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Critical Care Update 2009 Vineet Nayyar, JV Peter, Roop Kishen, S Srinivas

SECTION A: MANPOWER
ONE:Manpower in Critical Care—Global Issues
- INTRODUCTION
- WHAT DO WE MEAN BY CRITICAL CARE
- CONCERNS ABOUT STAFFING ISSUES IN ICUs
- FACTORS AFFECTING PHYSICIAN SUPPLY
- FUTURE DIRECTIONS
TWO:Teamwork and Leadership
- INTRODUCTION
  - Work Group
  - Action Teams
- TEAMWORK IN HEALTH CARE
- ENHANCING TEAM PERFORMANCE
- EFFECTIVE LEADERSHIP
- CONCLUSION
THREE:Shift Work and its Effect upon Staff Performance
- INTRODUCTION
- PATTERNS OF SLEEP DEPRIVATION
- SHIFT WORK, MEDICAL ERROR AND ATTENTIONAL FAILURES
- PERFORMANCE DEFICIT FOLLOWING SLEEP DEPRIVATION
- ADAPTATION TO SHIFT WORK
- CONCLUSION
FOUR:Burn Out Syndrome in the Health Care Environment
- INTRODUCTION
- GROUPS AT RISK
- FEATURES OF BURN OUT
- WHAT CAN BE DONE
- PREVENTION
  - Organizational Measures
  - Themes Associated with Low Likelihood of BOS
- CONCLUSION
SECTION B: AIRWAY AND VENTILATION
FIVE:Cricothyrotomy for Emergency Airway
- INTRODUCTION
- DECIDING TO DO IT
- WHAT TO USE HOW TO USE IT
- HOW TO TRAIN
- SUMMARY
SIX:Ventilator-induced Lung Injury
- INTRODUCTION
- MECHANISMS OF LUNG INJURY
- MICROSCOPIC AND MOLECULAR EFFECTS
- VENTILATORY STRATEGIES TO PREVENT VILI
- CONCLUSION
SEVEN:Extubation in Intensive Care
- INTRODUCTION
- CAUSE OF EXTUBATION FAILURE
- PRE-EXTUBATION ASSESSMENT
- EXTUBATION OF PATIENTS
- POST-EXTUBATION CARE
- SPECIAL SITUATIONS
- SUMMARY
EIGHT:Steroids in the Management of Acute Respiratory Distress Syndrome
- INTRODUCTION
- PATHOPHYSIOLOGY OF ARDS
- BASIS OF CORTICOSTEROID THERAPY FOR ARDS
- SEARCH STRATEGY AND IDENTIFICATION OF TRIALS
- STEROID THERAPY FOR ARDS/ALI
  - Prophylactic Steroid Therapy
  - Therapeutic Steroid Therapy
- CONCLUSION
SECTION C: ICU PHYSIOLOGY AND PHARMACOLOGY
NINE:Physiology, Benefit and Risk of RBC Transfusion in the ICU
- INTRODUCTION
- PHYSIOLOGY OF TISSUE OXYGEN DELIVERY
- OXYGEN DELIVERY IN THE CRITICALLY ILL
- BENEFITS OF RBC TRANSFUSION
- RISKS OF RBC TRANSFUSION
- CONCLUSION
TEN:Physiology of Hyperbaric Oxygen Therapy
- INTRODUCTION
- HISTORY
- MECHANISMS OF ACTION
  - Gas Laws and HBOT
  - Physiological and Biochemical Effects of HBOT
    - Hyperoxia
- CLINICAL APPLICATIONS
- PATHOPHYSIOLOGY OF HBOT
- CONCLUSION
ELEVEN:Pharmacology of Prostanoids Use in the ICU
- INTRODUCTION
- BIOLOGY OF PROSTANOIDS
- PHYSIOLOGY OF PROSTANOIDS
- THERAPEUTIC USE OF PROSTANOIDS IN ICU
- CONCLUSION
TWELVE:Antibiotic Dosing in Critically Ill Patients
- INTRODUCTION
- BASIC CLINICAL PHARMACOKINETICS AND PHARMACODYNAMICS
