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Books on the topic 'Acute intensive care unit'

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Published: 4 June 2021
Last updated: 4 February 2022

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1

European Society of Cardiology. Working Group on Acute Cardiac Care, ed. The ESC textbook of acute and intensive cardiac care. Oxford: Oxford University Press, 2011.

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2

The PICU book: A primer for medical students, residents and acute care practitioners. Singapore: World Scientific, 2012.

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3

Stapleton, David C., and Sally J. Kaplan. Ventilator dependent unit demonstration: Outcome evaluation and assessment of post acute care. [Fairfax, Va.?]: Lewin-VHI, 1996.

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4

2013), Summer Conference in Intensive Care Medicine (10th. Acute cardiac care: Selected proceedings from the 10th Summer Conference in Intensive Care Medicine. Mount Prospect, IL: Society of Critical Care Medicine, 2013.

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5

Booth, Sara. Palliative care in the acute hospital setting: A practical guide. Oxford: Oxford University Press, 2010.

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6

Sara, Booth. Palliative care in the acute hospital setting: A practical guide. Oxford: Oxford University Press, 2010.

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7

Booth, Sara. Palliative care in the acute hospital setting: A practical guide. Oxford: Oxford University Press, 2010.

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8

Debora, Downey, ed. Augmentative and alternative communication in acute and critical care settings. San Diego: Plural Pub., 2008.

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9

Bihari, David, and Guy Neild, eds. Acute Renal Failure in the Intensive Therapy Unit. London: Springer London, 1990. http://dx.doi.org/10.1007/978-1-4471-1750-6.

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10

Daniel, Teres, ed. Gatekeeping in the intensive care unit. Chicago, Ill: Health Administration Press, 1997.

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11

Esquinas, Antonio Matías, ed. Humidification in the Intensive Care Unit. Berlin, Heidelberg: Springer Berlin Heidelberg, 2012. http://dx.doi.org/10.1007/978-3-642-02974-5.

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12

Juffermans, Nicole P., and Timothy S. Walsh, eds. Transfusion in the Intensive Care Unit. Cham: Springer International Publishing, 2015. http://dx.doi.org/10.1007/978-3-319-08735-1.

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13

Netzer, Giora, ed. Families in the Intensive Care Unit. Cham: Springer International Publishing, 2018. http://dx.doi.org/10.1007/978-3-319-94337-4.

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14

Jankowich, Matthew, and Eric Gartman, eds. Ultrasound in the Intensive Care Unit. New York, NY: Springer New York, 2015. http://dx.doi.org/10.1007/978-1-4939-1723-5.

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15

Jaggar, Siân, and Helen Laycock. Acute pain in the intensive cardiac care unit. Oxford University Press, 2015. http://dx.doi.org/10.1093/med/9780199687039.003.0073.

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◆ Cardiac intensive care units admit a heterogeneous patient group◆ Pain is common, occurring in up to 70% of medical and surgical patients◆ Effective analgesia is important◆ Pain is under-recognized and inadequately treated, particularly in medical patients◆ Consequences of pain are widespread, involving multisystem physiological changes◆ Pain causes significant psychological sequelae for patients, and ethical implications for physicians◆ Pain management should utilize a systematic approach. Ensuring optimal patient comfort requires:○ Understanding of the potential causes of pain in cardiac intensive care○ Using validated pain assessment tools to identify the presence of pain and evaluate treatment effects○ Employing a multimodal, multidisciplinary management strategy
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16

Jaggar, Siân, and Helen Laycock. Acute pain in the intensive cardiac care unit. Oxford University Press, 2016. http://dx.doi.org/10.1093/med/9780199687039.003.0073_update_001.

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◆ Cardiac intensive care units admit a heterogeneous patient group◆ Pain is common, occurring in up to 70% of medical and surgical patients◆ Effective analgesia is important◆ Pain is under-recognized and inadequately treated, particularly in medical patients◆ Consequences of pain are widespread, involving multisystem physiological changes◆ Pain causes significant psychological sequelae for patients, and ethical implications for physicians◆ Pain management should utilize a systematic approach. Ensuring optimal patient comfort requires:○ Understanding of the potential causes of pain in cardiac intensive care○ Using validated pain assessment tools to identify the presence of pain and evaluate treatment effects○ Employing a multimodal, multidisciplinary management strategy
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17

1954-, Bihari David, Neild Guy 1948-, and Fisons Limited, eds. Acute renal failure in the intensive therapy unit. London: Springer-Verlag, 1990.

