2012 washington manual of critical care medicine 2nd edition

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THE WASHINGTON MANUALTM
OF CRITICAL CARE

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THE WASHINGTON MANUALTM
OF CRITICAL CARE

2nd Edition

Marin H. Kollef, MD
Professor of Medicine
Virginia E. and Sam J. Golman Chair in Respiratory Intensive Care Medicine
Director, Respiratory Care Services
Director, Critical Care Research
Division of Pulmonary and Critical Care Medicine
Washington University School of Medicine
Barnes-Jewish Hospital
St. Louis, Missouri

Warren Isakow, MD
Assistant Professor of Medicine
Director, Medical Intensive Care Unit
Division of Pulmonary and Critical Care Medicine
Washington University School of Medicine
Barnes-Jewish Hospital
St. Louis, Missouri

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Acquisitions Editor: Brian Brown
Product Manager: Nicole Dernoski
Production Manager: Bridgett Dougherty
Senior Manufacturing Manager: Benjamin Rivera
Design Coordinator: Holly McLaughlin
Production Service: Aptara, Inc.
©2012 by LIPPINCOTT WILLIAMS & WILKINS, a WOLTERS KLUWER business
Two Commerce Square
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Philadelphia, PA 19103 USA
LWW.com
All rights reserved. This book is protected by copyright. No part of this book may be reproduced in any form
by any means, including photocopying, or utilized by any information storage and retrieval system without
written permission from the copyright owner, except for brief quotations embodied in critical articles and
reviews. Materials appearing in this book prepared by individuals as part of their official duties as U.S.
government employees are not covered by the above-mentioned copyright.
1st edition ©2008 by Lippincott Williams & Wilkins, a Wolters Kluwer business
Printed in China
Library of Congress Cataloging-in-Publication Data
The Washington manual of critical care / [edited by] Marin H. Kollef, Warren Isakow.
p. ; cm.

Manual of critical care
Includes bibliographical references and index.
ISBN 978-1-4511-1022-7
I. Kollef, Marin H. II. Isakow, Warren. III. Title: Manual of critical care.
[DNLM: 1. Critical Care–methods–Handbooks. 2. Critical Illness–therapy–
Handbooks. WX 39]
LC classification not assigned
2011031694
616.02 8–dc23
Care has been taken to confirm the accuracy of the information presented and to describe generally accepted
practices. However, the authors, editors, and publisher are not responsible for errors or omissions or for any
consequences from application of the information in this book and make no warranty, expressed or implied,
with respect to the currency, completeness, or accuracy of the contents of the publication. Application of the
information in a particular situation remains the professional responsibility of the practitioner.
The authors, editors, and publisher have exerted every effort to ensure that drug selection and dosage
set forth in this text are in accordance with current recommendations and practice at the time of publication.
However, in view of ongoing research, changes in government regulations, and the constant flow of
information relating to drug therapy and drug reactions, the reader is urged to check the package insert for
each drug for any change in indications and dosage and for added warnings and precautions. This is
particularly important when the recommended agent is a new or infrequently employed drug.
Some drugs and medical devices presented in the publication have Food and Drug Administration
(FDA) clearance for limited use in restricted research settings. It is the responsibility of the health care
providers to ascertain the FDA status of each drug or device planned for use in their clinical practice.
To purchase additional copies of this book, call our customer service department at (800) 638-3030 or fax
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We dedicate this manual to all health care providers involved in
the care of critically ill patients and their families. We
acknowledge their efforts and sacrifices and hope that this manual
can assist them in some meaningful manner.
To our families for their support and to the critical
care and academic communities of Washington University and
Barnes-Jewish Hospital for their commitment to the education and
well-being of medical students and house staff physicians.

