To see the other types of publications on this topic, follow the link: Blood oxygenator.
Books on the topic 'Blood oxygenator'
Create a spot-on reference in APA, MLA, Chicago, Harvard, and other styles
Consult the top 43 books for your research on the topic 'Blood oxygenator.'
Next to every source in the list of references, there is an 'Add to bibliography' button. Press on it, and we will generate automatically the bibliographic reference to the chosen work in the citation style you need: APA, MLA, Harvard, Chicago, Vancouver, etc.
You can also download the full text of the academic publication as pdf and read online its abstract whenever available in the metadata.
Browse books on a wide variety of disciplines and organise your bibliography correctly.
1
B, Zwischenberger Joseph, Bartlett Robert H, and Extracorporeal Life Support Organization, eds. ECMO: Extracorporeal cardiopulmonary support in critical care. Extracorporeal Life Support Organization, 1995.
Find full text
2
Fisher, Joseph A. A new approach to non-invasive oxygenated mixed venous PCO₂. National Aeronautics and Space Administration, 1986.
Find full text
3
A, Ansel Clifford, and United States. National Aeronautics and Space Administration., eds. A new approach to non-invasive oxygenated mixed venous PCO₂. National Aeronautics and Space Administration, 1986.
Find full text
4
David, Hailey, and Canadian Agency for Drugs and Technologies in Health., eds. Adjunctive hyperbaric oxygen therapy for diabetic foot ulcer: An economic analysis. Canadian Agency for Drugs and Technologies in Health, 2007.
Find full text
5
1958-, Duncan Brian W., ed. Mechanical support for cardiac and respiratory failure in pediatric patients. M. Dekker, 2001.
Find full text
7
Hershey, Daniel. Blood Oxygenation: Proceedings of the International Symposium on Blood Oxygenation, Held at the University of Cincinnati, December 1-3 1969. Springer London, Limited, 2012.
Find full text
8
Maybauer, Marc O., ed. Extracorporeal Membrane Oxygenation. Oxford University Press, 2022. http://dx.doi.org/10.1093/med/9780197521304.001.0001.
Full textAbstract:
Extracorporeal Membrane Oxygenation—An Interdisciplinary Problem-Based Learning Approach provides an overview of the latest techniques, management strategies, and technology surrounding the clinical use of ECMO. This interdisciplinary book reviews the most common scenarios of ECMO in 62 chapters exploring the conditions and problems arising in ECMO practice. Each chapter begins with a stem case, followed by open questions to encourage critical thinking and enable the reader to follow the management strategies of the authors, who are world leaders in the field. Followed by an evidence-based discussion, each chapter concludes with multiple-choice questions for self-assessment. This book is current in its knowledge of organ systems and management and keeps pace with new ECMO technology and surgical techniques coupled with current guidelines for management. Starting with the history of ECMO to technical aspects, circuit biocompatibility and interaction with blood, drugs, and flow physics, the volume then continues into pediatric and adult sections, focusing on both respiratory and cardiovascular support, followed by a section on trauma. The volume then concludes with a section on neurologic complications and ethics, as well as rehabilitation and ambulation of ECMO patients. In addition, to reflect the current global health situation, this book includes a chapter on ECMO management in patients suffering with COVID-19 to cover the most urgent and pressing questions around ECMO during the ongoing pandemic. This is the first ECMO book on the market to utilize a problem-based learning approach and as such is an important unprecedented project on ECMO education.
9
Blood Oxygenation: Proceedings of the International Symposium on Blood Oxygenation, held at the University of Cincinnati, December 1-3, 1969. Springer, 2012.
Find full text
10
Wise, Matt, and Simon Barry. Respiratory failure. Edited by Patrick Davey and David Sprigings. Oxford University Press, 2018. http://dx.doi.org/10.1093/med/9780199568741.003.0135.
Full textAbstract:
Respiratory failure is a syndrome characterized by defective gas exchange due to inadequate function of the respiratory system. There is a failure to oxygenate blood (hypoxaemia) and/or eliminate carbon dioxide (hypercapnia). Hypoxaemia is defined as an arterial blood partial pressure of oxygen (PaO2) of <8 kPa, and hypercapnia as an arterial blood partial pressure of carbon dioxide (PaCO2) of >6 kPa. Respiratory failure is divided into two different types, conventionally referred to as type 1 and type 2. The distinction between these two is important because it emphasizes not only different their pathophysiological mechanisms and etiologies, but also different treatments. The preferred terminology and definitions are as follows: oxygenation failure (type I respiratory failure), PaO2 of <8 kPa; ventilation failure (type 2 respiratory failure), PaCO2 >6 kPa. Respiratory failure may be acute (onset over hours to days), or chronic (developing over months to years); alternatively, there may be an acute deterioration of a chronic state.