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18

Garner, Justin, and David Treacher. Intensive care unit and ventilation. Oxford University Press, 2017. http://dx.doi.org/10.1093/med/9780199657742.003.0009.

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Acute lung injury (ALI) and acute respiratory distress syndrome (ARDS) are characterized by rapidly developing hypoxaemic respiratory failure and bilateral pulmonary infiltrates on chest X-ray. ALI/ARDS are a relatively frequent diagnosis in protracted-stay patients in the intensive care unit. The pathology is a non-specific response to a wide variety of insults. Impaired gas exchange, ventilation-perfusion mismatch, and reduced compliance ensue. Mechanical ventilation is the mainstay of management, along with treatment of the underlying cause. Mortality remains very high at around 40%. The condition is challenging to treat. Injury to the lungs, indistinguishable from that of ARDS, has been attributed to the use of excessive tidal volumes, pressures, and repeated opening and collapsing of alveoli. Lung-protective strategies aim to minimize the effects of ventilator-induced lung injury. Use of low tidal volume ventilation has been shown to improve mortality. Emerging ventilatory therapies include high-frequency oscillatory ventilation and extracorporeal membrane oxygenation.
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19

J, Bihari D., and Neild Guy 1948-, eds. Acute renal failure in the intensive therapy unit. London: Springer Verlag, 1990.

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20

Bishop, Gillian, and Ken Hillman. Clinical Intensive Care and Acute Medicine. 2nd ed. Cambridge University Press, 2004.

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21

Nelson, Bret P., ed. Acute Care Casebook. Oxford University Press, 2018. http://dx.doi.org/10.1093/med/9780190865412.001.0001.

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Acute Care Casebook provides a case-based approach to the broad practice of acute care medicine, covering a variety of common patient presentations and clinical environments. This book features over 70 illustrated cases, including presentations of trauma and medical illness in wilderness medicine, military and prehospital environments, pediatrics, emergency medicine, and intensive care unit and floor emergencies. Designed for students and trainees in medicine, nursing, emergency medical services, and other acute care specialties, this text guides readers through not only symptom evaluation and treatment but also the thought process and priorities of experienced clinicians. Each chapter features key diagnoses and management pearls from leading experts that will help prepare readers for any event, from stabilizing and transporting a trauma patient in the field, to managing postoperative complications in the intensive care unit.
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22

Wood, Jayne, and Maureen Carruthers. Palliative care in the intensive cardiac care unit. Oxford University Press, 2015. http://dx.doi.org/10.1093/med/9780199687039.003.0078.

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Specialist palliative care services originally focused on improving the quality of life for patients with a diagnosis of cancer in the terminal phase of their illness. However, organizations, such as the World Health Organization, supported by recent national strategies, such as the End of Life Care Strategy (United Kingdom, 2008), promote the early integration of specialist palliative care into the management of patients with incurable disease, irrespective of the diagnosis. The primary goal of the intensive cardiac care unit is to help patients survive acute threats to their lives. However, the suddenness and severity of illness, particularly when associated with an underlying cardiological diagnosis, often means that the provision of optimal specialist palliative care is challenging. This chapter addresses key issues relating to the provision of specialist palliative care in the challenging and complex environment of the intensive cardiac care unit, including symptom control, end of life care, decision making, and communication. The benefits of multidisciplinary working for effective quality improvement in patient care and best support for patients, families/carers, and staff are also addressed. The importance of interdisciplinary working is highlighted, and, by embedding the principles of holistic care into daily practice, the intensive cardiac care unit can ensure that patients and their families/carers receive the support they need in a timely manner from individuals who are well supported in what is often considered to be one of the most challenging medical environments.
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23

Cist, Alexandra, and Philip Choi. Religion and Spirituality in the Intensive Care Unit. Oxford University Press, 2017. http://dx.doi.org/10.1093/med/9780190272432.003.0011.

