This issue of Critical Care Clinics, guest edited by Drs. John Kellum and Dana Fuhrman, focuses on Acute Kidney Injury. This is one of four issues each year selected by the series consulting editor, Dr. John Kellum. Articles in this issue include, but are not limited to: Acute Kidney Injury and Disease, AKI in Cardiac Surgery, AKI in Sepsis, Hepatorenal Disease, Cardiorenal Syndrome, Onconephrology, Renal Functional Reserve and more.

This book covers several areas, such as immunology, infectious diseases, physiology, general nursing, and medicine as well as measurement accuracy and the history of our understanding of fever. This book employs an interdisciplinary approach to exploring our concept of body temperature and specifically fever. The present volume revolves around thermometry, taking the reader on a journey from the past to the present. Yet while the emphasis is on the clinical importance of obtaining accurate, quantitative measurements of body temperature, the reader is also introduced to the most recent clinical work on the subject. This book represents a truly cross-disciplinary collaboration, using evidence-based practice to integrate physiological and immunological knowledge. The authors' intention with this volume is to help readers gain better insight into the importance of using knowledge from different disciplines to develop an appreciation of the different aspects of body temperature. In addition, the reader will come to understand the concept of fever in a broader perspective than is traditionally adopted.

The Comatose Patient is a single authored entirely new work written by a practicing critical care neurologist. It includes a critical historical overview of the concepts of consciousness and unconsciousness, principles of neurologic examination of the comatose patients including instruction of a new coma scale, the 'FOUR Score', a new practical multistep approach to the diagnosis of the comatose patient, extensive coverage of interpretation of neuroimaging and its role in daily practice and decision making, management in the emergency room and ICU and long-term supportive care and approach to communication with family members and end-of-life decision. It also discusses landmark legal cases and ethical problems and a chapter on the public perception of coma. The book is lavishly illustrated with 200 illustrations throughout the book.
Unprecedented, this book includes 75 comprehensive case vignettes covering the entire spectrum of causes leading to coma. In each case a specific cause is presented. Every example is fully discussed and explained with an emphasis on the mechanism of coma in that particular case and followed by a section on management and expected outcome.
This monograph additionally includes a 45-minute DVD with 5 narrated chapters and an easy to use navigation menu. Included are 40 patient examples showing the instructions of the FOUR score Coma Scale, common neurological findings in coma, breathing patterns in coma, different types of prolonged comatose states including a persistent vegetative state and a minimally conscious state. Using 3D animation, the DVD includes a comprehensive description of the determination of Brain Death and how to safely do the apneatest. There is an emphasis on pitfalls and common concerns. The DVD can also be used for neurology and neurosurgery residency programs, medical and nursing school curricula and physical therapy programs.

This book is one of the first to comprehensively summarise the latest thinking and research in the rapidly evolving field of quality management in intensive care. Quality indicators and outcome measures are discussed with a practical focus on patient-centred, evidence-based implementation for safer and more effective clinical practice. Chapters on topics such as teambuilding, patient satisfaction, mortality and morbidity, and electronic management systems are organised into three sections, covering quality management at the scale of the individual patient, the intensive care unit, and the national and international level. Written by a team of over forty international experts in the specialty, with editors who have been heavily involved for many years with the European Society of Intensive Care Medicine, the book reflects commonly accepted goals and guidelines for best practice, and will be valuable for practitioners worldwide. The ideal one-stop resource for intensive care physicians as well as ICU and hospital managers.

In this issue of Critical Care Clinics, guest editors Drs. Lauren R. Sorce and Joy D. Howell bring their considerable expertise to the topic of Pediatric Critical Care. Top experts in the field cover key topics such as point-of-care ultrasound for pediatric critical care providers; transfusion strategies in the 21st century; global pediatric critical care; workforce diversity; and more. Contains 13 relevant, practice-oriented topics including pediatric redeployment: unique challenges created by COVID-19; ECMO then and now; PCCM in 21st century and beyond; pediatric critical care outcomes; cardiac output monitoring; and more. Provides in-depth clinical reviews on pediatric critical care, offering actionable insights for clinical practice. Presents the latest information on this timely, focused topic under the leadership of experienced editors in the field. Authors synthesize and distill the latest research and practice guidelines to create clinically significant, topic-based reviews.

