, 378

Radiation injury, 800–801

Radiation therapy, 454, 456

Radiocontrast agents. See Iodinated contrast agents

Radiofibrinogen leg scans, 548

Radiographs, abdominal, 137–138

in acute calculous cholecystitis, 182

in acute pancreatitis, 179–180, 180f

in acute renal failure, 317

in bowel obstruction, 169–170, 171f, 173f, 353, 355

in colitis, 176f

in ileus, 172, 174f

in intestinal ischemia, 174

in intraabdominal abscess, 177, 373

in pneumoperitoneum, 167–168, 168f, 169f

in toxic megacolon, 177, 177f

Radionuclide angiography, 469

Radionuclide scintigraphy. See Nuclear scintigraphy

Radionuclide ventriculography, 653

Radiosurgery, 456

Ramipril, 510

Ranitidine, 240, 316t, 563, 565

Ranson’s criteria, severity of acute pancreatitis, 347, 347t

Rapid shallow breathing index, 278

Recombinant tissue plasminogen activator (r-tPA). See Alteplase;

Thrombolytic therapy

Red blood cell casts, 317, 323

Red blood cells (RBCs)

preparation, 71

transfusion. See also Transfusion therapy

complications, 79–84, 81–82t, 83t

indications, 71–74, 72t

in pregnancy, 73

products available, 72t

requirements, 74

Refractory hypoxemia, 298, 298f

Regional analgesia, 105

Remifentanil, 111t, 113

Renal angiography, 317, 320

Renal biopsy, 317

Renal failure

acute

in acute hepatic failure, 716

in acute pancreatitis, 349

after vascular surgery, 654–655

causes, 314

clinical features, 4t, 314–317, 315t

complications, 318, 318t

definition, 314

drug elimination in, 90–91

drug-induced, 94, 94t, 315–316t

in heat stroke, 787

in HIV/AIDS, 329

hyperkalemia in, 39–40

imaging studies, 184–185, 317–318

indicators, 234t

intrinsic

acute interstitial nephritis, 323–324

acute tubular necrosis, 94t, 325–326

causes, 4t, 322t

cortical necrosis, 326



INDEX

872

Renal failure, acute, intrinsic (Cont.):

