Applied Physiology in Intensive Care Medicine
Michael R. Pinsky, Laurent Brochard, Jordi Mancebo
Springer Science & Business Media, May 19, 2007 - Medical - 378 pages
Te practice of intensive care medicine is at the very forefront of titration of treatment andmonitoringresponse. Te substrateofthiscareisthe criticallyill patientwho,by defnition, is at the limits of his or her physiologic reserve. Such patients need immediate, aggressive but balanced life-altering interventions to minimize the detrimental aspects of acute illness and hasten recovery. Treatmentdecisionsandresponsetotherapyareusually assessed by measures of physiologic function, such as assessed by cardio-respiratory monitoring. However, how one uses such information is ofen unclear and rarely supported by prospective clinical trials. In reality, the bedside clinician is forced to rely primarily on physiologic principles in determining the best treatments and response to therapy. However, the physiologic foundation present in practicing physicians is uneven and occasionally supported more by habit or prior training than science. A series of short papers published in Intensive Care Medicine since 2002 under the heading Physiologic Notes attempts to capture the essence of the physiologic perspectives that underpin both our understanding of disease and response to therapy. Tis present volume combines the complete list of these Physiologic Notes up until July 2006 with the ass o cia t ed r e vie w a r tic les o v er t h e s a m e in t er val t ha t a ls o addr ess e d t hes e cen tral issues.
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acute lung injury acute respiratory distress airway pressure alveolar Appl Physiol ARDS arterial pressure assessment baby lung blood flow Ca2+ cardiac output catecholamines catheter cell changes Chest Clin clinical cortisol crease critically ill patients decrease diastolic dysfunction effects end-diastolic volume endothelial failure FIO2 fluid function glucose hemodynamic hypercapnia hypercapnic acidosis hypomagnesemia hypoxemia hypoxia increase induced insulin Intensive Jardin F lactate left ventricular levels magnesium measurement mechanical ventilation membrane metabolic Mg2+ mmHg monitoring muscle myocardial NF-kB nitric oxide normal occlusion oxygen PaCO2 PaO2 PCO2 PEEP Pel/V curves perfusion physiological plasma pneumonia positive end-expiratory pressure Ppao preload protein PslCO2 pulmonary artery pulmonary edema pulmonary vascular pulse pulse oximetry renal resistance Respir Crit respiratory distress syndrome response right ventricular sepsis septic shock serum shunt sleep sublingual SvO2 technique temperature therapy tidal volume tients tion tissue trauma venous