Critical Care Obstetrics part 76 pps

739
Index
Page numbers in italics represent fi gures, those in bold represent tables.
supportive care
388–9
treatment
388
acute lung injury/respiratory distress syndrome

338–45
burns patients
511–12
clinical presentation and pathophysiology

338–40, 339, 339
defi nitions
338
epidemiology
338
etiology
340–2, 340
fetal monitoring
342–4
corticosteroids
344
fl uid management
343
inhaled nitric oxide
343–4
mechanical ventilation
342–3

prone positioning
343
prognosis
344–5
surfactant therapy
344
acute respiratory distress syndrome, septic shock

584
ADAMTS-13, thrombotic thrombocytopenic
purpura
408–12, 409–11, 412
adenosine, fetal effects
629
adnexal masses
708–9
adnexal torsion
363
ADP
286
adrenal crisis
434
adrenal glands, pregnancy adaptations
46
agitation
689–94
management
690–2, 691
pregnant and postpartum patients
692

air embolism
157, 241
airway
chest trauma
497
obstruction
97
pregnancy adaptations
41
resuscitation
97–9, 98
airway pressure release ventilation
133, 134
albumin
70, 71, 72–3
indications
72
side effects
72–3
albuterol
331
alcohol see ethanol
alkalemia
54
alkalosis
54
metabolic
55, 64–5, 65
respiratory
55, 66, 66

Allen test
160–1
allergy, classifi cation
597
alteplase, ischemic stroke
246–7, 247
alveolar-arterial oxygen gradient
125
pulmonary embolism
291
American Nurses Association
16
amino acids
185
amiodarone, fetal effects
629–30
amniotic fl uid embolism
105, 241, 341–2, 466–72
clinical presentation
467–8, 468, 470–1, 470, 471
coagulopathy
468
hemodynamic alterations
467–8, 468
pulmonary manifestations
468, 468
diagnosis
471, 471
and DIC
401

experimental models
466–7, 467
history
466
pathophysiology
468–70, 469
treatment
471–2
amoxicillin, prophylaxis
641
amphetamine overdose
530–2
detection in urine
524
fetal considerations
531–2
lethal dose
531
management
532
maternal considerations
531, 531
metabolism
530–1
teratogenicity
531
toxicology
530
ampicillin, prophylaxis
641

amrinone, fetal effects
631
analgesia, ventilated patients
142–3, 144
anaphylactic shock
596–603
causative factors
596, 598–9
clinical presentation
597, 600
defi nitions
596
diagnosis
599, 600
differential diagnosis
602, 603
epidemiology
596
abdominal trauma
blunt
493–5, 494, 495
penetrating
495–6
ACE inhibitors, pre-eclampsia
445
acetaminophen overdose
524, 527, 528–30
antidotes
526
fetal/neonatal considerations

529–30
half-life
528
lethal dosage
528
management
530
maternal considerations
528–9, 529
metabolism
528
teratogenicity
530
toxicology
528
acetylcholinesterase inhibitors
735
acid-base balance
cardiopulmonary bypass
203
fetal
611–12
pregnancy adaptations
43, 54–5, 55
acid-base disorders
54–5, 55, 62–6
acidosis see acidosis
alkalosis see alkalosis
approach to
59–60, 60

graphic nomogram
59, 59
acid-base homeostasis
53–4
acidemia
54
acidosis
54
metabolic
55, 62–4, 63
respiratory
55, 65–6, 65
activated charcoal
525–6, 527
acute abdomen
358–63
adnexal torsion
363
appendicitis
359–61, 359, 360
bowel obstruction
362–3
cholecystitis
361–2
diagnostic imaging
359, 359
laparoscopy
358–9
acute fatty liver of pregnancy
380–1, 382, 385–9

clinical presentation
386–7, 386, 387, 388
diagnosis
387–8
and DIC
402–3
epidemiology
385
pathogenesis
385–6, 386
Index
740
management
599–603
acute
599–601
ongoing
601–2
pathophysiology
597
risk factors
596–7
exposure history
597
gender
596
history of atopy
597
type of exposure
597

timing/length of reaction
597, 599
anaphylactoid syndrome of pregnancy see amniotic
fl uid embolism
anaphylaxis, fetal distress
615
anemia
193
diabetic nephropathy
720
anesthesia
200–1
cardiac disease
639–53
mortality
560
anion gap
63–4
urinary
64
anthrax
731–2
antibiotics, prophylaxis
641
anticholinergics
antidotes
526
asthma
331
overdose

522
anticholinesterases, antidotes
526
anticoagulant therapy
648, 648
cardiopulmonary bypass
203
fetal effects
633
prosthetic heart valves
274–5
thromboembolic disease
293–300
antepartum management
297–8, 298
heparin
293–4, 293
intrapartum management
298–9
low molecular weight heparin
294–5, 294
postpartum management
299
prophylaxis
299–300
selective factor Xa inhibitors
297
warfarin
296–7, 296, 297
antidepressant overdose

532–4
fetal considerations
533
management
533–4
maternal considerations
533
teratogenicity
533
toxicology
532–3, 532
antidiuretic hormone
73
antifactor Xa
259
antiphospholipid syndrome
301, 479–82
catastrophic
481–2, 482
clinical features
480
pathogenesis
479–80
postpartum
481–2
treatment
480–1, 481
antithrombin
401
antithrombin III

259, 286–7
defi ciency
301
in DIC
405
antithymocyte globulin
658
aortic coarctation
263–4, 644
anesthesia
644
aortic dissection
567, 644
aortic insuffi ciency
267, 270
aortic stenosis
266
acquired
267, 269–70, 647
anesthesia
643–4, 647
congenital
643
Apgar score
110
apnea
primary
109–10, 110
secondary
109–10, 110

appendicitis
359–61, 359, 360
diagnostic imaging
360
mortality and morbidity
360
preparation for surgery
360–1
presentation
359–60
arginine vasopressin see antidiuretic hormone
arrhythmias see cardiac arrhythmias
arterial blood gases see blood gases
arterial catheters, complications
156
arterial oxygen tension see PaO
2
arteriovenous malformations 245–6
asphyxia
112
factors associated with
113
Hon pattern
613
aspirin overdose
534–6
fetal considerations
535
half-life
534

lethal dose
534
management
535–6
maternal considerations
534–5, 535
metabolism
534
teratogenicity
535
toxicology
534
asthma
327–35
arterial blood gases
328
assisted ventilation
143–4
diagnosis
327–8, 328
effect on pregnancy
329–30, 330
effect of pregnancy on
329
hospitalization rates
329
management
330–4, 333, 334
delivery
333–4

emergency
335
medications
331–4
postpartum
334
pregnancy
330–4
prepregnancy
330
severity
328
atracurium
143, 144
atrial fi brillation, mitral stenosis
647–8
atrial natriuretic peptide
36
atrial septal defect
260, 260
atropine, fetal effects
630
autologous blood transfusion
172–3
acute normovolemic hemodilution

