controlled mechanical ventilation

P¯ This is to elucidate if a pragmatic clinical trial comparing controlled and spontaneous mechanical ventilation is warranted and will allow us to formulate relevant research questions. Journal of Thoracic Imaging, 1(3), 25–30.Find this resource: 20. Volume-controlled ventilation is the most commonly used mode in inpatient settings. In the absence of ventilation or oxygenation, mechanical ventilation is started. Look it up now! Furthermore, CT observations in experimentally-induced lung injury showed no improvement in lung aeration, but demonstrated that during IRV the upper, already well-aerated lung regions become even more aerated, whereas poorly- or non-aerated lung units localized in the dependent lung regions are less aerated when compared with conventional mechanical ventilation with essentially the same mean airway pressure and extrinsic/intrinsic PEEP [16]. J Clin Monit Comput. Mercat A, Graïni L, Teboul JL, Lenique F, and Richard C. (1993). In controlled mechanical ventilation or AC modes the delivered tidal volume should be equivalent to exhaled tidal volume. Therefore, if a patient has a respiratory rate twice that of the preset frequency, the VE will be effectively doubled. Heat Recovery Ventilator (Double Flow Controlled Mechanical Ventilation): I built a DIY HRV Heat Recovery Ventilator (Double Flow Controlled Mechanical Ventilation) that works pretty well. A remaining terminal flow at the end of the expiration indicates that a certain PEEPi exists, but it does not quantify the amount [8]‌. Found inside – Page 114In anesthetized rats, two days of controlled mechanical ventilation reduced diaphragm muscle force-generating capacity by 42% compared with control animals ... The difference is that both the peak V and the rate at which flow tapers-off are˙ fixed and independent of patient effort, Crs or respiratory system resistance (Rrs). (2012). (p. 444) We investigate the effects of 12-hour controlled mechanical ventilation on contractile function, fiber dimension, cytokine production, proteolysis, autophagy, and oxidative stress in the diaphragm of septic rats . See text for details. . P¯ Maximum efficiency, with a maximum heat recovery of up to 91% efficiency, top performance … variables during pressure controlled mechanical ventilation. Since influence of changes in ventilator settings on carried the idea further and made the transition from passive to active ventilation an integral part of their Adaptive Lung Ventilation (ALV) and its first commercial implementation Adaptive Support Ventilation (ASV) [23 . High-flow nasal oxygen cannula vs. noninvasive mechanical ventilation to prevent reintubation in sepsis: a randomized controlled trial Ann Intensive Care. Chest, 104(3), 871–5.Find this resource: 10. DOI: 10.1056/NEJM199404143301507. In ARDS, volume-controlled ventilation with tidal volumes of 6 mL/kg are recommended based upon the ARDS Network study demonstrating a 22% reduction in mortality in those receiving a low tidal volume strategy [6]‌. This popular book covers the “how-to” of the respiratory care of newborns in outline format. It includes case studies for self-review and is illustrated with high quality radiographic images, figures, tables, and algorithms. Simple text, photographs, and diagrams introduce the respiratory system, its purpose, parts, and functions. Due to the squared waveform of the airway pressure during PCV, mean airway pressure ( As known from CT scans in patients with ARDS, alveolar collapse is primarily localized in the dependent lung regions (Fig 96.4), which correlates with intrapulmonary shunting and accounts entirely for the observed hypoxaemia [19]. Furthermore, tidal recruitment (cyclic collapse) that might be a major contributor to VALI is reduced [20] . volume control ventilation (VCV). Since January 1st, 2019 the company UTEK srl has been incorporated by the company CLA srl. As the time constant (t) is equal to resistance (R) × compliance (C), high time constants are caused by high airway R and/or C, which may occur on a regional basis, e.g. VT depends mainly on respiratory compliance and the A Today, modern ventilation systems can also be forced air heating systems . when showering) the system automatically boosts. Present practice suggests tidal volumes in the range of 6–8 mL/kg ideal body weight are appropriate for most clinical circumstances. 