Annual Update in Intensive Care and Emergency Medicine 2016 1st Edition by Jean Louis Vincent 3319273485 9783319273488

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ISBN 10: 3319273485

ISBN 13: 9783319273488

Author: Jean-Louis Vincent

The Annual Update compiles the most recent developments in experimental and clinical research and practice in one comprehensive reference book. The chapters are written by well recognized experts in the field of intensive care and emergency medicine. It is addressed to everyone involved in internal medicine, anesthesia, surgery, pediatrics, intensive care and emergency medicine.

Annual Update in Intensive Care and Emergency Medicine 2016 1st Table of contents:

Part I Infections and Antibiotics

Interpreting Procalcitonin at the Bedside

Introduction

Sepsis Is not a `Definitive’ Disease

From Localized Insult to Cytokine Storm

The Role of PCT in Diagnosing Infection

PCT-assisted Antibiotic Therapy

Conclusion

References

Reducing Antibiotic Use in the ICU: A Time-Based Approachto Rational Antimicrobial Use

Introduction

Time Point 1: Day 0 – Start of Empirical Antibiotic Therapy

Time Point 2: Day 1 – Early Reevaluation

Time Point 3: Day 3 – Microbiological Turnaround

Time Point 4: From Day 5 Onwards – End of the Antibiotic Course

Conclusion

References

Plasmacytoid Dendritic Cells in Severe Influenza Infection

Introduction

The Functional Plasticity of Plasmacytoid Dendritic Cells

Evidence for Beneficial Roles of Plasmacytoid Dendritic Cells

Evidence for Harmful Roles of Plasmacytoid Dendritic Cells

The Therapeutic Implications

New Anti-influenza Therapy to Target Plasmacytoid Dendritic Cells

Biomarker-guided Therapy for Plasmacytoid Dendritic Cells

New Biomarker to Measure Plasmacytoid Dendritic Cells

Advantage of the IFI27 Assay over Virus Detection Assays

Conclusion

References

Critically Ill Patients with Middle East Respiratory SyndromeCoronavirus Infection

Introduction

Epidemiology

Pathogenesis

Clinical Manifestations

Diagnosis

Management

Outcomes

Conclusions and Future Directions

References

Part II Sepsis

Immunomodulation: The Future for Sepsis?

Introduction

Extracorporeal Blood Purification Techniques

Pharmacological Approaches

Conclusion

References

Norepinephrine in Septic Shock: Five Reasons to Initiate it Early

Introduction

Five Arguments to Support Early Initiation of Norepinephrine

Conclusion

References

Myths and Facts Regarding Lactate in Sepsis

Introduction

The Physiology of Lactate

Lactate and Acidosis

Lactate and Sepsis

Adrenergic State: Rapid Increase in Cellular ATP Needs

Inflammation

Cancer

Hypoxia

Lactate Disposal

Lactate-based Resuscitation in Sepsis

Conclusion

References

Part III Renal Issues

Creatinine-Based Definitions: From Baseline Creatinineto Serum Creatinine Adjustment in Intensive Ca

Introduction

Estimating Baseline Serum Creatinine

Baseline Serum Creatinine in Cardiac Surgery and Pediatrics

Factors Influencing Serum Creatinine Values

Susceptibility to Kidney Damage

Conclusion

References

Detrimental Cross-Talk Between Sepsis and Acute Kidney Injury:New Pathogenic Mechanisms, Early Bioma

Introduction

New Pathogenic Mechanisms of Sepsis-Associated AKI: The `Liaison Dangereuse’ Revisited

Biomarkers of Sepsis-Associated AKI

Targeted Therapeutic Approaches for Sepsis-Associated AKI

Conclusion

References

Timing of Acute Renal Replacement Therapy

Introduction

Clinical Studies Comparing `Early’ and `Late’ Start of Acute RRT

Is There a Role for `Pre-Emptive’ RRT?

