Download ACCP Critical Care Medicine Board Review: 21st Edition 2012 by American College of Chest Physicians PDF

By American College of Chest Physicians

ACCP serious Care drugs Board assessment: twenty first Edition
DOI: 10.5555/978-0-916609-76-4


Chapter 1. Endocrine Emergencies unfastened TO VIEW
Chapter 2. Postoperative Crises
Chapter three. Mechanical Ventilation
Chapter four. Hypertensive Emergencies and Urgencies
Chapter five. being pregnant and significant Illness
Chapter 6. Venous Thromboembolic Disease
Chapter 7. Acute Coronary Syndromes
Chapter eight. middle Failure and Cardiac Pulmonary Edema
Chapter nine. Acute and persistent Liver Failure within the ICU
Chapter 10. Hemodynamic Monitoring
Chapter eleven. Tachycardia and Bradycardia within the ICU
Chapter 12. Infections in AIDS sufferers and different Immunocompromised Hosts
Chapter thirteen. Liberation From Mechanical Ventilation
Chapter 14. Trauma and Burns
Chapter 15. Airway administration, Sedation, and Paralytic Agents
Chapter sixteen. Acute Lung Injury/Acute breathing misery Syndrome
Chapter 17. Coma and Delirium
Chapter 18. the extreme stomach, Pancreatitis, and the stomach Compartment Syndrome
Chapter 19. Hypothermia/Hyperthermia and Rhabdomyolysis
Chapter 20. Ventilatory Crises
Chapter 21. Poisonings and Overdoses
Chapter 22. Anemia and RBC Transfusion within the ICU
Chapter 23. Shock
Chapter 24. Coagulopathies, Bleeding problems, and Blood part Therapy
Chapter 25. Gastrointestinal Bleeding within the ICU
Chapter 26. Nutrition
Chapter 27. Resuscitation: Cooling, medicinal drugs, and Fluids
Chapter 28. moral matters in extensive Care Medicine
Chapter 29. examining scientific study and figuring out Diagnostic checks in serious Care Medicine
Chapter 30. Imaging
Chapter 31. method of Acid-Base Disorders
Chapter 32. serious Pneumonia
Chapter 33. ICU instructions, top Practices, and Standardization
Chapter 34. prestige Epilepticus, Stroke, and elevated Intracranial Pressure
Chapter 35. Derangements of Serum Potassium, Sodium, Calcium, Phosphate, and Magnesium
Chapter 36. Antibiotic treatment in severe Illness
Chapter 37. Transplant-Related Issues
Chapter 38. Acute Kidney damage within the ICU
Chapter 39. frightened process Infections and Catheter Infections

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Additional resources for ACCP Critical Care Medicine Board Review: 21st Edition 2012

Sample text

Org/ 07/19/2012 ACCP Care Medicine Board Review:on21st Edition desired (eg, to strengthen or improve the coordination of the respiratory muscles; to assess the ability of the patient to sustain the work of breathing; or to begin spontaneous ventilation). It is important for the intensivist to be explicit about whether the respiratory muscles should be rested or exercised because the details of ventilation (mode, settings) usually follow logically from this fundamental point. For example, in a patient in profound shock, the ventilator should be set to fully take over the work of breathing (eg, using volume assist-control) while the flow and pressure waveforms are examined to determine whether this goal has been met.

Pay particular attention in the first hour to patient-ventilator synchrony, using waveform displays as a guide. Management of the Patient’s Initial Ventilator Settings Initial ventilator settings depend on the goals of ventilation (eg, full respiratory muscle rest vs partial exercise), the patient’s respiratory system mechanics, and minute ventilation needs. Although each critically ill patient presents myriad challenges, it is possible to identify five subsets of ventilated patients: (1) the patient with normal lung mechanics and gas exchange; (2) the patient with severe airflow obstruction; (3) the patient with acute-on-chronic respiratory failure; (4) the patient with acute hypoxemic respiratory failure, and (5) the patient with restrictive lung or chest wall disease.

When the goal of ventilation is to rest the respiratory muscles, ventilator adjustments, psychological measures, and pharmacologic sedation all may be effective. Ventilator strategies to reduce the patient’s work of breathing include increasing the minute ventilation to reduce PCO2 (although this may run counter to other goals of ventilation, especially in patients with ARDS or severe obstruction), increasing the inspiratory flow rate, and changing the mode to pressure-preset ventilation (PSV or PACV).

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