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The Intensive Care Unit is an area of the hospital that can elicit high levels of emotional and spiritual distress due to high mortality and prognostic uncertainty. Religion and spirituality are often manifest through prayer, rituals, and ceremonies, which can unite the patient and family with the care team. However, miracle language and other religious or spiritual topics that misalign with the expectations of the medical team can also lead to discord. The acute nature of ICU care poses challenges in creating a therapeutic alliance necessary to effectively address the religious and spiritual needs of patients and families. In this chapter, we provide a practical approach to provide high quality spiritual care in the ICU.
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24

Schwitter, Juerg, and Jens Bremerich. Cardiac magnetic resonance in the intensive and cardiac care unit. Oxford University Press, 2015. http://dx.doi.org/10.1093/med/9780199687039.003.0023.

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Current applications of cardiac magnetic resonance offer a wide spectrum of indications in the setting of acute cardiac care. In particular, cardiac magnetic resonance is helpful for the differential diagnosis of chest pain by the detection of ischaemia, myocardial stunning, myocarditis, and pericarditis. Also, Takotsubo cardiomyopathy and acute aortic diseases can be evaluated by cardiac magnetic resonance and are important differential diagnoses in patients with acute chest pain. In patients with restricted windows for echocardiography, according to guidelines, cardiac magnetic resonance is the method of choice to evaluate complications of an acute myocardial infarction. In an acute myocardial infarction, cardiac magnetic resonance allows for a unique characterization of myocardial damage by quantifying necrosis, microvascular obstruction, oedema (i.e. area at risk), and haemorrhage. These features will help us to understand better the pathophysiological events during infarction and will also allow us to assess new treatment strategies in acute myocardial infarction. To which extent the information on tissue damage will guide patient management is not yet clear, and further research, e.g. in the setting of the European Cardiovascular MR registry, is ongoing to address this issue. Recent studies also demonstrated the possiblity to reduce costs in the management of acute coronary syndromes when cardiac magnetic resonance is integrated into the routine work-up. In the near future, applications of cardiac magnetic resonance will continue to expand in the acute cardiac care units, as manufacturers are now strongly focusing on this aspect of user-friendliness. Finally, in the next decade or so, magnetic resonance imaging of other nuclei, such as fluorine and carbon, might become a reality in clinics, which would allow for metabolic and targeted molecular imaging with excellent sensitivity and specificity.
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25

Schwitter, Juerg, and Jens Bremerich. Cardiac magnetic resonance in the intensive and cardiac care unit. Oxford University Press, 2016. http://dx.doi.org/10.1093/med/9780199687039.003.0023_update_001.

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Current applications of cardiac magnetic resonance offer a wide spectrum of indications in the setting of acute cardiac care. In particular, cardiac magnetic resonance is helpful for the differential diagnosis of chest pain by the detection of ischaemia, myocardial stunning, myocarditis, and pericarditis. Also, Takotsubo cardiomyopathy and acute aortic diseases can be evaluated by cardiac magnetic resonance and are important differential diagnoses in patients with acute chest pain. In patients with restricted windows for echocardiography, according to guidelines, cardiac magnetic resonance is the method of choice to evaluate complications of an acute myocardial infarction. In an acute myocardial infarction, cardiac magnetic resonance allows for a unique characterization of myocardial damage by quantifying necrosis, microvascular obstruction, oedema (i.e. area at risk), and haemorrhage. These features will help us to understand better the pathophysiological events during infarction and will also allow us to assess new treatment strategies in acute myocardial infarction. To which extent the information on tissue damage will guide patient management is not yet clear, and further research, e.g. in the setting of the European Cardiovascular MR registry, is ongoing to address this issue. Recent studies also demonstrated the possiblity to reduce costs in the management of acute coronary syndromes when cardiac magnetic resonance is integrated into the routine work-up. In the near future, applications of cardiac magnetic resonance will continue to expand in the acute cardiac care units, as manufacturers are now strongly focusing on this aspect of user-friendliness. Finally, in the next decade or so, magnetic resonance imaging of other nuclei, such as fluorine and carbon, might become a reality in clinics, which would allow for metabolic and targeted molecular imaging with excellent sensitivity and specificity.
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26

Schwitter, Juerg, and Jens Bremerich. Cardiac magnetic resonance in the intensive and cardiac care unit. Oxford University Press, 2018. http://dx.doi.org/10.1093/med/9780199687039.003.0023_update_002.

