ABC algorithm, resuscitation, 3–4
abdomen
aortic aneurysm, hypotension after
repair, 1–9
compartment syndrome, 81
n-acetylcysteine
bronchoscopic lavage, 184
paracetamol poisoning, 229
acid–base balance
alkalosis, poisoning, 225, 226 (Table)
bowel fluid loss, 91–92
acidosis
see also metabolic acidosis; respiratory
acidosis
poisoning, 225, 226 (Table)
acrylate glue, oesophageal varices, 101
ACTH (adrenocorticotrophic hormone), 77
activated charcoal, 230
activated partial thromboplastin time, value
for correction, 6
activated protein C, 83
acute lung injury (ALI), 13
acute-on-chronic respiratory failure, 24
acute respiratory distress syndrome (ARDS),
13–14
burns, 156
management, 17–20
acute tubular necrosis, 41
pancreatitis, 137
pre-renal oliguria vs, 42 (Table)
adenosine antagonists, for oliguria, 46
adrenaline see epinephrine
adrenergic receptor blockers,
pre-eclampsia, 128
adrenergic receptors, TCA poisoning, 226
adrenocorticotrophic hormone (ACTH), 77
adult respiratory distress syndrome see acute
respiratory distress syndrome
adverse reactions to drugs, 63–71
afterload (cardiac), 2–3
age
blood pressure, 90
respiratory function, 86
agitation, drugs and poisons causing, 223
(Table)
airflow limitation, asthma, 177
air leaks, bronchopleural fistula, 16
airway
burns, 152, 153–154, 155
head injury, 143–144
injuries to, 16
management, 3
near-drowning, 109
neuromuscular failure, 167–168
spinal trauma, 212
alarm settings, ventilation in asthma, 182
albumin, burns, 156
alcohol
cirrhosis, 95–104
in overdoses, 228
pancreatitis, 135
aldosterone, 77
alfentanil, intubation in neuromuscular
failure, 168
INDEX
233
© Cambridge University Press www.cambridge.org
Cambridge University Press0521681014 - Core Cases in Critical CareEdited by Saxon Ridley, Gary Smith and Anna BatchelorIndexMore information
alkalosis, poisoning, 225, 226 (Table)
allergies
see also anaphylaxis
tracheal intubation in asthma, 181
alveolar–arterial oxygen tension difference,
age, 86
alveolar oedema, pulmonary contusion, 13
aminophylline
asthma, 179
chronic obstructive pulmonary disease
and, 29
ammonia, portal–systemic encephalopathy,
97–99
amniotic fluid embolism, 122, 125
amphetamines, 224
amylase, 132
anaesthesia
status epilepticus, 201
tracheal intubation in asthma, 180–181
anaesthetic agents
see also inhalational anaesthetics
anaphylaxis, 64
analgesia
burns, 158
chest trauma, 20
Guillain–Barré syndrome, 170
anaphylactoid reactions, 66
anaphylaxis
defined, 65–66
from drugs, 63–71
aneurysm, abdominal aorta, hypotension
after repair, 1–9
angiography, coronary, adverse reactions,
65 (Table)
anion gap, 91–92
poisoning, 226 (Table)
antibiotics
anaphylaxis, 64
burns, 160
chronic obstructive pulmonary disease,
29
gastrointestinal haemorrhage, 102
pancreatitis, 137
after splenectomy, 20–21
anticholinergic drugs
chronic obstructive pulmonary disease
and, 28
myasthenia gravis diagnosis, 165–167
anticoagulation, haemodialysis, 55–56
anticonvulsants
pre-eclampsia, 129
status epilepticus, 200–201
antidotes, 228–229
anti-emetics, gastrointestinal haemorrhage,
102
anti-fibrinolytic agents, 127
anti-inflammatory mediators, 75 (Fig.)
