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Cambridge.University.Press.Surgical.Critical.Care.Vivas.Dec.2002.
Surgical Critical Care Vivas For my wife, Pauline Cornelia O’Keeffe Surgical Critical Care Vivas Mazyar Kanani BSc (Hons) MBBS (Hons) MRCS (Eng) British Heart Foundation Paediatric Cardiothoracic Clinical Research Fellow Cardiac Unit Great Ormond Street Hospital London, UK cambridge university press Cambridge, New York, Melbourne, Madrid, Cape Town, Singapore, São Paulo Cambridge University Press The Edinburgh Building, Cambridge cb2 2ru, UK Published in the United States of America by Cambridge University Press, New York www.cambridge.org Information on this title: www.cambridge.org/9780521681537 © Greenwich Medical Media Limited 2003 This publication is in copyright Subject to statutory exception and to the provision of relevant collective licensing agreements, no reproduction of any part may take place without the written permission of Cambridge University Press First published in print format 2005 isbn-13 isbn-10 978-0-511-14670-1 eBook (NetLibrary) 0-511-14670-1 eBook (NetLibrary) isbn-13 isbn-10 978-0-521-68153-7 paperback 0-521-68153-7 paperback Cambridge University Press has no responsibility for the persistence or accuracy of urls for external or third-party internet websites referred to in this publication, and does not guarantee that any content on such websites is, or will remain, accurate or appropriate CONTENTS viii xi Abdominal Trauma: Investigations Accessing the Thorax Acid-Base Acute Renal Failure (see also table in ‘Low urine output’) Acute Respiratory Distress Syndrome (ARDS) Agitation and Sedation Airway Management Analgesia Aortic Dissection Atelectasis 10 15 20 23 26 31 35 Blood Pressure Monitoring Blood Products Blood Transfusion Brainstem Death and Organ Donation Bronchiectasis Burns 38 42 46 51 55 57 Calcium Balance Cardiac Assessment Cardiogenic Shock Central Line Insertion Chronic Renal Failure Coagulation Defects 62 66 68 73 78 83 Disseminated Intravascular Coagulation (DIC) 86 ECG I – Basic Concepts ECG II – Rate and Rhythm Disturbances Endotracheal Intubation Enteral Nutrition Extubation and Weaning CONTENTS List of Abbreviations Acknowledgements 88 92 97 101 104 䉲 v SURGICAL CRITICAL CARE VIVAS CONTENTS vi Fat Embolism Syndrome Flail Chest Fluid Therapy 106 111 114 Haemorrhagic Shock Head Injury I – Physiology Head Injury II – Pathophysiology Head Injury III – Principles of Management 119 124 127 130 Inotropes and Circulatory Support ITU Admission Criteria 134 139 Jugular Venous Pulse (JVP) 141 Lactic Acidosis Low Urine Output State 144 146 Magnesium Balance Mechanical Ventilatory Support Metabolic Acidosis (see also ‘Acid-base’ and and ‘Lactic acidosis’) Metabolic Alkalosis 151 153 156 159 Nutrition: Basic Concepts (see also parenteral nutrition & TPN) 161 Oxygen: Basic Physiology Oxygen Therapy 165 169 Parenteral Nutrition (TPN) Pneumonia Pneumothorax Potassium Balance Pulmonary Artery Catheter (see also ‘Central line insertion’) Pulmonary Thromboembolism Pulse Oximetry 171 173 177 180 183 187 192 䉲 SURGICAL CRITICAL CARE VIVAS Renal Replacement Therapy Respiratory Assessment Respiratory Failure (see also ‘Oxygen therapy’) Rhabdomyolysis 194 198 201 204 Septic Shock and Multi-Organ Failure Sodium and Water Balance Spinal Injury Systemic Response to Trauma 208 213 216 221 Tracheostomy Transfer of the Critically Ill Tube Thoracostomy (Chest Drain) 225 229 231 CONTENTS 䊏 vii LIST OF ABBREVIATIONS LIST OF ABBREVIATIONS viii ACTH ADH ADP ALI AMP APTT ARDS ATLS ATN ATP ATPase AV BBB 2,3 BPG CAPD cGMP CMV CO COPD CPAP CSF CVP CXR DIC DKA DPL DVT ECF ECG ELISA ESR FFA FFP FiO2 䉲 Adrenocorticotropic hormone Anti diuretic hormone Adenosine diphosphate Acute lung injury Adenosine monophosphate Activated partial thromboplastin time Acute respiratory distress syndrome Advance trauma life support Acute tubular necrosis Adenosine triphosphate Adenosine triphosphatase Atrioventricular Blood-brain barrier 2,3 Bisphosphoglycerate Citrate, Adenine, Phosphate, and Dextrose Cyclic guanosine monophosphate Cytomegalovirus Cardiac output Chronic obstructive pulmonary disease Continuous positive airway pressure Cerebrospinal fluid Central venous pressure Chest radiograph Disseminated Intravascular Coagulation Diabetic ketoacidosis Diagnostic peritoneal lavage Deep venous thrombosis Extracellular fluid Electrocardiogram Enzyme linked immunosorbent assay Erythrocyte sedimentation rate Free fatty acids Fresh frozen plasma Fraction of inspired oxygen SURGICAL CRITICAL CARE VIVAS Functional residual capacity Glassow coma score Glomerular filtration rate Heparin-induced thrombocytopenia syndrome Human immunodeficiency virus Human leucocyte antigen Her Majesty’s Stationery Office Hormone replacement therapy Inspiratory:Expiratory ratio Intracellular fluid Intracranial pressure Immunoglobulin A Interleukin Intermittent mandatory ventilation International normalised ratio Intermittent positive pressure ventilation Intensive therapy unit Jugular venous pulse/pressure Mean arterial pressure Myocardial infarction Multi-Organ dysfunction syndrome Mean pulmonary artery pressure Magnetic resonance imaging Methicillin resistant Staph aureus Nasogastric Nasojejunal Non-steroidal anti-inflammatory drugs Pulmonary artery Platelet activating factor Pulmonary artery occlusion pressure Patient-controlled analgesia Prothrombin complex concentrate Pulmonary embolus Positive end-expiratory pressure Pressure support ventilation Parathormone Pulmonary vascular resistance LIST OF ABBREVIATIONS FRC GCS GFR HITS HIV HLA HMSO HRT I:E RATIO ICF ICP IgA IL IMV INR IPPV ITU JVP MAP MI MODS MPAP MRI MRSA NG NJ NSAIDs PA PAF PAOP PCA PCC PE PEEP PSV PTH PVR 䉲 ix