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Contributors

Anupam Aditi, MD

Linda Bobo, MD, PhD

Resident
Department of Medicine
Washington University School of Medicine
Barnes-Jewish Hospital
St. Louis, Missouri

Fellow
Division of Infectious Diseases
Washington University School of
Medicine
Barnes-Jewish Hospital
St. Louis, Missouri

Jennifer Alexander-Brett, MD,
PhD

Alan C. Braverman, MD

Fellow
Division of Pulmonary and Critical Care
Medicine
Washington University School of Medicine
Barnes-Jewish Hospital
St. Louis, Missouri

Alumni Endowed Professor
in Cardiovascular Disease
Professor of Medicine
Cardiovascular Division
Chief of Service, Inpatient Cardiology
Firm
Director, Marfan Syndrome Clinic
Washington University School of
Medicine
Barnes-Jewish Hospital
St. Louis, Missouri

Richard G. Bach, MD
Associate Professor of Medicine
Cardiovascular Division
Director, Cardiac Intensive Care Unit
Washington University School of Medicine
Barnes-Jewish Hospital
St. Louis, Missouri

Timothy Bedient, MD
Fellow

Division of Pulmonary and Critical Care
Medicine
University of Colorado Denver
Aurora, Colorado

Morey A. Blinder, MD
Associate Professor of Medicine, Pathology
and Immunology
Division of Hematology
Washington University School of Medicine
Barnes-Jewish Hospital
St. Louis, Missouri

Stephen R. Broderick, MD
Fellow
Division of Cardiothoracic Surgery
Washington University School of
Medicine
Barnes-Jewish Hospital
St. Louis, Missouri

Steven L. Brody, MD
Associate Professor of Medicine
Division of Pulmonary and Critical Care
Medicine
Washington University School of
Medicine
Barnes-Jewish Hospital
St. Louis, Missouri
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CONTRIBUTORS

Derek E. Byers, MD, PhD

Steven C. Cheng, MD

Assistant Professor of Medicine
Division of Pulmonary and Critical Care
Medicine
Washington University School of Medicine
Barnes-Jewish Hospital
St. Louis, Missouri

Assistant Professor of Medicine
Renal Division
Washington University School of
Medicine
Barnes-Jewish Hospital
St. Louis, Missouri

Bernard C. Camins, MD, MSCR

William E. Clutter, MD

Assistant Professor of Medicine
Division of Infectious Diseases
Associate Hospital Epidemiologist
Washington University School of
Medicine
Barnes-Jewish Hospital
St. Louis, Missouri

Associate Professor of Medicine
Division of Endocrinology, Metabolism,
and Lipid Research
Washington University School of
Medicine
Barnes-Jewish Hospital
St. Louis, Missouri

Jeanine F. Carbone, MD

Daniel H. Cooper, MD

Fellow
Department of Obstetrics and Gynecology
Washington University School of Medicine
Barnes-Jewish Hospital
St. Louis, Missouri

Mario Castro, MD, MPH
Professor of Medicine and Pediatrics
Division of Pulmonary and Critical Care
Medicine
Washington University School of Medicine
Barnes-Jewish Hospital
St. Louis, Missouri

Murali M. Chakinala, MD
Associate Professor of Medicine
Division of Pulmonary and Critical Care
Medicine
Washington University School of Medicine
Barnes-Jewish Hospital
St. Louis, Missouri

Alexander Chen, MD
Assistant Professor of Medicine and
Surgery
Director of Interventional Pulmonology
Division of Pulmonary and Critical Care
Medicine

Washington University School of Medicine
Barnes-Jewish Hospital
St. Louis, Missouri

Assistant Professor of Medicine
Cardiovascular Division
Washington University School of Medicine
Barnes-Jewish Hospital
St. Louis, Missouri

Jeffrey S. Crippin, MD
Marilyn Bornefeld Chair in
Gastrointestinal Research and Treatment
Division of Gastroenterology
Medical Director, Liver Transplantation
Washington University School of
Medicine
Barnes-Jewish Hospital
St. Louis, Missouri

Alex E. Denes, MD
Associate Professor
Division of Oncology
Director, Inpatient Oncology
Washington University School of
Medicine
Barnes-Jewish Hospital
St. Louis, Missouri

Jeremiah Depta, MD

Fellow
Cardiovascular Division
Washington University School of
Medicine
Barnes-Jewish Hospital
St. Louis, Missouri

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CONTRIBUTORS

Rajat Dhar, MD, FRCPC

Jennifer L. Gnerlich, MD

Assistant Professor of Neurology
Department of Neurology
Washington University School of Medicine
Barnes-Jewish Hospital
St. Louis, Missouri

