Evidence-Based Practice of Critical Care

1. Cover image - p. i 2. Title page - p. ii 3. Table of Contents - p. iii 4. Copyright - p. iii 5. Dedication - p. v 6. Contributors - p. vi 7. Preface - p. vii 8. Is hypothermia useful to prevent brain injury after cardiac arrest? In other settings? - p. 1 9. SECTION 1. Critical Care and Critical Illness - p. 1 10. 1.  Has evidence-based medicine changed the practice of critical care? - p. 1 11. 2.  Do protocols/guidelines actually improve outcomes? - p. 5 12. 3.  What happens to critically ill patients after they leave the ICU? - p. 11 13. 4.  What can be done to enhance recognition of the post-ICU syndrome (PICS)? What can be done to prevent it? What can be done to treat it? - p. 17 14. 5.  How have genomics informed our understanding of critical illness? - p. 23 15. SECTION 2. Basic Respiratory Management and Mechanical Ventilation - p. 36 16. 6.  Is oxygen toxic? - p. 36 17. 7.  What is the role of noninvasive respiratory support and high-flow nasal cannula in the intensive care client? - p. 43 18. 8.  What is the role of PEEP and recruitment maneuvers in ARDS? - p. 50 19. 9.  What is the best way to wean and liberate patients from mechanical ventilation? - p. 57 20. 10.  How does mechanical ventilation damage lungs? What can be done to prevent it? - p. 68 21. SECTION 3. Non-ARDS and Noninfectious Respiratory Disorders - p. 74 22. 11.  How should exacerbations of COPD be managed in the intensive care unit? - p. 74 23. 12.  Is diaphragmatic dysfunction a major problem following mechanical ventilation? - p. 82 24. SECTION 4. ARDS - p. 90 25. 13.  ARDS: Are the current definitions useful? - p. 90 26. 14.  What are the pathologic and pathophysiologic changes that accompany ARDS? - p. 95 27. 15.  What factors predispose patients to acute respiratory distress syndrome? - p. 103 28. 16.  What is the best mechanical ventilation strategy in ARDS? - p. 109 29. 17.  Is carbon dioxide harmful or helpful in ARDS? - p. 121 30. 18.  Does patient positioning make a difference in ARDS? - p. 130 31. 19.  Do inhaled vasodilators in ARDS make a difference? - p. 137 32. 20.  Does ECMO work? - p. 142 33. 21.  What lessons have we learned from epidemiologic studies of ARDS? - p. 149 34. 22.  What are the long-term outcomes after ARDS? - p. 155 35. SECTION 5. General Critical Care Management - p. 161 36. 23.  How do I approach fever in the intensive care unit and should fever be treated? - p. 161 37. 24.  What fluids should be given to the critically ill patient? What fluids should be avoided? - p. 169 38. 25.  Should blood glucose be tightly controlled in the intensive care unit? - p. 174 39. 26.  Is there a role for therapeutic hypothermia in critical care? - p. 179 40. 27.  How do I manage the morbidly obese critically ill patient? - p. 186 41. 28.  How do I safely transport the critically ill patient? - p. 199 42. 29.  What are the causes of and how do I treat critical illness neuropathy/myopathy? - p. 208 43. SECTION 6. Sepsis - p. 215 44. 30.  What is sepsis? What is septic shock? What are mods and persistent critical illness? - p. 215 45. 31.  How do I identify the patient with “sepsis”? - p. 221 46. 32.  Is there immune suppression in the critically ill patient - pro? - p. 226 47. 33.  Is there immune suppression in the critically ill patient—con? - p. 233 48. 34.  Does the timing of antibiotic administration matter in sepsis? - p. 241 49. 35.  What is the role of vasopressors and inotropes in septic shock? - p. 250 50. 36.  Does monitoring the microcirculation make a difference in sepsis? Outcome? - p. 256 51. 37.  Are we getting any better at diagnosing sepsis? - p. 262 52. 38.  Do the surviving sepsis campaign guidelines work? - p. 270 53. 39.  Has outcome in sepsis improved? What works? What does not? - p. 274 54. SECTION 7. Persistent Critical Illness - p. 279 55. 40.  What happens to the autonomic nervous system in critical illness? - p. 279 56. 41.  Is persistent critical illness a syndrome of ongoing inflammation/immunosuppression/catabolism? - p. 285 57. SECTION 8. Infection - p. 291 58. 42.  How do I optimize antibiotic use in critical illness? - p. 291 59. 43.  How do I identify pathologic organisms in the 21st century? - p. 299 60. 44.  How do I diagnose and manage catheter-related bloodstream infections? - p. 307 61. 45.  