Since the advent of the mechanical ventilator and the modern era of critical care medicine, many topics have been the subject of intense debate and investigation. The acute respiratory distress syndrome (ARDS), first described over half a century ago by…
Hemorrhage continues to be the leading cause of death for traumatically injured patients despite all the advances that have been made in the past 20 years. Time to hemorrhage control is one of the most, if not the most, critical…
Approximately 15% of all blood transfusions in the United States are used in the care of patients who have sustained traumatic injury. Blood transfusion in trauma is lifesaving for those patients in hemorrhagic shock, as the median time to hemorrhagic…
The neuroendocrine axis The endocrine system is a complex system allowing communication between the nervous system and the end organs. It consists of the neuroendocrine axis (hypothalamus, pituitary, and glands), all of which influence the response to stress and critical…
Surgeons commonly encounter coagulation disorders in the course of caring for patients, especially those with serious injury and those undergoing or recovering from surgery. Whereas bleeding is a condition that has been well known throughout human history, understanding the pathophysiology…
Acute kidney injury (AKI) refers to an acute decrease in the glomerular filtration rate (GFR). AKI develops in approximately 20% of patients admitted to the hospital and in 50% of patients admitted to the ICU. Short- and long-term mortality is…
Key points ■ Mechanical ventilation (MV) must support gas exchange and promote patient comfort while minimizing lung injury due to elevated airway pressures. ■ Protective, low tidal volume ventilation reduces morbidity and mortality rates in patients following acute respiratory distress…
Key points ■ New technology as illustrated in the next chapter provides several modes by which a patient may be ventilated based on the fundamentals of mechanical ventilation (MV), with the goal of improved gas exchange, better patient comfort, and…
In the intensive care unit, it is not uncommon for today’s surgeon to take care of patients with multiple comorbidities unrelated to their surgical disease. A common knowledge of most major medical issues, and their potential consequences, is thus critical…
According to statistics provided by the American Heart Association in 2019, congestive heart failure (CHF) affects approximately 6.5 million American adults. The Centers for Disease Control estimates that CHF contributes to 1 in 8 deaths. Although survival from heart failure…