Download Annual Update in Intensive Care and Emergency Medicine 2011 PDF

TitleAnnual Update in Intensive Care and Emergency Medicine 2011
Author
LanguageEnglish
File Size10.0 MB
Total Pages830
Table of Contents
                            cover
front-matter
	Title Page
	Copyright Page
	Table of Contents
	List of Contributors
	Common Abbreviations
front-matter_2
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	The Role of Receptor for Advanced Glycation Endproducts (RAGE) in Infection
		Introduction
		RAGE: A Multiligand Receptor
		Putative RAGE Ligands in Infectious Diseases
			HMGB1
			S100A12
			B2 integrins
		RAGE: A Signal Transducing Receptor
		Soluble RAGE (sRAGE)
		RAGE During Infection
			RAGE During Pneumonia
				Localization and role of RAGE in the lungs
				RAGE expression during pneumonia
				Role of RAGE in pneumonia caused by different pathogens
			RAGE during Abdominal Sepsis
		Conclusion
		References
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	The Endocannabinoid System: A Janus-faced Modulator of Inflammation in the Intestinal Microcirculation
		Introduction
		The Endocannabinoid System
		Cannabinoid Receptors and Sepsis
		Inflammation and the Intestinal Microcirculation
		Conclusion
		References
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	Remote Ischemic Conditioning against Ischemia/reperfusion Injury
		Introduction
		Remote Ischemic Preconditioning
			Proposed Mechanisms (Fig. 1)
				Humoral mediators and neural pathways
				Signal transduction pathways involved in conferring protection on the target organ undergoing sustained ischemia
			Remote Ischemic Preconditioning in Healthy Volunteers
			Remote Ischemic Preconditioning in Patients
				Cardiac surgery
				Non-cardiac surgery
				Percutaneous coronary intervention
		Remote Ischemic Postconditioning
		Overview of Potential Clinical Settings for Remote Ischemic Conditioning
		Conclusion
		References
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	Hypoxia-inducible Factors and the Prevention of Acute Organ Injury
		Introduction
		HIF Regulation and Action
		Biological and Therapeutic Modes of HIF Activation
		HIF Expression under Hypoxic Stress and Tissue Injury
		Potential Usage of HIF Modulation in Clinical Practice
			Anemia
			Acute Kidney Injury
			Myocardial Injury
			Neuronal Injuries
			Lung Injury
			Liver Disease
			Peripheral Vascular Disease
			Oxidative Stress
		Important Considerations
		Conclusion
		References
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	Are Microparticles Reliable Deleterious Effectors in Septic Coagulopathy?
		Introduction
		How is Coagulopathy Initiated during Sepsis?
			Hemostasis
			Platelet and endothelial cell activation and microparticle release
			Initiation of thrombin generation: Role of tissue factor
			Amplification of thrombin generation: The Josso’ loop
			A renewed role for the ‘contact’ pathway
			Host-induced Hemostasis
			Pathogen-induced Hemostasis
		Why is Hemostasis not Efficiently Regulated During Sepsis?
		Why and How to Treat Septic Coagulopathy?
			Coagulopathy and Organ Dysfunction
			Overview of (Disappointing) Therapies to Modulate Thrombin Generation in Sepsis
			Microparticles as a Therapeutic Target in Septic Coagulopathy
		Conclusion
		References
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	The Inflammatory Potential of Fibrin(ogen) and its Degradation Products
		Introduction
		Fibrinogen and Fibrin Structure
		Inflammatory Potential of Fibrinogen and Fibrin
		Inflammatory Potential of Fibrin Fragments
			Pro-Inflammatory Effects of Fibrin Fragments
			The Anti-inflammatory Peptide, BB15-42 (or FX06)
		Conclusion
		References
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	Heparin-induced Thrombocytopenia in the ICU: An Overview
		Introduction
		Pathophysiology of HIT
		Epidemiology
		Clinical Manifestations
			Onset
			Thrombocytopenia
			Thrombotic Complications
			Other Complications of HIT
		Scoring System for HIT
		Laboratory Diagnosis of HIT
			Functional Assays
			Antigen Assays
			Interpretation of the Results of Laboratory Assays
		Management of Patients with HIT
			General Measures
			Alternative Anticoagulation
			Heparinoids
			Direct thrombin inhibitors
			Fondaparinux
			Heparin and Vitamin K Antagonist Therapy in Patients with HIT
		The Challenge of Diagnosis and Treatment of HIT in the ICU
		Summary and Conclusion
		References
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	Iron Deficiency in Critically Ill Patients: Highlighting the Role of Hepcidin
		Introduction
		Iron Metabolism Overview and the Role of Hepcidin
		Implication of Iron Metabolism in the Anemia of the Critically Ill: Hepcidin as a Diagnostic Tool?
		Is There a Place for Iron Supplementation or Treatment in Critically Ill Patients?
		Conclusion
		References
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	The Next Generation of ALI Genetics: Insights into Pathophysiology
		Introduction
		General Considerations in Designing ALI Genetic Studies
		Candidate Gene Studies
		Recent Candidate Gene Studies in ALI
		Gene and Pathway-based Analyses
		Genome-wide Association Studies
		Future Directions in ALI Genomics
		Conclusion
		References
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	Use of B-type Natriuretic Peptides in Acute Exacerbation of Chronic Obstructive Pulmonary Disease Requiring Ventilatory Support
		Introduction