172–3
intraoperative blood salvage
173
preoperative donation

172
automated external defi brillator
99
autonomic hyperrefl exia
232–3
confusion with pre-eclampsia
232
paradoxical bradycardia
232
prevention
232
severe systolic hypertension
232
treatment
232–3
autonomy, respect for
666
axillary artery, cannulation
161
azathioprine
658
azotemia, prerenal
377, 377
bacteremia
573
bacterial endocarditis
276
bacteriuria, asymptomatic
720
Bacteroides fragilis

577
barbiturate overdose
533, 536–8
detection in urine
524
fetal considerations
537
management
537–8
maternal considerations
536–7, 536
symptoms
536
teratogenicity
537
toxicology
536, 536
Bartter’s syndrome
79
basilizimab
658
battery
666
bedside nursing
13
benifi cence
666
benzodiazepine overdose
538–9
antidotes

526
detection in urine
524
fetal considerations
538–9
management
539
maternal considerations
538, 538
teratogenicity
539
toxicology
538
β-agonists, asthma
331
β-blockers, fetal effects
632
bicarbonate
62
biliary disease
366
biological agents
731–5, 731
anthrax
731–2
plague
733–4
Q fever
734
ricin

734–5
smallpox
732–3
viral hemorrhagic fevers
734
bioterrorism
729–37
biological agents
731–5, 731
general preparations
730
radiation exposure
735–7, 736
toxins/chemicals
735
birth depression
108–9, 113
blindness, temporary
455
blood collection/storage
165–6
blood component transfusion
165–78
autologous blood
172–3
blood inventory and ordering
170–1
cryoprecipitated antihemophilic factor
168
directed donation

173
disease transmission through
177–8
duration
169
fi lters
169
fresh frozen plasma and thawed plasma
168
intravenous solutions used with
169
massive
172
obstetric hemorrhage
171–2, 171
patient/donor identifi cation
169
platelets
168
red blood cells
167
frozen
167–8
leukocyte reduced
167
sickle cell crisis
398
washed
167
red cell antigen-antibody reactions

169–70, 170
separation
166–7
Index
741
transfusion reactions see transfusion reactions
warming of blood
169
whole blood
167
blood donation
165, 166
blood gas analysis
57–8
interpretation
58–9
mixed venous oxygenation
58
pulse oximetry
58
sample collection
57
blood gas analyzer
57–8
blood gases
53–66
asthma
328
bicarbonate
62

respiratory components
60–2
lung function assessment
61
oxygenation of peripheral tissues
61–2
PaCO
2
62
PaO
2
60–1, 61
blood loss, normal, physiologic changes
561
blood pH
58
blood pressure
diastolic
34
fetus, apnea
110
pregnancy adaptations
32, 32, 33
systolic
34
blood products, allergy to
599
blood transfusion see blood component transfusion;
exchange transfusion
blood volume, pregnancy adaptations

30–2, 31, 31
bone marrow transplantation
661–2
sickle cell crisis
398
bowel edema, crystalloid-induced
71
bowel obstruction
362–3
clinical management
363
diagnosis
362
presentation
362
brachial artery, cannulation
161
bradycardia, fetal
606, 606
brain death
675–8
criteria and tests
677
historical background
675–6
maintenance in vegetative state
676
management guidelines
676–8, 677
outcomes

676
perimortem cesarean delivery
103–4, 621–2, 621,
676
states of
677
brain injury
diffuse
500
focal
500–1
brain tumors
224
breast cancer
710–11
breathing, resuscitation
99
buffers
53
calcitonin, hypercalcemia
84
calcium, metabolic disturbances
81–5
hypercalcemia
83–5
hypocalcemia
82–3
calcium channel blockers
fetal effects
630

pre-eclampsia
444, 444
cancer
704–12
adnexal masses
708–9
breast
710–11
cervix
705–8
Hodgkin’s lymphoma
712
melanoma
711–12
ovarian
709–10
surgical principles
705
capnometry
210–11
carbamazepine
223
overdose
524
carbohydrates
185
carbon monoxide poisoning
539–41
antidotes
526

fetal considerations
540
management
540–1
maternal considerations
539–40, 540
teratogenicity
540
toxicology
539
carbonic acid-bicarbonate system
53
carboxyhemoglobin
524
cardiac arrest
95
cardiopulmonary resuscitation see
cardiopulmonary resuscitation
pregnancy-specifi c conditions
95, 98
reversible causes
98
cardiac arrhythmias
566–7, 652
cardiac disease
256–77
acquired
267–70, 267
aortic insuffi ciency
267, 270

aortic stenosis
267, 269–70, 647
mitral insuffi ciency
267, 269
mitral stenosis
267, 268–9, 644–7, 645, 645–6
mitral valve prolapse
269
pulmonic and tricuspid lesions
267, 268
anesthesia
639–53
anticoagulation and prosthetic heart valves

274–5
bacterial endocarditis
276
cardiac transplantation see cardiac transplantation
congenital
259–66, 640–4, 640
aortic stenosis
266, 643
atrial septal defect
260, 260
coarctation of aorta
263–4, 644
Ebstein’s anomaly
263
Eisenmenger’s syndrome
261–3, 262, 642–3

functional single ventricle and Fontan
procedure
266
left to right shunts
641–2, 641, 642
patent ductus arteriosus
261
pulmonary hypertension and Eisenmenger’s
syndrome
261–3, 262
pulmonary stenosis
266, 643
tetralogy of Fallot
264–5, 642
transposition of great vessels
265–6
ventricular septal defect
260–1
dysrhythmias
276–7
epidemiology
639
fetal considerations
266–7, 267
functional classifi cation
257
hypertrophic obstructive cardiomyopathy
272
ischemic
648–9

Marfan syndrome
210, 272–3
maternal risk
257
myocardial infarction
273–4, 274
patient counselling
256–8, 257
peripartum cardiomyopathy
270–2, 271
physiologic considerations
258–9, 258, 258, 259
cardiac index
34
cardiac output
18–24, 34, 38, 39, 258–9
coronary artery disease
18–24, 20–3, 20, 21
non-invasive monitoring
207–8
pregnancy adaptations
34–5, 34, 35, 259
pulmonary artery catheterization
218
cardiac surgery, timing of
197–8
cardiac tamponade
497–8
cardiac transplantation
276, 277, 652–3, 661

anesthesia
652–3
cardiac trauma
498
cardiogenic shock
564–5, 572
pathogenesis
564–5
cardiomyopathy
Doppler ultrasound
209–10
hypertrophic obstructive
272
mortality
560
peripartum
270–2, 271, 565–6, 651–2, 651
cardioplegia
202
cardiopulmonary bypass
196–204, 653
acid-base status
203
anesthesia and surgery
200–1
anticoagulation
203
avoidance of
197
duration