2009;37(10):2740-2745. (p. 445) Fouled air in rooms such as the bathroom, shower and kitchen, which are the rooms most affected by the phenomenon, is changed through a heat exchanger. Background Prolonged controlled mechanical ventilation (CMV) in humans and experimental animals results in diaphragm fibre atrophy and injury. Less sedation helps in reducing the doses of vasopressor and inotropic agents, while maintaining cardiovascular function in a stable condition, and reducing the duration of ventilator support [17]. The ventilator will constantly adjust gas flow so that inspiratory pressure is maintained during the entire set inspiratory time. New York, NY: McGraw-Hill Professional.Find this resource: 4. Found insideConcise, practical reference designed for use in the critical care setting Case-oriented content, organized according to commonly encountered clinical scenarios Flow charts and algorithms delineate appropriate treatment protocols The book ... thereby transpulmonary pressure that is the driving force to recruit non-aerated alveoli and to prevent alveolar recollapse during expiration. Mechanical ventilations are of two categories -(i) volume-controlled ventilation (VCV); (ii) pressure-controlled ventilation (PCV) [3, 4]. Effect of inverse I:E ratio ventilation on pulmonary gas exchange in acute respiratory distress syndrome. Effects of inverse ratio ventilation and positive end-expiratory pressure in oleic acid-induced lung injury. The goal of mechanical ventilation is to achieve adequate gas exchange while minimizing haemodynamic compromise and ventilator-associated lung injury. Volume controlled … ◆ Volume-controlled modes of mechanical ventilation guarantee flow and tidal volume, while airway pressures are variable. Baum M, Benzer H, Mutz N, Pauser G, and Tonczar L. (1980). The complexity of equine respiratory pathophysiology and the wide range of devices available is described in the two parts of this scoping review. Spontaneous versus controlled mechanical ventilation in patients with acute respiratory distress syndrome - Protocol for a scoping review. These breaths can be pressure- or flow-triggered. Role of the respiratory time ratio in artificial respiration in ARDS.] Therefore, careful monitoring and continuous display of VT and expiratory flow has to be recommended during PC-IRV. Ventilator settings for volume-controlled ventilation. VT depends mainly on respiratory compliance and resistance, and the difference between the preset pressure levels [2]. Found inside – Page iThe chapters are written by well recognized experts in the field of intensive care and emergency medicine. It is addressed to everyone involved in internal medicine, anesthesia, surgery, pediatrics, intensive care and emergency medicine. With the exception of mandatory ventilator breaths, the tidal volume delivered is highly variable. Gattinoni L, Carlesso E, Valenza F, Chiumello D, and Caspani ML. After endotracheal intubation, the first choice facing the clinician is between two basic modes of mechanical ventilation—pressure- and volume-controlled. The pressure, volume, and flow to time … Turn off any demand-controlled ventilation (DCV) controls that reduce air supply based on occupancy or temperature during occupied hours. Modes of Invasive Mechanical Ventilation. Based on the initial description, APRV keeps the duration of the low CPAP-level (release time) at 1.5 seconds or less (Fig 96.3). A longer inspiratory time increases mean airway pressure, increases intrathoracic pressure, can decrease cardiac output, particularly if hypovolaemia is present, increases oxygenation in patients with acute respiratory distress syndrome (ARDS), and can lead to air trapping [4]‌. Respiratory centers in the brain integrate these inputs and provide neuronal drive to the respiratory muscles, which maintain upper airway patency and drive the thoracic bellows to determine the level of ventilation [ 1,2 ]. "controlled mechanical ventilation" is relatively an older terminology. To find out how to control or delete cookies in the web browser you are using visit www.aboutcookies.org. Brower RG and Rubenfeld RG. Citing Literature. Pressure-controlled and inverse-ratio ventilation. Andrew D Bersten, in Oh's Intensive Care Manual (Seventh Edition), 2014. When compared with assisted VCV (flow-controlled, volume-cycled), assisted PCV results in lower peak Paw and reduced workload [3]‌. The MVHR - Mechanical Ventilation Heat Recovery System is an automatic system for continuous operation for air changing: provides to suck air from the service rooms and delivers fresh and filtered in the noble rooms, after recovery most of the heat content in the exhaust air. Unique text laying out the principles and practicalities of mechanical ventilation aimed at any practitioner. Thus, the inspiratory to expiratory (I:E) ratio is less than 1. Ventilation is a function of mechanics and intrinsic PEEP: the adequacy of the level of ventilation needs to be carefully monitored. Journal of Applied Physiology, 110(5), 1374–83.Find this resource: 12. In a pressure controlled mode of ventilation, the inspiratory pressure is the control variable, and is maintained during … Amato MB and Marini JJ. This increases the risk for patient-ventilator dys-synchrony. (2004). Current Opinion in Critical Care, 12(1), 13–18.Find this resource: 18. These facts are taught to help simplify the understanding of mechanical ventilation, but unfortunately can limit your understanding especially in grasping advanced modes or . Approaches to conventional mechanical ventilation of the patient with acute respiratory distress syndrome. volume cycling - used in volume controlled ventilation where ventilator cycles to expiration once set Vt has been delivered In volume-controlled ventilators, the … Pressure-controlled