		Natriuretic Peptides in the Diagnosis of Left Heart Failure in COPD Patients
		BNP and NT-proBNP in the Diagnosis of Left Heart Dysfunction in Difficult-To-Wean COPD Patients
		Natriuretic Peptide Performance as Prognostic Indicators in COPD Exacerbation Requiring Ventilatory Support
		Conclusion
		References
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	Acute Lung Injury in the ICU: Focus on Prevention
		Introduction
		Identifying the At-risk Population
			Acute Illnesses
			Premorbid Characteristics
		Modifiable Therapeutic Practices
			Mechanical Ventilation
			Blood Products
			Fluid Balance
			Resuscitation Timelines
		Emerging Concepts and Possibilities
			Amiodarone
			Gut Lymph Hypothesis of Multiple Organ Dysfunction
			Anti–Platelet Therapy
			Activated Protein C
		Conclusion
		References
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	Rapid Sequence Intubation: Overview and Myths Versus Facts
		Introduction
		Why and What is Rapid Sequence Intubation?
		Pre-hospital Rapid Sequence Intubation
		Pretreatment
		Cricoid Pressure
		Paralysis with Induction
			Etomidate
			Succinylcholine
			Midazolam
			Propofol
		Conclusion
		References
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	Research Priorities in Oral Care for Endotracheally-intubated Patients
		Introduction
		Pathophysiology
			Alterations in Oral Microbial Ecology
			Dental Plaque Formation
			Altered Salivary Production and Flow
			Drug-induced Adverse Effects
			Effects of Orotracheal Intubation
		Complications of Poor Oral Health
			Local Complications
			Systemic Complications
		Oral Care Practices
			Mechanical Strategies
			Pharmacological Strategies
				Chlorhexidine
				Povidone-iodine
			Combined Strategies
		Research Priorities in Oral Care
			Optimal Assessment of the Oral Cavity
			Optimal Method for Cleaning the Oral Cavity
				Mechanical cleaning
				Pharmacological cleaning
				Combined strategies
			Optimal Frequency of Oral Care
			Role of Oral Care in VAP
		Conclusion
		References
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	Pros and Cons of Assisted Mechanical Ventilation in Acute Lung Injury
		Introduction
		Modes of Assisted Ventilation
			a) Volume assist-control ventilation
			b) Pressure assist-control ventilation
			c) Pressure support ventilation
			d) Biphasic positive airway pressure/airway pressure release ventilation + supported/non-supported spontaneous breathing
			e) Proportional assist ventilation/proportional pressure support
			f) Adaptive support ventilation
			g) Neurally-adjusted ventilatory assist
			h) Noisy pressure support ventilation
		Effects on Gas Exchange
		Effects on the Regional Distribution of Lung Aeration
		Effects on the Regional Distribution of Lung Ventilation
		Effects on Regional Distribution of Lung Perfusion
		Ventilator-associated Lung Injury
		Patient-ventilator Asynchrony
		Sigh during Assisted Mechanical Ventilation
		Ventilator-induced Diaphragmatic Dysfunction
		Conclusion
		References
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	Can ’Permissive’ Hypercapnia Modulate the Severity of Sepsis-induced ALI/ARDS?
		Introduction
		Hypercapnia and the Innate Immune Response
			Function of the Innate Immune Response
			Activation of the Innate Immune Response
			Coordination of the Innate Immune Response
			The Cellular Innate Immune Response
		Hypercapnia and the Adaptive Immune Response
		Hypercapnia and Acidosis Modulate Bacterial Proliferation
		Implications for Hypercapnia in Sepsis
			Hypercapnia, Acidosis and the Host Response
			Early Versus Late Bacterial Infection
			Impact on Repair Following Injury
		Hypercapnia in Pulmonary Sepsis
			Early Lung Infection
			Prolonged Lung Infection
		Hypercapnia in Systemic Sepsis
			Early Systemic Sepsis
			Prolonged Systemic Sepsis
			Intraperitoneal Hypercapnia
		Buffering Hypercapnic Acidosis in Sepsis
			Pulmonary Sepsis
			Systemic Sepsis
		Hypercapnia and Sepsis: Where are we Now?
		Conclusion
		References
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	NAVA: Why, When, Who?
		Introduction
		Why NAVA?
		NAVA: When and Who?
		Conclusion
		References
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	Therapeutic Aerosols in Mechanically Ventilated Patients
		Introduction
		Basic Aerosol Physics
		Methods of Aerosol Generation
			Pressurized Metered Dose Inhalers (MDIs)
			Dry Powder Inhalers (DPIs)
			Nebulizers
			Jet nebulizers
			Ultrasonic nebulizers
			Vibrating mesh nebulizers
			Comparison of the Different Types of Nebulizer
		Issues of Aerosol Delivery in Mechanically Ventilated Patients
		Aerosolized Drugs
			Bronchodilators
			Corticosteroids
			Mucolytic Agents
			Pulmonary Vasodilators
			Nebulized Antimicrobial Therapy
			Heparin, Antithrombin, Activated Protein C and Sodium Bicarbonate
		Conclusion
		References
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	Cardiac Mitochondria and Heart Failure: The Chicken or the Egg?
		Introduction
		Cardiac Energy Metabolism
		Derangement of Myocardial Substrate Utilization
		Modulation of Substrate Utilization: Therapeutic Potential for the Treatment of Heart Failure
		Oxidative Stress and Derangement of Oxidative Phosphorylation: The Key Role of Mitochondria
		Oxidative Stress Studies: Pitfalls and Drawbacks
		Human Models of Ischemia/Reperfusion Phenomena