anti-inflammatory response syndrome,
compensatory, 76
anti-inflammatory therapy, ARDS, 20
anxiolysis, Guillain–Barré syndrome, 169
aortic aneurysm, hypotension after repair,
1–9
ARDS see acute respiratory distress
syndrome
ARDS Network protocol, 17
arrhythmias (cardiac)
chronic obstructive pulmonary disease,
29
drugs and poisons causing, 223 (Table)
postoperative, 7
arterial blood gases
brain stem death, 114
chronic obstructive pulmonary disease,
32
near-drowning, 110
respiratory failure, 27
arterial lines, blood pressure, 4
transport of patient, 145
arteriovenous access, 54
see also venous access
aspirin see salicylate poisoning
asthma, 175–186
atracurium, tracheal intubation in asthma,
181
atrial natriuretic peptide analogues, for
oliguria, 46
atropine, 169
autonomic dysfunction, neuropathic, 164,
167–168
autonomic mass effect, spinal trauma, 216
auto-PEEP see intrinsic PEEP
auto-regulation curve, cerebral perfusion
pressure, 143
INDEX
234
© Cambridge University Press www.cambridge.org
Cambridge University Press0521681014 - Core Cases in Critical CareEdited by Saxon Ridley, Gary Smith and Anna BatchelorIndexMore information
AVPU scale, 224
awake fibre-optic tracheal intubation, 168
awareness, 188
axonal degeneration, Guillain–Barré
syndrome, 172
bacterial infections
from bowel, 81–82, 136
central venous catheters, 55
chronic obstructive pulmonary disease,
26–27
gram-positive, intensive care, 203
balloon tamponade
uterine haemorrhage, 128
variceal bleeding, 102
Balthazar score, pancreatitis, 135 (Table)
band ligation, oesophageal varices, 101
barbiturates, seizure control, 113–114
barotrauma
see also pneumothorax; tension
pneumothorax
PEEP, 33
base excess, renal failure, 52
Battle’s sign, 192
benzodiazepine receptors, encephalopathy, 98
benzodiazepines
antidotes, 228
seizures, 200, 225
ventilation, chronic obstructive pulmonary
disease, 34
�2-adrenergic receptor agonists, chronic
obstructive pulmonary disease
and, 28
�-adrenergic receptor agonists, asthma, 179
bicarbonate
haemofiltration, 57
levels, hypercapnia, 27, 87
loss from bowel, 88
therapy
crush injuries, 216
near-drowning, 110–111
TCA poisoning, 229
bilevel ventilation, asthma, 182
biphasic reactions, contrast media, 65
bladder
pressure, 81
spinal trauma, 210
blisters, burns, 153
blood gases see arterial blood gases
blood pressure, 1–2
age, 90
arterial lines, 4
transport of patient, 145
glomerular filtration rate, 41
blood transfusion see transfusion
body surface area (BSA), burns, 151
Rule of 9s, 156
bone marrow, near-drowning, 109
botulism, 166 (Table), 167
bradycardia
drugs and poisons causing, 223 (Table)
Guillain–Barré syndrome, 169
spinal trauma, 209
brain damage, 142–143
asthma, 185
near-drowning, 106, 113
prevention, 141–149, 193–194
status epilepticus, 198–199
brain oedema
eclampsia, 124
encephalopathy, 98
fluid resuscitation, 127
near-drowning, 106, 114
brain stem death, 114–117
brain stem lesions, signs, 191
breathing
see also ventilation
burns, 155–156
coma, 192
Guillain–Barré syndrome, 168–169
head injury, 144
postoperative management, 4
breath stacking, asthma, 178 (Fig.)
British Trauma Society, spinal clearance, 215
(Fig.)
