Index

CSI: Handbook on Cardiac Critical Care S Ramakrishnan, Rishi Sethi, Santanu Guha

SECTION 1: BASICS IN ICU
CHAPTER 1:Blood Gases in Coronary Care Unit
- INTRODUCTION
- IS THIS BLOOD GAS MEASUREMENT RELIABLE?
- IS VENOUS BLOOD COMPARABLE TO ARTERIAL BLOOD FOR ANALYSIS?
- IS IT ACUTE OR CHRONIC ABNORMALITY?
- IS IT ONLY RESPIRATORY OR METABOLIC (MIXED)?
- USE OF BLOOD GAS ANALYSIS IN CCU
- CONDITIONS IN WHICH BLOOD GAS HELPS IN MANAGEMENT
- CONCLUSION
CHAPTER 2:Electrolyte Abnormalities
- HYPONATREMIA
- TREATMENT
  - How to Calculate and Give the 3% Saline Correction?
- TREATMENT (Table 2.3)
- VAPTANS IN HYPONATREMIA
- HYPERNATREMIA
- HYPOKALEMIA
- HYPERKALEMIA
  - Work-up
  - Treatment (Table 2.8)
- MAGNESIUM
- Clinical Manifestations
- Treatment
CHAPTER 3:Hyponatremia in Heart Failure
- DRUG-INDUCED HYPONATREMIA
  - Clinical Features
- CONSEQUENCES OF HYPONATREMIA IN HEART FAILURE
- MANAGEMENT OF HYPONATREMIAIN HEART FAILURE
- TREATMENT OF ACUTE SYMPTOMATIC HYPONATREMIA IN PATIENTS WITH HEART FAILURE
- Osmotic Demyelination Syndrome (ODS)
- Therapy of Diuretic-induced Hyponatremia
- CONCLUSION
CHAPTER 4:Ventilator Settings in Cardiac ICU
- HEMODYNAMIC EFFECTS OF PPV/PEEP
- HIGH FREQUENCY OSCILLATORYVENTILATION
- AIRWAY PRESSURE RELEASE VENTILATION
- PRONE VENTILATION
- EXTRACORPOREAL MEMBRANE OXYGENATION
- NONINVASIVE VENTILATION
- WEANING FROM MECHANICAL VENTILATION
- CONCLUSION
CHAPTER 5:Noninvasive Ventilation
- EQUIPMENT
- INDICATIONS OF NONINVASIVE VENTILATION
- INITIATION OF NONINVASIVE VENTILATION
- MONITORING DURING NONINVASIVE VENTILATION
- WHEN TO TERMINATE NONINVASIVE VENTILATION?
- CONTRAINDICATIONS OF NONINVASIVE VENTILATION
- PREDICTORS OF OUTCOME ON NONINVASIVE VENTILATION
  - Factors Predicting Success
  - Factors Predicting NIV Failure
- COMPLICATIONS OF NONINVASIVE VENTILATION
- WEANING FROM NONINVASIVE VENTILATION
CHAPTER 6:Weaning in Patients with Cardiac Diseases
- MECHANISMS CONTRIBUTING TO THE DEVELOPMENT OF WEANING RELATED CARDIOGENIC PULMONARY EDEMA
- DIAGNOSIS OF WEANING-RELATED CARDIOGENIC PULMONARY EDEMA (FLOW CHART 6.2)
- CARDIAC CATHETERIZATION
- CARDIAC BIOMARKERS
- TRANSTHORACIC ECHOCARDIOGRAPHY
- WEANING ASSOCIATED HEMOCONCENTRATION
- THERAPEUTIC OPTIONS (Table 6.1)
- SUMMARY
CHAPTER 7:Ventilator Associated Pneumonia
- EPIDEMIOLOGY AND RISK FACTORS
CHAPTER 8:Hemodynamic Monitoring in Cardiac Critical Care Units
- INTRODUCTION
  - Why Hemodynamic Monitoring is Needed?