		Ischemia/reperfusion Injury and Oxidative Stress: The Role of Mitochondrial ATP-Dependent Potassium (KATP) Channels on the Therapeutic Potential for the Treatment of Cardiac Dysfunction
		Conclusion
		References
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	Evolving Rationale for Minimally-interrupted Chest Compressions during Cardiopulmonary Resuscitation
		Introduction
		Minimizing Interruptions in Chest Compressions
		Concern Regarding Oxygen Desaturation
		Enhanced Oxygenation, Ventilation and Circulation – by Not Ventilating
		Gasping Enhances Continuous Chest Compressions – and Vice Versa
		New Technologies to Minimize Interruptions in CPR
		Pediatric Arrests and Cases of Presumed Respiratory Etiology
		Conclusion
		References
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	Hypoalbuminemia as a Risk Factor for Acute Kidney Injury
		Introduction
		Albumin
			Antioxidant Activity
			Inflammation
			Microcirculation
		Hypoalbuminemia
		Hypoalbuminemia and Acute Kidney Injury
		Conclusion
		References
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	Developing Biological Markers: The Case of Urinary Neutrophil Gelatinase-associated Lipocalin in Acute Kidney Injury
		Introduction
		Conventional Measures of Renal Function
			Glomerular Filtration Rate
			Tubular Function
			Renal Function versus Renal Injury
		Classification Schemes for Acute Kidney Injury
		Biological Markers
		Novel Biological Markers of AKI
		The Case of Urinary NGAL
			Phase 1: Discovery of NGAL
			Phase 2: Assay Development
			Phases 3 and 4: Early Detection and Risk Stratification
			Phase 5: Reduction in (burden of) AKI with the use of NGAL
		Conclusion
		References
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	Biomarkers of Acute Kidney Injury in Cardiorenal Syndromes
		Introduction
		The Pathophysiology of the Cardiorenal Interaction
		Current Definitions of Acute Kidney Injury
		Biomarker Features
		Biomarkers of Myocyte Necrosis and Wall Stress
		Cystatin C
		Neutrophil Gelatinase-Associated Lipocalin (NGAL)
		Kidney Injury Molecule-1 (KIM-1)
		Urinary a- and -  -GST
		Urinary Albumin
		Conclusion
		References
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	Cardio-renal Syndromes: A Complex Series of Combined Heart/Kidney Disorders
		Introduction
		The Definition or Classification of Cardio-renal Syndromes
		Epidemiology and Pathophysiology of Cardio-Renal Syndromes
			Cardio-renal Syndrome Type I or Acute Cardio-renal Syndrome
			Cardio-renal Syndrome Type 2 or Chronic Cardio-renal Syndrome
			Cardio-renal Syndrome Type 3 or Acute Reno-cardiac Syndrome
			Cardio-renal Syndrome Type 4 or Chronic Reno-cardiac Syndrome
			Cardio-renal Syndrome Type 5 or secondary Cardio-renal Syndrome
		Biomarkers in Cardio-renal Syndromes
		Management of Cardio-renal Syndromes
		Conclusion
		References
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	Blood Purification in Sepsis and Acute Kidney Injury in Critically Ill Patients
		Introduction
		‘New Active Transportation between two Asymmetric Compartments’ Hypothesis and New Insights into Rationale and Potential Mechanisms
		New Therapeutic Targets Defined by the Latest Findings
		Recent Positive Studies regarding Blood-Purification for Acute Kidney Injury in the ICU
		Update on Very Recent Negative Trials in Critically ill Patients with AKI
		Potential Impact of High Cut-off Membranes in Future Sepsis Trials
		What Is the Future for Blood Purification?
		Conclusions and Recommendations for the Clinician at the Bedside
		References
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	The Lymphatic Vasculature as a Participant in Microvascular Exchange
		Introduction
		Anatomy of the Lymphatic System
		Formation of Lymph
		Microvascular Exchange
		Collecting Lymphatics as Exchange Vessels
		Conclusion
		References
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	The Interstitium and Lymphatics have an Important Role in Edema Generation during Sepsis
		Introduction
		Normal Transcapillary Fluid Exchange
		Autoregulation of Jv and Edema Formation
		Fluid Exchange in Sepsis
		The Interstitium and Interstitial Fluid Pressure
		Integrins
		Pif Regulation during Inflammation
		Sepsis, Insulin and Pif
		Lymphatics and Lymph Formation
		Conclusion
		References
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	Fluid is a Drug that can be Overdosed in the ICU
		Introduction
		Can Fluid Be a Medication with Toxic Effects?
		Lessons from the Pediatric Intensive Care Unit
		Are Adults Different or are they Just Large Children?
		Conclusion
		References
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	Crystalloid or Colloid Fluids: A Matter of Volumes?
		Introduction
		How Does Fluid Loading Increase Cardiac Output?
		More Saline than Colloid Needed?
			Theory: Fluid Properties
			Practice
				Volunteers
				Iso- or normovolemic hemodilution
				Perioperative states and trauma
				Sepsis
				General critical illness conditions
		Conclusion
		References
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	Meaning of Pulse Pressure Variation during ARDS
		Introduction
		Why use PPV?
			The Concept of Preload Responsiveness
			The Cyclic Effects of Mechanical Ventilation on Hemodynamics
			PPV and Preload Responsiveness
			PPV as a marker of fluid responsiveness
			PPV as a marker of the hemodynamic effects of PEEP
		Practical Use of PPV in Patients with ARDS
		Limitations of the Use of PPV during ARDS
			Persistence of Spontaneous Breathing Activity