11
Kipnis, Eric, and Benoit Vallet. Tissue perfusion monitoring in the ICU. Oxford University Press, 2016. http://dx.doi.org/10.1093/med/9780199600830.003.0138.
Full textAbstract:
Resuscitation endpoints have shifted away from restoring normal values of routinely assessed haemodynamic parameters (central venous pressure, mean arterial pressure, cardiac output) towards optimizing parameters that reflect adequate tissue perfusion. Tissue perfusion-based endpoints have changed outcomes, particularly in sepsis. Tissue perfusion can be explored by monitoring the end result of perfusion, namely tissue oxygenation, metabolic markers, and tissue blood flow. Tissue oxygenation can be directly monitored locally through invasive electrodes or non-invasively using light absorbance (pulse oximetry (SpO2) or tissue (StO2)). Global oxygenation may be monitored in blood, either intermittently through blood gas analysis, or continuously with specialized catheters. Central venous saturation (ScvO2) indirectly assesses tissue oxygenation as the net balance between global O2 delivery and uptake, decreasing when delivery does not meet demand. Lactate, a by-product of anaerobic glycolysis, increases when oxygenation is inadequate, and can be measured either globally in blood, or locally in tissues by microdialysis. Likewise, CO2 (a by-product of cellular respiration) and PCO2 can be measured globally in blood or locally in accessible mucosal tissues (sublingual, gastric) by capnography or tonometry. Increasing PCO2 gradients, either tissue-to-arterial or venous-to-arterial, are due to inadequate perfusion. Metabolically, the oxidoreductive status of mitochondria can be assessed locally through NADH fluorescence, which increases in situations of inadequate oxygenation/perfusion. Finally, local tissue blood flow may be measured by laser-Doppler or visualized through intravital microscopic imaging. These perfusion/oxygenation resuscitation endpoints are increasingly used and studied in critical care.
12
Regulation of Tissue Oxygenation. Morgan & Claypool Life Science Publishers, 2011.
Find full text
13
BIOPATOLOGIA VASCULAR E SANGUÍNEA. VOL 1 (1974-1984): -. Lisboa: Publicações Ciência e Vida, 2005.
Find full text
14
Russo, Sebastian G., and Michael Quintel. Standard intubation in the ICU. Oxford University Press, 2016. http://dx.doi.org/10.1093/med/9780199600830.003.0080.
Full textAbstract:
Due to secretions, blood, or oedema in the patients’ airways, compromised pulmonary and haemodynamic, as well as limited access to the patients’ head the standard intubation in the ICU is an overall challenging procedure. Planning, preparation, and straight forwarded strategies are therefore mandatory. As a basic measure, sufficient pre-oxygenation should always be performed. Repetitive intubation attempts significantly worsen patients’ outcomes and need to be avoided. As adequate anaesthesia, including full neuromuscular blockade, can facilitate orotracheal intubation, this should be part of the routine. Apnoeic oxygenation during laryngoscopy by oxygen application via a nasal probe seems to be beneficial to prolong time to desaturation. Despite the fact that nowadays orotracheal intubation in the ICU is probably performed using mainly direct laryngoscopy, video laryngoscopes will possibly have increasing value on the ICU. Extraglottic airway devices represent useful tools to ventilate and oxygenate the patients’ lungs in case of an unexpected failed intubation attempt also on the ICU. In order to confirm adequate ventilation, capnography represents the standard of care and has to be a matter of course whenever a patient needs ventilator support on the ICU.
15
ANSI/AAMI/ISO 7199:2016; Cardiovascular implants and artificial organs— Blood-gas exchangers (oxygenators). AAMI, 2016. http://dx.doi.org/10.2345/9781570206559.
Full text
16
Bellani, Giacomo, and Antonio Pesenti. Treating respiratory failure with extracorporeal support in the ICU. Oxford University Press, 2016. http://dx.doi.org/10.1093/med/9780199600830.003.0105.
Full textAbstract:
During extracorporeal support or extracorporeal membrane oxygenation (ECMO) blood is diverted from the patient to an artificial lung for gas exchange, then returned into the patient’s circulation once arterialized. While a low-blood-flow bypass can remove comparatively high amounts of CO2, oxygenation is limited by venous haemoglobin saturation and requires high flows. Several technical improvements led to a profound change in the safety and applicability of ECMO in recent years, even permitting the transfer of patients undergoing ECMO. ECMO has been proposed as salvage therapy for the most severe acute respiratory distress syndrome patients—warranting viable levels of oxygenation. In 2009, the ‘CESAR’ trial provided formal evidence in favour of ECMO application in adults with ARDS. An important indication for the early use of ECMO in ARDS came from the outbreaks of H1N1 influenza, when several countries set up networks aimed at coordinating the application of ECMO. Recent reports suggest the use of ECMO in less severe patients with the purpose of removing CO2, decreasing the need for ventilation and ventilator-induced lung injury,
17
Joynt, Gavin M., and Gordon Y. S. Choi. Blood gas analysis in the critically ill. Oxford University Press, 2016. http://dx.doi.org/10.1093/med/9780199600830.003.0072.