Addressing all aspects of brain death and thoroughly detailing how a potential organ donor should be maintained to ensure maximum use of the organs and cells, The Brain-Dead Organ Donor: Pathophysiology and Management is a landmark addition to the literature. This first-of-its-kind, multidisciplinary volume will be of interest to a large section of the medical community. The first section of the book reviews the historical, medical, legal, and ethical aspects of brain death. That is followed by two chapters on the pathophysiology of brain death as investigated in small and large animal models. This includes a review of the many hormonal changes, including the neuroendocrine- adrenergic 'storm', that takes place during and following the induction of brain death, and how they impact metabolism. The next section of the book reviews various effects of brain death, namely its impact on thyroid function, the inflammatory response that develops, and those relating to innate immunity. The chapters relating to assessment and management of potential organ donors will be of interest to a very large group of transplant surgeons and physicians as well as critical care and neurocritical care physicians and nurses. Neurologists, endocrinologists, neurosurgeons, and pathologists will also be interested, especially in the more basic science sections on various aspects of brain-death and hormonal therapy. Organ procurement organizations and transplant coordinators worldwide will also be interested in this title. Other chapters will be of interest to medical historians, medico-legal experts, and ethicists.

Management of the airway is an important and challenging aspect of many clinicians' work and is a source of complications and litigation. The new edition of this popular book remains a clear, practical and highly-illustrated guide to all necessary aspects of airway management. The book has been updated throughout, to cover all changes to best practice and clinical management and provides extensive coverage of the key skills and knowledge required to manage airways in a wide variety of patients and clinical settings. The best of the previous editions has been preserved, whilst new chapters on videolaryngoscopy, awake tracheal intubation, lung separation, airway ultrasonography, airway management in an epidemic and many more have been added. This is an essential text for anyone who manages the airway including trainees and specialists in anaesthesia, emergency medicine, intensive care medicine, prehospital medicine as well as nurses and other healthcare professionals.

This book is designed to provide a comprehensive and state-of-the-art resource for clinicians who care for patients with sepsis and research scientist alike, . Patients with severe sepsis requiring ICU admission have very high rates of ICU and overall hospital mortality, with estimates ranging from 18 to 50%. Risk factors for death from sepsis include underlying illness, increased age, and multi-system organ failure. This is compounded by the significant variation in the management of early severe sepsis. Care of these patients and clinical conditions can be quite complex, and materials are collected from the most current, evidence-based resources. Book sections have been structured to review the overall definitions and epidemiology of sepsis as well as current insights into the pathophysiology of sepsis. This review summarizes the evidence for the international consensus guidelines for the identification and management of sepsis. The latter part of this book reviews emerging concepts and approaches in the diagnosis and management of sepsis that may significantly reduce mortality in the future. Sepsis: Pathophysiology, Definitions and the Challenge of Bedside Management represents a collaboration between authors drawn from a variety of disciplines and contributions from basic scientists and highly recognized clinical opinion leaders with expertise in clinical trials.

This book provides insights into the care of cancer patients in the intensive care unit in a comprehensive manner. It provides an evidence-based approach to practitioners and postgraduate students to understand about the critical care needs of the patients suffering from malignancies. It helps the readers to develop critical thinking and encourage discussion towards improving the overall care of the patients and their families as their optimal management requires expertise in oncology, critical care, and palliative medicine and there is a dearth of books explaining about the special requirements and critical care needs of cancer patients. Each chapter is prepared by an expert in the field and contains well-prepared illustrations, flowcharts and relevant images. Chapters include latest evidence-based information which is useful for the readers. The book is useful for residents, fellows and trainees in the field of onco-anaesthesia, onco-critical care, onco-surgery, critical care and anaesthesia; practitioners and consultants in anaesthesia and onco-anaesthesia as well as intensivist, critical care experts and postgraduates in nursing.

This text presents a basic guide of the principles and applications of ultrasound in the critical care setting. The text also addresses the basic and clinical uses of ultrasound, including clinical cases at the end of each of the 7 sections of the clinical subdivisions. The final chapters focus on the issues of training, certification, credentialing and billing. These discussions make the text unique, as literature regarding monetary and training issues for ultrasound in the ICU is sparse. Each chapter is written by experts in the field, and supplemented with illustrations and links to videos of actual ultrasound examinations in patients. Ultrasonography in the ICU: Practical Applications will be of great utility to critical care specialists in the disciplines of surgery, medicine, anesthesiology and emergency medicine. In addition this book can be used as a teaching tool for critical care fellows and residents interested in further training in ultrasound for the critically ill patient.