Resident
Division of General Surgery
Washington University School of
Medicine
Barnes-Jewish Hospital
St. Louis, Missouri

Erik R. Dubberke, MD, MSPH
Assistant Professor
Associate Hospital Epidemiologist
Division of Infectious Diseases
Washington University School of Medicine
Barnes-Jewish Hospital
St. Louis, Missouri

Michael J. Durkin, MD
Instructor in Medicine
Department of Medicine
Washington University School of
Medicine
Barnes-Jewish Hospital
St. Louis, Missouri

Gregory A. Ewald, MD

Associate Professor
Cardiovascular Division
Medical Director, Cardiac Transplant
Program
Washington University School of
Medicine
Barnes-Jewish Hospital
St. Louis, Missouri

Derrick R. Fansler, MD
Fellow
Cardiovascular Division
Washington University School of
Medicine
Barnes-Jewish Hospital
St. Louis, Missouri

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ix

Seth Goldberg, MD
Assistant Professor of Medicine
Renal Division
Washington University School of
Medicine
Barnes-Jewish Hospital
St. Louis, Missouri

Jonathan M. Green, MD

Associate Professor of Medicine, Pathology
and Immunobiology
Associate Dean for Human Studies
Executive Chair of the Institutional
Review Board (IRB)
Division of Pulmonary and Critical Care
Medicine
Washington University School of
Medicine
Barnes-Jewish Hospital
St. Louis, Missouri

Brenda J. Grossman, MD, MPH
Associate Professor of Pathology and
Immunology
Medical Director, Transfusion Medicine
Services
Department of Laboratory and Genomic
Medicine
Washington University School of
Medicine
Barnes-Jewish Hospital
St. Louis, Missouri

Chandra Prakash Gyawali, MD,

Saad Ghafoor, MD

MRCP

Fellow
Department of Pediatrics
Washington University School of
Medicine
St. Louis Children’s Hospital
St. Louis, Missouri

Professor of Medicine
Division of Gastroenterology
Washington University School of
Medicine
Barnes-Jewish Hospital
St. Louis, Missouri


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CONTRIBUTORS

Ahmed Hassan, MD

Peter Juran, MD

Assistant Professor of Neurology
Department of Neurology
Washington University School of
Medicine
Barnes-Jewish Hospital
St. Louis, Missouri

Postdoctoral Fellow
Renal Division
Washington University School of
Medicine
Barnes-Jewish Hospital
St. Louis, Missouri

Hitoshi Honda, MD

Andrew M. Kates, MD

Fellow
Division of Infectious Diseases
Washington University School of Medicine
Barnes-Jewish Hospital
St. Louis, Missouri

Associate Professor of Medicine
Director, Cardiovascular Fellowship
Program
Cardiovascular Division
Washington University School of
Medicine
Barnes-Jewish Hospital
St. Louis, Missouri

Molly Houser, MD
Fellow
Department of Obstetrics and Gynecology
Washington University School of Medicine
Barnes-Jewish Hospital
St. Louis, Missouri

Yen-Michael S. Hsu, MD, PhD
Resident
Department of Pathology and
Immunology
Washington University School of
Medicine
Barnes-Jewish Hospital
St. Louis, Missouri

Howard J. Huang, MD
Instructor in Medicine
Division of Pulmonary and Critical Care
Medicine

Washington University School of
Medicine
Barnes-Jewish Hospital
St. Louis, Missouri

Warren Isakow, MD
Assistant Professor of Medicine
Director, Medical Intensive Care Unit
Division of Pulmonary and Critical Care
Medicine
Washington University School of Medicine
Barnes-Jewish Hospital
St. Louis, Missouri

Jeremy Kilburn, MD
Fellow
Division of Pulmonary and Critical Care
Medicine
Washington University School of
Medicine
Barnes-Jewish Hospital
St. Louis, Missouri

John P. Kirby, MD
Associate Professor of Surgery
Division of General Surgery
Director, Wound Healing Program
Washington University School of
Medicine
Barnes-Jewish Hospital

