Extracorporeal membrane oxygenation (ECMO) is developing rapidly, and is now part of the toolkit for the management of all patients with severe respiratory or cardiac failure. Clinicians of all disciplines are in need of a simple manual, easy and fun to read, that will take them through the management of these patients, explaining the principles of safe and successful practice. Part of the Core Critical Care series, this book is an easy-to-read guide for the aspiring ECMO clinician. Doctors, nurses, physiotherapists, dieticians, pharmacists and all other key members of the team will learn the basics required to better understand the technology and care of the patient. The experienced clinician will enjoy reading through the chapters, which present structured thoughts and knowledge acquired through clinical experience.

For over thirty years, the Oxford Handbook of Clinical Specialties has guided students and junior doctors through their clinical placements, renowned for providing all the information needed for both practice and revision in a deceptively small package. Now in its eleventh edition, the Handbook has been revitalized by an expanded team of specialty experts and junior doctors to guide readers through each of the specialties encountered through medical school and Foundation Programme rotations, while remaining true to the humanity and patient focus of the original edition. Updated with the latest advice and clinical guidelines, packed full of high-quality illustrations, boxes, tables, and classifications, and with a brand new chapter on how to survive your junior doctor years and beyond, this handbook is ideal for both study and use at direct point of care. Each chapter is clear and concise and filled with medical gems, with features including ribbons to mark your most-used pages and mnemonics to help you memorize and retain key facts. With reassuring and friendly advice throughout, this is the ultimate guide and revision tool for every medical student and junior doctor for each clinical specialty placement. This well-loved Handbook remains the perfect companion to the Oxford Handbook of Clinical Medicine, together encompassing the entire spectrum of clinical medicine and unmatched by any competitor in their class, helping you become the doctor you want to be.

This volume describes the most recent medical guidelines for perioperative management in arthroplasty with the aim of facilitating excellent control of bleeding/thrombosis, pain and infection. For each area – hemostasis control, pain control and infection control – hot topics of key practical importance are discussed and contrasting perspectives are presented on controversial issues, covering the views of different practitioners and specialties. Using the information contained in this book, the practitioner will be in an excellent position to meet the principal goals of perioperative medical management. The information provided will assist in the choice of a multimodal guideline that minimizes the complication rate regarding bleeding and thromboembolism while not interfering with the patient’s recovery. Similarly, effective means of pain control and an optimized pain control protocol are discussed with a view to shortening hospital stay and achieving functional milestones that meet the patient’s expectations. Finally, host, wound and environmental factors relevant to infection and its prevention are explained, with discussion of the best means of prophylaxis, treatment and imaging. Surgeons, anesthesiologists and all medical practitioners and staff involved in the field of total hip and knee arthroplasty will find this book to be of value in their daily clinical practice. It will assist in the provision of enhanced medical management that ensures quicker recovery of the patient with fewer complications.

This comprehensive, state of the art overview of pediatric and adult cardiac anesthesia brings together all the latest developments in this rapidly developing field. This text is intended both as a reference and for daily use by practicing and prospective anesthesiologists.

Thoroughly updated for its third edition, "Anesthesia for Cardiac Surgery" fills the gap between encyclopaedic references and brief outlines, presenting just the right amount of information to guide trainees and practitioners who care for cardiac surgical patients.

This edition features:
The introduction of Dr Zvara as co-editor
A new chapter on Special Considerations
Practical clinical information coupled with comprehensive descriptions of physiology
Key facts and tables summarized for convenient access.

This essential resource will prove invaluable for residents, fellows, and practicing anesthesiologists.

Automated Drug Delivery in Anesthesia provides a full review of available tools and methods on the drug delivery of anesthesia, bridging the gap between academic development, research and clinical practice. The book takes an interdisciplinary approach, pulling information about tools developed in other disciplines such as mathematics, physics, biology and system engineering and applying them to drug delivery. The book's authors discuss the missing element of complete regulatory loop of anesthesia: the sensor and model for pain pathway assessment. This is the only book which focuses specifically on the delivery of anesthesia.

"This brilliantly assembled expert compendium provides a much-needed guide for the practical application of anesthesiology in medical practice in the most bereft underdeveloped and violence-afflicted regions of the globe." -Seymour Topping, Professor Emeritus of International Journalism, Columbia University This is a comprehensive guide to the role of anesthesiologists in medical missions. In their capacity as perioperative physicians, anesthesiologists improve the safety and efficacy of surgical interventions for underserved patients in low- and middle-income countries around the world. Contributions from international experts in global health provide essential historical context, practical medical and surgical considerations for planning missions, and scenarios of "on the ground" implementation of care. The final section considers anesthesiology education in the context of global health. This is an encompassing and eye-opening resource for trainees and physicians considering participating in a medical mission and students and faculty of global health.

