Over the past two decades, electrophysiology has undergone unprecedented changes thanks to technical improvements, which simplify measurement and analysis and allow more compact data storage. This book covers in detail the spectrum of electrophysiology applications in patients with disorders of consciousness. Its content spans from clinical aspects of the management of subjects in the intensive care unit, including EEG, evoked potentials and related implications in terms of prognosis and patient management to research applications in subjects with ongoing consciousness impairment. While the first section provides up-to-date information for the interested clinician, the second part highlights the latest developments in this exciting field. The book comprehensively combines clinical and research information related to neurophysiology in disorder-of- consciousness patients, making it an easily accessible reference for neuro-ICU specialists, epileptologists and clinical neurophysiologists as well as researchers utilizing EEG and event-related potentials.

Single Subject Designs in Biomedicine draws upon the rich history of single case research within the educational and behavioral research settings and extends the application to the field of biomedicine. Biomedical illustrations are used to demonstrate the processes of designing, implementing, and evaluating a single subject design. Strengths and limitations of various methodologies are presented, along with specific clinical areas of application in which these applications would be appropriate. Statistical and visual techniques for data analysis are also discussed. The breadth and depth of information provided is suitable for medical students in research oriented courses, primary care practitioners and medical specialists seeking to apply methods of evidence practice to improve patient care, and medical researchers who are expanding their methodological expertise to include single subject designs. Increasing awareness of the utility in the single subject design could enhance treatment approach and evaluation both in biomedical research and medical care settings.

The book will provide some basic aspects of the pathophysiology of infection, but essentially the book will be practical-based and use case-illustrations to highlight key aspects of diagnosis, management and prevention. Through a combination of text, tables, figures/line drawings, clinical illustrations and other illustrations, it is hoped to provide a comprehensive, interesting and stimulating approach to this important subject. Guidance on the appropriate use of laboratory investigations, as well as radiology, together with templates to use for deciding on the optimal choice of anti-infective agents will be amongst the strengths of this book.

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.

"It's raining and the reflections of the red and white lights are dancing off the buildings as we race down the wet streets. Sirens are screaming a warning to the very few people who dare to walk the street at night.
We make a final turn and the scene comes into view. There's a lone police car; its light bar extinguished so as not to call attention to itself. We follow suit and shut our lights and siren off as we approach. In the center of the rain-soaked street, a crowd has gathered. A woman is screaming, being held up by friends or family. A man lies crumpled in the middle of the road next to his wheelchair. The cop looks nervous as we roll to a stop and exit the ambulance. 'He's been shot - a lot, ' he shouts from about 10 feet away.
The decibel level immediately increases from the crowd of distraught onlookers. We know we're going to have to work quickly to try to save the patient and get away from the scene for our own safety. We grab the heart monitor, oxygen, trauma bag and the stretcher for the fourth time this shift and once again go wading into chaos..."
Paramedics and EMTs are the front line of the world's emergency medical system and serve as eyewitnesses to some of life's most precious and equally most tragic moments.
Wading Into Chaos, written by a veteran paramedic, gives you a first hand, real life glimpse inside the chaotic world of Emergency Medical Services. Ride along and experience the emotions, the frustration, the sadness and the dark humor that accompanies responding to fatal car crashes, 14-year-old suicides, inner city gang violence, train accidents, med-e-vac helicopter landings, and the forgotten elderly who just need someone to talk to.

Addressing physical and psychosocial matters of survivorship prior to, during, and after anticancer treatment is central to a patient's wellbeing. The MASCC Textbook of Cancer Supportive Care and Survivorship explores not only the diagnosis and treatment but also the increasingly recognized complex and ongoing symptoms experienced by long term cancer survivors. Significant advances have been made, designing strategies to manage the side effects and symptoms of treatment and to prevent them from occurring, maximizing the person's ability to pursue daily activities. The MASCC Textbook of Cancer Supportive Care and Survivorship assembles international, multidisciplinary experts who focus on a comprehensive range of symptoms and side effects associated with cancer and its treatment. Intended for health professionals involved with cancer care, medical oncologists, radiation oncologists, surgeons, general practitioners, nurses and allied health workers, this textbook provides current information on the management and prevention of cancer related side effects, referring to up-to-date sources that are useful for conducting further research.