St. Louis, Missouri

Marin H. Kollef, MD
Professor of Medicine
Virginia E. and Sam J. Golman Chair in
Respiratory and Intensive Care Medicine
Director, Respiratory Care Services
Director, Critical Care Research
Division of Pulmonary and Critical Care
Medicine
Washington University School of
Medicine
Barnes-Jewish Hospital
St. Louis, Missouri

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CONTRIBUTORS

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xi

Kevin M. Korenblat, MD

Michael Lippmann, MD

Associate Professor of Medicine
Division of Gastroenterology
Washington University School of Medicine
Barnes-Jewish Hospital
St. Louis, Missouri

Professor of Medicine
Division of Pulmonary and Critical Care
Medicine
Washington University School of Medicine
St. Louis Veterans Affairs Medical Center
St. Louis, Missouri

Mrudula V. Kumar, MD
Fellow
Division of Gastroenterology
Washington University School of Medicine
Barnes-Jewish Hospital

St. Louis, Missouri

Andrew Labelle, MD

John E. Mazuski, MD, PhD
Professor of Surgery
Division of General Surgery
Washington University School of Medicine
Barnes-Jewish Hospital
St. Louis, Missouri

Fellow
Division of Pulmonary and Critical Care
Medicine
Washington University School of Medicine
Barnes-Jewish Hospital
St. Louis, Missouri

Kevin W. McConnell, MD

Shane J. LaRue, MD

Scott T. Micek, PharmD

Fellow
Cardiovascular Division
Washington University School of Medicine
Barnes-Jewish Hospital
St. Louis, Missouri

Steven J. Lawrence, MD
Assistant Professor of Medicine
Division of Infectious Diseases
Washington University School of Medicine
Barnes-Jewish Hospital
St. Louis, Missouri

Tinting Li, MD

Assistant Professor of Surgery
Department of Acute and Critical
Care Surgery
Emory University
Atlanta, Georgia
Clinical Pharmacist
Department of Pharmacy
Washington University School of Medicine
Barnes-Jewish Hospital
St. Louis, Missouri

Nicholas M. Mohr, MD
Assistant Professor of Medicine
Department of Anesthesiology
Department of Emergency Medicine
Washington University School of Medicine
Barnes-Jewish Hospital
St. Louis, Missouri

Assistant Professor of Medicine
Renal Division

Washington University School of Medicine
Barnes-Jewish Hospital
St. Louis, Missouri

James C. Mosley III, MD

Stephen Y. Liang, MD

Daniel K. Mullady, MD

Fellow
Division of Infectious Diseases
Washington University School of Medicine
Barnes-Jewish Hospital
St. Louis, Missouri

Assistant Professor of Medicine
Division of Gastroenterology
Washington University School of Medicine
Barnes-Jewish Hospital
St. Louis, Missouri

Attending Physician
Department of Hematology
Southeast Hospital
Cape Girardeau, Missouri


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CONTRIBUTORS

Hannah Otepka, MD

Michael A. Rubin, MD

Resident
Department of Medicine
Washington University School of Medicine
Barnes-Jewish Hospital
St. Louis, Missouri

Assistant Professor of Neurology
Department of Neurology
Washington University School of
Medicine

Barnes-Jewish Hospital
St. Louis, Missouri

Laura A. Parks, MD
Assistant Professor
Department of Obstetrics and Gynecology
Washington University School of Medicine
Barnes-Jewish Hospital
St. Louis, Missouri

Varun Puri, MD
Assistant Professor of Surgery
Division of General Thoracic Surgery
Washington University School of Medicine
Barnes-Jewish Hospital
St. Louis, Missouri

Amy M. Richmond, RN, MHS, CIC
Department of Medicine
Washington University School of
Medicine
Barnes-Jewish Hospital
St. Louis, Missouri

David Rometo, MD
Fellow
Division of Endocrinology, Metabolism,
and Lipid Research
Washington University School of Medicine
Barnes-Jewish Hospital

St. Louis, Missouri

Ryan P. Roop, MD
Fellow
Divisions of Hematology and Oncology
Washington University School of Medicine
Barnes-Jewish Hospital
St. Louis, Missouri