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Current applications of cardiac magnetic resonance offer a wide spectrum of indications in the setting of acute cardiac care. In particular, cardiac magnetic resonance is helpful for the differential diagnosis of chest pain by the detection of ischaemia, myocardial stunning, myocarditis, and pericarditis. Also, Takotsubo cardiomyopathy and acute aortic diseases can be evaluated by cardiac magnetic resonance and are important differential diagnoses in patients with acute chest pain. In patients with restricted windows for echocardiography, according to guidelines, cardiac magnetic resonance is the method of choice to evaluate complications of an acute myocardial infarction. In an acute myocardial infarction, cardiac magnetic resonance allows for a unique characterization of myocardial damage by quantifying necrosis, microvascular obstruction, oedema (i.e. area at risk), and haemorrhage. These features will help us to understand better the pathophysiological events during infarction and will also allow us to assess new treatment strategies in acute myocardial infarction. To which extent the information on tissue damage will guide patient management is not yet clear, and further research, e.g. in the setting of the European Cardiovascular MR registry, is ongoing to address this issue. Recent studies also demonstrated the possiblity to reduce costs in the management of acute coronary syndromes when cardiac magnetic resonance is integrated into the routine work-up. In the near future, applications of cardiac magnetic resonance will continue to expand in the acute cardiac care units, as manufacturers are now strongly focusing on this aspect of user-friendliness. Finally, in the next decade or so, magnetic resonance imaging of other nuclei, such as fluorine and carbon, might become a reality in clinics, which would allow for metabolic and targeted molecular imaging with excellent sensitivity and specificity.
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27

Paul, Richard. Ultrasound-guided vascular access in intensive/acute cardiac care. Oxford University Press, 2015. http://dx.doi.org/10.1093/med/9780199687039.003.0021.

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Vascular access is an essential requirement for the care of the critically ill cardiac patient, being necessary for drug and fluid delivery and monitoring of a patient’s haemodynamic response to an instigated therapy. The most common vascular access procedures conducted in the acute cardiac care unit are central venous and peripheral venous access, and arterial cannulation. Traditional landmark methods are associated with complication rates, ranging from 18 to 40%, depending on the site of access. The use of ultrasound to guide venous and arterial access has been shown to reduce the incidence of complications, such as inadvertent arterial puncture and pneumothorax formation (venous) and posterior wall puncture (arterial), to reduce the time taken and number of attempts to place a catheter, and to reduce the incidence of complete failure to insert a vascular access device. Since 2002, international consensus groups have published recommendations that two-dimensional ultrasound guidance be the preferred method for elective and emergency internal jugular catheter insertion. This chapter explores the evidence for the use of ultrasound to guide vascular access across multiple sites of insertion and describes the basic equipment and techniques necessary for successful deployment.
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28

Acute Care Handbook For Physical Therapists. Elsevier - Health Sciences Division, 2013.

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29

Acute Care Handbook for Physical Therapists. Elsevier - Health Sciences Division, 2019.

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30

Giuseffi, Jennifer, John McPherson, Chad Wagner, and E. Wesley Ely. Acute cognitive disorders: recognition and management of delirium in the cardiovascular intensive care unit. Oxford University Press, 2015. http://dx.doi.org/10.1093/med/9780199687039.003.0074.

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Delirium is the most common acute cognitive disorder seen in critically ill patients in the cardiovascular intensive care unit. It is defined as a disturbance of consciousness and cognition that develops suddenly and fluctuates over time. Delirious patients can become hyperactive, hypoactive, or both. The occurrence of delirium during hospitalization is associated with increased in-hospital and long-term morbidity and mortality. The cause of delirium is multifactorial and may include imbalances in neurotransmitters, inflammatory mediators, metabolic disturbances, impaired sleep, and the use of sedatives and analgesics. Patients with advanced age, dementia, chronic illness, extensive vascular disease, and low cardiac output are at particular risk of developing delirium. Specialized bedside assessment tools are now available to rapidly diagnose delirium, even in mechanically ventilated patients. Increased awareness of delirium risk factors, in addition to non-pharmacological and pharmacological treatments for delirium, can be effective in reducing the incidence of delirium in cardiac patients and in minimizing adverse outcomes, once delirium occurs.
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31

McPherson, John, Jennifer Giuseffi, Chad Wagner, and E. Wesley Ely. Acute cognitive disorders: recognition and management of delirium in the cardiovascular intensive care unit. Oxford University Press, 2016. http://dx.doi.org/10.1093/med/9780199687039.003.0074_update_001.

