[...]...x Current Essentials of Critical Care Mallory D Witt, MD Associate Professor of Clinical Medicine, David Geffen School of Medicine at UCLA, Division of HIV Medicine, Department of Medicine, Harbor-UCLA Medical Center Torrance, California Preface Our goal in this book is to provide the reader with only the most crucial and important points for the variety of disorders likely to... Pearl Daily interruption of sedation reduces duration of mechanical ventilation, length of ICU stay, and number of diagnostic studies for unexplained altered mental status Reference Kress JP et al: Daily interruption of sedative infusions in critically ill patients undergoing mechanical ventilation N Engl J Med 2000;34:1471 [PMID: 10816184] 4 Current Essentials of Critical Care Arterial Pressure Monitoring... al: Prevention of venous thromboembolism Chest 2001;119(1 Suppl):132S [PMID: 11157647] 8 Current Essentials of Critical Care Delirium ■ Essentials of Diagnosis • • • • • ■ Differential Diagnosis • ■ Anxiety, depression, psychosis; treatment with neuroleptic agents, neuroleptic malignant syndrome Treatment • • • • • ■ Agitation, altered sensorium, disorientation, waxing and waning of level of consciousness,... infection, cortical damage • ■ Pearl Misinterpretation of the data obtained from an ICP monitoring system may result in improper choice of therapeutic intervention Reference Doyle DJ et al: Analysis of intracranial pressure J Clin Monit 1992;8:81 [PMID: 1538258] 14 Current Essentials of Critical Care Nutrition, Enteral ■ Essential Concepts • • • • • ■ Essentials of Management • • • • • • • • ■ Enteral feeding... Board of Directors and the Clinical Guidelines Task Force Guidelines for the use of parenteral and enteral nutrition in adult and pediatric patients JPEN J Parenter Enteral Nutr 2002;26(1 Suppl):1SA [PMID: 11841046] 16 Current Essentials of Critical Care Nutritional Support ■ Essential Concepts Critically ill patients often malnourished beforehand; severe illness associated with increased breakdown of. .. 2000; 120:1989 [PMID: 11742933] 18 Current Essentials of Critical Care Pain ■ Essentials of Diagnosis • • • • • ■ Differential Diagnosis • • • • ■ Hypoxemia Drug reactions Anxiety Delirium Treatment • • • • • • • ■ Frequent complaint of ICU patients; relief of pain results in better outcomes May not be expressed by patient, especially if sedated, delirious, altered level of consciousness; may show restlessness,... uses and controversies Crit Care Clin 2001;17:271-91 [PMID: 11450316] 20 Current Essentials of Critical Care Pulse Oximetry ■ Essential Concepts • • • • • ■ Essentials of Management • • • • • • • • ■ Finger, ear, or other cutaneous probe measures transmission or reflectance of red and infrared light through tissue Pulsatile absorbance (“beat-to-beat”) determines percentage of oxyhemoglobin in blood Oxyhemoglobin,... intensive care unit, including the key first steps in diagnosis, confirmation of diagnosis, and initial management strategies In preparing the manuscript, we were struck by several insights First was the importance of general supportive care of the patient regardless of the primary diagnosis leading to admission to the ICU Paying attention to prevention of aspiration pneumonia, reduction of risk for... glucose in postoperative patients, positioning patients to reduce the risk of nosocomial pneumonia, and preventing complications in status asthmaticus Those who take care of critically ill patients should look forward to more and better investigations that will help us improve care and outcomes Following in the footsteps of Essentials of Diagnosis and Treatment, we have tried to include a Clinical Pearl... challenge and we look forward to augmenting and updating both of these features xi xii Current Essentials of Critical Care We want to thank our colleagues at McGraw-Hill, Jack Farrell, for considering us for this project, and Shelley Reinhardt, for help and encouragement We are grateful to our contributors for enthusiastically taking on the challenge of this book Finally, we also would like to thank our families . h1" alt="" CURRENT ESSENTIALS of CRITICAL CARE Edited by Darryl Y. Sue, MD Professor of Clinical Medicine David Geffen School of Medicine at UCLA Division of Respiratory and Critical Care Physiology. 293 viii Current Essentials of Critical Care 5065_efm1_pi-xii 8/17/04 10:10 AM Page viii Contributors Chan-Chou Chuang, MD Attending Physician, Division of Respiratory and Critical Care Physiology. Clinical Professor of Medicine, David Geffen School of Medicine at UCLA, Division of General Internal Medicine and Division of Respiratory and Critical Care Physiology and Medicine, Department of Medicine,