How do I manage central nervous system infections (meningitis/encephalitis)? - p. 313 62. 46.  How can biomarkers be used to differentiate between infection and non-infectious causes of inflammation? - p. 319 63. 47.  What is ventilator-associated pneumonia? How do I diagnose it? How do I treat it? - p. 325 64. SECTION 9. Hemodynamic Management - p. 332 65. 48.  What is the role of invasive hemodynamic monitoring in critical care? - p. 332 66. 49.  Does the use of echocardiography aid in the management of the critically ill? - p. 338 67. 50.  How do I manage hemodynamic decompensation in a critically ill patient? - p. 345 68. 51.  What are the best tools to optimize the circulation? - p. 351 69. 52.  How should cardiogenic shock be managed (including assist devices)? - p. 359 70. SECTION 10. Cardiovascular Critical Care - p. 366 71. 53.  How do I manage acute heart failure? - p. 366 72. 54.  How do I diagnose and manage myocardial ischemia in the ICU? - p. 371 73. 55.  How do I prevent or treat atrial fibrillation in postoperative critically ill patients? - p. 378 74. SECTION 11. Kidney Injury and Critical Illness - p. 388 75. 56.  How do I rapidly and correctly identify acute kidney injury? - p. 388 76. 57.  What is the role of renal replacement therapy in the intensive care unit? - p. 394 77. 58.  What is the value of nondialytic therapy in acute kidney injury? - p. 401 78. SECTION 12. Metabolic Abnormalities in Critical Illness - p. 407 79. 59.  How should acid-base disorders be diagnosed? - p. 407 80. 60.  Is hyperchloremia harmful? - p. 416 81. 61.  Dysnatremias—what causes them and how should they be treated? - p. 423 82. 62.  Why is lactate important in critical care? - p. 436 83. 63.  How does critical illness alter metabolism? - p. 441 84. SECTION 13. Neurological Critical Care - p. 448 85. 64.  How should traumatic brain injury be managed? - p. 448 86. 65.  How should aneurysmal subarachnoid hemorrhage be managed? - p. 459 87. 66.  How should acute ischemic stroke be managed in the intensive care unit? - p. 473 88. 67.  How should status epilepticus be managed? - p. 482 89. SECTION 14. Nutrition, Gastrointestinal, and Hepatic Critical Care - p. 487 90. 68.  When and how should I feed the critically ill patient? - p. 487 91. 69.  What does critical illness do to the liver? - p. 495 92. 70.  How do I manage a patient with acute liver failure? - p. 498 93. SECTION 15. Endocrine Critical Care - p. 510 94. 71.  Is there a place for anabolic hormones in critical care? - p. 510 95. 72.  How do I diagnose and manage acute endocrine emergencies in the ICU? - p. 517 96. 73.  What is the current role for corticosteroids in critical care? - p. 527 97. SECTION 16. Trauma, Surgery, Obstetrics, and Environmental Injuries - p. 532 98. 74.  How should trauma patients be managed in the intensive care unit? - p. 532 99. 75.  What is abdominal compartment syndrome and how should it be managed? - p. 539 100. 76.  How should patients with burns be managed in the intensive care unit? - p. 546 101. 77.  What is the best approach to resuscitation in trauma? - p. 554 102. 78.  How do I diagnose and treat major gastrointestinal bleeding? - p. 565 103. 79.  How should the critically ill pregnant patient be managed? - p. 571 104. 80.  How do I diagnose and manage patients admitted to the intensive care unit after common poisonings? - p. 577 105. SECTION 17. Hematology Critical Care - p. 582 106. 81.  When is transfusion therapy indicated in critical illness and when is it not? - p. 582 107. 82.  Is there a role for granulocyte-macrophage colony-stimulating factor and/or erythropoietin in critical illness? - p. 591 108. 83.  What anticoagulants should be used in the critically ill patient? How do I choose? - p. 596 109. SECTION 18. Critical Care Resource Use and Management - p. 603 110. 84.  Is there a better way to deliver optimal critical care services? - p. 603 111. 85.  How do critical care pharmacists contribute to team-based care? - p. 610 112. 86.  What is the role of advanced practice nurses and physician assistants in the ICU? - p. 616 113. SECTION 19. Patient Suffering and Other Ethical Issues - p. 622 114. 87.  Do the guidelines for brain death determination need to be revised? - p. 622 115. 88.  How do I diagnose, treat, and reduce delirium in the intensive care unit? - p. 629 116. Index - p. 640