Here is an essential text for cardiologists, heart surgeons, intensive care specialists and anyone interested in pacing. It is a comprehensive guide to contemporary devices used in the resynchronization of patients' heartbeats. The treatment of congestive heart failure by implanted biventricular pacemakers, or cardiac resynchronization, has revolutionized the practice of implanting pacemakers and defibrillators. More cardiac resynchronization therapy devices than conventional pacemakers are now being implanted and the numbers are growing worldwide.

This is the premier evidence-based textbook in critical care medicine. The Third Edition features updated and revised chapters, numerous new references, streamlined content, and new chapters on key topics such as the new paradigm in critical care medicine, cardiac output monitoring, surgical optimization, vital signs, and arterial blood gas analysis. The book maintains the author's trademark humor and engaging writing style and is suitable for a broad and diverse audience of medical students, residents, fellows, physicians, nurses, and respiratory therapists who seek the latest and best evidence in critical care. From reviews of previous editions: "This is an excellent introduction to the concept of evidence-based medicine...The writing is clear, logical, and highly organized, which makes for fast and enjoyable reading. I believe this book will get daily use in most intensive care units, by a wide range of readers." -Respiratory Care "This is one of the most comprehensive handbooks on critical care medicine with a strong emphasis on evidence base...Overall, this book should be useful for junior doctors or intensive care trainees who are starting their term in an intensive care unit." -Anaesthesia and Intensive Care

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.

Critical Care Clinicians can use general drug references (Micomedex, Lexicomp) for data on dosing of high-alert medications in special patient populations but these references are not available to all healthcare clinicians, they are expensive and they are not specific to high-alert medications or critically ill patients. Doctors, nurses and pharmacists in the hospital setting will benefit from having one resource with all of this information. The purpose of this reference manual would be to guide critical care clinicians on dosing of high-alert medications in special patient populations. The most important feature of the book will be a summary of primary literature using tables when possible. This will be useful to readers because currently a reference book does not exist that guides clinicians in these difficult dosing decisions.

Completely revised and updated, Nutrition Support for the Critically Ill Patient: A Guide to Practice, Second Edition presents an unbiased, evidence-based examination of critical nutrition across the life cycle. Taking a multidisciplinary approach, each chapter has been carefully designed to provide a comprehensive review of the literature and a detailed exploration of the practical application of this information. With chapters written by experts, you get the most pertinent and current knowledge available, bolstered by tables, figures, and case studies that make the information accessible. New Coverage in the Second Edition: Gut microbiota support Short bowel syndrome Chronic critically ill phenomenon Professional nutrition practice guidelines and protocols Ethical considerations Quality and performance improvement Many challenges remain when providing optimal nutrition to all patients under all conditions at all times. Divided into eight sections, the book covers metabolic issues, nutrients for critically ill patients, delivery of nutrition therapy, nutrition therapy throughout the life cycle, special interest groups, specific organ system failure, general systemic failures, and professional issues in the field. It keeps you informed and aware of the continuous accrual of knowledge needed to craft and provide optimal nutrition therapy for the critically ill patient.

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.

Owing to their frequency and possible consequences and considering the fact they frequently affect young people, trauma tic lesions of the thoraco lumbar spine represent a special point of interest within the field of Neurotraumatology. Traffic accidents are the commonest cause, which accounts for the high peak of occurrence between 15 and 24 years of age. It is also worth noting that according to published series nearly 50% ofthe cases affect the thoraco-lumbar junction. From an anatomical point of view, we must note the severity of thoracic spinal cord lesions especially of the thoraco-lumbar junction and of the lumbar region and be able to associate injuries ofthe conus medullaris and of the ca uda equina where there is a possibility of neurological recovery. Clinical evaluation is not always easy, but remains the basis for diagnosis and prognosis. The neurological classification proposed by FRANKEL et al. in 1969 and used at STOKE MANDEVILLE Hospital seems to retain its value. A more sophisticated study of medullary evoked potentials, as described by TsUBOKAWA can allow a more precise localisation and appreciation of the extent ofthe lesion as well as a better evaluation ofthe prognosis and ofthe evaluation of treatment in the acute phase. The neuro-radiological study should include standard views ofthe whole of the spine with antero-posterior and lateral tomograms of the fractured or luxated area. At present, the unquestionable contribution of the CT.