mechanical ventilation. In inverse ratio ventilation (IRV) the TINSP is prolonged (I:E ratio is inversed), thereby increasing , and volume (V) during pressure-controlled (PCV) (left) and volume-controlled (VCV) (right) mechanical ventilation. ACV: Assist Control Ventilation VOLUME CONTROLLED ACV The patient makes an inspiratory effort, and every way to a normal mandatory breath. P¯ It is indicated in patients with severe neurological alterations, deep sedation, shock or severe respiratory failure. With volume-controlled modes, the clinician must set the flow pattern, flow rate, trigger sensitivity, tidal volume, respiratory rate, positive end-expiratory pressure (PEEP), and fraction of inspired oxygen (FiO2). Conversely, in an unpublished trial comparing SB and controlled ventilation (NCT01862016), the authors concluded that SB is feasible but did not improve outcomes in ARDS patients. At higher VR and decreases in TINSP, peak PA will not equilibrate to preset inspiratory pressure causing incomplete filling of slow lung compartments and a decline in VT. As a consequence, functional dead space to tidal volume ratio will increase, and CO2 elimination will be impaired by decreased alveolar ventilation. ◆ In volume-controlled modes, the clinician sets the flow pattern, flow rate, trigger sensitivity, tidal volume, respiratory rate, positive end-expiratory pressure (PEEP), and fraction of inspired oxygen (FiO2). © Oxford University Press, 2021. Nevertheless, clinicians should be cognizant of the fact that tidal volumes in excess of 700 mL have been associated with an increased risk of ARDS in post-operative patients with normal lungs. Intermittent mandatory ventilation. Inspiratory flow is greatest at the beginning of inspiration and decreases throughout the inspiratory cycle. While, in general, studies have demonstrated that it improves oxygenation, IRV has not been shown to improve clinical outcomes such as mortality or duration of mechanical ventilation. In mechanical ventilation, the pressure gradient results from increased (positive) pressure of the air source. Assisted PCV (PC-A/C) enables the patient to trigger the ventilator and in opposite to pressure-support ventilation (PSV) time and not flow determines the cycle off. ◆ Low tidal volume ventilation in conjunction with plateau pressure limitation should be employed in patients with acute respiratory distress syndrome (ARDS). Each breath terminates after delivery of the set tidal volume unless a pressure limit is exceeded. (1987). Airway pressure release ventilation (APRV). In controlled mechanical ventilation systems, the air is drawn in, filtered and pumped back in the rooms and bedroom. A ventilator is a machine that provides mechanical ventilation by moving breathable air into and out of the lungs, to deliver breaths to a patient who is physically unable to breathe, or breathing insufficiently.Ventilators are computerized microprocessor-controlled machines, but patients can also be ventilated with a simple, hand-operated bag valve mask. stockist The search for mechanical ventilation strategies that enhance lung-protection in patients with acute respiratory distress syn- Cardiorespiratory effects of pressure-controlled ventilation with and without inverse ratio in the adult respiratory distress syndrome. Volume-controlled, constant flow The pressure-time diagram shows the gradual changes in the airway pressure. ( In healthy patients breathing for themselves, the ratio of the time spent in inspiration to that in expiration is … The main risk of mechanical ventilation is an infection, as the artificial airway (breathing tube) may allow germs to enter the lung. While the term volume-controlled ventilation is commonly used, the ventilator actually is controlling the inspiratory flow. aw 2008 Oct-Dec;19(4):399-411 The link was not copied. Volume-controlled is the preferred mode of initial ventilation because it allows the calculation and administration of adequate minute ventilation; RR, respiratory rate, VT, tidal volume. Primarily used for patients who are apneic, such as C4 or above cervical injuries who have lost the phrenic nerve and can't breathe on their own (Think "C" for "Christopher") When allowing spontaneous breathing, lower levels of sedation are possible. In animals, prolonged CMV also triggers significant declines in diaphragm myofibril contractility. There are little data available regarding the benefits of one volume-controlled mode over another. The term utilized for this modality varies according to the designation created by the company. CHARACTERISTICS OF CMV CONTROLLED MECHANICAL VENTILATION CLIMAPAC BY COCIF. Most of the tidal volume is delivered early during inspiration and unless the flow rate is increased, the inspiratory time is lengthened with descending ramp flow. Controlled Mechanical Ventilation Preset TV and rate, ventilator does all work of breathing. ◆ When compared with flow-controlled, time-cycled (‘volume-controlled’) ventilation, PCV reduces peak airway pressure, while mean airway, and mean alveolar pressures and gas exchange improve. Oxford