			Cardiac Arrhythmias
			Low Tidal Volume Ventilation
			High-frequency Ventilation
			Right Ventricular Dysfunction
		Conclusion
		References
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	The Fluid Challenge
		Introduction
		Patient Selection
		Principle Behind the Fluid Challenge
		Application of the Fluid Challenge
		Maximal Stroke Volume
		Risks
		Conclusion
		References
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	Facing the Challenge: A Rational Strategy for Fluid and Volume Management
		Introduction
		The Physiological Basis: What Happens to Intravascular Fluids and Why?
			Why Does Fluid Stay Within the Vasculature? The Vascular Barrier!
			Degradation of the Vascular Barrier: Reasons and Consequences
			Fluid Balance: Where Do Fluids Get Lost?
		Fluid Replacement: Which Fluid is the Adequate Drug for Which Disease?
			Dehydration or Hypovolemia: What is the Treatment Intention?
			Crystalloids
			Colloids
		Infusion Management: A Rational Strategy
		Conclusion
		References
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	Mitochondrial Function in Septic Shock
		Introduction
		Role of the Microcirculation
		Metabolic Therapies in Sepsis
		Insulin as a Metabolic Therapy
		Beyond Oxygen Delivery: Cytopathic Hypoxia
		Mitochondrial ‘Hibernation’
		Mechanisms of Cytopathic Hypoxia
		Altered Metabolism: Pyruvate Dehydrogenase Inhibition in Sepsis
		Metabolic Therapy: Focus on L-carnitine
		The Interface of the Microcirculation and the Mitochondrion
		Conclusion
		References
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	How Can We Use Tissue Carbon Dioxide Measurement as an Index of Perfusion?
		Introduction
		Physiological Background for Increased Tissue PCO2
		PCO2Gap: A Marker of Tissue Hypoxia?
		Use of PCO2 Gap as a Complementary Tool to O2-derived Parameters
		Tissue PCO2 Measurements: Back to the Peripheral Tissues
		Conclusion
		References
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	Use of Non-invasive Tissue Oxygen Saturation Monitoring to Assess Cardiovascular Insufficiency
		Introduction
		Tissue Oxygen Saturation Measurement
		Assessing Cardiovascular Insufficiency in the Microcirculation
		StO2 Measurements as a Predictor of Cardiovascular Insufficiency
		Conclusion
		References
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	The Microcirculation of the Critically Ill Pediatric Patient
		Introduction
		Cardiovascular Physiology of the Pediatric Patient
		Hemodynamic Monitoring of the Pediatric Patient
		The Microcirculation as an Essential Hemodynamic Compartment
		Bedside Measurement of the Pediatric Microcirculation
		The Microcirculation in Development
		Microcirculation in Disease and the Effects of Treatment
		Prognostic Value of the Microcirculation
		Conclusion
		References
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	Heart Rate as Prognostic Marker and Therapeutic Target In MODS
		Introduction
		Patients with Multiorgan Dysfunction Syndrome
		Mechanisms
		Heart Rate as a Therapeutic Target in Non-MODS Patients
		Heart Rate Reduction in MODS
		Conclusion
		References
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	Hemodynamic Monitoring in Cardiogenic Shock
		Introduction
		Etiology of Cardiogenic Shock
		Choice of Bedside Monitoring Tool
			Invasive Hemodynamic Monitoring
			Non-invasive Cardiovascular Monitoring
				Intermittent monitoring
				Continuous monitoring
		Preload and Fluid Responsiveness
			Invasive Pressure Measurements
			Non-invasive Doppler echocardiography
		Assessment of Ventricular Function
		Conclusion: Assembling the Whole Hemodynamic Picture
		References
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	Non-invasive Estimation of Left Ventricular Filling Pressures by Doppler Echocardiography
		Introduction
		Tissue Doppler in Critical Care Patients
		Conclusion
		References
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	Hemodynamics from the Periphery
		Introduction
		From Otto Frank’s Theory to Modern Pulse Contour Methods
		Pulse Contour Methods with External Calibration and/or Pre-loaded Data (types I and I + II)
		Pulse Contour Methods with Pre-calibration (type II)
		Pulse Contour Methods that do NOT use External Calibration and/or Pre-estimated Data (Type III)
		Conclusion
		References
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	Totally Non-invasive Continuous Cardiac Output Measurement with the Nexfin CO-Trek
		Introduction
		The Principles of Continuous Cardiac Output Measurement using the Nexfin HD
			Measurement of Continuous Finger Blood Pressure
			Transformation of the Finger Blood Pressure Curve Into a Brachial Artery Waveform
			Calculation of Continuous Cardiac Output from the Brachial Arterial Pressure Waveform
		Validation of the Nexfin HD
		Clinical Applications
		Conclusion
		References
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	Cardiac Output Monitoring: An Integrative Perspective
		Introduction
		Overview of Cardiac Output Monitoring Devices
			Invasive Cardiac Output Monitoring
			Minimally Invasive Cardiac Output Monitoring
				Pulse pressure analysis
				Doppler cardiac output monitoring devices
				Applied Fick principle
				Bioimpedance and bioreactance
		Additional Hemodynamic Variables
			Static Preload Variables
			Functional Hemodynamic Variables
			Central Venous Oxygen Saturation
		Integrative Concept
		Conclusion
		References