The book covers vigorously debated controversial topics in the field of critical care medicine over the years. It provides the reader with a balanced approach and guidance based on historical and currently available evidence in dealing with contentious clinical scenarios. The book reviews the most relevant, contemporaneous evidence on each topic and provides practical guidelines for clinical practice. The book includes chapters that follow a structured approach to controversies related to specific organ systems. The topics covered provide a summary of the most relevant, practice-changing studies in the field of critical care medicine. Each topic describes the basic applied physiology, points of controversy, the evidence base, and summarizes the key points at the end. It includes brief description of landmark studies on each controversial topic. The book serves as an important clinical guide to practitioners of critical care medicine when confronted with challenging clinical scenarios. Besides, it is a useful source of information to postgraduate trainees in various medical specialties. The topics addressed are among the most widely discussed during postgraduate examinations. It is also relevant for practitioners in general medicine and specialized areas of practice, including pulmonology (respiratory medicine), cardiology, neurology, nephrology, gastroenterology, and surgical specialties.

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.

Ability to learn from errors is an essential aspect of the quest to improve treatment quality and patient safety. This book consists of 33 cases in anesthesiology that is based on real life situations and illuminate avoidable complications and mishaps. The cases are presented in a novel manner in that they are embedded within narratives. The reader comes to each case "cold", without any clue as to the content, and each case comprises a narrative and a factual component that are interwoven. The narrative parts provide the reader with information and tips regarding the clinical problems and tasks that the protagonist must face and try to solve. The idea is to engage the reader emotionally while reading and to entertain him or her while learning. All cases conclude with short debriefing sections which include possible strategies to prevent similar errors or mishaps.

Over the last two decades, the increasing use of noninvasive ventilation (NIV) has reduced the need for endotracheal ventilation, thus decreasing the rate of ventilation-induced complications. Thus, NIV has decreased both intubation rates and mortality rates in specific subsets of patients with acute respiratory failure (for example, patients with hypercapnia, cardiogenic pulmonary edema, immune deficiencies, or post-transplantation acute respiratory failure). Despite the increased use of NIV in clinical practice, there is still a need for more educational tools to improve clinicians knowledge of the indications and contraindications for NIV, the factors that predict failure or success, and also what should be considered when starting NIV. This book has the dual function of being a "classical" text where the major findings in the literature are discussed and highlighted, as well as a practical manual on the tricks and pitfalls to consider in NIV application by both beginners and experts. For example, setting the ventilatory parameters; choosing the interfaces, circuits, and humidification systems; monitoring; and the "right" environment for the "right" patient will be discussed to help clinicians in their choices."

To integrate current knowledge in terms of basic and clinical science and to highlight problems, thirty world-renowned experts in the field of acute lung injury describe the state of up to date knowledge regarding the epidemiology, pathophysiology, and clinical management of acute lung injury. Novel techniques for the clinical support of these difficult patients are discussed in full. Prospects for successful pharmacological intervention are also outlined. This book is aimed at those practising within the field of critical care and is likely to become an indispensable aid to all concerned with the investigation and management of patients with severe respiratory failure.

This is an introduction to the patient monitoring technologies that are used in today's acute care environments, including the operating room, recovery room, emergency department, intensive care unit, and telemetry floor. To a significant extent, day-to-day medical decision-making relies on the information provided by these technologies, yet how they actually work is not always addressed during education and training. The editors and contributors are world-renowned experts who specialize in developing, refining, and testing the technology that makes modern-day clinical monitoring possible. Their aim in creating the book is to bridge the gap between clinical training and clinical practice with an easy to use and up-to-date guide. * How monitoring works in a variety of acute care settings * For any healthcare professional working in an acute care environment * How to apply theoretical knowledge to real patient situations * Hemodynamic, respiratory, neuro-, metabolic, and other forms of monitoring * Information technologies in the acute care setting * New and future technologies