The critical care unit is an intense clinical environment with huge responsibilities on the professionals caring for these patients. Imaging is a key source of diagnostic information, but the conditions in which diagnostic imaging has to be performed are often extremely challenging and significantly different to imaging in the non acute setting. Imaging the ICU Patient reviews imaging procedures on the ICU in a highly practical and memorable manner. Swift and efficient clinical decision-making is rewarded on the ICU and this book serves as a practical handbook.

Because of his international prominence, Professor Khan has been able to gather an enviable list of experts in the field to contribute their experience with airway management in a multitude of clinical settings. The critical appraisal of the airway authored by the editor, Professor Khan, sets the stage for the important preoperative tests that may alert the clinician of the potential for a difficult airway so that appropriate plans can be made. The formidable "guest list" of authors spans the world and encompasses clinicians from Malaysia, the United States, Pakistan, India, Denmark, Singapore, Germany, Canada and Iran. What is equally remarkable is the list of topics discussed in the textbook and the varied clinical settings in which airway management is likely to pose particular and unique challenges: pediatrics; patients with cervical spine injury and those with traumatic brain injury; ambulatory surgery; patients with obstructive sleep apnea and obstetric patients. The book also addresses the latest in technological advances that can aid the clinician in diagnosing and managing the difficult airway, such as ultrasonography and also describes surgical approaches to managing the difficult airway, such as cricothyrotomy. Finally, underscoring the truly international appeal of the textbook and acknowledging the potential technological limitations of the developing world, a chapter is dedicated to the use of indigenous devices in managing the difficult airway.

This book is an up-to-date, comprehensive review of the neuropsychiatry of multiple sclerosis and related diseases, by active authorities in the field, with an emphasis on diagnosis and management. Critical appraisal of the methodological aspects and limitations of the current research on the neuropsychiatry of demyelinating diseases is included, and unanswered questions are highlighted. Pharmacological aspects of management are discussed. Neuropsychiatric Symptoms of Inflammatory Demyelinating Diseases is aimed at neurologists, multiple sclerosis specialists and psychiatrists, and will also be of interest to intensive care doctors, psychologists ad neuropsychologists, research and specialist nurses, clinical researchers and methodologists.

The management of critically ill patients not only involves a bedside clinical assessment, but also a thorough daily review of investigations and monitoring. A detailed knowledge and understanding of data are an important part of training and practice in the day-to-day management of patients in intensive care. This book will play a useful role in the education of trainees, providing a source of real clinical data, with questions and answers, enabling them to test and develop their interpretation skills. Answers with explanations follow each question, providing instant access to the correct interpretation and additional information to enhance the readers understanding. Important review for anesthesia and critical care personnel who need to know this information for practice or for exams.

This book examines the many ethical issues that are encountered in the Pediatric Intensive Care Unit (PICU). It supports pediatricians, nurses, residents, and other providers in their daily management of critically ill children with the dilemmas that arise. It begins by examining the evolution of pediatric critical care, and who is now impacted by this advancing medical technology. Subsequent chapters explore specific ethical concerns and controversies that are commonly encountered. These topics include how to conduct end-of-life discussions with families facing a myriad of challenging choices. It goes on to explore the concept of futility, and what that does and does not mean in the pediatric ICU setting. Controversial subjects such as children as organ donors, particularly using donation after cardiac death, in addition to issues surrounding the declaration of brain death are covered. Additional chapters address resource allocation, and also analyze the use of long-term technology in chronically critically ill children. Chapters include case examples with guidance on how to work through similar difficulties and decision-making. While this book is specifically targeted for care providers at the ICU bedside, it is also of benefit to medical students, students in bioethics, practicing ethical consultants and families who are dealing with critically ill children.