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Delirium is the most common acute cognitive disorder seen in critically ill patients in the cardiovascular intensive care unit. It is defined as a disturbance of consciousness and cognition that develops suddenly and fluctuates over time. Delirious patients can become hyperactive, hypoactive, or both. The occurrence of delirium during hospitalization is associated with increased in-hospital and long-term morbidity and mortality. The cause of delirium is multifactorial and may include imbalances in neurotransmitters, inflammatory mediators, metabolic disturbances, impaired sleep, and the use of sedatives and analgesics. Patients with advanced age, dementia, chronic illness, extensive vascular disease, and low cardiac output are at particular risk of developing delirium. Specialized bedside assessment tools are now available to rapidly diagnose delirium, even in mechanically ventilated patients. Increased awareness of delirium risk factors, in addition to non-pharmacological and pharmacological treatments for delirium, can be effective in reducing the incidence of delirium in cardiac patients and in minimizing adverse outcomes, once delirium occurs.
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32

Dr, Booth Sara, Edmonds Polly, and Kendall Margaret, eds. Palliative care in the acute hospital setting: A practical guide. Oxford: Oxford University Press, 2010.

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33

Acute Care A Summary Of The October 2009 Forum On The Future Of Nursing. National Academies Press, 2010.

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34

Nahir, Menachem, Doron Zahger, and Yonathan Hasin. Recommendations for the structure, organization, and operation of intensive cardiac care units. Oxford University Press, 2015. http://dx.doi.org/10.1093/med/9780199687039.003.0010.

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Care for the critically ill cardiovascular patients and their families requires a unique environment that is structurally different from other clinical units. Coronary care units were introduced in the 1960s for the main purpose of prevention and prompt treatment of life-threatening cardiac arrhythmias related to acute myocardial infarction. Since then, major progress in cardiology in general and acute cardiac care, in particular, dictated a major change in the structure and organization of these units, symbolically expressed in the new title of ‘intensive cardiac care unit’. Contemporary intensive cardiac care units receive older and more complex patients, often with multiple comorbidities and diverse diagnoses. The modern intensive cardiac care unit incorporates sophisticated monitoring and up-to-date equipment to meet the changing needs of the patient with cardiovascular disease requiring critical care. The intensive cardiac care unit operates in the centre of the hospital’s cardiology service, receiving patients from the mobile care unit (directly or via an ST elevation myocardial infarction network), the emergency department, and other wards, including coronary, structural, and electrophysiology intervention laboratories and operating rooms. Patients are usually unstable and require immediate full attention by highly trained medical and nursing staff. The 2005 recommendations for the structure, organization, and operations of the intensive cardiac care unit were issued by Hasin et al. for the Working Group of Acute Cardiac Care of the European Society of Cardiology, which serves as basis for this chapter. The chapter will focus on the requirements for staffing, training, and accreditation, as well as the structure organization and equipment of the intensive and intermediate cardiac care units.
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35

Fuhrman, Dana Y., and Michael L. Moritz. Diagnosis and Management of Renal Disorders in the Pediatric Intensive Care Unit. Oxford University Press, 2017. http://dx.doi.org/10.1093/med/9780199918027.003.0012.

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Renal disorders can occur in the pediatric intensive care unit (PICU) either as a primary diagnosis or secondary to other diagnoses. This chapter serves as a guide to the diagnosis and management of the more common renal disorders encountered in the PICU. A practical approach to patients presenting with hypernatremia, hyponatremia, and hyperkalemia is provided, including etiologies as well as treatment approaches to these electrolyte disturbances. The diagnosis and management of hypertensive emergencies are discussed as well. Important considerations in the evaluation and treatment of patients with acute kidney injury are reviewed. In addition, modalities for renal replacement therapy are described as well as factors that should be considered when choosing a dialysis treatment modality.
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36

Subhas, Kamalakkannan, and Martin Smith. Intensive care management after neurosurgery. Oxford University Press, 2016. http://dx.doi.org/10.1093/med/9780199600830.003.0369.