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	Perioperative Hemodynamic Optimization
		Introduction
		Which Hemodynamic Monitoring Tool and Targets For Goal-directed Therapy?
		How to Achieve the Goals?
		What is the Optimal Timing For Goal-directed Therapy?
		Who Should Benefit from Goal-directed Therapy?
		Goal-directed Therapy and Organ Function
		Conclusion
		References
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	Perioperative Myocardial Ischemia/reperfusion Injury: Pathophysiology and Treatment
		Introduction
		Pathophysiology of Ischemia/reperfusion Injury
		Treatment of Ischemia/reperfusion Injury
			Myocardial Oxygen Balance
			Protection before Ischemia: Preconditioning
			Protection during Ischemia
			Protection after Ischemia – during Reperfusion: Postconditioning
			Targeting the Mitochondrial Permeability Transition Pore
		Cardioprotective Strategies in Clinical Practice
		Perioperative Anesthetic Cardioprotection and Outcome
		Conclusion
		References
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	A New Approach to Ventilator-associated Pneumonia Based on the PIRO System
		Introduction
		Components of the VAP-PIRO Score: Predisposition
			Genetic Factors
			Underlying Diseases
				Chronic obstructive pulmonary disease
				Immunocompromised host
				Trauma patients
		Components of the VAP-PIRO Score: Insult
			Bacteremia
			Pathogens
				Pseudomonas aeruginosa
				Staphylococcus aureus
				Acinetobacter baumannii
				Candida species
			Ventilator-associated Tracheobronchitis (VAT) as an Intermediate Insult for VAP
			Blood Transfusion
		Components of the VAP-PIRO Score: Response
			Clinical Resolution
			Use of Biomarkers to Quantify the Response to VAP
			Compartmentalization
			Shock
			Immunoparalysis
			Immunomodulatory Effects of Macrolides
		Components of the VAP-PIRO Score: Organ Dysfunction
			Renal Failure
			Acute Respiratory Distress Syndrome
		Conclusion
		References
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	Selective Decontamination of the Digestive Tract and Antibiotic Resistance
		Introduction: Infections in Intensive Care Unit Patients
		Selective Decontamination of the Digestive Tract
		Selective Oropharyngeal Decontamination
		SDD/SOD and Antibiotic Resistance
			Enterobacteriaceae and P. aeruginosa
			Resistance in Gram-positive Bacteria
		Conclusion
		References
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	New Treatment Options against Gram-negative Organisms
		Introduction
		Mechanism of Resistance to Currently used Antimicrobial Agents in Multi-Drug Resistant Gram-Negative Bacteria
		Gram-negative Resistant Bacteria and Drug Development Needs
		New B-lactamase Inhibitors
			Inhibitors with a B-lactam Structure
				Imidazole-substituted 6-methylidene-penem molecules
				2B-alkenyl penam sulfones
				4-phenyl cyclic phosphate
				C3-modified penicillin sulfones
				Monobactam-based structure compounds
				Tricyclic carbapenem inhibitors
				Oxapenems
			Inhibitors with no B-lactam Structure
				NXL104
				Maleic acid derivates
		New Cephalosporins
			Ceftobiprole
			Ceftaroline
		New Carbapenems
			Ertapenem
			Doripenem
			Biapenem
			Panipenem/betamipron
			Tebipenem
			Tomopenem
			Other New Carbapenems
		Conclusion
		References
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	Antifungal Therapy in The ICU: The Bug, the Drug, and the Mug
		Introduction
		The ‘Bug’
		The Drug
			Absorption
			Distribution and Penetration
			Metabolism and Elimination
			Drug-drug Interactions
			Adverse Effects
			Dosage
			The ‘Mug’
			Renal Dysfunction
			Hepatic Dysfunction
			Clinical/Hemodynamic State
			Other Specific Populations
		Conclusion
		References
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	Mycobacterial Sepsis and Multiorgan Failure Syndrome
		Introduction
		Pathogenesis
			Predisposing Conditions
			Bacterial Factors
			Immunology
		Clinical Features
			Pulmonary Involvement
			Gastrointestinal Involvement
			Central Nervous System (CNS) Involvement
			Other Systems
		Diagnosis
			Laboratory Evaluation
			Testing for Latent TB
			Imaging
			Microbiological Evaluation
				Acid-fast bacillus smear
				Cultures
			Rapid Diagnostic Tests
				Adenosine deaminase levels
				Interferon gamma assay
				Nucleic acid amplification test
				Drug susceptibility testing
		Treatment
			Anti-tuberculous Therapy
				Drug-resistant TB
			Newer Anti-tubercular Therapy
		Adjunctive Therapy
			Corticosteroids
				Drotrecogin alfa
				Immunotherapy
			Surgery
			Micronutrient supplementation
		Conclusion
		References
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	Pentraxin 3 (PTX3): Possible Role in Critical Care Medicine
		Introduction
		PTX3: Role in Innate Immunity
		PTX3 in Human Pathology
		PTX3 in ALI/ARDS patients
		PTX3 in Septic Patients
		Conclusion
		References
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	The Role of IgM- and IgA-enriched Immunoglobu- lins in the Treatment of Sepsis and Septic Shock
		Introduction
		Structure and Function of Immunoglobulins
		Rationale for the use of Intravenous Immunoglobulins in Sepsis
		Clinical Indications for IVIG in Sepsis
		Conclusion
		References
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	Spontaneous Bacterial Peritonitis in Patients with Cirrhosis and Ascites
		Introduction: Definition and Epidemiology
		Pathogenesis of Spontaneous Bacterial Peritonitis
			Bacterial Overgrowth
			Intestinal Permeability