Full textAbstract:
Arterial blood gases allow the assessment of patient oxygenation, ventilation, and acid-base status. Blood gas machines directly measure pH, and the partial pressures of carbon dioxide (PaCO2) and oxygen (PaO2) dissolved in arterial blood. Oxygenation is assessed by measuring PaO2 and arterial blood oxygen saturation (SaO2) in the context of the inspired oxygen and haemoglobin concentration, and the oxyhaemoglobin dissociation curve. Causes of arterial hypoxaemia may often be elucidated by determining the alveolar–arterial oxygen gradient. Ventilation is assessed by measuring the PaCO2 in the context of systemic acid-base balance. A rise in PaCO2 indicates alveolar hypoventilation, while a decrease indicates alveolar hyperventilation. Given the requirement to maintain a normal pH, functioning homeostatic mechanisms result in metabolic acidosis, triggering a compensatory hyperventilation, while metabolic alkalosis triggers a compensatory reduction in ventilation. Similarly, when primary alveolar hypoventilation generates a respiratory acidosis, it results in a compensatory increase in serum bicarbonate that is achieved in part by kidney bicarbonate retention. In the same way, respiratory alkalosis induces kidney bicarbonate loss. Acid-base assessment requires the integration of clinical findings and a systematic interpretation of arterial blood gas parameters. In clinical use, traditional acid-base interpretation rules based on the bicarbonate buffer system or standard base excess estimations and the interpretation of the anion gap, are substantially equivalent to the physicochemical method of Stewart, and are generally easier to use at the bedside. The Stewart method may have advantages in accurately explaining certain physiological and pathological acid base problems.
18
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.
Full textAbstract:
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.
19
Bernal, William, and Alberto Quaglia. Normal physiology of the hepatic system. Oxford University Press, 2016. http://dx.doi.org/10.1093/med/9780199600830.003.0173.
Full textAbstract:
Hepatic blood inflow is from two sources—high-pressure, well-oxygenated blood from the hepatic artery and low-pressure, partly deoxygenated blood from the portal vein. Hepatic inflow is maintained by variation in flows in these two systems. Although less than a third of total blood flow is delivered via the hepatic artery, it is responsible for the majority of hepatic oxygen supply. The liver can be subdivided into eight functionally independent segments, each with its own vascular inflow, outflow, and biliary drainage. The tri-dimensional hepatic microstructure is complex with geographic heterogeneity of hepatocellular function, and resistance to toxic, ischaemic, and metabolic damage. The liver is central to a wide variety of synthetic, metabolic, and detoxification functions. The overall balance of activity may be altered rapidly in response to systemic inflammatory stimuli.
20
Trivedi, Premal M., and Pablo Motta. Tetralogy of Fallot. Edited by Erin S. Williams, Olutoyin A. Olutoye, Catherine P. Seipel, and Titilopemi A. O. Aina. Oxford University Press, 2018. http://dx.doi.org/10.1093/med/9780190678333.003.0027.
Full textAbstract:
Congenital heart conditions can be characterized as cyanotic or acyanotic. This chapter discusses one of the most common cyanotic congenital cardiac conditions: tetralogy of Fallot. Tetralogy of Fallot is composed of distinct anomalies which result in left-to-right shunting of blood resulting in cyanotic spells, under certain conditions such as pain (and associated tachycardia) decreased oxygenation, decreased venous return, or hypotension. Recognizing factors that accentuate the left-to-right shunting of blood in this condition is essential for adequate management of a TET spell which is frequently observed in children with tetralogy of Fallot.
21
Waberski, Andrew T., and Nina Deutsch. Transposition of the Great Arteries. Edited by Kirk Lalwani, Ira Todd Cohen, Ellen Y. Choi, and Vidya T. Raman. Oxford University Press, 2018. http://dx.doi.org/10.1093/med/9780190685157.003.0010.
Full textAbstract:
Transposition of the great arteries is a congenital cardiac abnormality that presents in the neonatal period, most commonly as cyanosis. While variations in anatomic features exist, dextro-transposition of the great arteries, the most common form, results in 2 separate circulatory systems in parallel, such that the right ventricle pumps deoxygenated blood to the systemic circulation, and the left ventricle sends oxygenated blood back to the pulmonary circulation. To ensure survival, early diagnosis and intervention to allow for adequate mixing of blood is necessary. The arterial switch operation is the definitive treatment, usually undertaken in the first few days of life. Known complications of surgery include ischemia, bleeding, hemodynamic compromise, and arrhythmias. Anesthetic management must take these factors into account.