  - Hemodynamic Monitoring
- NONINVASIVE HEMODYNAMIC MONITORING
- INVASIVE HEMODYNAMIC MONITORING
- ASSESSING THE FLUID RESPONSIVENESS
  - Dynamic Assessment of Preload Responsiveness
  - Use of Echocardiography
- RECENT ADVANCES IN HEMODYNAMIC MONITORING
- CONCLUSION
- ACKNOWLEDGMENTS
SECTION 2: HEART FAILURE
CHAPTER 9:Acute Decompensated Heart Failure
- BACKGROUND
- DEFINITION
- MAGNITUDE OF PROBLEM
- CAUSES
- CLASSIFICATION
- MANAGEMENT
- CONCLUSION
CHAPTER 10:Inotropes
- DOBUTAMINE
- DOPAMINE
- NORADRENALINE
- ADRENALINE
- MILRINONE
- LEVOSIMENDAN
- WHICH DRUG?
CHAPTER 11:Value of IABP and Assist Devices in Critical Care Unit
- INTRODUCTION
- ETIOLOGY
- MECHANISM OF DESTABILIZATION
- HIGH-RISK PCI
- NONISCHEMIC MYOCARDIAL INJURY
- MANAGEMENT OF ISCHEMIC AND HEMODYNAMIC SUPPORT IN HIGH-RISK PCI (FIGURE 11.3)
- CONCLUSION
CHAPTER 12:Extracorporeal Membrane Oxygenation in Cardiac ICU
- BACKGROUND
- DECISION TO INSTITUTE ECMO
- INCLUSION GUIDELINES FOR ECMOIN PEDIATRIC PATIENTS
- CONTRAINDICATIONs OF ECMO
- TYPES OF ECMO
- CENTRAL VERSUS PERIPHERAL ECMO
- USES OF ECMO
- ECMO IN CARDIOGENIC SHOCK
- ECMO IN HEART FAILURE
- ECMO AND SEPSIS
- NONCARDIAC INDICATIONS FOR EXTRCORPOREAL MEMBRANE OXYGENATION
- COMPLICATIONS
- SUMMARY
SECTION 3: ARRHYTHMIAS AND RESUSCITATION
CHAPTER 13:Bradyarrhythmias in Critical Care
- INTRODUCTION
- ETIOLOGY
- CAUSES OF BRADYARRHYTHMIA
- CLINICAL FEATURES
- DIAGNOSIS OF BRADYARRHYTHMIA
  - Sinus Node Dysfunction
    - Sinus Pause /Arrest
  - Sinus Exit Blocks
- ATRIOVENTRICULAR BLOCKS
- MEDICAL MANAGEMENT
- SPECIAL SITUATIONS
  - Bradyarrhythmia in Setting of Acute Coronary Syndrome/Myocardial Infarction
  - Prophylactic Placement of a Temporary Pacing System
- TRANSCUTANEOUS EXTERNAL CARDIAC PACING
- TRANSVENOUS PACING
- EPICARDIAL PACING
CHAPTER 14:Atrial Tachyarrhythmias
- DEFINITION
- CLASSIFICATION
- MANAGEMENT OF ATRIAL ARRHYTHMIAS
- DRUGS IN ATRIAL TACHYARRHYTHMIAS
CHAPTER 15:Ventricular Arrhythmias
- GENERAL PRINCIPLES
CHAPTER 16:Basic Life Support
- INTRODUCTION
- PREVALENCE
- RECOGNITION
- MAINTAINING CIRCULATION
- SECURING AIRWAY
- BREATHING
- DEFIBRILLATION
- ADDITIONAL CARE
CHAPTER 17:Advanced Life Support
- ADVANCED CARDIAC LIFE SUPPORT2010 ALGORITHMS
- ENSURING QUALITY AND MONITORING OF CPR
- WHEN TO INTERRUPT CHEST COMPRESSIONS?