- ALTERED PHARMACOKINETICS IN SEPSIS
- ANTIBIOTICS IN THE INTENSIVE CARE UNIT
  - Antibiotic Physicochemical Properties
- PHASES OF THERAPY: INITIAL VS MAINTENANCE DOSING
- STRATEGIES FOR OPTIMIZING ANTIBIOTIC INITIAL DOSING
- STRATEGIES FOR OPTIMIZING ANTIBIOTIC MAINTENANCE DOSING
- CONCLUSION
SECTION D: SEPSIS AND INFECTION CONTROL
THIRTEEN:Inflammatory and Immune Responses in Sepsis
- INTRODUCTION
- INNATE IMMUNITY AND TOLL-LIKE RECEPTORS
- GRAM-NEGATIVE SEPSIS: ACTIVATION OF TLR4 AND ITS CONSEQUENCES
- GRAM-POSITIVE SEPSIS: ACTIVATION OF TLR2
- PROINFLAMMATORY EFFECTS OF THE LIGATION OF OTHER TOLL-LIKE RECEPTORS
- IMPLICATIONS FOR THE MANAGEMENT OF SEPSIS
FOURTEEN:Epidemiology and Implications of ESBL among Gram-negatives in India
- INTRODUCTION
- WHAT ARE ESBL PRODUCING BACTERIA
- PREVALENCE OF ESBL
- ESBL DETECTION METHODS
- CLINICAL IMPLICATIONS
  - Treatment Options for Infection with ESBL Producing Organisms
  - Recommendations for Indian Hospitals
- CONCLUSION
FIFTEEN:Adjuvant Therapies in Sepsis
- INTRODUCTION
- DROTRECOGIN ALPHA (rhAPC)
- POOLED IMMUNOGLOBULIN (IVIG)
- CORTICOSTEROIDS
- HMG CoA REDUCTASE INHIBITORS
- MACROLIDE ANTIBIOTICS
- ANTICYTOKINE THERAPIES
  - Anti-TNF Agents
  - Other Anti-cytokine Therapies
- MISCELLANEOUS THERAPIES
- CONCLUSION
SIXTEEN:Clostridium Difficile Diarrhea in ICU Patients
- INTRODUCTION
- EPIDEMIOLOGY
- RISK FACTORS
- ANTIMICROBIAL USE
- PATHOGENESIS
- CLINICAL FEATURES
- DIAGNOSIS
- MANAGEMENT
- CONCLUSION
SECTION E: MONITORING AND DIAGNOSTICS
SEVENTEEN:Assessing Fluid Responsiveness in the Hypotensive Patients
- INTRODUCTION
- SIMPLE CLINICAL TECHNIQUES
- STATIC OR PRELOAD PARAMETERS
- DYNAMIC PRELOAD RESPONSIVENESS PARAMETERS
- CONCLUSION
EIGHTEEN:Risk Assessment and Prevention of Pressure Ulcers in the ICU
- INTRODUCTION
- EPIDEMIOLOGY OF PRESSURE ULCERS
- RISK FACTORS
- FINDING OUT WHO IS AT RISK
  - Risk Assessment Scales
  - Risk Assessment in ICU Patients
- PREVENTION
  - Risk Mitigation for those at Risk
  - Risk Minimization for those with Pressure Ulcers
- CONCLUSION
NINETEEN:Monitoring of Neuromuscular Blockade in the ICU
- INTRODUCTION
- METHODS OF MONITORING
  - Clinical Indicators
  - Nerve Stimulation
- EVIDENCE FOR MONITORING NEUROMUSCULAR BLOCKADE
- CONCLUSION
TWENTY:Point-of-Care Testing of Coagulation in a Bleeding Patient
- INTRODUCTION
- POINT-OF-CARE TESTING
- APPLICATIONS OF POINT-OF-CARE TESTING
- PRACTICAL ISSUES
  - Quality Assurance in POC
  - Training of Personnel and Proficiency Testing
- CONCLUSION

INDEX

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Index

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Chapter Notes