/ 9 9 r i h a t / r e s u / r c . t a k / / : s p t t h / 9 9 r i h a t / Principles of Critical Care r e s u / r c . t a k / / : s p t t h FM.indd 1 1/22/2015 8:29:38 AM / 9 9 r i h a NOTICE t / Medicine is an ever-changing science. As new research and clinical exprerience broaden our knowledge, changes in treatment and drug therapy are required. The authors and the publisher of this work have e checked with sources believed to be reliable in their efforts to provide information that is complete and generally in accord with the standards accepted at the timse of publication. However, in view of the possibility of human error or changes in medical sciences, neither the authors nor the publisher nor any other party who has been involved in the preparatioun or publication of this work warrants that the information contained herein is in every respect accurate or complete, and they disclaim all responsi- bility for any errors or omissions or for the results/ obtained from use of the information contained in r this work. Readers are encouraged to confirm the information contained herein with other sources. For example and in particular, readers are advisecd to check the product information sheet included in the package of each drug they plan to administer to be certain that the information contained in this work . is accurate and that changes have not been made in the recommended dose or in the contraindications t for administration. This recommendation is of particular importance in connection with new or infre- a quently used drugs. k / / : s p t t h FM.indd 2 1/22/2015 8:29:38 AM Principles of Critical Care Fourth Edition / 9 9 r Editors i h a Jesse B. Hall, MD Gregory A. Schmidt, MD t Professor of Medicine and of Anesthesia Professor of Internal Medicine / and Critical Care Division of Pulrmonary Diseases, Critical Care, and Section of Pulmonary and Critical Care eOccupational Medicine University of Chicago Department of Internal Medicine s Chicago, Illinois Associate Chief Medical Officer, Critical Care u University of Iowa Iowa City, Iowa / r c Associate Editor . t a John P. Kress, MD k Professor of Medicine / Director, Medical ICU / : Department of Medicine s Section of Pulmonary and Critical Care p University of Chicago Chicago, Illinois t t h New York Chicago San Francisco Athens London Madrid Mexico City Milan New Delhi Singapore Sydney Toronto FM.indd 3 1/22/2015 8:29:39 AM Copyright © 2015 by McGraw-Hill Education. All rights reserved. Except as permitted under the United States Copyright Act of 1976, no part of this publication may be reproduced or distributed in any form or by any means, or stored in a database or retrieval system, without the prior written permission of the publisher, with the exception that the program listings may be entered, stored, and executed in a computer system, but they may not be reproduced for publication. 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This limitation of liability shall apply to any clarim or cause whatsoever whether such claim or cause arises in contract, tort or otherwise. c . t a k / / : s p t t h We dedicate this edition to: / 9 Our many trainees and colleagues, Who have learned eagerly, 9 And taught us graciously. r i h a t / r e s u / r c . t a k / / : s p t t h FM.indd 5 1/22/2015 8:29:39 AM / 9 9 r i h a t / r e s u / This page interntionally left blank c . t a k / / : s p t t h Contents Contributors . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . xi 18 Providing Palliative Care and Withholding or Withdrawing Life-Sustaining Therapy . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .120 Preface . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . xxiii Dee W. Ford and J. Randall Curtis Introduction . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .xxv / 19 Legal Issues in Critical Care . . . . . . . . . . . . . . .9 . . . . . . . . . . . . . . . . . .125 PART 1 An Overview of the Approach to and Marshall B. Kapp 9 Organization of Critical Care . . . . . . . . . . . . . . . . . . . . . . . . 1 PART 2 General Managemenrt of the Patient .......131 1 An Approach to Critical Care . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .2 20 Nutrition Therapy in the Criticially Ill . . . . . . . . . . . . . . . . . . . . . . . . .132 Jesse B. Hall, Gregory A. Schmidt, and Lawrence D. H. Wood h Daren K. Heyland, Rupinder Dhaliwal, and 2 Measuring Quality . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .7 Stephen A. McClavea Andre Carlos Kajdacsy-Balla Amaral and Gordon D. Rubenfeld 21 Glycemic Control . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .141 3 Intensive Care Unit Staffing . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .15 t Jean-Charle/s Preiser and Carole Ichai Allan Garland, Hayley Beth Gershengorn, and r 22 Pain Control, Sedation, and Use of Muscle Relaxants . . . . . . . . . . .145 Constantine A. Manthous e Sarah Sokol, Bhakti K. Patel, Ishaq Lat, and John P. Kress 4 Infection Prevention and Surveillance in the Intensive Care Unit . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .23 23 sSleep . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .155 Hitoshi Honda, David K. Warren, and Marin H. Kollef u Brian K. Gehlbach and Sairam Parthasarathy 5 Preventing Morbidity in the ICU . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .32 24 Physical Therapy . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .162 / Promise Ariyo, Theresa L. Hartsell, and Peter J. Pronovost r William Schweickert, Amy J. Pawlik, and John P. Kress 6 Assessing Cost-Effectiveness in the Intensive Care Unit . . . . . . .c . . .37 25 Cardiopulmonary Resuscitation . . . . . . . . . . . . . . . . . . . . . . . . . . . . .166 David J. Wallace and Derek C. Angus Benjamin S. Abella and Marion Leary . 7 Interpreting and Applying Evidence in Critical Care Medticine . . . . .44 26 Therapeutic Hypothermia . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .174 Elizabeth Lee Daugherty Biddison and Douglas Ba. White Benjamin S. Abella and Marion Leary 8 Principles of Medical Informatics and Clinical Iknformatics 27 Intravascular Devices in the ICU . . . . . . . . . . . . . . . . . . . . . . . . . . . . .179 in the ICU . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .49 John F. McConville and Bhakti K. Patel / Vitaly Herasevich, Ognjen Gajic, and/ Brian W. Pickering 28 Interpretation of Hemodynamic Waveforms . . . . . . . . . . . . . . . . . .186 9 Preparedness for Catastrophe . . . . .: . . . . . . . . . . . . . . . . . . . . . . . . . . .56 James W. Leatherman and John Marini s James Geiling, Michael Rea, and Robert Gougelet 29 ICU Ultrasonography . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .202 10 Telemedicine and Regionaplization . . . . . . . . . . . . . . . . . . . . . . . . . . . .62 Paul Mayo and Seth Koenig Jeremy M. Kahn 30 Interventional Radiology . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .209 t 11 Transportation of tthe Critically Ill Patient . . . . . . . . . . . . . . . . . . . . . .69 Brian Funaki, Jonathan M. Lorenz, Rakesh Navuluri, Charlotte Smahll, Andrew McDonald Johnston, and Julian Bion Thuong G. Van Ha, and Steven M. Zangan 12 Rapid Response Teams . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .77 Daryl Jones and Rinaldo Bellomo PART 3 Cardiovascular Disorders..................227 13 Assessment of Severity of Illness . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 83 31 The Pathophysiology of the Circulation in Critical Illness . . . . . . . .228 James A. Russell Edward T. Naureckas and Lawrence D. H. Wood 14 Chronic Critical Illness . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .97 32 Assessing the Circulation: Oximetry, Indicator Dilution, and Shannon S. Carson Pulse Contour Analysis . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .242 Michael R. Pinsky 15 Long-Term Outcomes After Critical Illness . . . . . . . . . . . . . . . . . . . .103 Margaret S. Herridge, Jill I. Cameron, and 33 Shock . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .249 Ramona O. Hopkins Keith R. Walley 16 Care of the Caregiver in the ICU and After Critical Illness . . . . . . . .114 34 Judging the Adequacy of Fluid Resuscitation . . . . . . . . . . . . . . . . . .262 Yoanna Skrobik Gregory A. Schmidt 17 Caring for the Family . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 116 35 Ventricular Dysfunction in Critical Illness . . . . . . . . . . . . . . . . . . . . .266 Sabina Hunziker and Michael D. Howell Keith R. Walley vii FM.indd 7 1/22/2015 8:29:39 AM viii Contents 36 Cardiac Arrhythmias, Pacing, Cardioversion, and 58 Restrictive Disease of the Respiratory System . . . . . . . . . . . . . . . . .513 Defibrillation in the Critical Care Setting . . . . . . . . . . . . . . . . . . . . . .278 Benjamin David Singer, Thomas Corbridge, and Vikas P. Kuriachan and Anne M. Gillis Lawrence D. H. Wood 37 Myocardial Ischemia . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .293 59 Ventilator-Associated Pneumonia . . . . . . . . . . . . . . . . . . . . . . . . . . .520 Steven M. Hollenberg Jean Chastre and Jean-Yves Fagon 38 Acute Right Heart Syndromes . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .308 60 Liberation From Mechanical Ventilation . . . . . . . . . . . . . . . . . . . . . .535 Ivor S. Douglas Constantine A. Manthous, Gregory A. Schmidt, and 39 Pulmonary Embolic Disorders: Thrombus, Air, and Fat . . . . . . . . . .318 Jesse B. Hall Nuala J. Meyer and Gregory A. Schmidt PART 5 Infectious Disorders ......................543 40 Pericardial Disease . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .336 / Paul Sorajja 61 Principles of Antimicrobial Therapy and the C9linical Pharmacology of Antimicrobial Drugs . . . . . . . . . . . . . . . . . . . . . . . .544 41 Valvular Heart Disease . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .343 9 Amira Ashok Bhalodi and David P. Nicolau Sorin V. Pislaru and Maurice Enriquez-Sarano 62 Sepsis and Immunoparalysis . . .r . . . . . . . . . . . . . . . . . . . . . . . . . . . .551 42 Aortic Dissection . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .356 i Pavlos M. Myrianthefs, Elias Karabatsos, and Vlad Cotarlan and Joseph J. Austin h George J. Baltopoulos a 63 Persistent Fever . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .557 PART 4 Pulmonary Disorders .....................369 Gretchen Yandtle and Bennett P. deBoisblanc 43 The Pathophysiology and Differential Diagnosis of 64 Sepsis, Seve/re Sepsis, and Septic Shock . . . . . . . . . . . . . . . . . . . . . .562 Acute Respiratory Failure . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .370 r Jenny Han, Sushma K. Cribbs, and Greg S. Martin Edward T. Naureckas and Lawrence D. H. Wood e 65 Pneumonia . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 576 44 Noninvasive Ventilation . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .377 sRichard G. Wunderink and Grant Waterer Laurent Brochard, Evangelia Akoumianaki, and u66 Infectious Complications of Intravascular Access Devices Ricardo Luiz Cordioli Used in Critical Care . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .588 45 Airway Management . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .384/ John Conly r Michael F. O’Connor and David B. Glick c 67 Endocarditis and Other Intravascular Infections . . . . . . . . . . . . . . .593 46 Tracheostomy . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .396 Mark B. Carr and Kanistha Verma Jeffrey D. Doyle and Damon C. Scales . t 68 Approach to Infection in Patients Receiving Cytotoxic 47 Upper Airway Obstruction . . . . . . . . . . . . . . . . . . . . . .a . . . . . . . . . . .404 Chemotherapy for Malignancy . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .600 Brian K. Gehlbach and John P. Kress E. J. Bow k 48 Ventilator Waveforms: Clinical Interpretation . . . . . . . . . . . . . . . . .411 69 Human Immunodeficiency Virus (HIV) and AIDS in the Gregory A. Schmidt / Intensive Care Unit . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .625 / 49 Management of the Ventilated Pati:ent . . . . . . . . . . . . . . . . . . . . . . .424 Mark Hull, Adam M. Linder, JSG Montaner, and Gregory A. Schmidt and Jesses B. Hall James A. Russell 50 Novel Modes of Mechanicapl Ventilation . . . . . . . . . . . . . . . . . . . . . .434 70 Fungal Infections . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 643 Mashael Al-Hegelan and Neil R. MacIntyre Carol A. Kauffman t 51 Ventilator-Induced Lung Injury . . . . . . . . . . . . . . . . . . . . . . . . . . . . .439 71 Bacterial Infections of the Central Nervous System . . . . . . . . . . . . .651 t Vito Fanelli, Johhn T. Granton, and Arthur S. Slutsky Allan R. Tunkel and W. Michael Scheld 52 Acute Lung Injury and the Acute Respiratory Distress 72 Encephalomyelitis . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .665 Syndrome . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .449 Peter Spiro, Venkata Ranganadh Dodda, and Mark E. Mikkelsen, Paul N. Lanken, and Jason D. Christie Vel Sivapalan 53 Extracorporeal Lung Support . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .470 73 Life-Threatening Infections of the Head, Neck, and Upper Lena M. Napolitano Respiratory Tract . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .676 54 Acute-on-Chronic Respiratory Failure . . . . . . . . . . . . . . . . . . . . . . . .482 Anthony W. Chow Ivor S. Douglas 74 Soft Tissue Infections . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .688 55 Status Asthmaticus . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .496 John Conly Thomas Corbridge and Jesse B. Hall 75 Urinary Tract Infections . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .696 56 Thoracostomy . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .505 Gerard J. Sheehan and Eoghan de Barra Shruti B. Patel and John F. McConville 76 Gastrointestinal Infections and Clostridium Difficile . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .703 57 Massive Hemoptysis . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .509 Alexander Benson and Richard K. Albert Jodi Galaydick and Stephen G. Weber FM.indd 8 1/22/2015 8:29:40 AM Contents ix 77 Management of the Critically Ill Traveler . . . . . . . . . . . . . . . . . . . . .711 PART 8 Renal and Metabolic Disorders ............915 Christian Sandrock and Hugh Black 97 Acute Kidney Injury . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .916 78 Severe Malaria . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .721 Claire Hannon and Patrick T. Murray Sanjeev Krishna and Arjen M. Dondorp 98 Renal Replacement Therapy in the Intensive Care Unit . . . . . . . . . .932 79 Tetanus . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .729 Suneel M. Udani, Jay L. Koyner, and Patrick T. Murray David L. Pitrak, Jason T. Poston, and Jodi Galaydick 99 Electrolyte Disorders in Critical Care . . . . . . . . . . . . . . . . . . . . . . . . .943 80 Viral Hemorrhagic Fevers . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .733 Caitriona McEvoy and Patrick T. Murray Jean-Luc Benoit 100 Acid-Base Balance . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .968 81 Biological Warfare . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .744 David C. Kaufman, Andrew J. Kitching, and John A. Kellum Richard H. Savel, Ariel L. Shiloh, and 101 Hyperglycemic Crisis and Hypoglycemia . . . . . . ./ . . . . . . . . . . . . . . .974 9 Vladimir Kvetan David Carmody and Louis Philipson 9 102 Critical Illness–Related Corticosteroid Insufficiency . . . . . . . . . . . .980 PART 6 Neurologic Disorders .....................755 Paul E. Marik r 82 Delirium in the Intensive Care Unit . . . . . . . . . . . . . . . . . . . . . . . . . .756 103 Thyroid Disease . . . . . . . . . . .i . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .986 Nathan E. Brummel and Timothy D. Girard h Roy E. Weiss and Samuel Refetoff 83 ICU-Acquired Weakness . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .763 a William Schweickert and John P. Kress PART 9 Gastrointestinal Disorders.................997 84 Cerebrovascular Disease . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .770 t 104 Jaundice, Di/arrhea, Obstruction, and Pseudoobstruction . . . . . . . .998 William J. Powers and Dedrick Jordan Paul T. Enrgels and L. N. Tremblay 85 Seizures in the Intensive Care Unit . . . . . . . . . . . . . . . . . . . . . . . . . . .779 e 105 Gastrointestinal Hemorrhage . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .1008 Katharina M. Busl and Thomas P. Bleck sEmad Qayed and Ram M. Subramanian 86 Intracranial Pressure: Monitoring and Management . . . . . . . . . . .786 106 Acute Liver Failure . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .1022 Geraldine Siena L. Mariano, Matthew E. Fink, u Julia Wendon Caitlin Hoffman, and Axel Rosengart / 107 Management of the Patient With Cirrhosis . . . . . . . . . . . . . . . . . . .1026 87 Neuromuscular Diseases Leading to Respiratory Failure . . . . . . . . .8r21 Sonali Sakaria and Ram M. Subramanian William Marinelli and James W. Leatherman c 108 Acute Pancreatitis . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .1031 88 Coma, Persistent Vegetative State, and . Ajaypal Singh and Andres Gelrud Brain Death . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .t . . . . . . . . .829 a 109 Mesenteric Ischemia . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .1036 Halinder S. Mangat and Axel Rosengart Hassan A. Al-Zahrani and Thomas Lindsay k PART 7 Hematologic and Oncologic Disorders......................../................841 PART 10 The Surgical Patient ....................1045 / 89 Anemia and Red Blood Cell Transfu:sion in Critically 110 Special Considerations in the Surgical Patient . . . . . . . . . . . . . . . .1046 Ill Patients . . . . . . . . . . . . . . . . . .s . . . . . . . . . . . . . . . . . . . . . . . . . . . . .842 Aziz S. Alali, Andrew J. Baker, and Jameel Ali Kevin P. Desrosiers and Hpoward L. Corwin 111 Preoperative Assessment of the High-Risk 90 Bleeding Disorders . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .844 Surgical Patient . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .1053 t Karl Thomas Robert Chen and Jameel Ali t 91 TTP, HUS, and Ohther Thrombotic Microangiopathies . . . . . . . . . . . .858 112 Principles of Postoperative Critical Care . . . . . . . . . . . . . . . . . . . . .1060 X. Long Zheng and Nilam Mangalmurti Jonathan Simmons and Laura A. Adam 92 Acute Leukemia . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .865 113 The Acute Abdomen and Intra-abdominal Sepsis . . . . . . . . . . . . . 1077 Karen-Sue B. Carlson Elisa F. Greco and John M. A. Bohnen 93 Oncologic Emergencies . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 872 114 Abdominal Compartment Syndrome . . . . . . . . . . . . . . . . . . . . . . .1084 Cristina Gutierrez and Stephen M. Pastores Adam Schlichting and Gregory A. Schmidt 94 Hematopoietic Stem Cell Transplantation and 115 The Transplant Patient . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .1087 Graft-Versus-Host Disease . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .881 Laveena Munshi, Damon C. Scales, and John T. Granton Stephen M. Pastores, Michael A. Rosenzweig, and 116 Care of the Multiorgan Donor . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .1108 Ann A. Jakubowski Masaki Anraku and Shaf Keshavjee 95 Toxicities of Chemotherapy . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .891 117 Priorities in Multisystem Trauma . . . . . . . . . . . . . . . . . . . . . . . . . . .1116 Kaye E. Hale Jameel Ali 96 Sickle Cell Disease . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .902 118 Head Injury . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .1121 Gregory J. Kato and Mark T. Gladwin John M. Oropello, Nirav Mistry, and Jamie S. Ullman FM.indd 9 1/22/2015 8:29:40 AM