203
fetal monitoring
200
hematologic considerations
203
maternal and fetal risks
196–7
myometrial activity during
199–200
postoperative course
203
technique
cardioplegia
202
fl ow and perfusion pressure
202
hypothermia
201–2
priming pump
201
pulsatility
202
timing of cardiac surgery
197–8
and uteroplacental perfusion
198–9, 199, 200
cardiopulmonary resuscitation
93–105, 96, 97, 653
airway
97–9, 98

breathing
99
circulation
99–100
complications and aftercare
103
current recommendations
93–4, 94
drugs
100–1
modifi cations for pregnancy
101–3, 102
neurological impairment after
104
perimortem cesarean delivery
103–4
pregnancy effects
100, 101, 102
thrombolytic therapy
103
cardiovascular accident see stroke, pregnancy-related
cardiovascular system
pregnancy adaptations
30, 639–40, 640, 640
blood pressure
32, 32, 33
blood volume
30–2, 31, 31
cardiac output and stroke volume
34–5, 34, 35

central hemodynamic changes
39, 39
heart rate
32–4, 33
hemodynamic changes during labour
39–40,
39
hemodynamic changes postpartum
40–1, 40
postural effects
37–9, 37, 38
regional blood fl ow
36–7
systemic vascular resistance
35–6, 36
ventilator-associated complications
141
Index
742
cardioversion
647, 648
cathartics
526–7, 527
catheter-related infection
162
catheterization techniques
154–5, 156
Seldinger technique
154–5
catheters

central venous
153, 154
occlusion
176–7
vascular access
152–4, 153, 154
central nervous system, crystalloid effects

71–2
central venous access
17–18
associated infections
17–18
central venous catheters
154
peripherally inserted
153
central venous pressure
34, 38, 39
cephalic vein, cannulation
159
cerebral autoregulation
499
cerebral blood fl ow
237
cerebral edema
454–5
cerebral perfusion pressure, Doppler ultrasound

212–13

cerebral vasculopathy, postpartum
240
cerebral venous thrombosis
224, 239–40
cervical cancer
705–8
carcinoma
706–8
intraepithelial neoplasia
706
cesarean delivery
perimortem
103–4, 621–2, 621, 676
spinal injury
231
chemical burns
509
chest compressions
118–19
chest trauma
496–8
airway management
497
blunt cardiac injury
498
cardiac tamponade
497–8
classifi cation
496–7, 497
fl ail chest

498
hemothorax
497
open pneumothorax
497
tension pneumothorax
497
chest X-ray, pulmonary embolism
291
chlorhexidine gluconate
18
cholecystitis
361–2
diagnosis
361
management
clinical
361–2
medical
362
surgical
362
presentation
361–2, 361
cholestasis of pregnancy
388
cholinergics, overdose
522
cholinesterase
524

choriocarcinoma
241
Chvostek’s sign
83
circulation
resuscitation
99–100
spinal injury
229
cisatracurium
143, 144
Clostridium perfringens
573
coagulation, normal
440, 441
coagulation cascade, septic shock
585–6, 588
coagulation factors
259
pregnancy adaptations
45, 259
see also individual factors
cocaine poisoning
541–3
detection in urine
524
fetal considerations
542
management
542–3

maternal considerations
541–2
teratogenicity
542
toxicology
541
colloid osmotic pressure
39, 350
colloid solutions
72–3
albumin
72–3
hetastarch
73
competency
666–8
computed tomography, spiral, pulmonary embolism

292
congenital anomalies, neonatal resuscitation
122
continuous positive airway pressure (CPAP)
128
mask
116
neonate
115–16, 117
coronary artery disease
18–24, 20–3, 20, 21
diabetes mellitus

724–5
corticosteroids
acute lung injury/acute respiratory distress
syndrome
344
asthma
331–2
complications
231
fetal effects
634
hypercalcemia
84
immunosuppression
658
pre-eclampsia/HELLP syndrome
239
septic shock
587–8
spinal injury
230–1
systemic lupus erythematosus
478
Couvelaire uterus
309
Creutzfeldt-Jakob disease, blood transmission
178
critical care nursing
16–29
cardiac output evaluation

18–24
central venous access
17–18
heparin fl ush
18
invasive haemodynamic monitoring
16–17
mechanical ventilation
24–9, 25, 26, 26, 28, 28
preparation for caring
29
standards of care
16, 17
technology
16
critical illness polyneuropathy
138
cromolyn sodium
331
cryoprecipitated antihemophilic factor
168
crystalloid solutions
70–2, 70
indications
87
isotonic crystalloids
70–1
side effects
71–2
Cullen’s sign

367
cyanide, antidotes
526
cyclosporine
658
cytomegalovirus, blood transmission
178
D-dimer
401
assay 290
daclizumab
658
dead space
125
deep venous thrombosis
288–90
clinical diagnosis
288, 288
ascending venography
289, 289
D-dimers and thrombin assay
290
impedance plethysmography
289
iodine 125 fi brinogen scanning
289–90
radionuclide venography
290
thermography
289

ultrasound
288–9
incidence
284
and route of delivery
285
delta gap
64
dependent moral status
666
depression
684–7
during pregnancy
684–5
perinatal risk factors
685–6
postpartum
685
treatment
686–7
dexamethasone, fetal effects
634
dexmedetomidine
143
dextrose 5%
71
diabetes insipidus
cranial
77
transient of pregnancy

76
diabetes mellitus
717–25
coronary artery disease
724–5
diabetic ketoacidosis
425–7, 427, 721–4
clinical presentation
722
differential diagnosis
722–3
laboratory diagnosis
722, 722
management
723–4, 723
bicarbonate
723–4
fl uid and electrolytes
723
insulin
723
potassium
723
pathophysiology
721–2
precipitating factors
722
diabetic nephropathy
719–21
course in pregnancy

719–20
management
720–1, 721
prepregnancy evaluation
719
diabetic neuropathy
425
diabetic retinopathy
717–19
course in pregnancy
717
insulin effect
718
management
718–19
“pregnancy factor”
717–18
risk factors
718
dialysis
188–94, 721
antepartum management
193–4
fetal complications
192–3, 192
hemodialysis
189, 189, 190
indications
189
intensive