			Host Immunity in Cirrhosis
				Innate Immunity in cirrhosis
				Acquired immunity in cirrhosis
		Risk Factors
			Genetic Factors
			Severity of Liver Disease
			Environmental Factors
		Clinical Presentations and Complications of SBP
		Diagnosis
			Neutrophil Count in Ascitic Fluid
			Ascitic Fluid Culture
			Types of Diagnosis
			Differential Diagnosis
		Treatment and Prognosis
			Empirical Antibiotic Treatment (Box 2)
			Intravenous Albumin in Patients with SBP
			Prognosis
		Prophylaxis of SBP
			Patients Admitted with Acute Gastrointestinal Hemorrhage
			Patients with Low Total Protein Content in Ascitic Fluid and no Prior History of SBP
			Patients with Prior SBP
		Conclusion
		References
fulltext_53
	Acute-on-chronic Liver Failure: An Entity Still in Search of Itself?
		Liver Failure Associated With Cirrhosis: Magnitude of the Problem
		(Re-)Defining Liver Failure Associated with Cirrhosis: Towards the Construct of a Treatment-directed Classification?
		Potential Mechanisms Involved in Acute-on-chronic Liver Failure: SIRS, Bacterial Infections and Organ Failure
		Precise Diagnostic and Prognostic Criteria for Acute-on-chronic Liver Failure: An Ongoing Search towards the Truth
		Therapeutic Options for Acute-on-chronic Liver Failure
			Rational Basis for Non-biological Liver Support
			Currently Available Devices
				The Molecular Adsorbent Recirculating System: MARS (Gambro)
				Prometheus or FPSA (fractionated plasma separation and adsorption) (Fresenius)
				HepaWash®
			Clinical Impact of Liver Support on Survival
		Conclusion
		References
front-matter_15
fulltext_54
	Cocaine Intoxication
		Introduction
		Diagnostic Evaluation
			Laboratory Tests
			Imaging and Other Tests
		Treatment
			Sympathomimetic Toxidrome/agitation
			Hypertension
			Myocardial Ischemia or Infarction
			Dysrhythmias
			Seizures
			Cerebrovascular Infarction
			Aortic Dissection
			Abdominal Ischemia
			Body Stuffers and Packers
		Prognosis
		Conclusion
		References
fulltext_55
	Airway Management for Major Trauma
		Introduction
		Pre-hospital Intubation
		In-hospital Airway Management
		Cervical Spine Protection
		The Cricoid Pressure Controversy
		Induction Drugs in the Hemodynamically Compromised Trauma Patient
		Conclusion
		References
fulltext_56
	Goal-directed Coagulation Management in Major Trauma
		Introduction
		Pathophysiology of Coagulopathy in Trauma
		Hypothermia
		Acidosis
		Diagnosis
		Treatment of Coagulation Disorders
			Coagulation Therapy
				Ratio driven ‘damage-control resuscitation’
				Limitations of the ratio driven concept
				Survivor bias
				Potential harms
			Timing of Coagulation Therapy
				Individualized Goal-directed Coagulation Therapy
				Improvement in clot quality
				Improvement of thrombin generation
				Improvement in clot stability
		Conclusion
		References
front-matter_16
fulltext_57
	Understanding Posterior Reversible Encephalopathy Syndrome
		Introduction
		Epidemiology
		Diagnosis
			Clinical Manifestations of PRES
				Typical presenting manifestations
				A frequently associated sign: Acute hypertension
			Radiological Characteristics of PRES
				The four radiological patterns of PRES [11]
				a. Holohemispheric watershed pattern (23 %) (Fig. 2a)
				b. Superior frontal sulcus pattern (27 %) (Figure 2b)
				c. Dominant parietal-occipital pattern (22 %) (Fig. 2c)
				d. Partial or asymmetric expression of the primary patterns (28 %) (Fig. 2d)
				Roles for computed tomography and magnetic resonance imaging in the diagnosis of PRES
				Complications diagnosed radiologically at presentation of PRES
				Retrospective Diagnosis of PRES after Regression of the Initial Clinical and Radiological Abnormalities
		Differential Diagnosis
		Pathophysiology
			Cerebral Hyperperfusion Results in Vasogenic Edema by Exceeding the Capacity for Autoregulation of Perfusion Pressure
			Cerebral Hypoperfusion Related to Disruption of the Blood-brain Barrier Results in Vasogenic Edema
			Pathophysiology of Complications of PRES: Cerebral Ischemia and Cerebral Hemorrhage
		Conditions Most Commonly Associated With PRES
			Toxic Agents
			Hypertension
			Infection/Sepsis/Septic Shock
			Preeclampsia/Eclampsia
			Autoimmune Disease
			Other Conditions
		Outcomes
		Management of PRES
			Diagnostic Strategy
			Treatment
				General measures
				Correction of the underlying cause of PRES
		Conclusion
		References
fulltext_58
	Prediction of Neurological Outcome after Cardiac Arrest
		Introduction
		Definition of Neurological Outcome
		Prognostication in Normothermic Patients
			Clinical Examination
			Biochemical Markers
			Electrophysiological Testing
			Neuroimaging Studies
			Prognostication in Patients Treated with Therapeutic Hypothermia
		Conclusion
		References
fulltext_59
	Neuroprotection in Sepsis by Complement Inhibition and Immunoglobulin Therapy
		Introduction
		‘The Neuroinflammatory Hypothesis’ and Brain Injury in Sepsis
		Brain Injury Pathways Targeted by IVIG Treatment
		The Role of the Complement Cascade In Brain Injury
		Neuroprotection by IVIG in Sepsis
		Conclusion
		References
fulltext_60
	Ethics in Disorders of Consciousness
		Introduction
		Ethical Issues in Clinical Management
		Legal Issues in Disorders of Consciousness
		Conclusion
		References
front-matter_17
fulltext_61
	Metformin and Lactic Acidosis
		Introduction
		Epidemiology and Risk Factors
		Pathophysiology
		Clinical Presentation