University Press makes no representation, express or implied, that the drug dosages in this book are correct. It is considered a dual mode of ventilation that uses a decelerating waveform. (p. 439) Written by noted educators Robert Kacmarek, James Stoller, and Albert Heuer, this edition includes new chapters on heart failure as well as ethics and end-of-life care, plus the latest AARC practice guidelines. In this mode, breathi … As long as enough controlled fresh outdoor air is … Pressure modes of invasive mechanical ventilation. this is a continuous, not a threshold variable. In pressure control mode, peak inspiratory pressure is selected and tidal volumes are variable. "plant" in a control circuit for mechanical ventilation is the patient. Because lower levels of sedation are used to allow spontaneous breathing, APRV should not be used in patients who require deep sedation for management of their underlying disease (e.g. Paw is airway pressure, PIP is peak airway pressure . ( Clinical Cytogenetics and Molecular Genetics, Anesthesiology: A Problem-Based Learning Approach, The European Society of Cardiology Textbooks, International Perspectives in Philosophy and Psychiatry, Oxford Specialty Training: Basic Sciences, Oxford Specialty Training: Revision Texts, Oxford Specialty Training: Revision Notes, Section 1 ICU organization and management, Chapter 3 Rapid response teams for the critically ill, Chapter 4 In-hospital transfer of the critically ill, Chapter 5 Pre- and inter-hospital transport of the critically ill and injured, Chapter 6 Regional critical care delivery systems, Chapter 7 Integration of information technology in the ICU, Chapter 8 Multiple casualties and disaster response in critical care, Chapter 9 Management of pandemic critical illness, Chapter 10 Effective teamwork in the ICU, Chapter 11 Communication with patients and families in the ICU, Chapter 12 Telemedicine in critical care, Chapter 13 Clinical skills in critical care, Chapter 14 Simulation training for critical care, Chapter 17 Policies, bundles, and protocols in critical care, Chapter 18 Managing biohazards and environmental safety, Chapter 19 Managing ICU staff welfare, morale, and burnout, Chapter 20 ICU admission and discharge criteria, Chapter 21 Resource management and budgeting in critical care, Chapter 22 Costs and cost-effectiveness in critical care, Chapter 23 Evidence-based practice in critical care, Part 1.7 Medico-legal and ethical issues, Chapter 27 Medico-legal liability in critical care, Part 1.8 Critical illness risk prediction, Chapter 28 The role and limitations of scoring systems, Chapter 29 Severity of illness scoring systems, Chapter 31 Genetic and molecular expression patterns in critical illness, Chapter 33 Bronchodilators in critical illness, Chapter 34 Vasopressors in critical illness, Chapter 35 Vasodilators in critical illness, Chapter 36 Inotropic agents in critical illness, Chapter 37 Anti-anginal agents in critical illness, Chapter 38 Anti-arrhythmics in critical illness, Chapter 39 Pulmonary vasodilators in critical illness, Chapter 40 Gastrointestinal motility drugs in critical illness, Chapter 41 Stress ulcer prophylaxis and treatment drugs in critical illness, Chapter 42 Sedatives and anti-anxiety agents in critical illness, Chapter 43 Analgesics in critical illness, Chapter 44 Antidepressants in critical illness, Chapter 45 Antiseizure agents in critical illness, Chapter 46 Inhalational anaesthetic agents in critical illness, Chapter 47 Muscle relaxants in critical illness, Chapter 48 Neuroprotective agents in critical illness, Chapter 49 Hormone therapies in critical illness, Chapter 50 Insulin and oral anti-hyperglycaemic agents in critical illness, Chapter 51 Anticoagulants and antithrombotics in critical illness, Chapter 52 Haemostatic agents in critical illness, Part 2.7 Antimicrobial and immunological drugs, Chapter 53 Antimicrobial drugs in critical illness, Chapter 55 Immunotherapy in critical illness, Chapter 57 Crystalloids in critical illness, Chapter 58 Diuretics in critical illness, Chapter 59 Airway management in cardiopulmonary resuscitation, Chapter 60 Artificial ventilation in cardiopulmonary resuscitation, Chapter 61 Pathophysiology and causes of cardiac arrest, Chapter 62 Cardiac massage and blood flow management during cardiac arrest, Chapter 63 Defibrillation and pacing during cardiac arrest, Chapter 64 Therapeutic strategies in managing cardiac arrest, Chapter 65 Post-cardiac arrest arrhythmias, Chapter 66 Management after resuscitation from cardiac arrest, Chapter 67 Ethical and end-of-life issues after cardiac arrest, Chapter 69 Choice of resuscitation fluid, Chapter 70 Therapeutic goals of fluid resuscitation, Chapter 71 Normal physiology of the respiratory system, Chapter 72 Blood gas analysis in the critically ill, Chapter 73 Pulse oximetry and capnography in the ICU, Chapter 74 Respiratory system compliance and resistance in the critically ill, Chapter 75 Gas exchange principles in the critically ill, Chapter 76 Gas exchange assessment in the critically ill, Chapter 77 Respiratory muscle