190–1
maternal complications
191–2, 192
modifi cation of prescription
191
overview
188–9
peritoneal
189–90, 190, 190
and pregnancy
190–3, 190
and uteroplacental perfusion
191
diaphragmatic hernia
121
diazepam
142, 226
diazoxide, pre-eclampsia
444
DIC see disseminated intravascular coagulopathy
diet see nutrition
digital subtraction pulmonary angiography
293
digoxin
antidotes
526
fetal effects
631
overdose
524

diltiazem, fetal effects
630
Index
743
disseminated intravascular coagulopathy
400–5,
576
diagnosis
clinical
403
laboratory
403–4, 403
etiology
401–3, 401
acute fatty liver of pregnancy
402–3
amniotic fl uid embolism
401
eclampsia
402
intrauterine death
402
intrauterine infections
402
placental abruption
402
factor VIIa
405
fetal distress
615–17, 616

management
404–5
activated protein C
404
antithrombin III
405
blood/blood products
404
fl uid therapy
404
heparin
404
normal coagulation
400, 401
pathophysiology
400–1
septic shock
585–6
distributive (vasodilatory) shock
572
diuretics, fetal effects
631–2
dobutamine, fetal effects
631
dopamine
fetal effects
631
post-resuscitation
120
Doppler ultrasound

and cardiomyopathy
209–10
critical care
208–9
physiology of pregnnacy
208
pre-eclampsia
209
transcranial
211–13, 211
bias and confounders
211–12
cerebral perfusion pressure
212–13
transesophageal
210
dorsalis pedis artery, cannulation
161
drug reactions
598
drug-depressed infants
119
dysrhythmias
276–7
Ebstein’s anomaly
263
ECG, pulmonary embolism
291
eclampsia
224, 237–9, 455–7, 456

and DIC
402
fetal distress
615
maternal-fetal complications
456
see also pre-eclampsia
Eisenmenger’s syndrome
261–3, 262, 642–3
anesthesia
643
electrical burns
509
electrocardiogram see ECG
electrolyte balance see fl uid/electrolyte balance
electrolyte disorders
73–86
see also individual electrolytes
embolism
air
157, 241
amniotic fl uid
241
mortality
560
paradoxical
241
emesis, induction of
521, 523
enalapril, fetal effects

632
endocarditis, bacterial
276
endocrine emergencies
425–34
adrenal crisis
434
diabetic ketoacidosis
425–7, 427
hyperparathyroidism
432–3
hypoparathyroidism
433
pheochromocytoma
431–2, 432
thyroid dysfunction
428–31
hyperthyroidism
428–30, 429
hypothyroidism
430–1
thyroid storm
431
endocrine system
pregnancy adaptations
45–6
endotracheal intubation
117–18, 118, 130
complications
131

endovascular occlusion therapy
245
envenomation
548–53
scorpion stings
553
snakebites
548–50, 549, 550
spider bites
551–3, 551, 552
epidemiology
1–10
epidural hemorrhage
494
epilepsy
222–7
etiology
222
gestational
224
new-onset in pregnancy
224–5, 224
prophylaxis
222–4
seizure classifi cation
223
status epilepticus
225–6, 226
subsequent management
226–7

treatment
225
epinephrine
fetal effects
630
neonatal resuscitation
119
epistaxis
41
ergometrine, uterine atony
313
erythroblastosis
121–2
erythropoietin, sickle cell crisis
398
ethanol poisoning
524, 543–5
detection in urine
524
fetal considerations
544
management
544–5
maternal considerations
543–4
teratogenicity
544
toxicology
543
ethical issues

665–81
brain death
675–8
Jehovah’s Witnesses
678–80
letter of condolence
680–1
maternal-fetal confl ict see maternal-fetal
confl ict
medical-legal cases
667
ethical principles
665–9
competency
666–8
court cases
670–1
fetal rights
670–1
maternal autonomy
670
Roe vs Wade
670
fetal status
668–9
informed consent
665–6
ethosuximide
223
ethylene glycol poisoning

524
antidotes
526
exchange transfusion, sickle cell crisis
397–8
expiratory reserve volume
42
external jugular vein, cannulation
158
extracellular fl uid
69
volume control
73–4
extracorporeal membrane oxygenation
135–6
face tent
129
factor V
259
factor V Leiden
288
factor VII
259
factor VIIa, recombinant
405
factor VIII
259
factor IX
259
factor X

259
factor Xa inhibitors
297
factor XI
259
factor XII
259
factor XIII
259
Fallot’s tetralogy
264–5, 642
fat emulsions
185
feeding, post-resuscitation
120
femoral artery, cannulation
161
femoral vein, cannulation
159, 160
fentanyl
144
fetal effects
628
fetal brain injury
612–15
acute
612–13, 613
Hon pattern of asphyxia
613–14
persistent non-reactive heart rate pattern

614
reactive admission test
612
fetal distress
605–22
detection of
605–6
maternal and surgical conditions
615–22
anaphylaxis
615
burns patients
617–18, 617, 618
disseminated intravascular coagulopathy

615–17, 616
eclampsia
615
maternal brain death/persistent vegetative state

618–21, 619–21
fetal effects of drugs
626–34, 627
cardiovascular drugs
629–33
endocrinologic emergencies
633–4
maternal analgesia and sedation
626–9
see also individual drugs

fetal heart rate
606–8
apnea
110
bradycardia
606, 606
brain damage
612–15
coronary artery disease
22, 23
maternal cardiopulmonary bypass
199
and maternal temperature
200
mechanical ventilation
26, 28
response to uterine contractions
609–11, 610
accelerations
609–10
late decelerations
611
variable decelerations
610
sinusoidal pattern
609
tachycardia
606–8, 607, 608
variability
608–9

fetal monitoring
614–15
fetoscopy
700–1
fetus
acid-base balance
611–12
blood pressure, apnea
110
circulation
109
hazards of radiography
231–2, 231
Index
744
medical-legal status
668–9
monitoring, during cardiopulmonary bypass
200
response to hypoxia
109, 109
fi brinogen
259, 401
fi brosing alveolitis
340
fl ail chest
498
fl uid dynamics, pregnancy effects
69–70
fl uid resuscitation

70–3, 70
acute lung injury/acute respiratory distress
syndrome
343
spinal injury
230
fl uid/electrolyte balance
69–86
ventilated patients
141–2
fl uids, post-resuscitation
120
fl umazenil, overdose
521
Fontan procedure
266
food allergies
598
formoterol
331
fosphenytoin
226
fractures, burns patients
512
functional residual capacity
42
furosemide, fetal effects
631
gabapentin
223

gallbladder, pregnancy adaptations
44
Gardnerella vaginalis
577
gastric contents, aspiration of
341
gastric lavage
523, 525
gastrointestinal haemorrhage
138
gastrointestinal system
pregnancy adaptations
43–4
anatomy
43–4
hepatobiliary
44
physiology
44
septic shock
586–7
genitourinary system, pregnancy adaptations
43
gentamicin, prophylaxis
641
glomerular fi ltration rate
69
glomerulonephritis, acute
377–8, 378
glucose, post-resuscitation