glomerulonephritis, 94t, 322–323

microcapillary and glomerular occlusion, 324–325

platelet dysfunction in, 423–424

postrenal, 321–322, 321t

prerenal, 319–321, 319t

in renal transplant recipient, 329–330

syndromes associated with

Goodpasture’s syndrome, 327–328

hepatorenal syndrome, 328

paraquat poisoning, 328

pigment nephropathy, 326–327, 326t

pulmonary renal syndromes, 327–328, 327t

treatment

dialytic therapy, 334–336, 334t. See also Continuous renal

replacement therapy; Hemodialysis; Peritoneal dialysis

nondialytic therapy

acid-base balance, 331

electrolytes, 331–332, 331t, 332t

fluid balance, 330–332

nutritional support, 132, 332–333

reminders, 4t

chronic

drug elimination in, 90–91

fluid and electrolyte restrictions, 342

nutritional support in, 132, 342–343

thyroid function in, 578

Renal transplant recipient

acute renal failure in, 329–330

gastrointestinal complications in, 343

hypertension in, 344

infections in, 343

Renal tubular acidosis (RTA), 61

Renal vein thrombosis, 319–320

Reptilase time, 411t

Respiratory acidosis

clinical features, 67–68

controversies and unresolved issues, 68

definition, 58

essentials of diagnosis, 67

expected response, 59t

general considerations, 67

pathophysiology, 67, 67t

relationship between pH and HCO

–

,59t

treatment, 68

Respiratory alkalosis

clinical features, 69

definition, 58

differential diagnosis, 69

essentials of diagnosis, 68

expected response, 59t

general considerations, 68–69

hypophosphatemia in, 43

relationship between pH and HCO

–

,59t

treatment, 69–70

Respiratory failure, 247–248. See also Acute

respiratory failure

Respiratory system

dysfunction indicators, 234t

effectiveness and efficiency, 247

muscles, 280–281

in pregnancy, 802–803, 803f

thermal burn injury response, 725

Respiratory system compliance (C

), 267

Respired gas analysis, 206–207

Resting energy expenditure (REE), 126

Reteplase, 637, 638t, 836t. See also Thrombolytic therapy

Retinol. See Vitamin A

Retrograde pyelography, 322

Retrograde pyelography failure, 317

Retroperitoneal lavage, 349

Reverse T

, 118

Revised Trauma Score (RTS), 11, 12t

Rewarming

in frostbite, 792

in hypothermia, 790–791

Rhabdomyolysis

acute renal failure in, 326–327

causes, 326t

in cocaine intoxication, 764

hyperkalemia in, 327

hyperphosphatemia and, 46

hypocalcemia in, 53, 327

Rhinocerebral mucormycosis, 375

Riboflavin. See Vitamin B

Rickettsia rickettsii, 629

Rifabutin, 93t

Rifampin

contraindications, 603

drug interactions, 93t

nephrotoxicity, 315t

protein binding, 89t

for tuberculosis, 603

Right internal jugular vein, for hemodialysis

access, 337

Right-to-left shunt, 251

Right ventricular infarction, 511–512

Rigler’s sign, 168, 168f

Risperidone, 435, 440

Ristocetin cofactor assay, 411t

Risus sardonicus, 395

Riva-Rocci method, blood pressure monitoring, 189–190

Rocky Mountain spotted fever, 629

Rocuronium, 107t, 109

Rofecoxib, 316t

Ropivacaine, 106, 106t

Rotational therapy, 265

r-tPA (recombinant tissue plasminogen activator). See Alteplase;

Thrombolytic therapy

RTS (Revised Trauma Score), 11, 12t

Rubeola (measles), 627–628

Rule of nines, 728, 728f

Russell viper venom time (Stypven time), 411t

Sagittal sinus thrombosis, 678

Salicylates

poisoning/overdose

clinical features, 774, 774f

differential diagnosis, 774

essentials of diagnosis, 773

general considerations, 773–774



INDEX

873

metabolic acidosis in, 61t

treatment, 61t, 774–775, 775t

therapeutic ranges, 92t

Salmeterol, for status asthmaticus, 537

Sarcoidosis, 327t

Scleroderma, 327t

Sclerotherapy, for variceal bleeding, 709, 717

Scoliosis, 286

Scorpion fish envenomation, 797–798

Scorpion stings, 796–797

Sea urchin envenomation, 797–798

Second-degree burns, 728, 730t.

See also Thermal burn injury

Secretory diarrhea, 358t

Sedative-hypnotics

barbiturates, 111

benzodiazepines. See Benzodiazepines

in mechanical ventilation, 264

opioid. See Opioid(s)

