Diabetes insipidus is a disorder of water metabolism associated with polyuria, urine hypotonicity, and hypernatremia. , The quantitative criteria include urine output greater than 200 mL/hr or 3 mL/kg/hr, urine osmolality less than 150 mOsm/kg, and plasma sodium greater than…
Normal thyroid hormone economy Regulation Synthesis and secretion of thyroid hormone is under the control of the anterior pituitary hormone thyrotropin (or thyroid-stimulating hormone [TSH]). Consistent with a classic negative feedback system, TSH secretion increases when serum thyroid hormone levels…
During stress response, the central nervous system (CNS) induces activation of both the sympathoadrenergic system (by release of catecholamines) and the hypothalamic-pituitary-adrenal (HPA) axis (by release of steroid hormones, glucocorticoids [GCs], and mineralocorticoids), with the target of maintaining homeostasis by…
Diabetic ketoacidosis (DKA) and hyperosmolar hyperglycemic state (HHS) are endocrine emergencies occurring in diabetes patients. Both conditions require prompt, adequate treatment to avoid mortality. In patients with known diabetes mellitus, both conditions are most commonly triggered by noncompliance with diabetes…
Obstetric hemorrhage remains a leading cause of maternal mortality and morbidity worldwide, with most deaths occurring in the postpartum period. Recognition of blood loss in obstetric hemorrhage can be challenging. Therefore interventions focused at the patient level, provider and unit…
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…