Some important constraints of anesthesia must be taken into consideration when the pharmacological properties of modern anesthetics are discussed. The most imp- tant of these could be that the target effect be achieved preferably within seconds, at most within a few minutes. Similarly, offset of drug action should be achieved within minutes rather hours. The target effects, such as unconsciousness, are pot- tially life-threatening, as are the side effects of modern anesthetics, such as respi- tory and cardiovascular depression. Finally, the patient's purposeful responses are not available to guide drug dosage, because, either the patient is unconscious, or more problematically, the patient is aware but unable to communicate pain because of neuromuscular blockade. These constraints were already recognised 35 years ago, when in 1972 Volume XXX entitled "Modern Inhalation Anesthetics" appeared in this Handbook Series. The present volume is meant as a follow up and extension of that volume. At the beginning of the 1970's anesthesia was commonly delivered by inhalation, with only very few exceptions. The clinical understanding of that time considered anesthesia as a unique state achieved by any of the inhalation anesthetics, in- pendent of their specific molecular structure. "The very mechanism of anesthetic action at the biophase" was discussed within the theoretical framework of the "u- tary theory of narcosis".

A fully updated edition of a popular, illustrated review book, covering all of the essential topics required to pass the current American Board of Anesthesiology Applied Oral and OSCE Examinations. Thoroughly revised to reflect recent literature and changes in anesthesia practice, 12 new chapters explore topics like Point of Care Ultrasound (POCUS), Intraoperative Transesophageal Echocardiography (TEE), Foreign Body Aspiration, and Patient Blood Management. The book also contains questions and model answers, alongside valuable tips for exam success reflecting the new exam structure. Chapters feature a sample case and clinical issues alongside a Knockout Treatment Plan, a model providing an answer that could be used in the exam, and a Technical Knockout section, offering additional tips for successfully passing the examination. An evidence-based approach presented in a concise outline-oriented format, this resource also functions as an introduction to anesthesia rotations and as a technical study guide for students.

A thoroughly revised third edition of the acclaimed textbook for caregivers involved in the management of pregnant women with uncommon diseases or an unusual or rare condition. The book offers valuable case reports and experience collated by an international team of editors and contributors who are leading experts in the field. This edition contains five additional chapters covering topics like cardiac and neuraxial point of care ultrasound, substance abuse, rare inherited conditions, and anesthesia for rare fetal and placental conditions. Clear, concise management guidelines and algorithms are provided, and each chapter is written from the viewpoint of the obstetric anesthesiologist. Numerous tables, figures and photographs provide visual aids and each chapter contains valuable clinical insights highlighting the essential facts. Featuring updated figures and references, links to useful websites for further reading and a list of commonly used abbreviations. A valuable resource for obstetric anesthetists, perinatologists and other obstetric care providers.

A ground-breaking new volume and the first of its kind to concisely outline and explicate the emerging field of whole person care process, Whole Person Care: A New Paradigm for the 21st Century organizes the disparate strains of literature on the topic. It does so by clarifying the concept of 'whole person' and also by outlining the challenges and opportunities that death anxiety poses to the practice of whole person care. Whole person care seeks to study, understand and promote the role of health care in relieving suffering and promoting healing in acute and chronic illness as a complement to the disease focus of biomedicine. The focus is on the whole person -- physical, emotional, social, and spiritual. Using concise, easy-to-read language, the early chapters offer practitioners a thorough understanding of the concepts, skills and tools necessary for the practice of whole person care from a clinician-patient interaction standpoint, while the last two chapters review the myriad implications of whole person care for medical practice. An invaluable resource for all areas of medical practice and for practitioners at all stages of development, from medical students to physicians and allied health providers with many years of experience, Whole Person Care: A New Paradigm for the 21st Century will have a profound impact on western medical practice in North America and elsewhere.

At the Fifth International Neuromuscular Meeting held in Tokyo in 1994, leading experts in the field came together to discuss the physiology and pharmacology of neuromuscular receptor sites and neuromuscular blocking agents (NBAs). The proceedings of the meeting present a review of the history of muscle relaxants and a comprehensive examination of recent research, with a primary focus on clinical considerations. Among the topics covered by specific chapters are aspects of the neuromuscular junction (NMJ), pharmacokinetics, metabolism and metabolites of neuromuscular blocking agents, and drug interaction. Presenting the most up-to-date knowledge of the physiology and pharmacology of the NMJ and NBAs, this volume will be highly valuable to clinicians and researchers in anesthesiology, physiology, and pharmacology.