120
graft-vs-host disease, transfusion-associated

177
Graves’ disease
428–9
Grey Turner’s sign
367
gunshot wounds
495–6
haemodynamic monitoring, invasive
16–17
haloperidol
142
fetal effects
628
head trauma
499–503
brain injury mechanism
499
cerebral autoregulation
499
classifi cation
500
delivery considerations
502–3
diffuse brain injury
500
focal brain injury
500–1

general principles
501–2, 502
primary management
499–500
skull fractures
501
heart rate
34, 38, 39
fetal see fetal heart rate
pregnancy adaptations
32–4, 33
heavy metal poisoning
524
antidotes
526
Heimlich maneuver
97
HELLP syndrome
237–9, 380, 382, 417–19, 451–3,
452, 453
causes and pathogenesis
418
clinical features
417
differential diagnosis
419, 452
laboratory features
417–18
maternal outcomes
453

perinatal outcomes
453
treatment
238–9, 418–19
hematologic system
pregnancy adaptations
44–5
coagulation factors
45
platelet count
45
red cell mass
44–5
white cell count
45, 45
hemodialysis
189, 189, 190, 190
hemodynamic changes
central
39, 39
during labour
39–40, 39
postpartum
40–1, 40
hemolytic-uremic syndrome
381, 416–17
treatment
417
hemophilia
321

acquired
321
hemorrhage
171–2, 171, 308–22
bleeding disorders
319–22
causes
560, 561–2
clinical classifi cation
560
epidural
494
mortality
559, 560
placental abruption
308–9
postpartum see postpartum hemorrhage
uterine rupture
309–11
see also hypovolemic shock
hemostasis
285–7
pregnancy adaptations
287, 287
hemothorax
497
Henderson-Hasselbalch equation
53–4, 57,
62
heparin

antidotes
526
antiphospholipid syndrome
481
fetal effects
633
low molecular weight see low molecular weight
heparin
side effects
295–6, 295
thromboembolic disease
293–4, 293
heparin fl ush
18
hepatitis, acute
388
hepatitis B, blood transmission
177
hetastarch
70, 73
indications
73
side effects
73
high humidity mask
129
high-frequency oscillatory ventilation
133–4
Hodgkin’s lymphoma
712

Homan’s sign
288
hospitalization
length of hospital stay
2
perterm labor
13
pregnancy-related
2, 3
delivery
3, 4
non-delivery
3, 4
human T-lymphotropic virus, blood transmission

177–8
hydralazine
fetal effects
632
pre-eclampsia
443–4, 444
hydrochlorothiazide, fetal effects
631–2
hydrocortisone, fetal effects
634
hydromorphone
144
hydrops
121–2
hydroxychloroquine, systemic lupus erythematosus

478
hyperalimentation
181–6
normal nutrition
181–2, 182
weight gain
182
hypercalcemia
83–5
clinical presentation
84
diagnosis
84
etiology
83, 83
treatment
84–5, 84
hypercapnia, permissive
137–8
hypercoagulability
258, 259
hyperemesis gravidarum, and hyponatremia
74–5
hyperkalemia
79–81
clinical presentation
80
diagnosis
80–1

etiology
80, 80
management
81, 81
hypermagnesemia
86
hypernatremia
76–8
clinical presentation
77
diagnosis
77
etiology
76–7, 76
management
77–8
hyperparathyroidism
432–3
hypertension
pregnancy-induced
439
mortality
560
see also eclampsia; pre-eclampsia
hypertensive cardiomyopathy
449–50
hyperthyroidism
428–30, 429
hypertriglyceridemia
366–7

hypertrophic obstructive cardiomyopathy
272
hypocalcemia
82–3
clinical presentation
83
etiology
82–3, 82
treatment
83, 83
hypokalemia
78–9
clinical presentation
79
diagnosis
79
etiology
78–9, 78
management
79
hypomagnesemia
85–6, 85
hyponatraemia
74–6
clinical presentation
75–6, 75
etiology
74–5, 74
hypoparathyroidism
433

hypotension, spinal injury
230
hypothermia, cardiopulmonary bypass
201–2
hypothyroidism
430–1
hypovolemic shock
229, 559–64, 572
management
562–4
hemostasis
564
oxygenation
562
pharmacologic agents
564
volume replacement
562–4
hypoxemia
60, 128
treatment see mechanical ventilation
Index
745
hypoxia, fetal response to
109, 109
hypoxic ischemic encephalopathy
605
hysterectomy, postpartum hemorrhage
318–19
hysterotomy

699–700, 700
ibutilide, fetal effects
630
ICU see intensive care unit
idiopathic thrombocytopenic purpura
319–20
immune system, pregnancy adaptations
46–7
immunosuppression
657–9, 658
immunotherapy
anaphylaxis
598
asthma
332
septic shock
588
independent moral status
666
indium 111 platelet imaging
293
infection
573
catheter-related
162
central line-associated
17–18
mortality
560
intrauterine

402
inferior vena cava fi lter
300–1
informed consent
665–6
insect bites/stings
598
inspiratory capacity
42
insulin, fetal effects
634
intensive care unit
11–15
admission criteria
12
design of
14–15
patient population
11–12, 12
patient-centered care
12, 12
pregnancy-related admissions
6, 7
illnesses responsible for
6, 8
mortality causes
7–8, 9
rationale for
11
team members

12–14
nurses
13, 13
physicians
12–13
internal jugular vein, cannulation
157–8, 157,
158
International Normalized Ratio
168
interstitial nephritis
378, 378
intracerebral hemorrhage
241
intracranial hemorrhage
224
intracranial pressure, subarachnoid hemorrhage

244
intrauterine death, and DIC
402
intrauterine infection, and DIC
402
intravascular volume
258, 258
intubation, spinal injury
228–9
inverse ratio ventilation
132–3
iodine poisoning

527
ipratropium
331
iron poisoning
524, 527, 545–6
antidotes
526
fetal considerations
546
management
546
maternal considerations
545–6
teratogenicity
546
toxicology
545
ischemic heart disease
648–9
ischemic stroke
246–8, 247
prevention
248
symptoms
246
thrombolytic therapy
246
isoniazid, antidotes
526
isopropanol, overdose

524
isoproterenol, fetal effects
631
Jehovah’s Witnesses
678–80
guidelines for treatment
679–80
historical background
678
legal issues
678–9
justice
666
kallikrein
286
kidney, role in acid-base regulation
54
kininogen
286
labetalol
238
fetal effects
632
pre-eclampsia
444–5, 444
labor and delivery
cesarean see cesarean delivery
fetal heart rate
22, 23
fetal monitoring