The ACMT National Case Conference (NCC) is a monthly discussion of novel or interesting cases in medical toxicology. Participation is through online webinar, and the conferences are recorded to allow for review at any time. The cases in this book are taken from recordings of NCC with edits and revisions by contributors and editors to demonstrate educational points. The majority of the case information is from the original recording and represents actual patient presentations. However, some of the details have been changed and fictional information added to enhance the educational value. This volume covers a broad range of toxicological topics, and specialty guidance is offered at the end of every case to aid non-toxicologists. The dilemmas are applicable to both academic and clinical medicine. A list of relevant questions is also provided for each case. Subjects include common toxicological problems, rare presentations of common problems, common problems with controversial treatments or difficult diagnoses, and rare problems. Case Studies in Medical Toxicology from the American College of Medical Toxicology is a detailed reference text on specific toxicological issues and also serves as a practical review for those taking board exams. As a result, this volume is an important and necessary resource for medical students, residents, and fellows, as well as primary-care physicians, intensivists, and toxicologistsCase Studies in Medical Toxicology from the American College of Medical Toxicology is a detailed reference text on specific toxicological issues and also serves as a practical review for those taking board exams. As a result, this volume is an important and necessary resource for medical students, residents, and fellows, as well as primary-care physicians, intensivists, and toxicologists. All proceeds from this book will be donated to the Medical Toxicology Foundation.

"An engrossing human drama . . . The Shift is one nurse's story, but it contains elements of every nurse's experience."--The Wall Street Journal Practicing nurse and New York Times columnist Theresa Brown invites us to experience not just a day in the life of a nurse but all the life that happens in just one day on a busy teaching hospital's cancer ward. In the span of twelve hours, lives can be lost, life-altering treatment decisions made, and dreams fulfilled or irrevocably stolen. Unfolding in real time--under the watchful eyes of this dedicated professional and insightful chronicler of events--The Shift gives an unprecedented view into the individual struggles as well as the larger truths about medicine in this country. By shift's end, we have witnessed something profound about hope and humanity.

This issue of Critical Care Clinics, Guest Edited by Dr. Stephen M. Pastores and Dr. Wendy R. Greene, focuses on Critical Care of the Cancer Patient (Pastores) and Geriatric Critical Care (Greene). Dr. Pastores' section of the issue is devoted to Critical Care of the Cancer Patient and includes the following topics: Triage and Prognostication of Cancer Patients Admitted to the ICU; ICU Organization and Interdisciplinary Care for Critically Ill Patients with Cancer; Critical Care of the Hematopoietic Stem Cell Transplant Recipient; Management of Drug Toxicities; Acute Kidney Injury in the Critically Ill Patient with Cancer; Infectious Disease Complications in Cancer Patients; and Palliative, Ethics, and End-of-Life Care Issues in the Cancer Patient. Dr. Green's section of the issue, devoted to Geriatric Critical Care, includes the following topics: The effect of aging physiology on critical care; The frailty syndrome: a critical issue in geriatric oncology; Detection of delirium in the intensive care unit: comparison of confusion assessment method for the intensive care unit with confusion assessment method ratings; Evidence-based geriatric nursing protocols for best practice; The effect of dementia in the critically ill geriatric patient; Nutritional assessment: a primary component of multidimensional geriatric assessment in the ICU; Rehabilitation concerns in the geriatric critically ill and injured; and Geriatric palliative care.

This book is an important new resource for clinicians caring for ventilator dependent children, who often have complex health care needs, are supported by advanced technology and are at high-risk of serious complications. Despite the complicated health care needs of children who rely on chronic respiratory support, there are few guidelines and little evidence available to guide the clinicians who care for these patients. This book covers the many aspects involved in the care of these complex children, with input from experts in the fields of pediatric pulmonology, intensive care, ethics, respiratory therapy, and nursing. In depth chapters provide an introduction to the use of chronic invasive and non-invasive ventilation in children and describe and review what is known about methods of delivering ventilator support, care of the chronically ventilated patient in the community , use of chronic ventilator support in patients with disorders commonly leading to respiratory failure and outcomes for patients and their caregivers. This book is intended to be useful not only for pediatric pulmonologists, but also for intensivists, cardiologists, physical medicine/rehabilitation specialists, nurses, respiratory therapists and the primary care physicians involved in the complexities of managing care for this unique group of special needs children.