22
Navaratnam, M., and C. Ramamoorthy. Hypoplastic Left Heart Syndrome. Edited by Kirk Lalwani, Ira Todd Cohen, Ellen Y. Choi, and Vidya T. Raman. Oxford University Press, 2018. http://dx.doi.org/10.1093/med/9780190685157.003.0009.
Full textAbstract:
Approximately 960 babies are born per year in the United States with hypoplastic left heart syndrome. Over the last 20 years, advances in surgical techniques, perioperative care, cardiopulmonary bypass, and intensive care unit management have converted this previously fatal condition to one with a neonatal survival rate of 90% to 92% for standard risk patients. Understanding the factors affecting the balance of pulmonary blood flow and systemic blood flow and ensuring adequate cardiac output and end-organ perfusion is critical to successful outcomes. Extracorporeal membrane oxygenation remains an important support modality following stage I palliation. This chapter discusses this syndrome and describes treatment options.
23
Jain, Shilpa, and Mark T. Gladwin. Sickle crisis in the critically ill. Oxford University Press, 2016. http://dx.doi.org/10.1093/med/9780199600830.003.0275.
Full textAbstract:
Sickle cell disease crises are precipitated by an acute occlusion of microvessels, which can lead to end organ ischaemia reperfusion injury and acute haemolysis. Acute fat emboli syndrome, acute lung injury (the acute chest syndrome), acute pulmonary hypertension, and cor pulmonale, haemorrhagic and occlusive stroke, and systemic infection represent the most common life-threatening complications observed in current ICU practice. General principles of management in all patients admitted to the critical care unit are hydration, antibiotics, pain control, and maintenance of oxygenation and ventilation. Red blood cell transfusion therapy is the treatment of choice for most complications of sickle cell disease requiring intensive care management. Transfusion of sickle negative, leukoreduced red blood cells, phenotypically matched for Rhesus and Kell antigens is the minimum standard of care in sickle cell disease patients as they have a high incidence of red blood cell alloimmunization.
24
Sainz, Jorge G., and Bradley P. Fuhrman. Basic Pediatric Hemodynamic Monitoring. Oxford University Press, 2017. http://dx.doi.org/10.1093/med/9780199918027.003.0005.
Full textAbstract:
Physiological monitoring using a variety of technological advances supplements, but does not replace, our ability to distinguish normal from abnormal physiology traditionally gleaned from physical examination. Pulse oximetry uses the wavelengths of saturated and unsaturated hemoglobin to estimate arterial oxygenation noninvasively. Similar technology included on vascular catheters provides estimation of central or mixed venous oxygenation and helps assess the adequacy of oxygen delivered to tissues. End-tidal carbon dioxide measurements contribute to the assessment of ventilation. Systemic arterial blood pressure and central venous pressure measurements help evaluate cardiac performance, including the impact of ventilatory support. Intra-abdominal pressure may increase as a result of intraluminal air or fluid, abnormal fluid collections within the peritoneal cavity, or abnormal masses. Increased pressure may impede venous return to the heart and compromise intra-abdominal organ perfusion. Pressure measurement guides related management decisions.
25
Wise, Matt, and Paul Frost. ICU treatment of respiratory failure. Edited by Patrick Davey and David Sprigings. Oxford University Press, 2018. http://dx.doi.org/10.1093/med/9780199568741.003.0149.
Full textAbstract:
Respiratory failure is a syndrome characterized by defective gas exchange due to inadequate function of the respiratory system. There is a failure to oxygenate blood (hypoxaemia) and/or eliminate carbon dioxide (hypercapnoea). Respiratory failure can develop over years when it is due to conditions such as kyphoscoliosis or motor neuron disease, or minutes in the case of an acute asthma attack or pneumothorax. In this context, respiratory failure is often called acute (e.g. asthma), chronic (e.g. kyphoscoliosis), or acute on chronic (kyphoscoliosis complicated by pneumonia). Chronic respiratory failure is characterized by compensatory mechanisms which aim to adjust the pH of the blood back to the normal physiological range and involve the retention of bicarbonate by the kidney. This topic covers the etiology of respiratory failure as well as signs, symptoms, diagnosis, investigations, prognosis, and treatment.
26
Dalton, Heidi J., Mark Davidson, and Peter P. Roeleveld. Extracorporeal Life Support. Oxford University Press, 2017. http://dx.doi.org/10.1093/med/9780199918027.003.0002.