614–15
hemodynamic changes
39–40, 39
preterm see preterm labor
spinal cord injury
233
transplant patients
662
laparoscopy
358–9
latex allergy
599
left to right shunts
641–2, 641, 642
anesthetic management
641–2, 642
left ventricular outfl ow tract obstruction
644
left ventricular stroke work index
38, 39
letter of condolence
680–1
leukotriene modifi ers
332
Libman-Sacks endocarditis
210
lidocaine, fetal effects
630–1
lithium, overdose
524

liver function, pregnancy adaptations
44
liver rupture
453–4
liver transplantation
660–1
lorazepam
142, 144, 226
fetal effectsd
627
losartan, fetal effects
632
low molecular weight heparin, thromboembolic
disease
294–5, 294
Lowenberg test
288
lung function, assessment
61
lung injury, ventilator-induced
137
lung transplantation
661
lung volumes, pregnancy adaptations
42, 42,
329
magnesium, metabolic disturbances 85–6
hypermagnesemia
86
hypomagnesemia

85–6
magnesium sulfate
238
antidotes
526
pre-eclampsia
442
malnutrition
186–7
mania
692–4
treatment
693–4
mannitol
fetal effects
634
subarachnoid hemorrhage
244
Marfan syndrome
210, 272–3
marijuana, detection in urine
524
maternal mortality
1, 2–5, 4
pregnancy-related
5
thermal injuries
512
maternal-fetal confl ict
669–70

compromise views
673–4, 673
fetal rights
669–70, 672
management of
674–5
maternal autonomy
669, 672
special considerations
671–3
fetal rights
672
forcible restraint with good outcome
672–3
maternal autonomy
672
maternal-fetal unit, transport of substances between

182
maximal sterile barriers
17
mean arterial pressure
34, 38, 39
mechanical ventilation see ventilation
meconium aspiration
120–1, 121
melanoma
711–12
Mendelson’s syndrome
577

mercury poisoning
527
metabolic acidosis
55, 62–4, 63
metabolic alkalosis
55, 64–5, 65
metaproteronol
331
methanol poisoning
524
methemoglobinemia
524
antidotes
526
methimazole, fetal effects
634
methylergonovine, uterine atony
313
methylxanthines, asthma
331
microalbuminuria
719–20
midazolam
142, 144
fetal effects
626–7
milrinone, fetal effects
631
minerals
186

misoprostol, uterine atony
314
mitral insuffi ciency
267, 269
mitral regurgitation
267
mitral stenosis
267, 268–9, 269, 566, 566, 644–7,
645, 645–6
anesthesia
646–7, 646
atrial fi brillation
647–8
mitral valve prolapse
269
mixed venous oxygenation
58, 128
monitoring
fetal, cardiopulmonary bypass
200
non-invasive
207–13
capnometry
210–11
Doppler ultrasound
208–10, 211–13
oximetry
210, 210
montelukast
332

morbidity, ICU admissions
8
morphine
144
fetal effects
628
mortality
causes
560
ICU admissions
7–8, 9
maternal see maternal mortality
perinatal see perinatal mortality
motor vehicle accidents
493
Moyamoya disease
241
muromononab-CD3
658
mycophenolate mofetil
658
myocardial infarction
273–4, 274, 565
myopathy
138
Index
746
naloxone, overdose
521
nasal cannula

129
negligence
666
neonatal lupus erythematosus
476–7
neonatal resuscitation
108–22
anticipation of
111–12
Apgar score
110
assisted ventilation
114–18
causes of birth depression
108–9
chest compressions
118–19
complications
120–2
diaphragmatic hernia
121
erythroblastosis/hydrops
121–2
meconium aspiration
120–1, 121
pneumothorax
121
congenital anomalies
122
drug-depressed infants

119
equipment
112
initial steps and evaluation
112–14
airway clearance
113–14
free-fl ow oxygen
114
tactile stimulation
114
thermal management
112–13, 114
medications
119
overview
110–11, 111
personnel
112
post-resuscitation care
120
primary and secondary apnea
109–10, 110
ventilation
111
nerve agents
735
neurogenic shock
229
neutralizing agents

526
nicotine poisoning
527
nifedipine
82
pre-eclampsia
444
nimodipine, subarachnoid hemorrhage
243–4
nitric oxide
136
inhaled
343–4
nitroglycerin
fetal effects
632
pre-eclampsia
444, 445
nitroprusside, fetal effects
632–3
non-malefi cence
666
non-steroidal anti-infl ammatory drugs see
NSAIDs
NSAIDs, systemic lupus erythematosus
478–9
nurses, ICU
13, 13
nutrition
181–2, 182

hyperalimentation
181–6
renal failure
193
septic shock
586–7
ventilated patients
140–1
nutritional assessment
183
nutritional support
183–4, 184, 186
amino acids
185
carbohydrates
185
fat emulsions
185
fl uids and electrolytes
185
total parenteral nutrition
184
obstetric critical care unit see intensive care unit
obstetric hemorrhage see hemorrhage
oliguria
diagnosis
71
pre-eclampsia
450–1
opiates

antidotes
526
overdose
522
organ transplantation see transplant patients
organophosphate/carbamate poisoning
546–8
fetal considerations
547
management
547–8
maternal considerations
547
teratogenicity
547
toxicology
546–7
orotracheal intubation
228–9
orthopedic trauma
503
osmolarity, control of
73–4
ovarian cancer
709–10
overdose and poisoning
514–48
antidotes
526
decontamination procedures

520–7
gastrointestinal
521, 523, 525–7
skin
520–1
defi nitions
514
evaluation
515–27, 516, 517, 519–20
altered mental status
517, 521
initial
515, 517
secondary
517–19
toxic identifi cation
519–20, 524
incidence by substance
527
management
524
activated charcoal
525–6, 527
cathartics
526–7, 527
dialysis
525
emesis
521, 523
gastric lavage

523, 525
hemoperfusion
525
neutralizing agents
526
whole-bowel irrigation
527
medications
514, 515
physical signs
523
suicide attempts
528
toxic exposures
514
during pregnancy
514–15, 515
toxicologic considerations in pregnancy

515
see also specifi c agents
oximetry
210, 210
oxygen
free-fl ow
114
toxicity
137
oxygen consumption
55–6, 56, 56, 125–7, 126,

126
and oxygen delivery
56–7, 127
in pregnancy
57, 127
oxygen delivery
55–6, 56, 56, 125–7, 126, 126
impaired
126
and oxygen consumption
56–7, 127
in pregnancy
57, 127
oxygen delivery systems
129
oxygen extraction ratio
56
oxygen therapy, sickle cell crisis
398
oxygenation
127–8, 127
impaired
128
mixed venous
128
pulse oximetry
127–8
oxyhemoglobin dissociation curve
56, 126
fetal