This book is a comprehensive summary of the recommendations for best practice, and current evidence, for physical activity and rehabilitation of functional deficits in individuals with end-stage diseases. While advances in technology have afforded us the opportunity to live longer lives, it has also demanded an expansion of focus of medical interventions towards palliative care to enhance the quality of life. Exercise and healthcare professionals must strive to broaden their perspectives to provide for the unique needs of these individuals, and to successfully engage with them, to achieve the most positive outcomes throughout the entire continuum of care. Healthcare providers play a critical role in advocating for care to allow individuals to remain physically active for as long as possible, even in the face of declining health. Finally, due to the increasing and progressively emergent healthcare utilization required by these individuals, a significant cost burden is experienced by healthcare systems, patients, families, and payers. There is evidence of substantial protective effects of physical activity, prevention, safety, and rehabilitative procedures to reduce hospital readmissions, reduce length of stay, and assist in avoiding unwarranted or unnecessary diagnostic tests or procedures. Physical activity has been proven to have a substantial impact and protective effects on virtually all medical conditions. During curative management, but especially during transitional phases to palliative care, other strategies need enhanced consideration to complement the existing plan of care and help to improve patient's quality of life. Ideally, physical medicine would be at the forefront of allowing individuals to live their best life until the very end. Physical Activity and Rehabilitation in Life-threatening Illness is key reading for academics and policy makers in physical activity, international exercise, wellness and rehabilitation, and related disciplines, as well as research-focused clinicians in settings where patients with advanced illness are frequently encountered.

Intensive care is a rapidly changing area of medicine, and after four years from the 2nd edition the volume editors and authors have deemed necessary to update it. In the recent years, in fact, five new randomised controlled trials and five new meta-analyses demonstrate that selective decontamination of the digestive tract SDD] is an antimicrobial prophylaxis to prevent severe infections of not only lower airways but also of blood. Additionally, SDD has been shown to reduce inflammation including multiple organ failure and mortality. An intriguing observation is the evidence that SDD using parenteral and enteral antimicrobials reduces rather than increases antimicrobial resistance. Moreover, a new chapter on microcirculation had been added.

The volume will be an invaluable tool for all those requiring in depth knowledge in the ever expanding field of infection control.

This issue of Critical Care Clinics, guest edited by Drs. Geno Merli, Bharat Awsare, and Michael Baram, focuses on Pulmonary Embolism in the ICU. This is one of four issues each year selected by the series consulting editor, Dr. John Kellum. Articles in this issue include, but are not limited to: Making the Diagnosis of Pulmonary Embolism: Stable Versus Unstable; Risk Stratification; Overview of Management of Sub-massive and Massive Pulmonary Embolism; Standard Therapy: Systemic Thrombolytics; IR Therapy: IVC Filter and Catheter-based Therapies; Surgical Therapy: Embolectomy; Supportive Therapy: Management of Acute RV Failure; Supportive Therapy: ECMO/RVAD; Special Considerations; Therapy in Sub-populations; and Post-ICU Follow-up.

The pathophysiology of sepsis can be regarded as a series of steps, beginning with the invasion of normally sterile tissue by microbes and the elaboration of various pro-inflammatory mediators. The final common pathway is often the development of the multiple organ dysfunction syndrome (MODS). Whereas a great deal has been learned during the past quarter century about the inflammatory processes associated with sepsis (and other related conditions, such as ischemia/reperfusion injury), our understanding is far less developed with respect to the pathophysiological events that lead to organ dysfunction under these conditions. Nevertheless, efforts by both clinical and laboratory scientists are leading to new knowledge in this area. The chapters in this volume provide a state-of-the-art overview of many aspects of the pathophysiology of organ dysfunction in critical illness.

This issue of Critical Care Clinics, guest edited by Drs. Hernando Gomez Danies and Joseph Carcillo, focuses on Coagulation/Endothelial Dysfunction. This is one of four issues each year selected by the series consulting editor, Dr. John Kellum. Articles in this issue include, but are not limited to: Cell-cell communication breakdown and endothelial dysfunction; Role of the Tie2/Angiopoetin pathway in endothelial dysfunction; The Glycocalyx; Platelet activation and endothelial dysfunction; Role of antithrombin III and tissue factor pathway; Red blood cell dysfunction; Microvascular hemodynamics, autoregulation and mechanotransduction control of blood flow distribution; Nitric oxide and endothelial dysfunction; Microvascular dysfunction; Hemolytic Uremic Syndrome and atypical HUS; Thrombotic thrombocytopenic purpura, Heparin induced thrombocytopenia and Disseminated intravascular coagulation in the critically ill; Thrombocytopenia associated multiple organ failure (TAMOF); Meningococcemia; Immune consequences of endothelial dysfunction during sepsis; Therapeutic targets in thrombotic microangiopathies with a focus on endothelial disorders; and Coagulation disorders in HLH/Macrophage activation syndrome.