Jamie M. Rosini, PharmD
Clinical Pharmacist
Department of Pharmacy
Washington University School of Medicine
Barnes-Jewish Hospital
St. Louis, Missouri

Tonya D. Russell, MD
Associate Professor of Medicine
Director, Pulmonary & Critical Care
Medicine Fellowship
Division of Pulmonary and Critical Care
Medicine
Washington University School of
Medicine
Barnes-Jewish Hospital
St. Louis, Missouri

Douglas J.E. Schuerer, MD
Associate Professor of Surgery
Director of Trauma

Director of Surgical Critical
Care Fellowship
Division of General Surgery
Washington University School of
Medicine
Barnes-Jewish Hospital
St. Louis, Missouri

Jennifer Shaffer, MD
Fellow
Division of Pulmonary and Critical Care
Medicine
Washington University School of
Medicine
Barnes-Jewish Hospital
St. Louis, Missouri

Jay Shah, MD
Fellow
Cardiovascular Division
Washington University School of
Medicine
Barnes-Jewish Hospital
St. Louis, Missouri

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CONTRIBUTORS

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Devin P. Sherman, MD

Garry S. Tobin, MD

Fellow
Division of Pulmonary and Critical Care
Medicine
Washington University School of
Medicine
Barnes-Jewish Hospital
St. Louis, Missouri

Associate Professor of Medicine
Division of Endocrinology

Director, Diabetes Center
Washington University School of Medicine
Barnes-Jewish Hospital
St. Louis, Missouri

Lee P. Skrupky, PharmD

Clinical Fellow
Renal Division
Washington University School of
Medicine
Barnes-Jewish Hospital
St. Louis, Missouri

Clinical Pharmacist
Department of Pharmacy
Washington University School of
Medicine
Barnes-Jewish Hospital
St. Louis, Missouri

Robert Southard, MD
Assistant Professor of Surgery
Division of General Surgery
Washington University School of
Medicine
Barnes-Jewish Hospital
St. Louis, Missouri

Molly J. Stout, MD

Fellow
Department of Obstetrics and Gynecology
Washington University School of
Medicine
Barnes-Jewish Hospital
St. Louis, Missouri

Toshibumi Taniguchi, MD

Ahsan Usman, MD

Anitha Vijayan, MD
Associate Professor of Medicine
Renal Division
Medical Director, Acute Dialysis Unit
Washington University School of Medicine
Barnes-Jewish Hospital
St. Louis, Missouri

Sundeep Viswanathan, MD
Instructor in Medicine
Department of Medicine
Washington University School of
Medicine
Barnes-Jewish Hospital
St. Louis, Missouri

David K. Warren, MD, MPH

Fellow

Division of Infectious Diseases
Washington University School of
Medicine
Barnes-Jewish Hospital
St. Louis, Missouri

Associate Professor of Medicine
Division of Infectious Diseases
Hospital Epidemiologist
Washington University School of
Medicine
Barnes-Jewish Hospital
St. Louis, Missouri

Beth E. Taylor, MS, RD, CNSD,

Chad A. Witt, MD

FCCM

Fellow
Division of Pulmonary and Critical Care
Medicine
Washington University School of
Medicine
Barnes-Jewish Hospital
St. Louis, Missouri

Clinical Dietician
Department of Food and Nutrition

Washington University School of
Medicine
Barnes-Jewish Hospital
St. Louis, Missouri

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CONTRIBUTORS

Keith F. Woeltje, MD, PhD

Roger D. Yusen, MD, MPH, FCCP

Professor of Medicine

Division of Infectious Diseases
Director, Clinical Advisory Group
and Healthcare Informatics
Washington University School of
Medicine
Barnes-Jewish Hospital
St. Louis, Missouri

Associate Professor of Medicine
Medical Director, Lung Volume Reduction
Surgery
Division of Pulmonary and Critical Care
Medicine
Washington University School of Medicine
Barnes-Jewish Hospital
St. Louis, Missouri