61
maternal
61
oxytocin
and hyponatremia
74
uterine atony
313
PaCO
2
62
pamidronate, hypercalcemia
84
pancreas, endocrine, pregnancy adaptations
46
pancreas transplantation
660
pancreatitis, acute
365–72
clinical manifestations
367
complications
368, 368
diagnosis
368–70
differential
369–70, 369
laboratory evaluation
368–9
radiologic evaluation

369, 369
epidemiology
365–6
etiology
366–7, 366
biliary disease
366
drugs
367
hypertriglyceridemia
366–7
management
371–2
pathology and pathophysiology
367
in pre-eclampsia
454
prognostic indicators
370, 370
pancuronium
143
fetal effects
628–9
PaO
2
60–1, 61, 125
paralysis, ventilated patients
142–3, 144
parvovirus B19, blood transmission
178

patent ductus arteriosus
261
paternalism
666
patient-centered care
12, 12
PCO
2
54, 57–8
percutaneous balloon mitral commissurotomy
197
perinatal mortality
5–6, 5
peripartum cardiomyopathy
270–2, 271, 565–6
peripheral edema, crystalloid-induced
71
peripheral vascular resistance
34, 38, 39
peritoneal dialysis
189–90, 190, 190
perterm labor, hospitalization
13
phenobarbital, overdose
524
phenytoin
223, 226
overdose
524
pheochromocytoma

431–2, 432
phosphates, hypercalcemia
84
physicians, ICU
12–13
physiologic adaptations to pregnancy
30–47
cardiovascular system
30
endocrine system
45–6
gastrointestinal system
43–4
hematologic system
44–5
immune system
46–7
respiratory system
41–3
physostigmine, overdose
527
pica
79
pituitary gland, pregnancy adaptations
45
placenta, substances crossing
182
placental abruption
308–9
and DIC

402
plague
733–4
plasma
fresh frozen
168
thawed
168
plasminogen activator inhibitor
401
platelets, transfusion
168
Index
747
platelet count
normal values
401
pregnancy adaptations
45
pneumonia, ventilator-associated
139–40
pneumothorax
neonatal
121
open
497
tension
497
PO
2

57–8
poisoning see bioterrorism; overdose and poisoning
polyneuropathy
138
positive end-expiratory pressure (PEEP)
115,
134–5, 135
positive-pressure ventilation
neonate
116–17, 117
non-invasive
128–9, 129
postpartum hemorrhage
311–12, 311
etiology
311–12
secondary
321–2
surgical management
314–19, 316, 317
arterial embolization
318
bilateral uterine artery ligation
316–17, 316
hysterectomy
318–19
uterine brace suture
315, 316
uterine devascularization
315–16

uterine tamponade
315
uterine inversion
312
postpartum period
agitation
692
depression
685
hemodynamic changes
40–1, 40
psychosis
692–4
renal failure
381, 382
suicidality
689
postpartum psychosis
694
postural changes in pregnancy
37–9, 37, 38
potassium, metabolic disturbances
78–81
hyperkalemia
79–81
hypokalemia
78–9
povidone iodine
18
pre-eclampsia

237–9, 438–58
abnormal cerebral hemodynamics
238
acute renal failure
380
analgesia-anesthesia
445–6
antihypertensive therapy
443–5, 444
ACE inhibitors
445
calcium channel blockers
444
diazoxide
444
hydralazine
443, 444
labetalol
444–5, 444
nitroglycerin
445
sodium nitroprusside
445
cardiopulmonary complications
341, 447–50
hypertensive cardiomyopathy
449–50
malignant ventricular arrhythmias
450
pulmonary edema

448–9
confusion with autonomic hyperrefl exia
232
defective cerebral autoregulation
238
diagnosis
440, 440
differential diagnosis
388
Doppler ultrasound
209
etiology
438–40, 439
HELLP syndrome see HELLP syndrome
hemodynamic monitoring
446–7, 446, 447
liver rupture
453–4
management
440–1, 440
fl uid therapy
441
seizure prophylaxis
441–3, 442
neurologic complications
454–5
cerebral edema
454–5
temporary blindness
455

pancreatitis
454
renal complications
450–1
oliguria
450–1
uteroplacental-fetal complications
457
prednisolone, systemic lupus erythematosus
479
pregnancy loss, burns patients
512
pregnancy-related mortality ratio (PRMR)
4
pressure support ventilation
132
pressure-regulated volume control ventilation

132
preterm labor, burns patients
512
procainamide, fetal effects
631
propofol
142, 144
fetal effects
627–8
propylthiouracil, fetal effects
634
prostacyclin

286
prostaglandins
septic shock
588
uterine atony
313–14
prosthetic heart valves
274–5
protein C
287, 401
activated
404
defi ciency
301
protein S
287, 401
defi ciency
301
protein Z
401
prothrombin
259, 401
pseudohyperkalemia
79–80
pseudohyponatremia
75
pseudoseizures
224
psychiatric conditions, acute
684–94

agitation and psychosis
689–94
depression
684–7
suicidality
687–9
psychosis
689–94
management
690–2, 691
pregnant and postpartum patients
692, 693–4
postpartum
694
pulmonary arteriography, pulmonary embolism

292, 293
pulmonary artery catheterization
16, 215–19
cardiac output determination
218
catheter placement
216–18, 216, 217
catheter insertion
216–17, 216
sheath insertion
216
waveforms
217–18, 217
complications

218
non-invasive techniques
218–19
pulmonary embolism
292
pulmonary artery pressure
34
pulmonary capillary wedge pressure (PCWP)
27,
34, 38, 39
pulmonary edema
348–56, 349
clinical setting
349
crystalloid-induced
71
diagnosis
352, 354, 354, 355
literature reviews
353
lung mechanics and gas exchange
352
pathophysiology
349–52, 350
hydrostatic pulmonary edema
383–5
lymphatic insuffi ciency
351
permeability edema
350–1, 351

unknown causes
351–2
pre-eclampsia
448–9
prevention
356
tocolytic-induced
341
treatment
354, 356, 356
pulmonary embolism
290–3
clinical diagnosis
290–1, 290
diagnosis
291–3, 291
alveolar-arterial oxygen gradient
291
chest X-ray
291
digital subtraction pulmonary angiography