Conclusion: Practical Approach to Individualized Initiation of RRT

References

(Multiple) Organ Support Therapy Beyond AKI

Introduction

Sepsis

Lung

Liver

Heart

Conclusions

References

Part IV Fluid Therapy

Crystalloid Fluid Therapy

Introduction

Unbuffered/Unbalanced Crystalloids

Buffered/Balanced Crystalloids

Animal Studies Comparing 0.9% Saline to Buffered Crystalloid Fluids

Observational Studies Comparing 0.9% Saline to Buffered Crystalloid Fluids

Interventional Studies Comparing 0.9% Saline to Buffered Crystalloid Fluids

The SPLIT Program

Conclusion

References

Part V Bleeding

Emergency Reversal Strategies for Anticoagulants and Antiplatelet Agents

Introduction

Incidence and Risk Factors for Bleeding in Patients on Anticoagulants

Reversal of Vitamin K Antagonists

Reversal of Heparin and Heparin Derivatives

Reversal of New Direct Factor Xa Inhibitors

Reversal of New Direct Thrombin Inhibitors

Reversal of Antiplatelet Agents

Conclusion

References

Part VI Cardiovascular System

Bedside Myocardial Perfusion Assessmentwith Contrast Echocardiography

Introduction

Contrast Echocardiography Agents

Effect of Ultrasound on Contrast Agents

Myocardial Perfusion Imaging

Safety Profile

Applications in the Critically Ill

Conclusion

References

Pathophysiological Determinants of Cardiovascular Dysfunctionin Septic Shock

Introduction

Pathophysiology in Septic Shock

Novel Considerations in Septic Shock

Novelties in Pathophysiological Understanding and Management

Conclusion

References

Cardiovascular Response to ECMO

Introduction

Microcirculatory Alterations During ECMO

Fluid Management in VA-ECMO

Reperfusion Damage

Weaning from VA-ECMO

Conclusion

References

Mechanical Circulatory Support in the New Era: An Overview

Introduction

Case Vignette

Mechanical Circulatory Support Strategies

Quality Assurance, Governance and Benchmarking

Resource and Ethical Issues

Research Priorities and Advancing the Field of Mechanical Circulatory Support

Conclusion

Acknowledgements

References

Part VII Cardiac Arrest

Cardiac Arrest in the Elderly: Epidemiology and Outcome

Introduction

Epidemiology of Cardiac Arrest in the Elderly

Prevention of In-Hospital Cardiac Arrest in the Elderly

Decision to Resuscitate

Conclusion

References

Regional Systems of Care: The Final Link in the “Chain of Survival”Concept for Out-of-Hospital C

Introduction

Rationale for Regional Systems of Care for Post-Cardiac Arrest Care

Provision of Post-Resuscitation Care and Outcome

Hospital Case-Volumes and the Level-of-Care

Interventional Programs to Improve the Provision of Post-Resuscitation Care

Even for Elderly Patients?

The Links in the “Chain of Survival” Are a Relay Baton from Layperson to Pre-Hospital and In-Hos

Limitations

Conclusion

References

Cardiac Arrest Centers

Introduction

Lessons from Existing Regionalization of Non-Cardiac Care

OHCA and Emergency Cardiac Intervention

Post-Resuscitation Critical Care Management

Existing Models of Regionalized Cardiac Arrest Care

Alternative Models of Regionalization

Conclusion

References

Part VIII Oxygenation and Respiratory Failure

High-Flow Nasal Cannula Oxygen Therapy: Physiological Effectsand Clinical Data

Introduction

Main Mechanisms of Action

Clinical Trials in Adults

Clinical Trials in Children

Conclusion

References

The Potential Value of Monitoring the Oxygen Reserve Indexin Patients Receiving Oxygen

Introduction

The Clinical Value of Monitoring O2 Saturation (SpO2)

The Oxygen Reserve Index

Conclusion

References

Variable Ventilation from Bench to Bedside

Introduction

Respiratory Variability and Rationale

Modes of Variable Ventilation

Mechanisms of Variable Ventilation

Variable Mechanical Ventilation in Experimental Studies (Table 1 )

Clinical Application of Variable Mechanical Ventilation

Potential Application of Variable Ventilation

Conclusion

References

Monitoring Respiratory Effort by Means of the Electrical Activityof the Diaphragm

Introduction

What Is EAdi?

Monitoring Patient-Ventilator Interaction and Dynamic Hyperinflation

Monitoring Inspiratory Muscle Pressure and Work of Breathing

Monitoring by Surface Electromyography

Conclusion

References

Dissipated Energy is a Key Mediator of VILI: Rationale for Using Low Driving Pressures

Introduction

History of Ventilator-Induced Lung Injury

Clinical Evidence for Benefit of Tidal Volume Reduction and Up-Titration of PEEP

A New Concept: Energy Transferred from the Ventilator to the Lung

Clinical Evidence for Benefit of Low Driving Pressure

How to Limit the Driving Pressure?