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Preface

This is the second edition of The Washington Manual TM of Critical Care, building
upon the first edition and adding to the long tradition of medical education promoted
by The Washington Manual TM of Medical Therapeutics and the associated medical and
surgical subspecialty manuals published from Washington University. Our continued
goal in publishing this manuscript is to provide experienced clinicians and trainees a
resource containing comprehensive and current treatment algorithms for the bedside
diagnosis and management of the most frequently encountered illnesses and problems
in the intensive care unit (ICU). In this edition, we continue to focus on the delivery
of concise algorithms in order to expedite bedside decision-making. The chapters
include annotated bibliographies of select references to guide more in-depth reading
when time permits. We again include sections on common ICU procedures, equations,
nutrition, and pharmacology. All chapters were written by Washington University
faculty physicians and experts in their respective fields, often with the assistance of
subspecialty fellows and residents.
We recognize that the field of critical care is constantly changing with the availability of new study results. Therefore, this manual is meant to be a starting place for
the initial care and stabilization of critically ill patients. The tables and figures that
accompany each chapter are meant as guides and may not be applicable for all patients.
We strongly encourage further reading of the literature and consultation with more
expert clinicians to optimize the outcomes of critically ill patients.
We again especially give our sincerest thanks to Becky Light for her devoted
efforts in preparing chapters and for acting as the liaison between the chapters’ authors
and Lippincott Williams & Wilkins. We also thank the entire production staff at
Lippincott Williams & Wilkins and Wolters Kluwer for their efforts in the production

of this manual.
M.H.K. would like to thank his loving family for all their support and encouragement. W.I. would like to thank his wife for her support and understanding.

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Acknowledgments

The editors thank Becky Light who expertly coordinated all of the chapter communications, preparation, and revisions.