function in the critically ill, Chapter 78 Imaging the respiratory system in the critically ill, Chapter 79 Upper airway obstruction in the critically ill, Chapter 80 Standard intubation in the ICU, Chapter 81 The difficult intubation in the ICU, Chapter 82 The surgical airway in the ICU, Chapter 83 Dyspnoea in the critically ill, Chapter 84 Pulmonary mechanical dysfunction in the critically ill, Chapter 85 Hypoxaemia in the critically ill, Chapter 86 Hypercapnia in the critically ill, Chapter 87 Cardiovascular interactions in respiratory failure, Chapter 88 Physiology of positive-pressure ventilation, Chapter 89 Respiratory support with continuous positive airways pressure, Chapter 90 Non-invasive positive-pressure ventilation, Chapter 91 Indications for mechanical ventilation, Chapter 92 Design and function of mechanical ventilators, Chapter 93 Setting rate, volume, and time in ventilatory support, Chapter 94 Respiratory support with positive end-expiratory pressure, Chapter 95 Volume-controlled mechanical ventilation, Chapter 96 Pressure-controlled mechanical ventilation, Chapter 98 High-frequency ventilation and oscillation, Chapter 100 Failure to ventilate in critical illness, Chapter 101 Ventilator trauma in the critically ill, Chapter 102 Assessment and technique of weaning, Chapter 103 Weaning failure in critical illness, Chapter 104 Extracorporeal respiratory and cardiac support techniques in the ICU, Chapter 105 Treating respiratory failure with extracorporeal support in the ICU, Chapter 106 Aspiration of gastric contents in the critically ill, Chapter 107 Inhalation injury in the ICU, Part 4.10 Acute respiratory distress syndrome, Chapter 108 Pathophysiology of acute respiratory distress syndrome, Chapter 109 Therapeutic strategy in acute respiratory distress syndrome, Chapter 110 Pathophysiology and causes of airflow limitation, Chapter 111 Therapeutic approach to bronchospasm and asthma, Chapter 112 Therapeutic strategy in acute or chronic airflow limitation, Part 4.12 Respiratory acidosis and alkalosis, Chapter 113 Pathophysiology and therapeutic strategy of respiratory acidosis, Chapter 114 Pathophysiology and therapeutic strategy of respiratory alkalosis, Chapter 115 Pathophysiology of pneumonia, Chapter 116 Diagnosis and management of community-acquired pneumonia, Chapter 117 Diagnosis and management of nosocomial pneumonia, Chapter 118 Diagnosis and management of atypical pneumonia, Part 4.14 Atelectasis and sputum retention, Chapter 119 Pathophysiology and prevention of sputum retention, Chapter 120 Lung recruitment techniques in the ICU, Chapter 121 Chest physiotherapy and tracheobronchial suction in the ICU, Chapter 122 Toilet bronchoscopy in the ICU, Chapter 123 Pathophysiology of pleural cavity disorders, Chapter 124 Management of pneumothorax and bronchial fistulae, Chapter 125 Management of pleural effusion and haemothorax, Chapter 126 Pathophysiology and causes of haemoptysis, Chapter 127 Therapeutic approach in haemoptysis, Chapter 128 Normal physiology of the cardiovascular system, Chapter 130 Arterial and venous cannulation in the ICU, Chapter 131 Blood pressure monitoring in the ICU, Chapter 132 Central venous pressure monitoring in the ICU, Chapter 133 Pulmonary artery catheterization in the ICU, Chapter 134 Mixed and central venous oxygen saturation monitoring in the ICU, Chapter 135 Right ventricular function in the ICU, Chapter 136 Cardiac output assessment in the ICU, Chapter 137 Oxygen transport in the critically ill, Chapter 138 Tissue perfusion monitoring in the ICU, Chapter 139 Lactate monitoring in the ICU, Chapter 140 Measurement of extravascular lung water in the ICU, Chapter 141 Doppler echocardiography in the ICU, Chapter 142 Monitoring the microcirculation in the ICU, Chapter 143 Imaging the cardiovascular system in the ICU, Part 5.3 Acute chest pain and coronary syndromes, Chapter 144 Causes and diagnosis of chest pain, Chapter 145 Pathophysiology of coronary syndromes, Chapter 146 Diagnosis and management of non-STEMI coronary syndromes, Chapter 147 Diagnosis and management of ST-elevation of myocardial infarction, Chapter 148 Pathophysiology, diagnosis, and management of aortic dissection, Chapter 150 Diagnosis and management of shock in the ICU, Chapter 151 Pathophysiology and causes of cardiac failure, Chapter 152 Therapeutic strategy in cardiac failure, Chapter 153 Intra-aortic balloon counterpulsation in the ICU, Chapter 154 Ventricular assist devices in the ICU, Chapter 155 Causes and diagnosis of tachyarrhythmias, Chapter 156 Therapeutic strategy in tachyarrhythmias, Chapter 157 Causes, diagnosis, and therapeutic strategy in bradyarrhythmias, Chapter 158 Causes and diagnosis of valvular problems, Chapter 159 Therapeutic strategy in valvular problems, Chapter 160 Pathophysiology and causes of endocarditis, Chapter 161 Prevention and treatment of endocarditis, Chapter 162 Pathophysiology and causes of severe hypertension, Chapter 163 Management of severe hypertension in the ICU, Chapter 164 Pathophysiology of severe capillary leak, Chapter 165 Management of acute non-cardiogenic