Controversies in Critical Care

ISBN-13: 9789811999390 / Angielski

Gagan Brar

Opis

The book covers vigorously debated controversial topics in the field of critical care medicine over the years. It provides the reader with a balanced approach and guidance based on historical and currently available evidence in dealing with contentious clinical scenarios. The book reviews the most relevant, contemporaneous evidence on each topic and provides practical guidelines for clinical practice.The book includes chapters that follow a structured approach to controversies related to specific organ systems. The topics covered provide a summary of the most relevant, practice-changing studies in the field of critical care medicine. Each topic describes the basic applied physiology, points of controversy, the evidence base, and summarizes the key points at the end. It includes brief description of landmark studies on each controversial topic.The book serves as an important clinical guide to practitioners of critical care medicine when confronted with challenging clinical scenarios. Besides, it is a useful source of information to postgraduate trainees in various medical specialties. The topics addressed are among the most widely discussed during postgraduate examinations. It is also relevant for practitioners in general medicine and specialized areas of practice, including pulmonology (respiratory medicine), cardiology, neurology, nephrology, gastroenterology, and surgical specialties.

Spis treści

Section 1. Respiratory support in the critically ill 

 

Oxygen: the elixir of life or a double-edged sword?

The hypoxic drive: an urban legend?

Lung protective ventilation strategies in acute respiratory distress syndrome 

Non-invasive ventilation in acute hypoxemic respiratory failure

High-flow nasal cannula

Titration of positive end-expiratory pressure by the bedside

The role of recruitment maneuvers in acute respiratory distress syndrome 

Patient self-inflicted lung injury

Prone ventilation in acute respiratory distress syndrome 

Neuromuscular blocking drugs in acute respiratory distress syndrome 

Ventilator-associated pneumonia: newer outlook

Is hypercapnia harmful during lung-protective ventilation 

Tracheostomy: timing it right 

Diaphragmatic dysfunction in critical illness

Weaning from mechanical ventilation 

How to decannulate a tracheostomy 

Thrombolysis in acute pulmonary embolism 

Section 2. Shock and circulatory support

Steroids in septic shock 

Hyperlactatemia in sepsis 

Permissive hypotension in trauma

Assessment of volume responsiveness 

Are we done with early goal-directed therapy? 

Normal saline vs. balanced crystalloid as resuscitation fluid

Liberal vs. conservative fluid resuscitation strategy in septic shock 

Epinephrine in cardiopulmonary resuscitation 

Targeted temperature management vs. hypothermia after cardiac arrest 

Section 3. Acute kidney injury and renal replacement therapy

Augmented renal clearance in the critically ill 

Renal replacement therapy: timing it right

Dosing of renal replacement therapy

Anticoagulation during renal replacement therapy: heparin vs. citrate

Continuous vs. intermittent renal replacement therapy

Section 4. Neurocritical care 

ICP monitoring: does it impact clinical outcomes?

Decompressive craniectomy in traumatic brain injury

Salt or sugar for the swollen brain?

Sedation in critically ill patients

Delirium management in the ICU 

Corticosteroids in spinal cord injury 

Section 5. Metabolic support in critical illness

Glycemic control in the critically ill

Thiamine and vitamin C critical illness

Section 6. The gut and nutrition 

Abdominal compartment syndrome

Interruption of enteral feeds in the ICU

Location of feeds: gastric vs. post pyloric

Enteral feeds: how early?

Permissive underfeeding 

Enteral vs. parenteral nutrition 

Stress ulcer prophylaxis in the ICU 

Section 7. Infections and antibiotic therapy 

How to cope multi-drug resistance 

How early should antibiotics be administered in sepsis?

De-escalation of antibiotic therapy

Aerosolized antibiotics 

Is procalcitonin level useful in the critically ill?

Selective digestive decontamination: helpful or harmful? 