293
ECG
291
indium 111 platelet imaging
293
laboratory studies
291, 291
pulmonary arteriography

292, 293
pulmonary artery catheterization
292
spiral CT
292
ventilation-perfusion lung scan
291–2, 292
incidence
284
mortality
284
risk factors
285
and route of delivery
285
pulmonary hypertension
261–3, 262, 649–51,
649
pathophysiology
649, 649
perioperative management
650–1
pharmacologic therapies
649–50
pulmonary stenosis
266, 267, 643
anesthesia
643–4
pulmonary toxins
735

pulmonary vascular resistance
109
pulmonic insuffi ciency
267
pulse oximetry
58, 127–8
pulse pressure
34
purpura, post-transfusion
177
Purtscher’s angiopathic retinopathy
368
pyelonephritis
379–80, 382, 720
Q fever
734
quinine, overdose
527
radial artery, cannulation
159–61
radiation exposure
735–7, 736
radiocontrast media, allergy to
599
radiofrequency ablation
701–2
radiology
fetal exposure
231–2, 231
spinal injury

231
rapamycin
658
red cells
antigen-antibody reactions
169–70, 170
transfusion
167
frozen
167–8
leukocyte reduced
167
washed
167
red cell mass
69
pregnancy adaptations
44–5
red cell volume, pregnancy adaptations
31
regional anesthesia, spinal cord injury
233
regional blood fl ow, pregnancy adaptations
36–7
renal cortical necrosis, bilateral
382, 382
Index
748
renal failure
acute

194, 376–83, 382
acute fatty liver of pregnancy
380–1
acute glomerulonephritis
377–8, 378
bilateral renal cortical necrosis
382
burns patients
511
etiology
376–7, 377
HELLP syndrome
380
interstitial nephritis
378, 378
intrinsic renal disease
377–9, 378
management
382
pre-eclampsia
380
prerenal azotemia
377, 377
prognosis
382–3
pyelonephritis
379–80
thrombotic thrombocytopenic purpura/
hemolytic uremic syndrome
381

tubular necrosis
378–9
urinary obstruction
379, 379
dietary guidelines
193
end-stage, incidence in pregnancy
188, 189
postpartum
381
signs and symptoms
189
ventilation-induced
139
see also dialysis
renal function
pregnancy effects
69–70
septic shock
586
renal physiology, pregnancy adaptations
43
renal tract, pregnancy adaptations
43
renal transplantation
659–60, 659, 721
renin–angiotensin-aldosterone system
73
reserve volume
42

reservoir mask
129
respiratory acidosis
55, 65–6, 65
respiratory alkalosis
55, 66, 66
respiratory failure
124–5, 125
alveolar-arterial oxygen tension gradient
125
arterial oxygen tension
125
dead space
125
defi nition of
130
shunts
124–5
ventilation/perfusion mismatch
124–5
respiratory system
pregnancy adaptations
41–3, 298, 299, 299
mechanics of respiration
41–2
physiologic changes
42–3, 42, 42
upper airways
41
resuscitation

cardiopulmonary see cardiopulmonary
resuscitation
neonatal see neonatal resuscitation
resuscitation devices
116, 117
rhinitis of pregnancy
41
ricin
734–5
Ringer’s lactate
70, 71
salicylates, overdose
524
saline
70, 71
salmeterol
331
schizophrenia
692–4
treatment
693–4
scorpion stings
553
sedation, ventilated patients
142–3, 144
sedatives, overdose
522
seizures see epilepsy
Seldinger technique
154–5

self-injurious behavior
688
sepsis
573
burns patients
511–12
severe
572, 573
septic shock
571–88, 572
clinical presentation
576–7
defi nition
573
diagnosis
579–80, 580
disseminated intravascular coagulopathy
585–6
gastrointestinal tract and nutrition
586–7
outcome
586
pathophysiology
572–6, 574
predisposing factors
577–8, 578
pregnancy-related factors
578–9, 578
renal function
586

systemic infl ammatory response syndrome
571–2
treatment
580–6
antimicrobial therapy
584–5
coagulation cascade
585–6, 588
corticosteroids
587–8
immunotherapy
588
oxygenation
583–4
prostaglandins
588
resuscitation
581
surgery
585
vasoactive drug therapy
582–3
volume expansion
581–2
serotonin
286
Sheehan’s syndrome
75
shock
anaphylactic

596–603
cardiogenic
564–5, 572
distributive (vasodilatory)
572
hypovolemic
229, 559–67, 572
septic
571–88
treatment, crystalloids
71
shunts
fetal
701–2
intrapulmonary
124–5
sickle cell crisis
391–8
diagnosis
392
epidemiology
391
management
394–6, 395, 396
chest syndrome
395–7
fetal assessment
395
hepatic crisis
397

pain management
397, 398
uncomplicated acute pain crisis
394–5
molecular basis
391–2, 392
pathophysiology
392–3
secondary organ system effects
393–4
cardiovascular
393
renal
394
respiratory
393–4
therapeutic options
398–9
bone marrow transplant
399
erythropoietin
399
exchange transfusion
398–9
hydroxyurea
399
oxygen therapy
398
simple transfusion
399

silver sulfadiazine
511
single ventricle
266
sinus thrombosis
239–40
sirolimus
658
skin, decontamination
520–1
skull fractures
501
smallpox
732–3
snakebites
548–50, 549, 550
sodium, metabolic disturbances
74–8
hypernatraemia
76–8
hyponatraemia
74–6
sodium nitroprusside, pre-eclampsia
444, 445
spider bites
551–3, 551, 552
spinal cord injury
228–33
fetal considerations
231–2

cesarean delivery
231
hazards of diagnostic radiography
231–2,
231
long-term concerns
232–3
autonomic hyperrefl exia
232–3
labor and delivery
233
maternal considerations
228–31, 229
circulatory system
229
corticosteroids
230–1
fetal status
230
hemodynamic status
230
hypotension and fl uid resuscitation
230
neurogenic vs hypovolemic shock
229
orotracheal intubation
228–9
pregnancy physiology
229
radiologic imaging

231
spinal immobilization
228
ultrasound
230
spinal immobilization
228
spinal trauma
503–4
stab wounds
496
Staphylococcus aureus
573
status epilepticus
225–6, 226
stenosis, catheter-related
176–7
stillbirth, burns patients
512
Streptococcus pyogenes
573
stroke, pregnancy-related
235–48
air embolism
157, 241
amniotic fl uid embolism
241
cardioembolism
241
causation and time of occurrence

235, 236
cerebral blood fl ow
237
cerebral venous and sinus thrombosis

239–40
choriocarcinoma
241
diagnosis
236–7
gestational hypertension
237–9
intracerebral hemorrhage
241
ischemic
246–8, 247
Moyamoya disease
241
paradoxical embolism
241
physiology and pathophysiology
235–6
postpartum cerebral vasculopathy
240
pre-eclampsia-eclampsia-HELLP syndrome

237–9
risk factors
236
subarachnoid hemorrhage

241–4
aneurysm
245
arteriovenous malformations
245–6
types of
236, 237
stroke volume
34
pregnancy adaptations
34–5, 34, 35