pulmonary oedema, Chapter 166 Pathophysiology and causes of pericardial tamponade, Chapter 167 Management of pericardial tamponade, Chapter 168 Pathophysiology and causes of pulmonary hypertension, Chapter 169 Diagnosis and management of pulmonary hypertension, Chapter 170 Pathophysiology and causes of pulmonary embolism, Chapter 171 Diagnosis and management of pulmonary embolism, Chapter 172 Normal physiology of the gastrointestinal system, Chapter 173 Normal physiology of the hepatic system, Chapter 174 Imaging the abdomen in the critically ill, Chapter 175 Hepatic function in the critically ill, Chapter 176 Pathophysiology and causes of upper gastrointestinal haemorrhage, Chapter 177 Diagnosis and management of upper gastrointestinal haemorrhage in the critically ill, Chapter 178 Diagnosis and management of variceal bleeding in the critically ill, Chapter 179 Pathophysiology and causes of lower gastrointestinal haemorrhage, Chapter 180 Diagnosis and management of lower gastrointestinal haemorrhage in the critically ill, Chapter 181 Vomiting and large nasogastric aspirates in the critically ill, Chapter 182 Ileus and obstruction in the critically ill, Chapter 183 Diarrhoea and constipation in the critically ill, Chapter 184 Pathophysiology and management of raised intra-abdominal pressure in the critically ill, Chapter 185 Perforated viscus in the critically ill, Chapter 186 Ischaemic bowel in the critically ill, Chapter 187 Intra-abdominal sepsis in the critically ill, Chapter 188 Acute acalculous cholecystitis in the critically ill, Chapter 189 Management of the open abdomen and abdominal fistulae in the critically ill, Chapter 190 Pathophysiology, diagnosis, and assessment of acute pancreatitis, Chapter 191 Management of acute pancreatitis in the critically ill, Chapter 192 Pathophysiology and causes of jaundice in the critically ill, Chapter 193 Management of jaundice in the critically ill, Chapter 194 Pathophysiology and causes of acute hepatic failure, Chapter 195 Diagnosis and assessment of acute hepatic failure in the critically ill, Chapter 196 Management of acute hepatic failure in the critically ill, Chapter 197 The effect of acute hepatic failure on drug handling in the critically ill, Chapter 198 Extracorporeal liver support devices in the ICU, Part 6.9 Acute on chronic hepatic failure, Chapter 199 Pathophysiology, diagnosis, and assessment of acute or chronic hepatic failure, Chapter 200 Management of acute or chronic hepatic failure in the critically ill, Chapter 201 Normal physiology of nutrition, Chapter 202 The metabolic and nutritional response to critical illness, Chapter 203 Pathophysiology of nutritional failure in the critically ill, Chapter 204 Assessing nutritional status in the ICU, Chapter 205 Indirect calorimetry in the ICU, Chapter 206 Enteral nutrition in the ICU, Chapter 207 Parenteral nutrition in the ICU, Chapter 208 Normal physiology of the renal system, Part 8.2 Renal monitoring and risk prediction, Chapter 209 Monitoring renal function in the critically ill, Chapter 210 Imaging the urinary tract in the critically ill, Part 8.3 Oliguria and acute kidney injury, Chapter 211 Pathophysiology of oliguria and acute kidney injury, Chapter 212 Diagnosis of oliguria and acute kidney injury, Chapter 213 Management of oliguria and acute kidney injury in the critically ill, Chapter 214 Continuous haemofiltration techniques in the critically ill, Chapter 215 Haemodialysis in the critically ill, Chapter 216 Peritoneal dialysis in the critically ill, Chapter 217 The effect of renal failure on drug handling in critical illness, Chapter 218 The effect of chronic renal failure on critical illness, Chapter 219 Normal anatomy and physiology of the brain, Chapter 220 Normal anatomy and physiology of the spinal cord and peripheral nerves, Chapter 221 Electroencephalogram monitoring in the critically ill, Chapter 222 Cerebral blood flow and perfusion monitoring in the critically ill, Chapter 223 Intracranial pressure monitoring in the ICU, Chapter 224 Imaging the central nervous system in the critically ill, Chapter 225 Pathophysiology and therapeutic strategy for sleep disturbance in the ICU, Part 9.4 Agitation, confusion, and delirium, Chapter 226 Causes and epidemiology of agitation, confusion, and delirium in the ICU, Chapter 227 Assessment and therapeutic strategy for agitation, confusion, and delirium in the ICU, Chapter 228 Causes and diagnosis of unconsciousness, Chapter 229 Management of unconsciousness in the ICU, Chapter 230 Non-pharmacological neuroprotection in the ICU, Chapter 231 Pathophysiology and causes of seizures, Chapter 232 Assessment and management of seizures in the critically ill, Chapter 233 Causes and management of intracranial hypertension, Chapter 235 Diagnosis and assessment of stroke, Chapter 236 Management of ischaemic stroke, Chapter 237 Management of parenchymal haemorrhage, Part 9.9 Non-traumatic subarachnoid haemorrhage, Chapter 238 Epidemiology, diagnosis, and assessment on non-traumatic subarachnoid haemorrhage, Chapter 239 Management of non-traumatic subarachnoid haemorrhage