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The post-operative management of neurosurgical patients is directed towards the prevention, prompt detection, and management of surgical complications, and other factors that put the brain or spinal cord at risk. Close monitoring is required in the first 6–12 post-operative hours as deterioration in clinical status is usually the first sign of a potentially fatal complication. The majority of patients do not require complex monitoring or management beyond the first 12 hours after elective surgery, although prolonged intensive care unit management may be required for those who develop complications, or after acute brain injury. Cardiovascular and respiratory disturbances adversely affect the injured or ‘at risk’ brain, and meticulous blood pressure control and prevention of hypoxia are key aspects of management. Hypertension is particularly common after intracranial neurosurgery and may cause complications, such as intracranial bleeding and cerebral oedema, or be a consequence of them. A moderate target for glycaemic control (7.0–10 mmol/L) is recommended, avoiding hypoglycaemia and large swings in blood glucose concentration. Pain, nausea, and vomiting occur frequently after neurosurgery, and a multimodal approach to pain management and anti-emesis is recommended. Adequate analgesia not only ensures patient comfort, but also avoids pain-related hypertension. Disturbances of sodium and water homeostasis can lead to serious complications, and a structured approach to diagnosis and management minimizes adverse outcomes. Post-operative seizures must be brought rapidly under control because of the risks of secondary cerebral damage and/or progression to status epilepticus.
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37

Hurtig, Richard, and Deborah Downey. Augmentative and Alternative Communication in Acute Care Settings. Plural Publishing Inc, 2008.

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38

Barclay, Philip, and Helen Scholefield. High dependency and intensive care. Oxford University Press, 2016. http://dx.doi.org/10.1093/med/9780198713333.003.0030.

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The development of maternal critical care is essential in reducing morbidity and mortality due to a substandard level of care. The level of critical care should depend upon the patient’s severity of illness, not their physical location. Escalation to level 3 (intensive) care is uncommon in pregnancy, with a median admission rate of 2.7 per 1000 births, mainly due to hypertensive disorders of pregnancy and haemorrhage. Maternal ‘near misses’ occur more frequently, with 6.5 per 1000 births meeting Mantel’s criteria, of which 85% is due to major obstetric haemorrhage. The admission rate to maternal high dependency units (level 2 care) varies from 1% to 5%. Acute physiological scoring systems have been found to be reliable when applied to parturients receiving level 3 care but overestimate mortality. Maternal early warning scores have been derived from simplified versions of these systems, with allowance made for physiological changes seen in pregnancy. There are many different maternity scoring systems in use throughout England and Wales. All share the same principle that parameters should be recorded regularly during the hospital stay, with deviations from normal quantified, recorded, and acted upon. A chain of response is then required to ensure that suitably qualified staff, possessing appropriate critical care competencies, attend in a timely fashion. Appropriate resources must be available with equipment readily to hand and suitably trained staff so that invasive monitoring can be used. Clear admission criteria are required for level 2 care within the delivery suite and escalation to level 3, with suitable arrangements for transfer.
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39

De Deyne, Cathy, and Jo Dens. Neurological assessment of the acute cardiac care patient. Oxford University Press, 2015. http://dx.doi.org/10.1093/med/9780199687039.003.0016.

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Many techniques are currently available for cerebral physiological monitoring in the intensive cardiac care unit environment. The ultimate goal of cerebral monitoring applied during the acute care of any patient with/or at risk of a neurological insult is the early detection of regional or global hypoxic/ischaemic cerebral insults. In the most ideal situation, cerebral monitoring should enable the detection of any deterioration before irreversible brain damage occurs or should at least enable the preservation of current brain function (such as in comatose patients after cardiac arrest). Most of the information that affects bedside care of patients with acute neurologic disturbances is now derived from clinical examination and from knowledge of the pathophysiological changes in cerebral perfusion, cerebral oxygenation, and cerebral function. Online monitoring of these changes can be realized by many non-invasive techniques, without neglecting clinical examination and basic physiological variables such as invasive arterial blood pressure monitoring or arterial blood gas analysis.
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40

De Deyne, Cathy, Ward Eertmans, and Jo Dens. Neurological assessment of the acute cardiac care patient. Oxford University Press, 2018. http://dx.doi.org/10.1093/med/9780199687039.003.0016_update_001.