G. SERRATRICE This book is new and original. For some decades mitochondriopathies have been extensively studied: morphology, biochemistry, genetics. However these studies mainly concerned encephalopathies and myopathies related to mito- chondrial disorders. In this book the field of mitochondrial cytopathies is largely extended to "Mitochondrial Medicine". Very new data are gathered. A new step is jumped. Many medical specialities are concerned. Part I is devoted to mitochondrial biology: the mitochondrial machinery, the dysfunction of mitochondrial in elderly: cell decline, deleterious effects of oxidative stress in ageing, especially dysfunction of cardiac mitochondria, as well mitochondrial involvement in neurodegeneration. An attractive chapter concerns the implication of apoptosis, the programmed cell death, linked to cytochrome oxidase defect. Iatrogenic mitochondrial diseases are studied in Part II either due to a sen- sitivity to some drug or especially induced by antiretroviral drugs. Several drugs lead to a mitochondrial toxicity: antiepileptic treatment, anticancer drugs. Mitochondrial damage involving mainly the mitochondrial DNA is frequent in patients treated for several years by antiretroviral drugs, with absolute deple- tion of mitochondrial DNA. Some patients with severe lactic acidosis and mul- tiple organ failures may be improved by carnitine. Special problemes arise in newborn and in perinatal exposure to antiretroviral drugs. In case of treated mother a mitochondrial disease could occur in non infested newborn.

A large number of cardiovascular diseases are accompanied by inflammation. This volume on the molecular basis of microcirculatory disorders gives a comprehensive summary of key steps in the inflammatory cascade. Leading investigators present a state-of-the-art analysis of the molecular determinants of leukocyte-endothelial cell adhesion, mechanotransduction in endothelial and inflammatory cells, mechanisms of cell activation, microvascular apoptosis with applications to ischemia-reperfusion in the brain, the heart and in venous disease, diabetes and hypertension. The book provides the latest thinking in these important cardiovascular problems, with the most contemporary literature and a look at the increasingly complex events during inflammation. Molecular biology tools, microvascular and modern bioengineering analysis are seamlessly integrated into the analysis of clinical problems. The book helps not only newcomers to gain entry into the interesting problems associated with microvascular disorders, but lays the foundation for the design of new therapeutic interventions.

Complete reference on hypoxic pulmonary vasoconstriction and hypoxia-mediated pulmonary hypertension. Can be utilized by the physician-scientist and researcher in the laboratory as both a technical manual and reference. Designed for clinicians to guide and improve clinical treatment and diagnosis of patients with hypoxia mediated pulmonary vascular disease and right heart failure.

Catheter-Related Infections in the Critically Ill provides an overview from an international perspective on intravascular catheters and the risk of infection. This volume highlights: Epidemiology Diagnosis Impact of Infection Management and Treatment Prevention - including Education as the Primary Tool for Prevention The purpose of this book is to provide the practitioner with the most interesting and useful data in the field of catheter-related infection. It is hoped that the strategies to prevent infection detailed by the authors will be implemented and have a measurable impact in decreasing rates of infection in the intensive care unit setting.

The Update compiles the most recent, widespread developments of experimental and clinical research and practice in one comprehensive reference book. The chapters are written by well recognized experts in the field of intensive care and emergency medicine. It is addressed to every on involved in internal medicine, anesthesia, surgery, pediatrics, intensive care and emergency medicine.

In recent years much progress has been made in the field of neurochemical monitoring for the acutelly injured brain. The development of safe continuous microdialysis techniques coupled with microanalytical methodology can generate semi-continuous time profiles of the changes in numerous brain analytes such as lactate, glucose, pyruvate, excitatory amino acids, structural amino acids, indicators of free radical generation, cytokines, adenosine, and neuroprotective drugs. Descriptive studies have shown profound, prolonged, and severe abnormalities in many of the analytes measured and the next phase is to determine the effects of therapeutic interventions upon these parameters. This field of research has contributed tremendously to our understanding of pathomechanisms in acute human brain damage.