poisoning/overdose, 753t, 757–758

uses, 110

withdrawal, 758

Seizures

classification, 663–664, 663t

clinical features, 664

controversies and unresolved issues, 666

differential diagnosis, 665

in drug withdrawal, 664

general considerations, 662

generalized tonic-clonic, 663, 663t

pathophysiology, 662–663

in preeclampsia-eclampsia, 808, 809

in sympathomimetic poisoning/overdose, 761

treatment, 665–666, 665t

Seldinger technique, 480

Selenium, 123t

Self-esteem, ICU staff, 440

Sentinel loop, 172, 180f

Sepsis

ARDS and, 300

clinical features, 360–361

definition, 360

differential diagnosis, 361

essentials of diagnosis, 359

general considerations, 359–360

in HIV disease, 605–607

microbiologic etiology, 360

nutritional support in, 133

pathophysiology, 360

stages, 361t

treatment, 361–362

Septic abortion, 813

Septic shock

clinical features, 233, 235

controversies and unresolved issues, 238

definition, 360, 361t

differential diagnosis, 227t, 235

essentials of diagnosis, 230

general considerations, 230–231

hemodynamic effects, 232–233

metabolic effects, 233

multiple organ failure in, 233, 234t

pathogenesis, 231–232, 231f

treatment

antimicrobial agents, 237

corticosteroids, 237

drotrecogin alfa, 237–238

early goal-directed, 235, 235f

fluid resuscitation, 235–236, 238

glycemic control, 237

pharmacologic support, 236–237

respiratory support, 236

transfusion, 238

Serotonin syndrome, 766–767

Serum albumin, 119–121, 120t, 121f

Serum creatinine, 314–315

Serum sickness, 614t

Severe sepsis, 360, 361t

Shock

anaphylactic. See Anaphylactic shock

cardiac compressive. See Cardiac compressive shock

cardiogenic. See Cardiogenic shock

hypovolemic. See Hypovolemic shock

neurogenic. See Neurogenic shock

septic. See Septic shock

SIADH. See Syndrome of inappropriate secretion of ADH

Sick euthyroid syndrome

controversies and unresolved issues, 580

disorders associated with, 577–579, 578t

drugs causing, 579, 579t

essentials of diagnosis, 576

general considerations, 576

pathophysiology, 576–577

treatment, 579–580

Sick sinus syndrome, 492

Sickle cell anemia, 73

Silvadene. See Silver sulfadiazine burn cream

Silver nitrate solution, 736

Silver sulfadiazine burn cream, 735

Sinistral portal hypertension, 649

Sinus bradyarrhythmias, 492

Sinusitis, after thermal burn injury, 743

Skin disorders. See Cutaneous disorders

Skin g

afting, 738

Skin substitutes, 738–739

Sleep, 310. See also Obstructive sleep apnea

Slow continuous ultrafiltration (SCUF), 341

SLUDGE syndrome, 784

Small bowel obstruction. See also Bowel; Obstruction

clinical features, 352–353, 353f

differential diagnosis, 353–354

essentials of diagnosis, 351

general considerations, 352

imaging studies, 169–170, 171f, 172f, 353

pathophysiology, 169, 352

postoperative, 700

treatment, 354

Smoke inhalation. See Inhalation injury

Snakebite, 795–796

Sodium

in acute renal failure, 331, 331t

in body fluids, 125t



INDEX

874

Sodium (Cont.):

daily requirements, 123t

excretion, 15

factors affecting balance of, 15t

imbalances. See Hypernatremia; Hyponatremia

intake and output, 331t

restriction, in hypervolemia, 21

Sodium bicarbonate

for diabetic ketoacidosis, 590

for hyperkalemia, 42

for metabolic acidosis, 63

for TCA poisoning/overdose, 765

Soft tissue infections

necrotizing. See Necrotizing fasciitis

surgical, 406–407, 408t

Soluble cell adhesion molecules (SCAMs), 225

Somatostatin, 717

Sotalol, 488, 497

Spike-wave status, 664

Spinal cord, 692f

Spinal cord compression

clinical features, 452–453, 668

differential diagnosis, 453

essentials of diagnosis, 451, 667

general considerations, 451, 667

imaging studies, 452–453

pathophysiology, 451

treatment, 453–454, 668

Spinal cord disorders/trauma. See also Cervical

spinal cord injuries

nutritional support in, 132

respiratory failure in, 283

Spinal shock, 691

Spirometry, in status asthmaticus, 536

Spironolactone

for ascites, 718

for heart failure, 471

hyperkalemia and, 40

for hypervolemia, 21

Splenectomy, 76t

Sputum, Gram-stained smears, 364, 364t

ST-segment elevation myocardial infarction (STEMI)