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Many techniques are currently available for cerebral physiological monitoring in the intensive cardiac care unit environment. The ultimate goal of cerebral monitoring applied during the acute care of any patient with/or at risk of a neurological insult is the early detection of regional or global hypoxic/ischaemic cerebral insults. In the most ideal situation, cerebral monitoring should enable the detection of any deterioration before irreversible brain damage occurs or should at least enable the preservation of current brain function (such as in comatose patients after cardiac arrest). Most of the information that affects bedside care of patients with acute neurologic disturbances is now derived from clinical examination and from knowledge of the pathophysiological changes in cerebral perfusion, cerebral oxygenation, and cerebral function. Online monitoring of these changes can be realized by many non-invasive techniques, without neglecting clinical examination and basic physiological variables—with possible impact on optimal cerebral perfusion/oxygenation—such as invasive arterial blood pressure monitoring or arterial blood gas analysis.
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41

Kahn, Jeremy M. Long-term weaning centres in critical care. Oxford University Press, 2016. http://dx.doi.org/10.1093/med/9780199600830.003.0384.

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Successfully weaning patients from prolonged mechanical ventilation requires the varied expertise of a dedicated multidisciplinary care team. Traditionally, this care was provided in acute care hospitals, increasingly these patients are transferred to specialized weaning centres. These may improve patient outcomes by concentrating weaning expertise in a low-acuity environment and implementing protocols for liberation from mechanical ventilation. However, these centres might also worsen patient outcomes because they typically offer less intense nurse and physician staffing compared with traditional intensive care units. Generally, the clinical evidence is mixed, with the best studies suggesting that weaning centres offer similar outcomes as acute care hospitals, but at lower costs. Health systems also might stand to gain from dedicated weaning centres, because they can release intensive care unit beds for more acutely-ill patients. Many gaps remain in our understanding of which patients should be transferred to dedicated weaning centres, the optimal timing of transfer, and the best approach to care for patients in this highly specialized setting.
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42

Gevaert, Sofie A., Eric Hoste, and John A. Kellum. Acute kidney injury. Oxford University Press, 2015. http://dx.doi.org/10.1093/med/9780199687039.003.0068.

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Acute kidney injury is a serious condition, occurring in up to two-thirds of intensive care unit patients, and 8.8-55% of patients with acute cardiac conditions. Renal replacement therapy is used in about 5-10% of intensive care unit patients. The term cardiorenal syndrome refers to combined heart and kidney failure; three types of acute cardiorenal syndrome have been described: acute cardiorenal syndrome or cardiorenal syndrome type 1, acute renocardiac syndrome or cardiorenal syndrome type 3, and acute cardiorenal syndrome type 5 (cardiac and renal injury secondary to a third entity such as sepsis). Acute kidney injury replaced the previously used term ‘acute renal failure’ and comprises the entire spectrum of the disease, from small changes in function to the requirement of renal replacement therapy. Not only failure, but also minor and less severe decreases, in kidney function are of clinical significance both in the short and long-term. The most recent definition for acute kidney injury is proposed by the Kidney Disease: Improving Global Outcomes clinical practice guidelines workgroup. This definition is a modification of the RIFLE and AKIN definitions and staging criteria, and it stages patients according to changes in the urine output and serum creatinine (see Tables 68.1 and 68.2). Acute kidney injury is a heterogeneous syndrome with different and multiple aetiologies, often with several insults occurring in the same individual. The underlying processes include nephrotoxicity, and neurohormonal, haemodynamic, autoimmune, and inflammatory abnormalities. The most frequent cause for acute kidney injury in intensive cardiac care patients are low cardiac output with an impaired kidney perfusion (cardiogenic shock) and/or a marked increase in venous pressure (acute decompensated heart failure). Predictors for acute kidney injury in these patients include: baseline renal dysfunction, diabetes, anaemia, and hypertension, as well as the administration of high doses of diuretics. In the intensive cardiac care unit, attention must be paid to the prevention of acute kidney injury: monitoring of high-risk patients, prompt resuscitation, maintenance of an adequate mean arterial pressure, cardiac output, and intravascular volume (avoidance of both fluid overload and hypovolaemia), as well as the avoidance or protection against nephrotoxic agents. The treatment of acute kidney injury focuses on the treatment of the underlying aetiology, supportive care, and avoiding further injury from nephrotoxic agents. More specific therapies have not yet demonstrated efficacy. Renal replacement therapy is indicated in life-threatening changes in fluid, electrolyte, and acid-base balance, but there are also arguments for more early initiation.
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43

Gevaert, Sofie A., Eric Hoste, and John A. Kellum. Acute kidney injury. Oxford University Press, 2017. http://dx.doi.org/10.1093/med/9780199687039.003.0068_update_001.