Full textAbstract:
Extracorporeal membrane oxygenation (ECMO) can provide support as a bridge to recovery or a bridge to more definitive therapy for patients with severe respiratory or cardiorespiratory disease. In this chapter, the criteria for ECMO are discussed and a practical decision tree for mode of ECMO (venovenous or venoarterial) is presented. A stepwise approach to initiation and management of ECMO for the patient is described, including flow rate goals, ventilator management, anticoagulation, blood product replacement, identification of recovery, weaning procedures, and specific issues relating to the two different modes of ECMO.
27
Archer, Nick, and Nicky Manning. Septal anomalies. Oxford University Press, 2011. http://dx.doi.org/10.1093/med/9780199230709.003.0009.
Full textAbstract:
Atrial septal defects 122Ventricular septal defects 124Atrioventricular septal defects 134• The presence of a patent foramen ovale (PFO) is essential for right-to-left flow of oxygenated blood returning from the placenta to reach vital organs.• Distinguishing between PFO and an ASD is difficult and the diagnosis can only be made with certainty if the atrial septum is virtually absent. It is suggested that if the size of the gap in the atrial septum is greater than the diameter of the AA then the possibility of a significant ASD postnatally should be considered....
28
Hedenstierna, Göran, and João Batista Borges. Normal physiology of the respiratory system. Oxford University Press, 2016. http://dx.doi.org/10.1093/med/9780199600830.003.0071.
Full textAbstract:
The lungs contain 200–300 million alveoli that are reached via 23 generations of airways. The volume in the lungs after an ordinary expiration is called functional residual capacity (FRC) and is approximately 3–4 L. The lung is elastic and force (pressure) is needed to expand it and to overcome the resistance to gas flow in the airways. This pressure can be measured as pleural minus alveolar pressure. The inspired volume goes mainly to dependent, lower lung regions, but with increasing age and in obstructive lung disease airways may close in dependent lung regions during expiration, impeding oxygenation of the blood. With lowered functional residual capacity,airways may be continuously closed with subsequent gas adsorbtion from the closed off alveoli. Perfusion of the lung goes also mainly to dependent regions, but there is in addition, possibly more important, a non-gravitational inhomogeneity. A ventilation-perfusion mismatch may ensue that impedes oxygenation and CO2 removal, but can to some extent be corrected for by hypoxic pulmonary vasoconstriction.
29
Gaddam, Samson Sujit Kumar, and Claudia S. Robertson. Cerebral blood flow and perfusion monitoring in the critically ill. Oxford University Press, 2016. http://dx.doi.org/10.1093/med/9780199600830.003.0222.
Full textAbstract:
Prevention of secondary cerebral ischaemic insults is an important management strategy in acute neurological conditions. Monitoring of cerebral perfusion may aid in early identification of ischaemic insults and help with management. A number of tools are available for this purpose. Cerebral perfusion pressure (CPP) is the simplest assessment of cerebral perfusion, but in some cases ischaemia can be present even with a normal CPP. Cerebral blood flow (CBF) imaging, either with computed tomography or magnetic resonance imaging techniques, can provide quantitative regional CBF measurement, but only at a single instance in time. Such studies are valuable in the diagnosis of ischaemia, but are difficult for the management of critically-ill patients. CBF can also be measured within the intensive care unit (ICU), either directly or indirectly through the measurement of cerebral oxygenation. These monitors provide a more continuous measure of CBF, and are more useful in assessing response to treatment. Some of the ICU tools monitor global perfusion and some assess perfusion only in a local area of brain surrounding the monitor. With local monitors, the location of the probe is important for interpretation of the findings.
30
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.
Full textAbstract:
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.
31
Teitel, P., and Holger Schmid-Schönbein. Basic Aspects of Blood Trauma: A Workshop Symposium on Basic Aspects of Blood Trauma in Extracorporeal Oxygenation Held at Stolberg near Aachen, Federal Republic of Germany, November 21-23 1978. Springer London, Limited, 2012.
Find full text
32
Stanghellini, Giovanni. What is a symptom? Oxford University Press, 2016. http://dx.doi.org/10.1093/med/9780198792062.003.0021.
Full textAbstract:
This chapter explains that the concept of symptom covers a vast array of indexicalities, focusing on the bio-medical concept of ‘symptom’. In biological medicine, a symptom is an index for diagnosis and the epiphenomenon of an underlying pathology. In the biomedical paradigm, symptoms have causes, rather than meanings. In general, causality goes from aetiology (e.g. a virus), to symptom(s) (breathing difficulties), to dysfunction (poor physical performance due to blood hypo-oxygenation, and thus reduced adaptation of the person to his or her environment). Another important assumption is that symptoms are considered accidental, i.e. non-essential to the living organism. Many of these assumptions—if we apply this paradigm to the field of psychic pathology— are at least controversial, or even counterfactual.
