Key Clinical Topics in Critical Care Key Clinical Topics in Critical Care Sara-Catrin Cook MB BCh FRCA EDIC DICM Consultant in Intensive Care and Anaesthesia, Royal Gwent Hospital Newport, UK Matt Thomas MB ChB MRCP FRCA Consultant in Intensive Care, Bristol Royal Infirmary Bristol, UK Jerry Nolan FRCA FCEM FRCP FFICM Consultant in Anaesthesia and Intensive Care Medicine, Royal United Hospital Bath, UK Michael Parr FRCP FRCA FANZCA FCICM Director of Intensive Care, Liverpool Hospital and Macquarie University Hospital University of New South Wales and Macquarie University Sydney, Australia London Philadelphia Panama City New Delhi â 2014 JP Medical Ltd Published by JP Medical Ltd, 83 Victoria Street, London, SW1H 0HW, UK Tel: +44 (0)20 3170 8910 Fax: +44 (0)20 3008 6180 Email: info@jpmedpub.com Web: www.jpmedpub.com The rights of Sara-Catrin Cook, Matt Thomas, Jerry Nolan and Michael Parr to be identified as editors of this work have been asserted by them in accordance with the Copyright, Designs and Patents Act 1988 All rights reserved No part of this publication may be reproduced, stored or transmitted in any form or by any means, electronic, mechanical, photocopying, recording or otherwise, except as permitted by the UK Copyright, Designs and Patents Act 1988, without the prior permission in writing of the publishers Permissions may be sought directly from JP Medical Ltd at the address printed above All brand names and product names used in this book are trade names, service marks, trademarks or registered trademarks of their respective owners The publisher is not associated with any product or vendor mentioned in this book Medical knowledge and practice change constantly This book is designed to provide accurate, authoritative information about the subject matter in question However readers are advised to check the most current information available on procedures included and check information from the manufacturer of each product to be administered, to verify the recommended dose, formula, method and duration of administration, adverse effects and contraindications It is the responsibility of the practitioner to take all appropriate safety precautions Neither the publisher nor the editors assume any liability for any injury and/or damage to persons or property arising from or related to use of material in this book This book is sold on the understanding that the publisher is not engaged in providing professional medical services If such advice or services are required, the services of a competent medical professional should be sought Every effort has been made where necessary to contact holders of copyright to obtain permission to reproduce copyright material If any have been inadvertently overlooked, the publisher will be pleased to make the necessary arrangements at the first opportunity ISBN: 978-1-907816-67-3 British Library Cataloguing in Publication Data A catalogue record for this book is available from the British Library Library of Congress Cataloging in Publication Data A catalog record for this book is available from the Library of Congress JP Medical Ltd is a subsidiary of Jaypee Brothers Medical Publishers (P) Ltd, New Delhi, India Commissioning Editor: Editorial Assistant: Design: Steffan Clements Sophie Woolven Designers Collective Ltd Indexed, typeset, printed and bound in India Preface There have been significant developments within the world of critical care over the last few years Evidence generated from high-quality research has underpinned major changes in clinical practice and has created a need for up-to-date textbooks in critical care In the United Kingdom, the creation of new intensive care exams is also driving the need for succinct and current information for clinicians training in this field Key Clinical Topics in Critical Care has been written to ensure full coverage of the specialty of intensive care medicine Topics are presented alphabetically, with cross references to other related topics to allow easy navigation Each topic provides a succinct overview of its subject, with reference to current key papers and guidelines in the field and including a further reading section at the end of the topic The topics have been written by well-established and new authors from across the globe They have created an invaluable reference for trainees working in critical care units, enabling them to obtain a full range of key information from a single text The book also provides a valuable revision resource for readers who are studying for exams in intensive care medicine or for the critical care elements of surgical, medical, emergency medicine and