- AIRWAY MANAGEMENT AND VENTILATION
- DRUGS AND ROUTES OF ADMINISTRATION
- COMMON RESUSCITATION DRUGS
- TERMINATION OF CPR
- POSTCARDIAC ARREST CARE
- PEDIATRIC ADVANCED LIFE SUPPORT
- ROLE OF WAVEFORM CAPNOGRAPHY IN ACLS
- KEY MESSAGES FOR HEALTHCARE PROVIDERS
CHAPTER 18:Cardiac Arrest Survivor
- INTRODUCTION
- STEP CARE MANAGEMENT OF CARDIAC ARREST SURVIVOR
- NEUROLOGIC ASSESSMENT AND MANAGEMENT
- MAINTAIN HEMODYNAMIC STABILITY
- ADEQUATE OXYGENATION
- MAINTAIN INTERNAL MILIEU
- EVALUATE CARDIAC CAUSES OF ARREST
- TREATMENT OF CARDIAC CAUSES OF ARREST
  - Acute Coronary Syndrome
  - Ventricular Tachycardia
- PROGNOSIS OF CARDIAC ARREST SURVIVOR
- CONCLUSION
SECTION 4: ACUTE CORONARY SYNDROME
CHAPTER 19:Caring for a Thrombolysed Patient
- INTRODUCTION
- REASSURANCE
- CLOSE OBSERVATION
- ADVERSE EFFECTS OF THROMBOLYSIS
  - Bleeding
  - Intracranial Hemorrhage (ICH)
- RESULT OF THROMBOLYSIS
  - Successful Thrombolysis
  - Failed Thrombolysis
- COMPLICATIONS OF STEMI
  - Ventricular Septal Rupture
- ADJUVANT AND CONCOMITANT THERAPY
- TRANSFER
- SECONDARY PREVENTION
- SUMMARY OF STEPS TO BE TAKEN IN THE CARE OF A THROMBOLYSED PATIENT
CHAPTER 20:Nonthrombolysed STEMI
- INTRODUCTION
  - CURRENT STATUS OF TREATMENT OF STEMI IN INDIA
- ROLE OF THROMBOLYSIS IN THE TREATMENT OF AMI
- INDICATIONS FOR FIBRINOLYSIS
- TIMING OF FIBRINOLYTIC THERAPY
- THERAPIES FOR NON-REPERFUSED PATIENTS
  - Use of Noninvasive Testing for Ischemia before Discharge: Recommendations
    - Class I
    - Class IIb
  - Assessment of LV Function: Recommendation
    - Class I
- SUMMARY
CHAPTER 21:Practical Tips in Managing a Patient with USA/NSTEMI
- MANAGEMENT OF UA/NSTEMI
- ANTI-ISCHEMIC THERAPY
- ANTIPLATELET AGENTS
  - Other Drugs
    - Bleeding Risk: Risk Assessment, Prevention and Treatment
    - Invasive Versus Conservative Approach
  - Indications of Urgent Invasive Strategy
    - Indications of Early Invasive Strategy
    - Conservative (no PCI/elective PCI) Strategy
- CONCLUSION
CHAPTER 22:ECG Diagnosis of Myocardial Infarction in Challenging Situations
- INTRODUCTION
- CAUSES OF NON ISCHEMICST-SEGMENT ELEVATION
- BENIGN EARLY REPOLARIZATION SYNDROME
- ACUTE PERICARDITIS
- LEFT VENTRICULAR HYPERTROPHY (LVH)
- Left Bundle Branch Block and Myocardial Infarction
- SGARBOSSA CRITERIA
- LEFT VENTRICULAR ANEURYSM
- ELECTROLYTE IMBALANCE: HYPERKALEMIA
- HYPERCALCEMIA AND HYPOCALCEMIA
- BRUGADA SYNDROME
- TAKOTSUBO SYNDROME(APICAL BALLOONING SYNDROME)