Over the years, interventional radiology has developed many effective and less invasive procedures. As the number and types of interven tions increase, radiologists are becoming more and more involved in clinical patient care. This includes pre-interventional patient workup, sophisticated medical therapy and monitoring during interventions, regular inpatient rounds and complete follow-up management. Therefore interventional radiologists are faced with a broad spectrum of clinical and pharmacological questions. Adjunctive medical therapy should increase the patient's comfort, should improve the success rates, and should further reduce the risks of the procedures. In order to fulfill our responsibility to the patients, a profound knowledge of certain drugs is indispensable. This in cludes, for example, sedatives, analgesics, cardiovascular drugs and agents to prevent infections, thromboembolic complications or restenoses. Moreover, a good monitoring system during complex procedures will increase the safety of radiological interventions. These topics and several more have been presented and discussed during an international symposium in Basel, Switzerland, in January 1992. It is the benefit of the authors, that all these results could be published shortly after the event. Connected with our thanks to all the co-workers the editors hope to find this publication assisting an increasing number of safe interventions.

Dysfunction of the gastrointestinal tract in critically ill patients has recently become a focus of intensive research. This book, the first one on this topic, is a comprehensive overview of what is currently known about the role of the gut in patients requiring intensive care. The definitions and pathogenesis of intestinal dysfunction are critically evaluated. Currently available and potential new ways to monitor intestinal function in the intensive care setting are presented. Emphasis has been placed on the evaluation of therapeutic strategies in the prevention and treatment of gut dysfunction. Options for monitoring and treating gut dysfunction in critically ill patients are rapidly evolving. This volume provides state-of-the-art information for both clinicians and clinical researchers.

This book covers a broad range of topics, providing trainee and practising anaesthetists with a comprehensive source of knowledge on applied sciences and clinical anaesthesia. The book has been divided into six sections with various chapters serving as a synopsis of the practice of anaesthesia. Each chapter discusses the significance and importance of problems that can impact the peri-operative management of the surgical patient. The case scenarios at the end of each chapter will additionally help in understanding the practical relevance of basic science. This book will be an invaluable educational resource for trainee anaesthetists and an indispensable aide-memoire for practising anaesthetists. It is, therefore, essential study material for trainees and a great educational tool for trainers. Medical students and junior doctors, who are about to embark on a career in anaesthesia or intensive care medicine, will also find the book to be a useful companion.

The World Federation of Societies of Intensive and Critical Care Medicine (WFSIC- CM) has reached the age of maturity. Physicians, nurses, and many others associated with the field of Intensive and Critical Care Medicine will be coming from all corners of the world to Florence, Italy in August, 2009 to celebrate the 10th quadrennial congress. Every 4 years for the last 36 years, congresses in the magnificent venues of London (1973), Paris (1977), Washington (1981), Jerusalem (1985), Kyoto (1989), Madrid (1993), Ottawa (1997), Sydney (2001), and Buenos Aires (2005) have sig- fied an ever-developing process which has resulted in the four pillars of the field of Intensive and Critical Care Medicine, namely partnership, ethics, professionalism, and competence. The first pillar is based on a stronger interdisciplinary collaboration and a mul- professional partnership in the field of Intensive and Critical Care Medicine. In recent decades, professional activity in medicine has been regulated by well-defined, universal principles, such as the welfare of the patient, autonomy, social justice, and the patient-physician relationship. The second pillar, ethics, has offered welcomed assistance to all these principles in establishing an ethics curriculum.

This book describes the state of the art concerning some of the most hotly debated topics in anesthesia and intensive care and is at the same time intended to serve as a useful practical guide that will assist in improving outcomes. The topics covered are wide ranging and include, for example, use of the prone position in ARDS, the role of therapeutic hypothermia in the critically ill, the value of immunoglobulins in the treatment of severe sepsis, drug management of septic shock, new strategies for prevention of ventilator-associated pneumonia, non-invasive ventilation outside of the ICU, management of postoperative bleeding and prognostic factors in cardiac arrest. Written by recognized experts in the field, the book will offer a comprehensive and easy to understand update for specialists and students of anesthesia and intensive care.