		Diagnosis
		Treatment
		Prognosis
		Conclusion
		References
fulltext_62
	Energy Goals in the Critically Ill Adult
		Introduction
		Determination of Energy Goals
			Indirect Calorimetry
			Predictive Equations
			Fixed Prescription
		Effect of Energy Delivery on Clinical Outcomes
			Hypocaloric Feeding
			Evidence that Achieving Nutritional Goals may Improve Outcomes
			Overfeeding
		Energy Delivery in The Malnourished Patient
		Energy Delivery in Obesity
			Metabolic Changes Associated With Obesity
			How Many Calories should be Administered?
			How to Estimate Caloric Goals?
		Conclusion
		References
front-matter_18
fulltext_63
	Frailty: A New Conceptual Framework in Critical Care Medicine
		A Brief History of Critical Care: How Did We Get Here?
		What Can We Learn From Other Specialties?
		How Might Frailty Be Applicable To Critical Care?
		How Might We Treat Critical Illness More Effectively?
		How Might Frailty Change Our Current Understanding Of Critical Care?
		Conclusion
		References
fulltext_64
	Access Block and Emergency Department Overcrowding
		Introduction
		Magnitude of the Problem
		Hospital and System Factors
			Policy Interventions
			Emergency Departments
			Ambulance Service
			Radiology and Pathology
			Operating Room
			Medical, Surgical Wards and the ICU
		Potential Solutions
		Conclusion
		References
fulltext_65
	Triage of High-risk Surgical Patients for Intensive Care
		Introduction
		Prediction of Postoperative Outcomes
			Preoperative Evaluation
			Intraoperative Events
			Perioperative Scoring Systems
		Postoperative Complications
			“Failure to Rescue”
		Intensive Care Triage
			Improved Outcomes with Intensive Care
			ICU Admission Guidelines
			Alternatives to ICU Admission
			Post-anesthesia Care Units
		Improvement of Postoperative Outcomes
			Patient Interventions
			Hospital Interventions
			Health Care System Interventions
		Conclusion
		References
fulltext_66
	Transportation of the Critically Ill: Moving in the Right Direction
		Introduction
		Risks
		Airway
		Breathing
		Circulation
		Central Nervous System
		Transport Options
		Transport Education
		Improving Teamwork and Communication
		Conclusion
		References
fulltext_67
	Should We Still Order Chest X-rays in the ICU?
		Introduction
		Heterogeneity of Prescription Practices
		Searching for a Consensus on Indications for CXRs in ICUs
		Reduction in the Number of CXRs Ordered in Patients on Mechanical Ventilation
		Alternatives to CXR
			Alternatives to CXR to Ensure Correct Placement of Enteral Feeding Tube
			Alternative to CXR to Diagnose and Monitor Pneumothorax
			Alternative to CXR after Central Venous Catheter (CVC) Insertion
		Conclusion
		References
fulltext_68
	The Effect of Light on Critical Illness
		Introduction
		Light
		The Biological Perspective: Non-Visual Effects of Light
			Circadian Pathways
			Melatonin
			Cortisol
			Photo-immunomodulation
			Central Pathways: The Inflammatory Reflex
			Skin Pathways: Immunosuppression by Ultraviolet B Radiation
			Vitamin D3, 1,25(OH)D2, and Cathelicidin
		The Biological Perspective: Visual Effects of Light
		The Behavioral Perspective
		The Holistic Perspective
		Conclusion
		References
fulltext_69
	Context Information in Critical Care
		Introduction
		What is Context Information?
		Context Information in Critical Care Monitoring
		Context Information and Patient Safety
		Context Information and Telemedicine
		Beyond Patients and Problems
		Technical Requirements for Providing Context Information in a Monitoring System
		Conclusion
		References
front-matter_19
fulltext_70
	Ambient Intelligence in the Intensive Care Unit: Designing the Electronic Medical Record of the Future
		Introduction
		Intensive Care Can Be Costly and Error-Prone
		Medical Decision Making Takes Place in a Distributed Cognitive Network
		Information Overload Impairs Timely and Rational Decision Making
		EMR Systems may Facilitate Medical Error
		Adoption of New Electronic Tools Must Be Preceded By Rigorous Testing
		Potential Solutions
			Simple Tools Can Improve System Performance and Patient Outcomes
			Ambient Intelligence Principles Can Guide the Development of a Smarter EMR
		Practical Examples from a Single Institution
			Building a Comprehensive Informatics Infrastructure
			Defining Provider Information Needs
			Developing Metrics for Work Load, Medical Error, Omissions, and Waste
			Designing Progressively Complex EMR Applications for the ICU
				Passive electronic oversight of transfusion orders
				Active oversight of mechanical ventilation (a “sniffer” for ventilator-induced lung injury)
				A parsimonious data display for the ICU
			Testing Novel Tools in a Safe, High-Fidelity Environment
		Conclusion
		References
fulltext_71
	Simulation in Critical Care Medicine: The Next Ten Years
		Introduction
		The Danger of Complacency
		Engineering a Better Simulation Experience
		Updating our Understanding of Simulation
		Simulation and Adult Education Theory
		Simulation and Error Mitigation
		Simulation as an Agent of Culture Change
		Conclusion
		References
fulltext_72
	Intensive Care Medicine: Where We Are and Where We Want To Go?
		Introduction
		Evolution of Intensive Care
		Why We Need Intensive Care Units
		The ICU of Today
		Interfacing the ICU
		Triage of Admissions and Discharges
		Where are we Going and Where do we Want to Go?
		References
back-matter
	Subject Index
                        