33
Nielsen, Niklas, and David B. Seder. Non-pharmacological neuroprotection in the ICU. Oxford University Press, 2016. http://dx.doi.org/10.1093/med/9780199600830.003.0230.
Full textAbstract:
After control of the primary process causing acute neurological injury, further control of secondary injury pathways can be achieved by manipulating brain temperature, and achieving biochemical and metabolic homeostasis. Surgical techniques are routinely used to remove blood or trapped cerebrospinal fluid, control mass effect, or repair unstable vascular abnormalities. Therapeutic temperature management to a defined target can be achieved and maintained using cold fluids, ice packs, body surface cooling pads, and surface and intravascular devices with servo (feedback) mechanisms. Successful temperature management requires attentive surveillance and control of shivering and other potential complications, such as bleeding, infection, cardiac arrhythmias, and electrolyte and metabolic disturbances. Extremes of oxygenation and ventilation are associated with worse long-term functional outcomes, and should be avoided.
34
Colwell, Cynthia M. Researching Music Therapy in Medical Settings. Edited by Jane Edwards. Oxford University Press, 2015. http://dx.doi.org/10.1093/oxfordhb/9780199639755.013.16.
Full textAbstract:
Research has indicated that music therapy is effective in hospital contexts for managing pain, reducing anxiety, ameliorating social isolation, slowing the impact of cognitive or developmental regression or delays, expressing emotions, and altering physiological responses as medically needed. Music can impact physiological responses including heart rate, blood pressure, pulse oxygenation, pain indicators, respiration, muscle tension, cardiac output, and immunologic function. Participation in music therapy interventions can improve treatment adherence, reduce deleterious symptoms of diseases and effects of medical procedures, and generally enhance quality of life in an unfamiliar and potentially unappealing environment. This chapter will describe a sample of how music therapists have conducted research in medical contexts and will present ways in which such research can be planned and undertaken.
35
Lee, Jae Myeong, and Michael R. Pinsky. Cardiovascular interactions in respiratory failure. Oxford University Press, 2016. http://dx.doi.org/10.1093/med/9780199600830.003.0087.
Full textAbstract:
Acute respiratory failure not only impairs gas exchange, but also stresses cardiovascular reserve by increasing the need for increased cardiac output (CO) to sustain O2 delivery in the face of hypoxaemia, increased O2 demand by the increased work of breathing and inefficient gas exchange, and increased right ventricular afterload due to lung collapse via hypoxic pulmonary vasoconstriction. Mechanical ventilation, though often reversing these processes by lung recruitment and improved arterial oxygenation, may also decrease CO by increasing right atrial pressure by either increasing intrathoracic pressure or lung over-distention by excess positive end-expiratory pressure or inadequate expiratory time causing acute cor pulmonale. Finally, spontaneous negative swings in intrathoracic pressure also increase venous return and impede left ventricular ejection thus increasing intrathoracic blood volume and often precipitating or worsening hydrostatic pulmonary oedema. Positive-pressure breathing has the opposite effects.
36
Dangayach, Neha S., Charles L. Francoeur, Stephan A. Mayer, and Tarek Sharshar. Neuroprotection in Sepsis and Acute Respiratory Distress Syndrome. Edited by David L. Reich, Stephan Mayer, and Suzan Uysal. Oxford University Press, 2017. http://dx.doi.org/10.1093/med/9780190280253.003.0013.
Full textAbstract:
Diffuse cerebral dysfunction in sepsis and acute respiratory distress syndrome (ARDS) patients is highly prevalent. Delirium and alterations in level of consciousness in septic patients are symptoms that constitute sepsis-associated encephalopathy (SAE), which is distinct from hypoxic encephalopathy. SAE is associated with substantial mortality and long-term cognitive impairment. The underlying pathophysiology of SAE is complex and poorly understood. The pathophysiology of SAE includes neuroinflammation, microglial activation, microcirculatory failure, autoregulation impairment, blood–brain barrier disruption, apoptosis, and development of microinfarcts and microhemorrhages. Apart from standard resuscitation techniques targeted at maintaining adequate cerebral perfusion and oxygenation, specific neuroprotective interventions are not currently available. Given the vast unmet need for improving functional outcome among survivors of SAE, it is a priority for the critical care community to better define, understand, and prevent this common and devastating form of neurological injury.
37
Taccone, Paolo, and Davide Chiumello. Prone positioning in the ICU. Oxford University Press, 2016. http://dx.doi.org/10.1093/med/9780199600830.003.0099.