- ELECTRICAL CARDIOVERSION
- CONCLUSION
CHAPTER 23:Biomarkers in Acute Coronary Syndrome
- INTRODUCTION
- BIOMARKERS IN ACUTE CORONARY SYNDROME
- CARDIAC TROPONIN
- CREATINE KINASE
- MYOGLOBIN
- NATRIURETIC PEPTIDES
- EMERGING DIAGNOSTIC MARKERS OF ACUTE CORONARY SYNDROME
  - Biomarkers of Oxidative Stress
  - Biomarkers of Tissue Necrosis
- LIMITATIONS OF DIAGNOSTIC BIOMARKERS IN ACUTE CORONARY SYNDROME
  - New Development in Biomarker Discovery
- CONCLUSION: HOW SHOULD WE USE ALL THIS INFORMATION? MY POINT OF VIEW
CHAPTER 24:Postmyocardial Infarction Angina or Reinfarction: Always a Diagnostic Challenge in Critical Care Unit
- INTRODUCTION
- CAUSES OF RECURRENT CHEST DISCOMFORT
- CAUSES AS PER TIME FRAME
  - Up to 24 Hours
  - After 24 Hours up to 2 Weeks
- PATHOPHYSIOLOGIC MECHANISMS
CHAPTER 25:Reinfarction
- ISCHEMIC COMPLICATIONS POSTMYOCARDIAL INFARCTION
CHAPTER 26:Cardiogenic Infarction in Acute Myocardial Infarction
- INTRODUCTION
- DEFINITION
- ETIOLOGY
- PATHOPHYSIOLOGY
- ADVERSE PROGNOSTIC FACTORS
- MANAGEMENT
- CONCLUSION
CHAPTER 27:Mechanical Complications of Acute Myocardial Infarction
- INTRODUCTION
- VENTRICULAR SEPTAL RUPTURE
- LEFT VENTRICULAR FREE WALL RUPTURE
- PSEUDOANEURYSM
- VENTRICULAR ANEURYSM
- SUMMARY
CHAPTER 28:Stent Thrombosis in Drug-eluting Stents Era
- INTRODUCTION
- DEFINITION OF STENT THROMBOSIS
- ARC DEFINITION OF STENT THROMBOSIS4
- PATHOGENESIS OF STENT THROMBOSIS
- DRUG-RELATED THROMBOGENICITY
  - Antithrombotic Therapy
- DEVICE (STENT)-RELATED THROMBOGENICITY
- EFFECT OF SYSTEMIC PROTHROMBOTIC ENVIRONMENT AND PLAQUE CHARACTERISTICS (ACUTE CORONARY SYNDROME)
- STENT MALAPPOSITION AND ROLE OF INTRAVASCULAR IMAGING
- ACQUIRED STENT MALAPPOSITION
- ENDOTHELIAL AND NEOINTIMAL REGENERATION AND NEOATHEROSCLEROSIS
- CLINICAL IMPLICATIONS OF STENT THROMBOSIS
- INCIDENCE OF STENT THROMBOSIS
- MANAGEMENT OF STENT THROMBOSIS
  - Acute Management of ST
  - Preventive Strategies
    - Selection of Patients
    - Technique of Stent Deployment
- IMPROVEMENT IN DEVICES TECHNOLOGY
- CONCLUSION
CHAPTER 29:Management of Postpercutaneous Coronary Intervention Complications
- INTRODUCTION
- CORONARY VASCULAR INJURY
  - Stent Thrombosis
- NONCORONARY VASCULAR INJURY
- SYSTEMIC EVENTS
CHAPTER 30:Anticoagulants in Cardiac Critical Care
- UNFRACTIONATED HEPARIN
- NEWER ORAL ANTICOAGULANTS
SECTION 5: CARDIAC EMERGENCIES
CHAPTER 31:Cardiac Tamponade
- ANATOMY AND PHYSIOLOGY OF THE PERICARDIUM
  - What is Cardiac Tamponade?