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Contents

Contributors vii
Preface xv
Acknowledgments

SECTION I

xvii

MANAGEMENT OF SHOCK

1 Introduction to Shock

1

Marin H. Kollef

2 Hypovolemic Shock

4

Marin H. Kollef

3 Severe Sepsis and Septic Shock

8

Marin H. Kollef and Scott T. Micek

4 Cardiogenic Shock

14

Sundeep Viswanathan and Richard G. Bach

5 Anaphylactic Shock

23

Timothy J. Bedient and Marin H. Kollef

6 Mechanical Causes of Shock

27

Howard J. Huang

SECTION II

MANAGEMENT OF RESPIRATORY DISORDERS

7 An Approach to Respiratory Failure

39

Warren Isakow

8 Initial Ventilator Setup

44

Warren Isakow
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CONTENTS

9 Upper Airway Obstruction

50

Warren Isakow

10 Acute Lung Injury and the Acute Respiratory
Distress Syndrome 57
Timothy J. Bedient and Marin H. Kollef

11 Status Asthmaticus

67

Saad Ghafoor and Mario Castro

12 Acute Exacerbations of Chronic Obstructive
Pulmonary Disease 76
Chad A. Witt and Marin H. Kollef

13 Sleep-Disordered Breathing in the Intensive
Care Unit 82
Tonya D. Russell

14 Pulmonary Hypertension and
Right Ventricular Failure in the Intensive
Care Unit 87
Murali M. Chakinala

15 Pulmonary Embolism

97

Hannah C. Otepka and Roger D. Yusen

16 Pleural Disorders in the Intensive
Care Unit 105
Alexander C. Chen

17 Weaning of Mechanical
Ventilation 116
Chad A. Witt

18 Noninvasive Positive Pressure

Ventilation 120
Michael Lippmann

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CONTENTS

SECTION III

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xxi

CARDIAC DISORDERS

19 Acute Myocardial Infarction

125

Jeremiah P. Depta and Andrew M. Kates

20 Cardiac Arrhythmias and Conduction
Abnormalities 139
Sundeep Viswanathan and Marin Kollef

21 Aortic Dissection

155

Jay Shah and Alan C. Braverman

22 Acute Decompensated Heart Failure

163

Shane J. LaRue and Gregory A. Ewald

23 Approach to Hypertensive Emergencies

171

Derrick R. Fansler and Daniel H. Cooper

SECTION IV

ELECTROLYTE ABNORMALITIES

24 Electrolyte Abnormalities

178

Ahsan Usman and Seth Goldberg

SECTION V

ACID–BASE DISORDERS

25 Metabolic Acid–Base Disorders

209

Peter Juran and Steven Cheng

26 Respiratory Acid–Base Disorders

222

Andrew Labelle

SECTION VI

ENDOCRINE DISORDERS

27 Thyroid Disorders

228

William E. Clutter

28 Adrenal Insufficiency in Critical Illness
Timothy J. Bedient and Marin H. Kollef

29 Diabetic Ketoacidosis and Hyperosmolar
Hyperglycemic State 239
David A. Rometo, Marin H. Kollef, and Garry S. Tobin

232


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CONTENTS

30 Glucose Control in the ICU

245

David A. Rometo, Marin H. Kollef, and Garry S. Tobin

SECTION VII

ONCOLOGIC EMERGENCIES

31 Oncologic Emergencies

255

Ryan Roop and Alex Denes

SECTION VIII

TEMPERATURE REGULATION

32 Temperature Alterations

265

Derek E. Byers

SECTION IX

TOXICOLOGY

33 Toxicology

273

Nicholas M. Mohr, Devin P. Sherman, and Steven L. Brody

SECTION X

INFECTIOUS DISEASES

34 Central Nervous System Infections

294

Hitoshi Honda and Keith F. Woeltje

35 Community-Acquired Pneumonia

300

Bernard C. Camins

36 Nosocomial Pneumonia

304

Michael J. Durkin and Marin H. Kollef

37 Cellulitis/Fasciitis/Myositis

311

Kevin W. McConnell, John P. Kirby, and John E. Mazuski

38 Bacteremia and Catheter-Related Bloodstream
Infections 316
David K. Warren

39 Invasive Fungal Infection

321

Toshibumi Taniguchi and Keith F. Woeltje

40 Infections in the Immunocompromised
Host 328
Stephen Y. Liang and Steven J. Lawrence

14:42


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CONTENTS

41 Prevention of Infection in the Intensive
Care Unit 337
Amy M. Richmond

42 Clostridium difficile and Other Infectious
Causes of Diarrhea 343
Linda D. Bobo and Erik R. Dubberke

SECTION XI

RENAL DISORDERS

43 Acute Kidney Injury

351

Tingting Li and Anitha Vijayan

44 Renal Replacement Therapy

367

Tingting Li and Anitha Vijayan

SECTION XII

HEPATIC DISEASES

45 Fulminant Hepatic Failure

376

Anupam Aditi and Jeffrey S. Crippin

46 Hyperbilirubinemia

387

Anupam Aditi and Jeffrey S. Crippin

47 End-Stage Liver Disease

391

Mrudula V. Kumar and Kevin M. Korenblat

SECTION XIII

GASTROINTESTINAL DISORDERS

48 Upper Gastrointestinal Bleeding

397

Chandra Prakash Gyawali

49 Lower Gastrointestinal Bleeding
Chandra Prakash Gyawali

50 Acute Pancreatitis

416

Mrudula Kumar and Daniel K. Mullady

SECTION XIV

NEUROLOGIC DISORDERS

51 Status Epilepticus
Rajat Dhar

423

408

xxiii

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September 22, 2011

CONTENTS

52 Acute Ischemic Stroke

429

Michael A. Rubin

53 Aneurysmal Subarachnoid Hemorrhage
Rajat Dhar

54 Intracerebral Hemorrhage

441

Ahmed Hassan

55 Coma

445

Michael A. Rubin

56 Declaration of Brain Death

452

Rajat Dhar

57 Delirium and Sedation

458

Michael A. Rubin

58 Acute Spinal Cord Disorders

465

Michael A. Rubin

59 Neuromuscular Disorders in
the Critically Ill 470
Rajat Dhar

60 Traumatic Brain Injury and Elevated
Intracranial Pressure 477
Ahmed Hassan

61 Neurologic Approach to Central Nervous
System Infections 481
Michael A. Rubin

SECTION XV

HAEMATOPOEITIC DISORDERS

62 Thrombocytopenia in the Intensive
Care Unit 488
Warren Isakow

434

14:42