in the critically ill, Chapter 240 Epidemiology, diagnosis, and assessment of meningitis and encephalitis, Chapter 241 Management of meningitis and encephalitis in the critically ill, Chapter 242 Pathophysiology, causes, and management of non-traumatic spinal injury, Chapter 243 Epidemiology, diagnosis, and assessment of neuromuscular syndromes, Chapter 244 Diagnosis, assessment, and management of myasthenia gravis and paramyasthenic syndromes, Chapter 245 Diagnosis, assessment, and management of tetanus, rabies, and botulism, Chapter 246 Diagnosis, assessment, and management of Guillain–Barré syndrome, Chapter 247 Diagnosis, assessment, and management of hyperthermic crises, Chapter 248 Diagnosis, assessment, and management of ICU-acquired weakness, Section 10 The metabolic and endocrine systems, Chapter 249 Normal physiology of the endocrine system, Chapter 250 Disorders of sodium in the critically ill, Chapter 251 Disorders of potassium in the critically ill, Chapter 252 Disorders of magnesium in the critically ill, Chapter 253 Disorders of calcium in the critically ill, Chapter 254 Disorders of phosphate in the critically ill, Part 10.3 Metabolic acidosis and alkalosis, Chapter 255 Pathophysiology and causes of metabolic acidosis in the critically ill, Chapter 256 Management of metabolic acidosis in the critically ill, Chapter 257 Pathophysiology, causes, and management of metabolic alkalosis in the critically ill, Chapter 258 Pathophysiology of glucose control, Chapter 259 Glycaemic control in critical illness, Chapter 260 Management of diabetic emergencies in the critically ill, Chapter 261 Pathophysiology and management of adrenal disorders in the critically ill, Chapter 262 Pathophysiology and management of pituitary disorders in the critically ill, Chapter 263 Pathophysiology and management of thyroid disorders in the critically ill, Chapter 264 Pathophysiology and management of functional endocrine tumours in the critically ill, Chapter 265 The blood cells and blood count, Chapter 267 Blood product therapy in the ICU, Chapter 269 Pathophysiology of disordered coagulation, Chapter 270 Disseminated intravascular coagulation in the critically ill, Chapter 271 Prevention and management of thrombosis in the critically ill, Chapter 272 Thrombocytopenia in the critically ill, Chapter 273 Pathophysiology and management of anaemia in the critically ill, Chapter 274 Pathophysiology and management of neutropenia in the critically ill, Chapter 275 Sickle crisis in the critically ill, Section 12 The skin and connective tissue, Part 12.1 Skin and connective tissue disorders, Chapter 276 Assessment and management of dermatological problems in the critically ill, Chapter 277 Vasculitis in the critically ill, Chapter 278 Rheumatoid arthritis in the critically ill, Part 12.2 Wound and pressure sore management, Chapter 279 Principles and prevention of pressure sores in the ICU, Chapter 280 Dressing techniques for wounds in the critically ill, Chapter 281 Microbiological surveillance in the critically ill, Chapter 282 Novel biomarkers of infection in the critically ill, Chapter 283 Definition, epidemiology, and general management of nosocomial infection, Chapter 284 Healthcare worker screening for nosocomial pathogens, Chapter 285 Environmental decontamination and isolation strategies in the ICU, Chapter 286 Antimicrobial selection policies in the ICU, Chapter 287 Oral, nasopharyngeal, and gut decontamination in the ICU, Chapter 288 Diagnosis, prevention, and treatment of device-related infection in the ICU, Chapter 289 Antibiotic resistance in the ICU, Part 13.3 Infection in the immunocompromised, Chapter 290 Drug-induced depression of immunity in the critically ill, Chapter 292 Diagnosis and management of malaria in the ICU, Chapter 293 Diagnosis and management of viral haemorrhagic fevers in the ICU, Chapter 294 Other tropical diseases in the ICU, Chapter 295 Assessment of sepsis in the critically ill, Chapter 296 Management of sepsis in the critically ill, Chapter 297 Pathophysiology of septic shock, Chapter 298 Management of septic shock in the critically ill, Chapter 299 Innate immunity and the inflammatory cascade, Chapter 300 Brain injury biomarkers in the critically ill, Chapter 301 Cardiac injury biomarkers in the critically ill, Chapter 302 Renal injury biomarkers in the critically ill, Chapter 303 The host response to infection in the critically ill, Chapter 304 The host response to trauma and burns in the critically ill, Chapter 305 The host response to hypoxia in the critically ill, Chapter 306 Host–pathogen interactions in the critically ill, Chapter 307 Coagulation and the endothelium in acute injury in the critically ill, Chapter 308 Ischaemia-reperfusion injury in the critically ill, Chapter 309 Repair and recovery mechanisms following critical illness, Chapter 310 Neural and endocrine function in the immune response to critical illness, Chapter 311 Adaptive immunity in critical illness, Chapter 312 Immunomodulation strategies in the critically ill, Chapter 313 Immunoparesis in the critically ill, Chapter 314 Pathophysiology