Section 8. Contentious issues in Covid-19 infection

Corticosteroids in Covid-19

Interleukin antagonism in Covid-19

Anticoagulation strategy in severe Covid-19

Vaccine-induced immune thrombotic thrombocytopenia 

Section 9. Organizational challenges in the ICU

The open vs. closed ICU debate

Critical incidents in the ICU

Rapid response teams 

Measuring ICU performance 

Section 10. Coagulopathy and transfusion 

Red cell transfusion thresholds in the critically ill

Tranexamic acid in the bleeding patient  

Platelet transfusion in dengue fever 

Fixed ratio transfusion strategy in trauma 

Section 11. Ancillary issues 

O autorze

Dr. Jose Chacko, MD, DA, DNB, EDIC, MBA, graduated in medicine and completed post-graduation in anesthesia from Medical College, Trivandrum, India. He underwent advanced training in critical care medicine from leading hospitals in Australia and worked as a consultant in anesthesia and critical care with the National Health Services in the United Kingdom. He has completed the European Diploma in Intensive Care (EDIC) from the European Society of Intensive Care Medicine (ESICM) and currently works as a senior consultant in critical care medicine at Narayana Health, Bangalore, India. A renowned teacher and academician, he is a leading practitioner and teacher of critical care medicine in India. He has many publications in peer-reviewed journals and contributed to text books in critical care and emergency medicine. He contributes regularly to academic meetings in critical care medicine. Dr. Chacko runs a blog site (criticalcareblogspot.com) and creates podcasts (critcareedu.com.au) that address provocative topics in critical care medicine.

Dr. Swapnil Pawar, MD, FCICM, EDIC, completed his post-graduation in anesthesia in 2010 from the Post Graduate Institute of Medical Education and Research (PGIMER), Chandigarh, India. He is a fellow of the College of Intensive Care Medicine (FCICM), Australia and New Zealand and has also completed his European Diploma in Intensive Care (EDIC) with the European Society of Intensive Care Medicine (ESICM). He is currently working as a consultant intensivist at the St. George Hospital in Sydney and is the coordinator for Innovation in Intensive Care. He is the chair of the education committee of the Australia and New Zealand Intensive Care Society (ANZICS). He has a keen interest in simulation and medical education and is a certified simulation healthcare educator (CHSE) with the Society of Simulation in Healthcare (SSH). He is the host and producer of six educational podcast series and runs his educational website Critical Care Education (www.critcareedu.com.au). He is currently pursuing his Ph.D. in the field of cognitive load theory and has delivered numerous oral and posters presentations at international meetings. He is a trained mediator and enjoys grooming young talent as a captain of St George district cricket club metro team. 

Professor Ian Seppelt, FANZCA, FCICM, graduated in medicine from the University of Sydney, Australia. He is a senior specialist in intensive care medicine at Nepean Hospital, University of Sydney, professor of anesthesia at Macquarie University, and professorial fellow at The George Institute for Global Health, Sydney. He has more than 100 peer-reviewed international publications and has delivered numerous invited presentations at international meetings. He is a past executive member of the ANZICS Clinical Trials Group and lead investigator for SuDDICU (Australia) for which he received a National Health and Medical Research Council Research Excellence Award in 2015. He is on the management committees for several clinical trials including SuDDICU, SPICE-IV, and REMAP-CAP. He chairs the Nepean Blue Mountains Local Health District Human Research Ethics Committee (HREC) and is a member of various data safety monitoring boards. He is a medical advisor to Equestrian Australia and assistant groom and transport technician for his wife and children when they are competing.

Dr. Gagan Brar, MD, DNB, EDIC, IDCCM, graduated in medicine and completed post-graduation in anesthesia from Kasturba Medical College, Manipal, India. She underwent training in critical care medicine at Manipal Hospital and Fortis Hospital, Bangalore, India. She is a fellow of the National Board of Examinations in critical care medicine and has completed the European diploma in intensive care (EDIC) with the European Society of Intensive Care Medicine (ESICM). She currently works as a consultant in critical care medicine, Aster RV Hospital, Bangalore. Dr. Brar has published several original papers in peer-reviewed journals and is an invited speaker for major academic meetings in critical care medicine.