In susceptible individuals, malignant hyperthermia (MH) can be triggered by various anesthetics during surgery. First described in 1960, research since then has concentrated on reducing the very high mortality rate associated with MH. Although significant progress in treatment has been made with the introduction of dantrolene sodium in 1979, many questions remain unanswered. Following on the results of more than 30 years of investigative efforts, the Third International Symposium on MH was held in Hiroshima, Japan, in 1994, immediately before the Seventh International Workshop on MH. Specialists in the field discussed the most up-to-date findings from the point of view of clinical classification, history, and incidence based on the evidence of epidemiology, diagnostic muscle testing, genetics, and biochemistry. These proceedings of the symposium present important keys to understanding the mechanism of MH and related syndromes at the genetic level and include procedures for the monitoring and care of patients. This volume will be invaluable not only for surgeons and anesthesiologists but also for physiologists and researchers.

Patients with cardiac conditions routinely present for noncardiac surgeries, requiring special protocols for perioperative assessment and management by the anesthesiologist. Essentials of Cardiac Anesthesia for Noncardiac Surgery: A Companion to Kaplan's Cardiac Anesthesia provides current, easily accessible information in this complex area, ideal for general anesthesiologists and non-cardiac subspecialists. From preoperative assessment through postoperative care, this practical reference covers all perioperative approaches to today's patients with cardiac conditions. Provides guidance on the anesthetic diagnosis and management of the full range of cardiac lesions, helping minimize adverse outcomes and reduce complications for patients with common, complex, or uncommon cardiac conditions. Includes complete coverage of echocardiography and current monitoring techniques needed for thorough perioperative assessment - all from the anesthesiologist's perspective. Discusses safe and effective perioperative anesthetic management of patients presenting with advanced levels of cardiac care such as drug-eluting stents, multiple antiplatelet drugs, ventricular assist devices, multiple drugs for end-stage heart failure, and implanted electrical devices that produce cardiac resynchronization therapy, as well as patients with complicated obstetric problems or other significant cardiovascular issues. Features a concise, easy-to-navigate format and Key Points boxes in each chapter that help you find answers quickly. Enhanced eBook version included with purchase. Your enhanced eBook allows you to access all of the text, figures, and references from the book on a variety of devices.

Perioperative Addiction addresses an issue that every anesthesiologist will encounter many times during the course of his or her career: the patient who arrives for operative care under the influence of legal or illegal drugs. The editors and contributors provide expert guidance on how to identify and manage the addicted patient, approaching the subject from the vantage points of the specific drug and of special patient populations. Features: * Guidance for spotting and managing addicted patients * All common and important drugs of addiction, from opioids, cocaine, club drugs, and alcohol, to tobacco, marijuana, nitrous oxide, inhalants, and propofol * Special populations, including pregnant women, pain patients, adolescents, older patients, and healthcare professionals * Fascinating overview of the long history of addiction * Genetic basis of addiction, and the range of pharmacological treatments for addiction

The prevalence of obesity, an important risk factor for various diseases, has increased markedly worldwide in recent years. The results of long-term dietary behavioural therapy, however, remain sadly inadequate, with a relapse rate of about 90%. Surgery is still the only effective treatment for these patients. The annual number of weight loss operations performed in the United States in the early 1990s totaled only about 16,000, but by 2005 the figure exceeded 200,000. The anesthetic care of severely obese patients entails particular issues, and difficulties are believed to escalate in the presence of co-morbidities. Despite this, outcome data in respect of anesthetic care and pain management are still scarce. Anesthetic Management of the Obese Patient considers a wide range of important practical issues and controversies. Key questions in preoperative, intraoperative, and postoperative management are carefully addressed, and different approaches are evaluated, casting light on their effectiveness and limitations. Written by world leaders in the field, this book will be an invaluable aid for anesthesiologists.

Many drugs used in current anesthetic practice are administered intravenously. An appreciation of their kinetics and dynamics is of great assistance in determining the most appropriate drug to use, and optimal dosage regimens for any given patient. This book is specially oriented to the requirements of anesthesiologists. It will enable the student of those subjects to gain enough knowledge to make these subjects usable in daily anesthetic practice. As such it is intermediate in difficulty between mathematically oriented texts, and those which only offer a very qualitative understanding of these subjects. Practical applications and examples of the uses to which kinetic and dynamic principles can be put in daily practice are emphasized and illustrated. Basic principles and techniques with which the reader can perform kinetic and dynamic calculations are explained simply and demonstrated in detail using examples derived from clinical practice. Two appendices provide kinetic and dynamic data on the most commonly used anesthetic drugs. The last chapters use the principles discussed in the first chapters to show how variations of normal physiology and disease affect drug kinetics and dynamics. This is especially valuable to the clinician as it enables clinically useful, albeit qualitative, predictions to be made of the direction of any change of kinetic and dynamic parameters of drugs due to these factors.

