During pregnancy, the respiratory system undergoes a number of changes and is subject to functional and anatomic stresses. The critical care provider must remember these changes to appropriately care for the maternal-fetal unit. Although the need for ventilatory support is…
Hypertensive disorders associated with pregnancy are the most common medical diagnoses in pregnancy, occurring in approximately 6%–8% of pregnancies. , Guidelines from the Society of Obstetricians and Gynecologists have classified hypertension of pregnancy into two categories: (1) preexisting chronic hypertension…
Fundamental to the management of a critically ill pregnant woman is a detailed knowledge of the normal physiologic changes that occur during gestation and immediately after delivery. Some of these physiologic adaptations are from the hormonal changes associated with pregnancy,…
Hematopoietic stem cell transplantation (HSCT) is used to treat an ever-increasing array of disorders, including hematologic and lymphoid cancers; selected solid tumors; and nonneoplastic diseases, including autoimmune disorders, amyloidosis, and aplastic anemia. The main indications for autologous transplantation include multiple…
Overview of effective coagulation Components of hemostasis Fig. 129.1 depicts an overview of hemostasis. In a normal physiologic state, the body maintains a fine balance between hemorrhage and thrombosis through the regulation of various anticoagulant and prothrombotic systems. Four primary…
Introduction Patients in an intensive care unit (ICU) often have received or require anticoagulation for multiple reasons that include acute thrombotic issues, mechanical valves, venous thromboembolic prophylaxis, atrial fibrillation, ischemic cardiovascular disease, and/or extracorporeal life support. The types of anticoagulation…
Introduction Venous thromboembolism (VTE), which includes both deep vein thrombosis (DVT) and pulmonary embolism (PE), is a source of significant morbidity and mortality for the critically ill patient. The development of DVT alone in the intensive care unit (ICU) is…
Blood component therapy is generally supportive for the correction of one or more hematologic deficiencies until the basic disease process can be controlled or corrected. Anemia is pervasive in the intensive care unit (ICU), with over 30%–50% of critically ill…
Anemia remains common in the critical care population, and its etiology is multifactorial, related to hemorrhage, hemodilution, diagnostic phlebotomy, acute inflammation, and functional iron deficiency. These factors result in decreased red blood cell (RBC) production and reduced RBC survival. This…
Introduction Clostridioides difficile is an anaerobic, spore-forming, gram-positive bacillus that may be part of the normal intestinal microbiota in healthy babies. It was officially renamed in 2016 to Clostridioides difficile. The new name reflects the taxonomic differences between this species…