Limitations of Aiming at Low Driving Pressures

Conclusion

References

Corticosteroids as Adjunctive Therapy in Severe Community-Acquired Pneumonia

Introduction

Systemic Adjunctive Corticosteroid Therapy in Severe CAP

Corticosteroids in Patients with Severe CAP with Marked Inflammation and Non-Influenza Pneumonia

Conclusion

References

Part IX Abdominal Issues

The Neglected Role of Abdominal Compliancein Organ-Organ Interactions

Introduction

Definitions

Pathophysiology

Measurement

Prognostic and Predictive Factors Related to Abdominal Compliance

Treatment

Conclusion

References

Part X Metabolic Support

Metabonomics and Intensive Care

Introduction

Nuclear Magnetic Resonance Spectroscopy

Mass Spectrometry

Data Analysis

Metabonomics and Intensive Care

Conclusion

References

The Rationale for Permissive Hyperglycemia in Critically Ill Patientswith Diabetes

Introduction

The Concept of Relative Hypoglycemia

Effects of Relative Hypoglycemia on Cardiovascular Function

Hyperglycemia, Hypoglycemia and Clinical Outcomes

Detecting Relative Hypoglycemia in ICU Patients

Conclusion

References

Indirect Calorimetry in Critically Ill Patients: Concept, Current Use,and Future Challenges

Indirect Calorimetry: From Concept to Practical Use in the ICU

Measuring or Calculating Energy Expenditure in Critically Ill Patients?

Extracorporeal Techniques: A Challenge for Indirect Calorimetry

Conclusion

References

Part XI Ethical Issues

Managing Intensive Care Supply-Demand Imbalance

Introduction

Increasing Supply

Elective Postoperative Admissions

Emergency Admissions

Advanced Organ Support Outside Intensive Care Units

Conclusion

References

Advances in the Management of the Potential Organ DonorAfter Neurologic Determination of Death

Introduction

Physiological Changes Related to Brain Death

Deceased Organ Donation Pathways

Donor Management

Conclusion

References

Humanizing Intensive Care: Theory, Evidence, and Possibilities

Introduction

Theory

The Nature of Uncertainty

Potential Barriers to a More Human ICU

Practical Solutions

Conclusion

References

Part XII Applying New Technology

Ultrasound Simulation Education for Intensive Careand Emergency Medicine

Introduction

Current Practice

Simulation

Evidence of Benefit from Ultrasound Simulation Education

Significance for Educational Programs

Future Developments

Conclusion

References

Virtual Patients and Virtual Cohorts: A New Way to Think Aboutthe Design and Implementation of Perso

Introduction

Model Types and Requirements

Data Required for Virtual Patients

Virtual Patients, Cohorts and their Validation

Conclusion

References

Part XIII Intensive Care Unit Trajectories: The Bigger Picture

Predicting Cardiorespiratory Instability

Introduction

Integrated Monitoring Systems Improve Diagnosis of Cardiorespiratory Insufficiency and Treatment Eff

Advanced Signal Processing Improves Predictive Value of HR for Identifying Impending Instability

Advanced Signal Processing of Physiologic Variable Time Series Identifies Those SDU Patients Who Wil

Advanced Monitoring-Derived Comprehensive Libraries

Extending Biosensor Utility Using Functional Hemodynamic Monitoring for Prediction

Non-Invasive Measures of Oxygen Sufficiency

Predicting the Need for Life-Saving Interventions In Stat Medevac Air Transport

Using Machine Learning Principles to Define Health and Disease

Acknowledgement

References

Long-Term Outcomes After Critical Illness Relevantto Randomized Clinical Trials

Introduction

Short-Term Physiological Outcomes and Mortality Versus Long-Term Functional Assessment

Declining Mortality Rates Mean That Clinical Trials Using Mortality May Be Unfeasible

Prior Approaches to Describing Long-Term Outcome in Australia and New Zealand

International Collaboration and Consensus on Measuring Long-Term Outcomes

Pros and Cons of Standardizing Outcomes Assessment

International Efforts to Standardize Outcomes or International Consensus Process

ANZICS-CTG Long-Term Outcomes Program

Conclusion

Acknowledgements

References

Long-Term Consequences of Acute Inflammation in the Surgical Patient:New Findings and Perspectives

Introduction

Acute Inflammation in Cancer Surgery

Acute Inflammation in Non-Cancer Surgery

The Vision

The Options

Conclusion

References

Kairotropy: Discovering Critical Illness TrajectoriesUsing Clinical Phenotypes with Big Data

Introduction

The Kairotropic Stimulus

Data Signatures and Phenotypes of Kairotropy

Breaking down `Big Data’

Areas for Future Investigation

Conclusion

Acknowledgements

References

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