Book Name: The Washington Manual of Critical Care Third Edition
Author: Marin Kollef
ISBN-10, 13: 978-1496328519,1496328515
Pages: 784 pages
File size: 31 MB
File format: PDF,EPUB
The Washington Manual of Critical Care Third Edition Pdf Book Description:
This is the third edition of The Washington Manual of Critical Care, building on the long tradition of The Washington Manualette of Medical Therapeutics, and the two prior Critical Care manuals. This project was originally inspired by the expanding knowledge base in critical care medicine and the demands this places on health care professionals treating critically ill patients. Our primary goal in preparing this manual is to provide clinicians and students with comprehensive and current treatment algorithms for the bedside diagnosis and management of the most frequently encountered illnesses and problems encountered in the intensive care unit (ICU) setting. Since the last edition we have included new chapters on extracorporeal membrane oxygenation and the management of the transplant patient in the ICU. We have also revamped most of the existing chapters to keep them up to date with the expanding medical literature.
The chapters were written by Washington University faculty physicians and experts in their fields from the Departments of Internal Medicine, Neurology, Surgery, Obstetrics and Gynecology, and Anesthesiology, often with the assistance of subspecialty fellows and residents. The tables and algorithms that accompany each chapter are meant as guides and may not be appropriate for all patients. Further reading of the literature is always encouraged and this manual is expected to be used in conjunction with trained critical care clinicians. We would especially like to give our sincerest thanks to Becky Light for her tireless efforts in preparing chapters and for acting as the liaison between the Pulmonary and Critical Care Department, the chapter’s authors, and Lippincott Williams & Wilkins.
Hypovolemic shock occurs as a result of decreased circulating blood volume, most commonly from acute hemorrhage. It may also result from heat related intravascular volume depletion or fluid sequestration within the abdomen. Table 2.1 provides a classification of hypovolemic shock based on the amount of whole blood volume lost. In general, the greater the loss of whole blood, the greater the resultant risk of mortality. However, it is important to note that other factors can influence the outcome of hypovolemic shock including age, underlying comorbidities (e.g., cardiovascular disease), and the rapidity and adequacy of the fluid resuscitation. Lactic acidosis occurs during hypovolemic shock because of inadequate tissue perfusion. The magnitude of the serum lactate elevation is correlated with mortality in hypovolemic shock and may be an early indicator of tissue hypo perfusion, despite near-normal appearing vital signs. The treatment of lactic acidosis depends on reversing organ hypo perfusion. This is reflected in the equation for tissue oxygen delivery shown here. Optimizing oxygen delivery to tissues requires a sufficient hemoglobin concentration to carry oxygen to tissues. Additionally, ventricular preload is an important determinant of cardiac output. Providing adequate intravascular volume will ensure that stroke volume and cardiac output are optimized to meet tissue demands for oxygen and other nutrients. If, despite adequate preload, cardiac output is not sufficient for the demands of tissues, then dobutamine can be employed to further increase cardiac output and oxygen delivery. Here you can download for free for educational purpose and you can buy at amazon.
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