clinical features, 506–507

complications, 509–512. See also Cardiogenic shock

differential diagnosis, 507

general considerations, 506

imaging studies, 506–507

treatment, 507–509

Stanford classification, aortic dissection, 515

Staphylococcus aureus

in dialysis-related peritonitis, 339t

in infective endocarditis, 367–368

methicillin-resistant. See Methicillin-resistant

Staphylococcus aureus

resistance issues, 376t

vancomycin-insensitive, 390

vancomycin-resistant, 390

Staphylococcus epidermidis, 339t

Starling’s law, 23

Starvation, ketoacidosis in, 62

Static respiratory system compliance, 267

Status asthmaticus

atelectasis in, 145f

clinical features, 535–536

controversies and unresolved issues

general anesthesia, 539

helium-oxygen inhalation, 539–540

mucolytic administration by fiberoptic bronchoscopy, 539

noninvasive ventilation, 540

differential diagnosis, 536

essentials of diagnosis, 534

general considerations, 5t, 534

imaging studies, 536

pathophysiology and pathogenesis, 534–535

in pregnancy, 815–816

spirometry, 536

treatment

bronchodilators, 537

corticosteroids, 537–538

mechanical ventilation, 274t, 538–539

oxygen, 537

principles, 5t, 536–537

Status epilepticus, 663–664, 663t. See also Seizures

Stevens-Johnson syndrome, 614t, 616–618

Stewart-Hamilton indicator dilution equation, 199

Stingray envenomation, 797–798

Streptococcus pneumoniae, 365, 365t, 376t, 377

Streptokinase, 558, 646, 836t. See also Thrombolytic therapy

Stress ventriculography, 500

String of pearls sign, 171f

Stroke

after cardiac catheterization, 482–483

after carotid endarterectomy, 655

clinical features, 674

controversies and unresolved issues, 676

differential diagnosis, 674

essentials of diagnosis, 673

general considerations, 673–674

imaging studies, 674, 675f

nutritional support in, 133

respiratory complications, 283

treatment, 675–676, 676t, 837

Stroke volume, 201t

Stroke volume index, 201t

Stypven time (Russell viper venom time), 411t

ubar

achnoid hemorrhage

aneurysmal, 686–688, 687t

humate: P, 76t, 416t

traumatic, 682

Subclavian vein, for hemodialysis access, 337

Subdural hematoma, 681, 681f

Succinylcholine, 107t, 108

Sufentanil, 111t, 113

Sulfadiazine, 315t

Sulfamethoxazole, 315t

Sulfamylon. See Mafenide burn cream

Sulfisoxazole, 315t

Sulfosalicylic acid, 317

Sulindac, 316t

Superior mesenteric artery syndrome, 743

Superior vena cava syndrome, 465–466

Suppurative thrombophlebitis, 407, 408t, 742



INDEX

875

Surgical infections

abdominal, 403–405, 406t. See also Intraabdominal

infections/abscess

diagnosis, 398

general considerations, 397

head and neck, 400, 401t

prevention, 397–398

soft tissue, 406–408, 408t

thoracic, 400–403, 404t

treatment, 398–399, 401t, 404t, 406t, 408t

Surrogate decision makers, 216–217

Swan-Ganz catheters, 6t. See also Pulmonary artery catheters

Sympatholytic poisoning/overdose, 753t

Sympathomimetic poisoning/overdose, 753t, 760–761

Syndrome of inappropriate secretion of ADH (SIADH)

causes, 463

hyponatremia in, 25

laboratory findings, 27

in malignancy, 463

treatment, 28

Syphilis, transfusion-associated, 81t

Syrup of ipecac, 755, 757

Systemic inflammatory response syndrome (SIRS), 359–360, 361t

Systemic lupus erythematosus, 327t

Systemic oxygen delivery (DO

), 224

Systemic vascular resistance (SVR), 189, 201t

Systemic vasculitis, 323

T tube, 278–279

Tachy-brady syndrome, 492

Tachycardia

AV nodal or reentrant, 486–487

postoperative, 654

TACO (transfusion-associated circulatory overload), 83t

Tacrolimus, 315t

Target lesions, 615

TBW (total body water), 22–23

Tenecteplase, 637, 638t, 836t. See also Thrombolytic therapy

Tension pneumothorax, 165–166, 166f, 246, 531

Teratogens, 804, 805t

Terbutaline, 260

Tetanus, 394–396, 396t, 730

Tetracycline, 124t

Thallium scintigraphy, 500, 652–653

Theophylline

for acute respiratory failure, 262, 292

adverse effects, 262

drug interactions, 93t

hypokalemia and, 36

poisoning/overdose, 775–777, 777t

for status asthmaticus, 537

therapeutic ranges, 92t

Therapeutic drug monitoring, 92, 92t

Thermal burn injury

beta-blockers in, 135–136

burn center referral guidelines, 723, 724t

in children, growth hormone for, 135

classification, 728, 730f, 730t

complications, 742–743

controversies and unresolved issues

hypermetabolism, 746–747

infection, 746

inhalation injury, 746–747

postburn hemodynamics, 746

wound closure, 746

edema formation in, 723–724

histopathologic characteristics, 723

incidence, 723

inhalation injury in. See Inhalation injury

nutritional support, 133, 743–745, 744t

organ system responses, 724–726

total body surface area estimate, 728, 728f, 729f

treatment. See also Burn wound

emergency management, 728–730, 728f, 729f

fluid resuscitation

formulas, 730–732, 731t, 732t

monitoring, 732–734

principles, 730

infection control, 741

prehospital treatment, 727–728

Thiamine. See Vitamin B

Thiopental, 111

Thioureas, 568

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

Thoracic aortic aneurysms, 515f. See also Aneurysms, great vessels

Thoracic bioimpedance, 200

Thoracic wall disorders, acute respiratory failure in, 274t, 285–288

Thoracostomy tubes, 144

Thrombin, 410t

Thrombin inhibitors, 636

Thrombin time (TT), 409, 411t

Thrombocytopenia

clinical features, 425, 426t

controversies and unresolved issues, 427

differential diagnosis, 427

essentials of diagnosis, 425

general considerations, 425

heparin-induced, 522, 557, 645, 828–829, 829t

nutritional support in, 132

pathophysiology, 425, 426t

treatment, 427

Thromboelastography, 523, 523f

Thrombolytic therapy

for acute arterial insufficiency, 637–638, 638t

for acute myocardial infarction, 507–508

comparison of agents for, 836t, 837

complications, 837–838

for deep venous thrombosis/pulmonary embolism, 557–558,

645–647

indications, 836–837

monitoring, 838

principles, 836

for prosthetic valve dysfunction, 476

for stroke, 676, 676t

Thrombomodulin, 410t

Thrombophlebitis, 407, 408t, 742. See also

Acute arterial insufficiency

Thrombosis

in acute mesenteric ischemia, 648–649

in cancer patients, 840

cerebrovascular, 674. See also Stroke



INDEX

876

Thrombosis (Cont.):