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Acute kidney injury is a serious condition, occurring in up to two-thirds of intensive care unit patients, and 8.8-55% of patients with acute cardiac conditions. Renal replacement therapy is used in about 5-10% of intensive care unit patients. The term cardiorenal syndrome refers to combined heart and kidney failure; three types of acute cardiorenal syndrome have been described: acute cardiorenal syndrome or cardiorenal syndrome type 1, acute renocardiac syndrome or cardiorenal syndrome type 3, and acute cardiorenal syndrome type 5 (cardiac and renal injury secondary to a third entity such as sepsis). Acute kidney injury replaced the previously used term ‘acute renal failure’ and comprises the entire spectrum of the disease, from small changes in function to the requirement of renal replacement therapy. Not only failure, but also minor and less severe decreases, in kidney function are of clinical significance both in the short and long-term. The most recent definition for acute kidney injury is proposed by the Kidney Disease: Improving Global Outcomes clinical practice guidelines workgroup. This definition is a modification of the RIFLE and AKIN definitions and staging criteria, and it stages patients according to changes in the urine output and serum creatinine (see Tables 68.1 and 68.2). Acute kidney injury is a heterogeneous syndrome with different and multiple aetiologies, often with several insults occurring in the same individual. The underlying processes include nephrotoxicity, and neurohormonal, haemodynamic, autoimmune, and inflammatory abnormalities. The most frequent cause for acute kidney injury in intensive cardiac care patients are low cardiac output with an impaired kidney perfusion (cardiogenic shock) and/or a marked increase in venous pressure (acute decompensated heart failure). Predictors for acute kidney injury in these patients include: baseline renal dysfunction, diabetes, anaemia, and hypertension, as well as the administration of high doses of diuretics. In the intensive cardiac care unit, attention must be paid to the prevention of acute kidney injury: monitoring of high-risk patients, prompt resuscitation, maintenance of an adequate mean arterial pressure, cardiac output, and intravascular volume (avoidance of both fluid overload and hypovolaemia), as well as the avoidance or protection against nephrotoxic agents. The treatment of acute kidney injury focuses on the treatment of the underlying aetiology, supportive care, and avoiding further injury from nephrotoxic agents. More specific therapies have not yet demonstrated efficacy. Renal replacement therapy is indicated in life-threatening changes in fluid, electrolyte, and acid-base balance, but there are also arguments for more early initiation.
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44

Simon, Robert, Gesine Hofinger, and Michael St Pierre. Crisis Management in Acute Care Settings: Human Factors and Team Psychology in a High-Stakes Environment. Springer, 2018.

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45

Simon, Robert, Gesine Hofinger, and Michael St Pierre. Crisis Management in Acute Care Settings: Human Factors and Team Psychology in a High-Stakes Environment. Springer, 2016.

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46

Hofinger, Gesine, Cornelius Buerschaper, and Michael St Pierre. Crisis Management in Acute Care Settings: Human Factors and Team Psychology in a High Stakes Environment. Springer, 2010.

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47

Rickman, Otis B. Critical Care Medicine. Oxford University Press, 2012. http://dx.doi.org/10.1093/med/9780199755691.003.0148.

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Critical care medicine is a multidisciplinary branch of medicine encompassing the provision of organ support to patients who are severely ill. All areas of medicine may have relevance for critically ill patients; however, this review focuses only on aspects of cardiopulmonary monitoring, life support, technologic interventions, and disease states typically managed in the intensive care unit (ICU). Airway management, venous access, respiratory failure, mechanical ventilation, acute respiratory distress syndrome, shock, and sepsis are reviewed.
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48

Watson, Max, Caroline Lucas, Andrew Hoy, and Jo Wells. Hospital liaison palliative care. Oxford University Press, 2010. http://dx.doi.org/10.1093/med/9780199234356.003.0048.

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This chapter covers the need for hospital liaison palliative care services, challenges in an acute hospital setting, aims and evaluation of the hospital specialist palliative care team, things to think about when considering a referral, urgent discharge of a dying patient who wants to die at home, dying in the intensive care unit (ICU), and using the Liverpool Care Pathway (LCP) in the hospital setting.
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49

Wood, Ian, and Michelle Rhodes. Medical Assessment Units: The Initial Management of Acute Medical Patients. Wiley, 2002.

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50

1962-, Wood Ian, and Rhodes Michelle, eds. Medical assessment units: The initial management of acute medical patients. London: Whurr, 2003.

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