- CLASSIFICATION
- PRESSURE-VOLUME RELATIONSHIP
  - Stages of Cardiac Tamponade
    - Early Stage
    - Late Stage
  - Physiological Compensatory Mechanisms
- CLINICAL FEATURES
- CLINICAL SIGNS
- INVESTIGATIONS
- MANAGEMENT
  - Medical Management
- PERCARDIOCENTESIS
- ECHO GUIDED
- ECG GUIDED
  - Flaws
- BLIND APPROACH
- FLUOROSCOPY GUIDED
- COMPLICATIONS
- CONTRAINDICATIONS
- SURGICAL THERAPY
CHAPTER 32:Accelerated Hypertension
- HYPERTENSIVE URGENCIES
- HYPERTENSIVE EMERGENCY
- KEY POINTS
CHAPTER 33:Management of Pulmonary Embolism
- INTRODUCTION
- EPIDEMIOLOGY
- PREDISPOSING FACTORS
- ACQUIRED RISK FACTORS
- INHERITED RISK FACTORS
- NATURAL HISTORY
- PATHOPHYSIOLOGY
- CLINICAL CLASSIFICATION OF PULMONARY EMBOLISM SEVERITY
- DIAGNOSIS
- CLINICAL PRESENTATION
- THROMBOLYTIC THERAPY
- ADVANCED THERAPY
- CONCLUSION
CHAPTER 34:Acute Dissection of Aorta
- INTRODUCTION
- EPIDEMIOLOGY
- PATHOPHYSIOLOGY
- PREDISPOSITIONS
- GENETIC PREDISPOSITION
- NATURAL HISTORY
- CLINICAL PRESENTATION
  - Complications of Type B Dissection
- CLASSIFICATION
- DIAGNOSIS
- BIOMARKERS (Table 34.4)
- MANAGEMENT
- MEDICAL THERAPY
- CONCLUSION
CHAPTER 35:Acute Limb Threatening Ischemia
- INTRODUCTION
- COMMON ETIOLOGIES
- OTHER LESS COMMON ETIOLOGIES (10%)
- EVALUATION
- CLINICAL CLASSIFICATION OF ACUTE LIMB ISCHEMIA
  - Differential Diagnosis of Acute Limb Ischemia
- DIAGNOSTIC STUDIES
- TREATMENT OF ACUTE LIMB ISCHEMIA
- TECHNIQUE
- CONCLUSION
CHAPTER 36:Unexplained Hypotension in ICU Setting
- INTRODUCTION
- ULTRASOUND TRIAGING IN HYPOTENSIVE PATIENT
CHAPTER 37:Acute Dyspnea
- INTRODUCTION
- ETIOLOGY OF ACUTE DYSPNEA
- PATHOPHYSIOLOGY OF DYSPNEA
- DIFFERENTIATING CARDIAC FROM RESPIRATORY DYSPNEA
- APPROACH TO A PATIENT WITH ACUTE DYSPNEA
- INVESTIGATIONS
- TREATMENT
- CASE ILLUSTRATIONS
- CONCLUSION
CHAPTER 38:Emergency Cardiovascular Drugs
- ACCESS TO THE ECVDS
- SCOPE FOR THE USE OF ECVDS
- ADENOSINE
  - Uses
- ATROPINE
- AMIODARONE
  - Uses
  - Down Sides
- ASPIRIN
- DIGOXIN (LANOXIN)
  - Uses
- DILTIAZEM
- DIURETICS (FRUSEMIDE)
  - Dosage and Route
- DOPAMINE AND DOBUTAMINE
- EPINEPHRINE (ADRENALINE)
- NOREPINEPHRINE
- IBUTILIDE
- ISOPRENALINE
- LIDOCAINE
- MAGNESIUM SULPHATE
- MORPHINE
- NITROGLYCERIN OR GLYCERYL-TRINITRATE (NTG OR GTN)
  - Doses and Routes
  - Uses
- NESIRITIDE
- PROCAINAMIDE
- SODIUM NITROPRUSSIDE
- VERAPAMIL
- HYDROCORTISONE
- THROMBOLYTIC AGENTS
  - Doses
  - Adverse Effects
CHAPTER 39:Emergency Procedures in Cardiac Critical Care
- PERIPHERALLY PLACED CENTRAL VENOUS ACCESS
- PERICARDIOCENTESIS
  - Technique
CHAPTER 40:Stress Cardiomyopathy: Recognition and Management
- INTRODUCTION
- INVESTIGATIONS
- CONCLUSION

INDEX

TOC
Index

Chapter Notes