Regional anaesthesia is used across specialties within anaesthesia, and is a rapidly growing sub-specialty. This new handbook covers both traditional and ultrasound guided techniques, concentrating on the differences between them. Offering readers a comprehensive overview for clinical practice, it includes paediatric and acute pain applications. Each topic covers anatomy, contraindications, landmark/US settings, technique, complications, and clinical notes. Discrete sections on pharmacology, principles, and training further the book's use for teaching purposes. It will appeal to both trainees and consultants in regional anaesthesia, as well as anaesthetic nurses and anaesthetic practitioners. Presented in the Oxford Specialist Handbook series, it offers practical advice as well as background information in a convenient pocket-sized title.

This book presents the development and experimental validation of the structural test strategy called Oscillation-Based Test - OBT in short. The results presented here assert, not only from a theoretical point of view, but also based on a wide experimental support, that OBT is an efficient defect-oriented test solution, complementing the existing functional test techniques for mixed-signal circuits.

Sleep and anesthesia resemble in many ways at a first glance. The most prominent common feature of course is the loss of consciousness, i.e. the loss of awareness of external stimuli. However a closer look at the loss of consciousness reveals already a difference between sleep and anesthesia: anesthesia is induced by an anesthetic drug whereas we may fall asleep without external cause. Other questions may arise about the difference of the two effects: do we dream during surgery under anesthesia, do we feel pain during sleep? Essentially, we may ask: what is common and what are the differences between sleep and anesthesia? To answer these questions, we may take a look at the neural origin of both effects and the involved physiological pathways. In which way do they resemble? Moreover, we ask what are the detailed features of normal sleep and general anesthesia as applied during surgery and which features exist in both phenomena? If yes in which way? To receive answers to these questions, it is necessary to consider several experimental techniques that reveal underlying neural mechanisms of sleep and anesthesia. Moreover, theoretical models of neural activity may model both phenomena and comes up with predictions or even theories on the underlying mechanisms. Such models may attack several different description levels, from the microscopic level of single neurons to the macroscopic level of neural populations. Such models may give deeper insight into the phenomena if their assumptions are based on experimental findings and their predictions can be compared to experimental results. This comparison step is essential for valuable theoretical models. The book is motivated by two successful workshops on anesthesia and sleep organized during the Computational Neuroscience Conferences in Toronto in 2007 and in Berlin 2009. It aims to cover all the previous aspects with a focus on the link to experimental findings. It elucidates important issues in theoretical models that at the same time reflect some current major research interests. Moreover it considers some diverse issues which are very important to get an overview of the fields. For instance, the book discusses not only neural activity in the brain but also the effects of general anesthesia on the cardio-vascular system and the spinal cord in the context of analgesia. In addition, it considers different experimental techniques on various spatial scales, such as fMRI and EEG-experiments on the macroscopic scale and single neuron and LFP-measurements on the microscopic scale. In total all book chapters reveal aspects of the neural correlates of sleep and anesthesia motivated by experimental data. This focus on the neural mechanism in the light of experimental data is the common feature of the topics and the chapters. In addition, the book aims to clarify the shared physiological mechanisms of both phenomena, but also reveal their physiological differences.

The seventh "Oxford Conference" on Modeling and Control of Ventilation was held in the beautiful setting of Northem Ontario at the Grandview Inn in Hunstville. This meet- ing was called the Canadian Conference on Modeling and Control ofVentilation (CCMCV) to follow on LCMCV held in London, England, three years ago. The beautiful view over Fairy Lake greeted everyone in the moming and provided an ideal setting for many discus- sions about respiratory physiology and modeling. The Oxford Conferences began in 1971 when Dr. Richard Hercynski (a mathematical modeler with an interest in respiratory physiology) and Dr. Dan Cunningham (a respiratory physiologist with an interest in modeling) decided to organize a meeting "Modelling of a Biological Control System: Tbe Regulation of Breathing" in Oxford, England, in 1978. The meeting was a success, and it spawned aseries of meetings that have continued to today. A second conference was organized at Lake Arrowbead, Califomia, in 1982. After tbis, con- ferences were repeated at tbree-year intervals. My first Oxford Conference was at tbe abbey in Solignac, France, in 1985. Next, we met in tbe cabins overlooking Grand Lake, Colorado, in 1988. In 1991, we traveled to the training institute at the base ofMt. Fuji (or at least they tell us Mt. Fuji was out there--we never saw it because of a typhoon rolling through). Our last meeting was at Royal Holloway College (University of London) where we got to dine in a castle among artwork that required guards and an electronic security system.