Document Text Contents
Page 2

Annual Update
in Intensive Care
and Emergency Medicine 2011
Edited by J.-L. Vincent

Page 415

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beta-blockade after severe burns. N Engl J Med 345: 1223–1229

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Heart Rate as Prognostic Marker and Therapeutic Target In MODS 405

X

Page 829

– intestinal decontamination 569
Sellick’s maneuver 604
Sepsis 10, 51, 267, 297, 317, 357, 395, 516,

531, 546, 550, 606, 644, 664, 668, 770
Septic shock 19, 118, 278, 355, 387, 546,

550, 562, 768
Sequential organ failure assessment

(SOFA) 136, 236, 278, 370, 378, 387, 342,
481, 547, 580, 606, 732

Serotonin 768
– release assays (SRA) 85
Serum amyloid P component (SAP) 543
Sevoflurane 475
Shock 375, 411, 487, 612
Side-stream darkfield (SDF) imaging 384,

356
Sigh 169
Sildenafil 203
Simplified acute physiology score (SAPS) II

378, 547, 732
Simulation 803
Single nucleotide polymorphism (SNP) 98,

101
– photon emission CT (SPECT) 641
Sirolimus 643
Situation-background-assessment-recom-

mendation (SBAR) 749
Soluble triggering receptor expressed on

myeloid cells (sTREM)-1 488, 543
Somatostatin 18
Spine surgery 31
Spontaneous bacterial peritonitis (SBP) 559
– breathing trials (SBTs) 112, 188
Staphylococcus aureus 483, 485, 493, 567,

774
Statins 473
Status epilepticus 638, 660
Stroke 26, 32, 595, 640
– volume 338, 381, 408, 412, 424, 434
– – variations 441
– work 317
Subarachnoid hemorrhage 591
Subjective global assessment (SGA) tool

701
Succinylcholine 138, 139, 594
Superoxide 176
– dismutase (SOD) 213
Sustained low efficiency dialysis (SLED)

277
Syndecan-1 342
Systemic lupus erythematosus (SLE) 544,

644
– sclerosis 644
– vascular resistance (SVR) 381, 434, 461

Tachyarrhythmias 398
Tachycardia 327, 395, 401, 745
Tacrolimus 643
Tebipenem 511

Telemedicine 784
Terlipressin 237, 568
Thermodilution 439
Thrombin 614, 621
– activatable fibrinolysis inhibitor (TAFI)

55
– antithrombin III complex (TAT) 487
– generation 52
– inhibitors 87
Thrombocytopenia 80, 83
Thromboelastography (TEG) 611
Thromboelastometry (TEM) 611
Thrombomodulin 56
Thrombosis 80
Tidal volume 120, 200, 326
Tifacogin 58
Tigecycline 501, 504
Tissue Doppler 420, 421
– factor (TF) 52, 62, 612
– oxygen saturation (StO2) 375
– PCO2 367
– plasminogen activator (t-PA) 55, 596,

612
Tobramycin 565
Toll-like receptor (TLR) 3, 105, 175, 560,

668
Tomopenem 511
Tracheotomy 755
Training programs 810
Tranexamic acid 622
Transcapillary fluid exchange 297
Transfer 741
Transferrin 71
Transforming growth factor (TGF)-β 73
Transfusion 75, 121, 486, 616, 620, 799
– related acute lung injury (TRALI) 122,

618
Transplantation 631, 644
Transpulmonary pressure 167, 327
Trauma 125, 483, 599, 702
– induced coagulopathy 617
– injury severity score (TRISS) 622
Traumatic brain injury (TBI) 664
Triage 734, 815
Tricarboxylic acid (TCA) cycle 358
Trinems 512
Troponin 254, 268, 476, 592
Tuberculosis 552, 531
Tubular function 243
Tumor lysis syndrome 644
– necrosis factor (TNF) 3, 63, 175, 212,

267, 523, 532
– – – α 357, 543, 550, 579, 641, 665

Ultrasonic nebulizers 199 (see also Neb-
ulizers)

Ultrasonography 758
Ultraviolet 772
Urapidil 648

830 Subject Index

Page 830

Vagal activity 398
– stimulation 745
Vancomycin 497
– resistant enterococcus (VRE) 497
Vascular endothelial growth factor

(VEGF) 37
– occlusion test 376
– permeability 300, 343
Vasodilatation 303
Vasodilators 269
Vasopressin 269, 612
Vasospasm 595
Vecuronium 134, 138
Vegetative state 676
Venous return 323, 333
Ventilation perfusion matching 165, 201
Ventilator-associated pneumonia (VAP)

146, 178, 203, 481, 493, 745

– – tracheobronchitis (VAT) 204, 485
– induced lung injury (VILI) 102, 119,

799
Ventricular fibrillation (VF) 220
Vessel density index (VDI) 384
Vibrating mesh nebulizers 199
Videophotometric microscopy 385, 386
Viscosity 314
Vitamin D 269, 772
– K 89, 621
Von Willebrand factor 347, 543
Voriconazole 518

Weaning 112

Xerostomia 145

Subject Index 831

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