and management of anaphylaxis in the critically ill, Chapter 315 Role of toxicology assessment in poisoning, Chapter 316 Decontamination and enhanced elimination of poisons, Part 15.2 Management of specific poisons, Chapter 317 Management of salicylate poisoning, Chapter 318 Management of acetaminophen (paracetamol) poisoning, Chapter 319 Management of opioid poisoning, Chapter 320 Management of benzodiazepine poisoning, Chapter 321 Management of tricyclic antidepressant poisoning, Chapter 322 Management of poisoning by amphetamine or ecstasy, Chapter 323 Management of digoxin poisoning, Chapter 324 Management of cocaine poisoning, Chapter 326 Management of cyanide poisoning, Chapter 327 Management of alcohol poisoning, Chapter 328 Management of carbon monoxide poisoning, Chapter 329 Management of corrosive poisoning, Chapter 330 Management of pesticide and agricultural chemical poisoning, Chapter 331 Management of radiation poisoning, Chapter 332 A systematic approach to the injured patient, Chapter 333 Pathophysiology and management of thoracic injury, Chapter 334 Pathophysiology and management of abdominal injury, Chapter 335 Management of vascular injuries, Chapter 336 Management of limb and pelvic injuries, Chapter 337 Assessment and management of fat embolism, Chapter 338 Assessment and management of combat trauma, Chapter 339 Pathophysiology of ballistic trauma, Chapter 340 Assessment and management of ballistic trauma, Chapter 341 Epidemiology and pathophysiology of traumatic brain injury, Chapter 342 Assessment of traumatic brain injury, Chapter 343 Management of traumatic brain injury, Chapter 344 Assessment and immediate management of spinal cord injury, Chapter 345 Ongoing management of the tetraplegic patient in the ICU, Chapter 346 Pathophysiology and assessment of burns, Chapter 347 Management of burns in the ICU, Chapter 348 Pathophysiology and management of drowning, Chapter 349 Pathophysiology and management of electrocution, Part 17.3 Altitude- and depth-related disorders, Chapter 350 Pathophysiology and management of altitude-related disorders, Chapter 351 Pathophysiology and management of depth-related disorders, Chapter 352 Pathophysiology and management of fever, Chapter 353 Pathophysiology and management of hyperthermia, Chapter 354 Pathophysiology and management of hypothermia, Chapter 355 Pathophysiology and management of rhabdomyolysis, Chapter 356 Pathophysiology and assessment of pain, Chapter 357 Pain management in the critically ill, Chapter 358 Sedation assessment in the critically ill, Chapter 359 Management of sedation in the critically ill, Section 19 General surgical and obstetric intensive care, Part 19.1 Optimization strategies for the high-risk surgical patient, Chapter 360 Identification of the high-risk surgical patient, Chapter 361 Peri-operative optimization of the high risk surgical patient, Part 19.2 General post-operative intensive care, Chapter 362 Post-operative ventilatory dysfunction management in the ICU, Chapter 363 Post-operative fluid and circulatory management in the ICU, Chapter 364 Enhanced surgical recovery programmes in the ICU, Chapter 365 Obstetric physiology and special considerations in ICU, Chapter 366 Pathophysiology and management of pre-eclampsia, eclampsia, and HELLP syndrome, Chapter 367 Obstetric Disorders in the ICU, Part 20.1 Specialized surgical intensive care, Chapter 368 Intensive care management after cardiothoracic surgery, Chapter 369 Intensive care management after neurosurgery, Chapter 370 Intensive care management after vascular surgery, Chapter 371 Intensive care management in hepatic and other abdominal organ transplantation, Chapter 372 Intensive care management in cardiac transplantation, Chapter 373 Intensive care management in lung transplantation, Chapter 374 ICU selection and outcome of patients with haematological malignancy, Chapter 375 Management of the bone marrow transplant recipient in ICU, Chapter 376 Management of oncological complications in the ICU, Section 21 Recovery from critical illness, Part 21.1 In-hospital recovery from critical illness, Chapter 378 Promoting physical recovery in critical illness, Chapter 379 Promoting renal recovery in critical illness, Chapter 380 Recovering from critical illness in hospital, Part 21.2 Complications of critical illness, Chapter 381 Physical consequences of critical illness, Chapter 382 Neurocognitive impairment after critical illness, Chapter 383 Affective and mood disorders after critical illness, Part 21.3 Out-of-hospital support after critical illness, Chapter 384 Long-term weaning centres in critical care, Chapter 386 Rehabilitation from critical illness after hospital discharge, Part 22.1 Withdrawing and withholding treatment, Chapter 387 Ethical decision making in withdrawing and withholding treatment, Chapter 388 Management of the dying patient, Part 22.2 Management of the potential organ donor, Chapter 389 Beating heart organ donation, Chapter 390 Non-heart-beating organ donation, Chapter 391 Post-mortem examination in the ICU.

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