Introduction Evidence of ileus, gastroparesis, or small bowel dysmotility is common in the setting of critical illness. Data on the incidence of ileus estimate an occurrence ranging from 50% to 80% in critically ill patients, with an average incidence of…
Introduction Diagnosing acute abdominal pain in critically ill patients can be difficult if the clinician tries to work through a comprehensive list of differential diagnoses ( Fig. 25.1 ). The most common etiologies seen outside of the intensive care unit…
Definition and diagnosis Whereas a normal peritoneal cavity contains only 25 mL of fluid, the peritoneum has the capacity to absorb 900 mL Ascites is the pathologic accumulation of peritoneal fluid, occurring most commonly in decompensated liver cirrhosis (85%), with…
Bilirubin is a by-product of heme metabolism. Heme is largely derived from the hemoglobin in senescent red blood cells and is oxidized in the spleen, liver, and other organs by two isoforms of the enzyme heme oxygenase, in the presence…
Divergent patient populations: Trauma versus sepsis Noncardiac intensive care units (ICUs) predominantly manage coagulopathy in patients with trauma or sepsis. Although trauma is known as the third most frequent cause of death in the United States, sepsis, which is not…
Introduction Anemia is defined as a reduction in the circulating red cell mass, the hemoglobin concentration, or both with an associated decrease in the oxygen-carrying capacity of blood. It is among the most common clinical problems encountered among critically ill…
Introduction Alterations in glucose metabolism are common in the intensive care unit (ICU). The adverse effects of uncontrolled hyperglycemia, especially in a critically ill patient, are fairly well described. Management strategies for hyperglycemia in the critically ill patient have gone…
Abnormal serum calcium concentration is a common finding in critically ill patients. The prevalence of hypocalcemia in intensive care unit (ICU) patients ranges from 70% to 90% when total serum calcium is measured and from 15% to 50% when ionized…
Magnesium is an important ion that participates as a cofactor in over 300 enzymatic reactions, especially in those involving adenosine triphosphate (ATP). Hypomagnesemia is common in critically ill patients and is associated with increased mortality. , Cellular physiology and metabolism…
Introduction Disturbances in the phosphate balance are common in critically ill patients, but are not always easy to relate to specific symptoms. Dysphosphatemia, however, may cause a significant increase in multiorgan failure. In a Swedish critical care cohort, more than…