Full textAbstract:
Prone positioning (also known as ‘proning’, ‘prone manoeuvre’ or ‘prone ventilation’) refers to mechanical ventilation with patients positioned in prone position in contrast of standard supine (flat or semi-recumbent) position. The use of the prone positioning was proposed over 30 years ago as a means to improve arterial oxygenation in patients with acute respiratory distress syndrome (ARDS). Since then, extensive physiological research has been conducted to explore the possible mechanisms underlying the observed improvement in gas exchange, which involve changes in the distribution of both ventilation and pulmonary blood flow. Furthermore, it has been shown that, independently of gas exchange, prone positioning may reduce the harm of mechanical ventilation, which is known to adversely impact patient survival. In this chapter we will summarize the physiological effect of prone positioning, as well as the clinical evidences supporting its use to reduce mortality in patients with ARDS.
38
Gattinon, Luciano, and Eleonora Carlesso. Acute respiratory failure and acute respiratory distress syndrome. Oxford University Press, 2015. http://dx.doi.org/10.1093/med/9780199687039.003.0064.
Full textAbstract:
Respiratory failure (RF) is defined as the acute or chronic impairment of respiratory system function to maintain normal oxygen and CO2 values when breathing room air. ‘Oxygenation failure’ occurs when O2 partial pressure (PaO2) value is lower than the normal predicted values for age and altitude and may be due to ventilation/perfusion mismatch or low oxygen concentration in the inspired air. In contrast, ‘ventilatory failure’ primarily involves CO2 elimination, with arterial CO2 partial pressure (PaCO2) higher than 45 mmHg. The most common causes are exacerbation of chronic obstructive pulmonary disease (COPD), asthma, and neuromuscular fatigue, leading to dyspnoea, tachypnoea, tachycardia, use of accessory muscles of respiration, and altered consciousness. History and arterial blood gas analysis is the easiest way to assess the nature of acute RF and treatment should solve the baseline pathology. In severe cases mechanical ventilation is necessary as a ‘buying time’ therapy. The acute hypoxemic RF arising from widespread diffuse injury to the alveolar-capillary membrane is termed Acute Respiratory Distress Syndrome (ARDS), which is the clinical and radiographic manifestation of acute pulmonary inflammatory states.
39
Gattinon, Luciano, and Eleonora Carlesso. Acute respiratory failure and acute respiratory distress syndrome. Oxford University Press, 2018. http://dx.doi.org/10.1093/med/9780199687039.003.0064_update_001.
Full textAbstract:
Respiratory failure (RF) is defined as the acute or chronic impairment of respiratory system function to maintain normal oxygen and CO2 values when breathing room air. ‘Oxygenation failure’ occurs when O2 partial pressure (PaO2) value is lower than the normal predicted values for age and altitude and may be due to ventilation/perfusion mismatch or low oxygen concentration in the inspired air. In contrast, ‘ventilatory failure’ primarily involves CO2 elimination, with arterial CO2 partial pressure (PaCO2) higher than 45 mmHg. The most common causes are exacerbation of chronic obstructive pulmonary disease (COPD), asthma, and neuromuscular fatigue, leading to dyspnoea, tachypnoea, tachycardia, use of accessory muscles of respiration, and altered consciousness. History and arterial blood gas analysis is the easiest way to assess the nature of acute RF and treatment should solve the baseline pathology. In severe cases mechanical ventilation is necessary as a ‘buying time’ therapy. The acute hypoxemic RF arising from widespread diffuse injury to the alveolar-capillary membrane is termed Acute Respiratory Distress Syndrome (ARDS), which is the clinical and radiographic manifestation of acute pulmonary inflammatory states.
40
Wagner, Peter D. Gas exchange assessment in the critically ill. Oxford University Press, 2016. http://dx.doi.org/10.1093/med/9780199600830.003.0076.
Full textAbstract:
Chapter 75 laid out the basic principles that govern pulmonary gas exchange, a step necessary for the appropriate application and interpretation of common clinical tests of gas exchange. The present chapter discusses the several common tests and indices used to analyse and quantify gas exchange abnormalities in critically-ill patients. There is special emphasis on inherent limitations of each technique, as well as on ways to minimize technical and experimental errors when the necessary measurements are made. Limitations and errors are considered to be of major clinical importance because, while the measurements and indices themselves are easy to obtain, and have been in routine use for many years, serious errors of interpretation can occur if the limitations and common errors are not appreciated and allowed for. In particular, it is pointed out that factors external to the lungs can dramatically change arterial oxygenation in the critically-ill patient. This means that not all changes in gas exchange reflect changes in lung pathology. It is not uncommon for arterial PO2 to change without change in lung disease severity when external factors such as metabolic rate, cardiac output, and blood temperature change.
