Download Anaesthesia, Pain, Intensive Care and Emergency A.P.I.C.E.: by A. Gullo PDF

By A. Gullo

ISBN-10: 8847007720

ISBN-13: 9788847007727

Bettering criteria of care is a true problem in in depth Care drugs. enhancing medical functionality, sufferer safeguard, probability administration and audit represents the cornerstone for elevating the standard of care in ICU sufferers. communique is the platform from the place to begin to arrive a consensus in a really crowded sector, a different multidisciplinary and multiprofessional setting within which caliber of care and, eventually, sufferer survival must be ameliorated.

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Extra resources for Anaesthesia, Pain, Intensive Care and Emergency A.P.I.C.E.: Proceedings of the 22st Postgraduate Course in Critical Medicine Venice-Mestre, Italy - November 9-11, 2007

Example text

More recently, DPOP was studied in the intensive care unit and in the operating room with positive results [19-21]. Natalini et al [21] studied patients in intensive care and found that a DPOP threshold value of 15% predicted fluid responsiveness with a positive predictive value of 55% and a negative predictive value of 100%. Feissel et al [20] found that a DPOP value of 14% discriminates between responders and non responders to volume expansion with a sensitivity of 100% and a specificity of 94% in patients in the intensive care unit.

Fig. 2. Depending upon the tissue, glycerol may serve as a marker of cell membrane damage or lipolysis. In the brain, where there is little or no lipolysis, an increase in glycerol signals a breakdown of cell membranes due to a decrease in capillary perfusion and an insufficient supply of oxygen and glucose. g. e. release of noradrenalin from sympathetic nerve endings stimulating adrenoreceptors on the adipocytes that trigger the breakdown of triglycerides (fat) to free fatty acid and glycerol.

Intracardiac right-to-left shunt through a patent foramen ovale (PFO) may result in the development of hypoxaemia in the ICU. Cardiac tamponade and mechanical ventilation with high positive end expiratory pressure are the most common factors responsible for enhancing intracardiac right-to-left shunt through a PFO. TOE can reveal right-to-left shunting via a PFO. Surgical closure of the PFO must be done without delay. Hypoxaemia may be caused by a pulmonary embolus. Prompt diagnosis is essential to initiate the therapy in haemodynamically unstable patients.

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