pre-hospital care exams It will also be of interest to critical care nurses who want to expand their understanding of their field We hope that you will find Key Clinical Topics in Critical Care effective as a reference source in day-to-day practice, as well as during study and revision Sara-Catrin Cook, Matt Thomas Jerry Nolan Michael Parr February 2014 v Acknowledgements We thank all the authors for their very hard work We thank our families, friends and colleagues for their invaluable support during the writing of this book Thank you to Dr Timothy Hooper and Dr Christine Weaver for their advice Thank you to the authors of the forerunner to this book, Key Topics in Critical Care, last published in 2004, whose chapters have been revised for this book: Tim Cook, Jonathan Hadfield, Jeff Handel, Stephen Laver, Caleb McKinstry, Cathal Nolan, Andrew Padkin, Minh Tran, Jenny Tuckey, Nicky Weale We dedicate this book to the memory of our friend and colleague Guy Jordan (1972–2013) SCC MJCT JPN MJAP Publisher Acknowledgements The publishers wish to thank Series Advisors Dr Tim M Craft and Dr Paul M Upton for their assistance during the planning of the Key Clinical Topics series vi Contents Page Preface v Acknowledgements vi Contributors xii Abdominal compartment syndrome Acute coronary syndrome Acute respiratory distress syndrome (ARDS) – diagnosis Acute respiratory distress syndrome (ARDS) – treatment Adrenal disease Airway complications on the intensive care unit Airway management in an emergency Airway obstruction – upper and lower Analgesia in critical care – advanced 10 Anaphylaxis 11 Antibiotics, antivirals and antifungals 12 Arterial blood gases – acid–base physiology 13 Arterial blood gases – analysis 14 Arterial cannulation 15 Asthma 16 Blood and blood products 17 Blood coagulopathies 18 Blood transfusion and complications 19 Brain death and organ donation 20 Burns 21 Calcium, magnesium and phosphate 22 Cancer patients and critical care 23 Cardiac arrhythmias 24 Cardiac failure – acute 25 Cardiac output measurement 26 Cardiac pacing 11 13 17 20 23 27 30 33 37 40 43 46 50 53 57 60 63 67 72 76 79 82 87 vii Page 27 Cardiac surgery – postoperative care 28 Cardiac valve disease 29 Cardiopulmonary resuscitation 30 Care bundles 31 Central venous cannulation 32 Chest tube thoracostomy 33 Chronic obstructive pulmonary disease 34 Coma 35 Consent 36 Critical illness polyneuromyopathy 37 Delirium 38 Diabetes mellitus 39 Diarrhoea 40 Drug overdose and poisons 41 Echocardiography for critical care 42 Extracorporeal membrane oxygenation 43 Endocarditis 44 End-of-life care 45 Ethics 46 Fibreoptic bronchoscopy 47 Fluid therapy 48 Guillain–Barré syndrome 49 Haematological disorders 50 HIV and critical care 51 Hypertension 52 Hyperthermia 53 Hypothermia 54 ICP monitoring 55 Infection acquired in hospital 56 Infection prevention and control 57 Inotropes and vasopressors 58 Liver failure – acute viii 90 96 99 103 105 108 111 115 118 121 123 126 132 135 141 146 149 154 158 161 164 169 172 175 178 181 185 188 191 196 199 203 Page 59 Liver failure – chronic 60 Major haemorrhage 61 Meningitis and encephalitis 62 Meningococcal sepsis 63 Myasthenia gravis 64 Neurological diseases 65 Nutrition 66 Obstetric emergencies – haemorrhage 67 Obstetric emergencies – medical 68 Oscillation and high-frequency ventilation 69 Pancreatitis – acute severe 70 Pandemic influenza 71 Patient safety 72 Pituitary disease 73 Pleural disease 74 Pneumonia – community acquired 75 Pneumonia – hospital acquired 76 Post-resuscitation care 77 Potassium 78 Pre-hospital care 79 Pulmonary function tests 80 Quality indicators 81 Quality of life after ICU 82 Radiology for critical care 83 Rapid response systems 84 Refractory hypoxaemia 85 Renal – acute kidney injury 86 Renal – treatment of established acute kidney injury 87 Respiratory support – invasive 88 Respiratory support – non-invasive techniques 89 Scoring systems 90 Sedation 208 212 216 220 222 225 229 232 235 239 242 246 251 254 259 262 265 268 273 276 279 283 286 289 292 294 297 301 305 310 315 318 ix .. .Key Clinical Topics in Critical Care Key Clinical Topics in Critical Care Sara-Catrin Cook MB BCh FRCA EDIC DICM Consultant in Intensive Care and Anaesthesia, Royal... textbooks in critical care In the United Kingdom, the creation of new intensive care exams is also driving the need for succinct and current information for clinicians training in this field Key Clinical. .. studying for exams in intensive care medicine or for the critical care elements of surgical, medical, emergency medicine and pre-hospital care exams It will also be of interest to critical care