coronary graft, 523, 524–525

prosthetic valve, 522

Thrombotic thrombocytopenic purpura, 324, 325

Thromboxane A

, 232t, 423

Thrombus, 633t

Thrush (oral candidiasis), 610–611

THT (topical hemostatic tamponade therapy), 543

Thumb sign, 153

Thymectomy, for myasthenia gravis, 671

Thyroid hormones, 118, 571, 571t. See also Sick

euthyroid syndrome

Thyroid storm, 566–569, 568t

Thyrotoxic crisis. See Thyroid storm

Ticlopidine, 316t, 823–824, 824t

Tigecycline, 377

Timolol, 446, 509

Tinzaparin, 646t. See also Low-molecular-weight heparin

Tirofiban, 504, 825

Tissue factor, 410t

Tissue factor pathway inhibitor, 410t

Tissue plasminogen activator, 410t

Tobramycin, 92t

Tocodynamometry, 820

Tolmetin, 316t

Tonsillar herniation, 684

Topical hemostatic tamponade therapy (THT), 543

Torsade de pointes

characteristics, 489, 490f

drug-induced, 95, 496

treatment, 491

Total body water (TBW), 22–23

Toxic epidermal necrolysis, 614t, 616–618

Toxic megacolon, 176–177, 177f

Toxic shock syndrome, 630–631

Toxidromes, 752t. See also Poisoning/overdose

Toxoplasmosis, 82t, 677–678

Tracheal stenosis, 140

Tracheostomy, 140, 256

Tranexamic acid, 417

Transcutaneous blood gases, 204

Transcutaneous pacing, 511

TransCyte, 739

Transfusion-associated circulatory overload (TACO), 83t

Transfusion-related acute lung injury (TRALI), 82, 83t

Transfusion therapy

administration, 79

blood component preparation, 79

blood resource conservation, 86–87

complications

infectious, 80–82, 81t

nonhemolytic, noninfectious, 82, 83t

red cell antibody-mediated reactions, 79–80

cryoprecipitate, 77–78

directed donations in, 84

in emergency situations, 86

emerging technologies, 86

granulocytes, 72t, 78

for hypovolemic shock, 230

indications, 72t

informed consent, 79

during interfacility transport, 212

massive, 85–86

patient identification, 79

perioperative, 82–84

plasma, 72t, 75–77, 76t

platelets, 72t, 74–75, 76t

postoperative, 524

pretransplant, 86

products available, 72t

red blood cells. See Red blood cells, transfusion

refusal of, 85

safety considerations, 84–85

for septic shock, 238

Transient ischemic attacks, 674

Transjugular intrahepatic portosystemic shunt

for ascites, 719

for variceal bleeding, 709–710, 717

Transport, interfacility

controversies and unresolved issues, 214

crew composition, 208–209, 212

crew qualifications, 213

equipment monitoring, 211–212

liability and legal issues, 210–211

modes, 209–210, 209t

outcome, 211

physician duties in, 212–213

reimbursement, 213–214

standards, 213

Transtentorial herniation, 684

Transtubular potassium gradient

(TTKG), 38

Transvenous pacing, 511

Trauma

ARDS and, 300–301

cervical spinal cord. See Cervical spinal cord injuries

head. See Head injury

nutritional support in, 132–133

during pregnancy, 818–820

Trauma Score, 11, 11t

iazolam, 440

Triazoles, 377

Tricyclic antidepressants, 124t, 438, 764–766

Triiodothyronine (T

), for myxedema coma, 571, 571t

Trimethoprim-sulfamethoxazole, 40, 601

Trismus, 395

Tuberculosis, 541, 602–603

Tumor lysis syndrome, 46, 462

Tumor necrosis factor (TNF), 297, 360

Typhlitis, 176

Ultrafiltration, for heart failure, 471

Ultrasound examination, 138. See also Doppler ultrasound

in acalculous cholecystitis, 183, 183f

in acute arterial insufficiency, 635

in acute calculous cholecystitis, 182, 182f

in acute pancreatitis, 346

in acute renal failure, 317

in ascites, 718

in deep venous thrombosis, 548, 642–643

in hydronephrosis, 184