41
Gibson, Alistair A., and Peter J. D. Andrews. Management of traumatic brain injury. Oxford University Press, 2016. http://dx.doi.org/10.1093/med/9780199600830.003.0343.
Full textAbstract:
Traumatic brain injury (TBI) is a leading cause of death and disability worldwide and although young male adults are at particular risk, it affects all ages. TBI often occurs in the presence of significant extracranial injuries and immediate management focuses on the ABCs—airway with cervical spine control, breathing, and circulation. Best outcomes are achieved by management in centres that can offer comprehensive neurological critical care and appropriate management for extracranial injuries. If patients require transfer from an admitting hospital to a specialist centre, the transfer must be carried out by an appropriately skilled and equipped transport team. The focus of specific TBI management is on the avoidance of secondary injury to the brain. The principles of management are to avoid hypotension and hypoxia, control intracranial pressure and maintain cerebral perfusion pressure above 60 mmHg. Management of increased intracranial pressure is generally by a stepwise approach starting with sedation and analgesia, lung protective mechanical ventilation to normocarbia in a 30° head-up position, maintenance of oxygenation, and blood pressure. Additional measures include paralysis with a neuromuscular blocking agent, CSF drainage via an external ventricular drain, osmolar therapy with mannitol or hypertonic saline, and moderate hypothermia. Refractory intracranial hypertension may be treated surgically with decompressive craniectomy or medically with high dose barbiturate sedation. General supportive measures include provision of adequate nutrition preferably by the enteral route, thromboembolism prophylaxis, skin and bowel care, and management of all extracranial injuries.
42
Merry, Alan F., Simon J. Mitchell, and Jonathan G. Hardman. Hazards in anaesthetic practice: body systems and occupational hazards. Edited by Jonathan G. Hardman. Oxford University Press, 2017. http://dx.doi.org/10.1093/med/9780199642045.003.0045.
Full textAbstract:
“Can’t intubate, can’t oxygenate” crises and aspiration of gastric contents are important hazards in anaesthesia, and may result in the death of relatively young and healthy patients. Airway difficulties may manifest at the end of anaesthesia as well as at induction and are commoner in emergency departments and intensive care settings than during anaesthesia in operating rooms. Elements of poor management characterize the majority of airway complications. Emergency cricothyroidotomy performed by anaesthetists is associated with a high rate of failure. Other important hazards associated with anaesthesia may involve excessive or inadequate levels of oxygen or carbon dioxide in the blood, hypertension or hypotension, hypothermia or hyperthermia (including malignant hyperpyrexia), hypovolaemia, embolism of gas or thrombus, awareness, infection, and injury to the peripheral or central nervous system, or the eyes. Stroke and postoperative cognitive dysfunction may be particularly devastating for patients. These hazards are typically increased in low- and middle-income countries. The World Federation of Societies of Anaesthesiologists and the World Health Organization have endorsed international standards for a safe practice of anaesthesia, which are structured to reflect different levels of resource. The Lifebox Foundation seeks to improve the safety of surgery and anaesthesia in resource-constrained areas, notably by closing the substantial global gap in pulse oximetry. Several hazards are integral to the occupation of anaesthesia, including certain infections, increased rates of suicide, and medico-legal risks. In the end, the best way to mitigate these risks is through focusing on the safety of our patients.
43
Miletich, John J., and Tia Laura Lindstrom. An Introduction to the Work of a Medical Examiner. ABC-CLIO, LLC, 2010. http://dx.doi.org/10.5040/9798400672156.
Full textAbstract:
Medical examiners play an increasingly important role in society as unexpected and violent deaths increase, not only due to crime, but also due to new toxins in the environment, emerging diseases crossing from animals to humans, bizarre suicides, sadistic sexual practices, and other non-natural causes. John Miletich and Tia Lindstrom take us into the world of these medical detectives. Biological clues from bite marks and skin abnormalities to blood chemical levels and brain oxygenation are just some factors exposed in their quest for truth and justice. We learn the basics of death determination from rigor and livor mortis to signs of death by design, drug use, disease, suicide, and more. We also come to understand the tools of this work, from the Stryker's Saw to the grocer's scale, and tests that reveal factors from DNA evidence to toxins from insect bites. Each case begins with a biological mystery and ends with a conclusion that can provide loved ones with relief, or shock. Miletich, who trained at the Alberta Office of the Chief Medical Examiner and with the Royal Canadian Mounted Police, teams with Lindstrom to introduce readers to the medical examiner's role, including autopsy techniques and analysis. Twists and turns emerge as what was initially thought to be a murder proves to be suicide; what was suspected to be a natural death proves to be murder or environmental poisoning; or what was thought to be an accidental death proves to be something more sinister. This work includes appendices with guides to Medical Examiner organizations, seminars, and conventions.