Introduction Pain management in the critically ill patient is complex. Each patient brings a unique set of sociodemographic, pharmacokinetic, and pharmacogenomic variables that are coupled with underlying psychosocial and medical comorbidities. These not only influence a patient’s response to painful…
Agitation and delirium are commonly encountered in the intensive care unit (ICU). Although frequently underrecognized, delirium is present in up to 80% of critically ill adults on mechanical ventilation when routinely assessed. Delirium and agitation are more than just an…
Patients admitted to the intensive care unit (ICU) with critical illness or injury are at risk for neurologic complications. A sudden or unexpected change in the neurologic condition of a critically ill patient often heralds a complication that may cause…
Specialty and category within specialty Critical care medicine Mechanical support for refractory respiratory and cardiac failure Before procedure Indications Venovenous extracorporeal membrane oxygenation (ECMO) Acute severe respiratory failure with high mortality risk, reversible and nonresponsive to optimal conventional therapy. ECMO…
Before the procedure Indications A need for estimating energy expenditure (EE) in critically ill patients in whom the EE is highly variable and difficult to predict by simple equations, such as: Patients with liver disease Obese patients Trauma patients Patients…
Before procedure Indications Common Traumatic brain injury (TBI) Subarachnoid hemorrhage Intracranial hemorrhage (ICH) Hydrocephalus Uncommon Meningitis/encephalitis/brain abscess Acute liver failure Pseudotumor cerebri Postoperative Contraindications Absolute Anticoagulation Bleeding diathesis Relative Scalp infection Lack of specialized healthcare personnel You’re Reading a Preview…
Ultrasound-guided internal jugular vein oxygen saturation (SjvO 2 ) catheter placement: Before the procedure Indications Severe traumatic brain injury Subarachnoid hemorrhage During neurosurgical and cardiovascular procedures in which cerebral blood flow may be reduced Detection of arteriovenous fistulas To titrate…
Before procedure Indications Suspicion of a central nervous system (CNS) infection Suspicion of a subarachnoid hemorrhage The need to obtain cerebrospinal fluid to diagnose other inflammatory or degenerative CNS diseases Reduction of cerebrospinal fluid (CSF) pressure in pseudotumor cerebri Contraindications…
Before procedure Indications Inability to maintain volitional intake (in the setting of a functional gastrointestinal tract) and : Critical illness expected to require an intensive care unit (ICU) stay of more than 2 days Poor nutritional status Weight loss and…
Before procedure Indications Short-term hemostasis and stabilization of patients until definitive therapy can be arranged Failure to achieve hemostasis after endoscopic treatment of bleeding esophageal varices As a temporizing measure when endoscopic treatment is not immediately available or emergency transcutaneous…