bronchi, asthma, 176–177
bronchodilators
asthma, 179–180
ventilation, 182–183
chronic obstructive pulmonary disease,
28–29, 35
bronchopleural fistula, 16
mechanical ventilation, 19, 184
bronchoscopic lavage, n-acetylcysteine, 184
INDEX
235
© Cambridge University Press www.cambridge.org
Cambridge University Press0521681014 - Core Cases in Critical CareEdited by Saxon Ridley, Gary Smith and Anna BatchelorIndexMore information
bulbar reflexes, Guillain–Barré syndrome
management, 168
burns, 151–161
buttock burns, 159
Caesarean section, obstetric haemorrhage,
121–130
calcium, intravenous, 217
Campylobacter, Guillain–Barré syndrome,
172
carbon dioxide tension
brain stem death, 114
ventilation, head injury, 144
carbon monoxide poisoning, 153, 155
carboprost, 128
cardiac index
management, 80
Shoemaker’s goal, 79
cardiac output, 2
dopamine on, 46
monitoring, PEEP, 17
cardiopulmonary bypass, rewarming, 112
(Table)
cardiopulmonary resuscitation, near-
drowning, 106
cascade humidifier, 112 (Table)
cathartics, 230
catheters
see also central venous catheters;
pulmonary artery catheters
haemodialysis, 54–55
infections, 204
urinary, spinal trauma, 213
cellular energy failure, brain damage, 142
cellular hypoxia, lactate, 90
cellular poisons, 224
central nervous system
see also brain damage; brain oedema;
spine
near-drowning, 106, 113–114
central venous catheters
haemodialysis, 55
infections, 204
transport of patient, 145
central venous pressure, 2, 4
obstetric haemorrhage resuscitation, 126
pre-eclampsia, 124
cephalosporins, cross-sensitivity with
penicillin, 64
cerebral blood flow, 143
status epilepticus, 199
cerebral hypoxia, 105–119, 142
cerebral oedema see brain oedema
cerebral perfusion pressure, 143, 193–194
cerebrospinal fluid, Guillain–Barré
syndrome, 165
filtration, 171
cervical spine
coma, 192
immobilisation, 144, 212
trauma, 208
charcoal, activated, 230
checklists, transport of patient, 147–148
chelating agents, 228
chemical burns, 154
chest
drains, asthma, 183–184
manual compression, 184
trauma, 11–22
Child’s classification, oesophageal varices,
haemorrhage risk, 96
Chlamydia pneumoniae, chronic obstructive
pulmonary disease, 27
cholangitis, pancreatitis, 137
chronic inflammatory demyelinating
polyneuropathy, 172
chronic obstructive pulmonary disease,
87
oxygen therapy, 28, 89
respiratory failure, 23–37
circulation
see also haemodynamics
burns, 156–157
coma, 192
Guillain–Barré syndrome, 169
poisoning, 223–224
resuscitation, 4
near-drowning, 110–111
spinal trauma, 212–213
TCA poisoning, 226
circumferential burns, 153, 156
cirrhosis
alcohol, 95–104
definition, 97
INDEX
236
© Cambridge University Press www.cambridge.org
Cambridge University Press0521681014 - Core Cases in Critical CareEdited by Saxon Ridley, Gary Smith and Anna BatchelorIndexMore information
citrate toxicity, blood transfusion, 99, 123
(Table)
coagulation, endoscopic thermal, 43–44
coagulopathy
dilutional, 123, 124 (Table)
near-drowning, 109
obstetric haemorrhage, 122–123
treatment, 127
cockpit drill, allergic reactions, 68
cold shock, 76
collars, cervical, 144
colloids
anaphylaxis from, 64
fluid resuscitation, 6, 126
burns, 156
coma, 187–196
poisoning, 222
tricyclic antidepressants, 227
community acquired pneumonia,
203–204
compartment syndrome
abdomen, 81
crush injury, 210–211, 216
electrical burns, 154
compensatory anti-inflammatory response
syndrome, 76
complement, measurement after contrast
media reactions, 69
computed tomography
ARDS, 13–14
brain, near-drowning, 113
coma, 193
pancreatitis, 134–135
spinal trauma, 214
conduction velocity, nerves, Guillain–Barré
syndrome, 165 (Table)
confusion, 188 (Table)
consciousness, 188
AVPU scale, 224
causes of depression, 189 (Table)
Glasgow Coma Scale (GCS), 188 (Table),
191
continuous positive airways pressure (CPAP),
asthma, 180, 182
contrast media, adverse reactions, 63–71
contusion, lung, trauma, 11–22
convulsions see seizures
coronary angiography, adverse reactions, 65
(Table)
coroners, organ donation and, 115
cor pulmonale, 25–26
electrocardiography, 28
corticosteroids
see also hydrocortisone;
methylprednisolone
ARDS, 20
asthma, 179
chronic obstructive pulmonary disease, 29
myopathy, 35
HELLP syndrome, 129
long-term
postoperative care and, 73
on stress response, 77
septic shock, 80–81
spinal trauma, 213
cortisol, 77
cranial nerves, Guillain–Barré syndrome, 164
C-reactive protein, pancreatitis, 133
creatinine clearance, 53
creatinine kinase, myocardial specific, 7
critical illness neuropathy, 82
cross-sensitivity, penicillin with other drugs,
64
crush injuries, 208, 210–211, 216–217, 218
cryoprecipitate, 127
indications, 6
crystalloids, fluid resuscitation, 6
CT see computed tomography
Cullen’s sign, 132
cultures (bacteriology), catheters, 204
cyanide poisoning, 154, 156
cytokines, 75–76
cytotoxic oedema, brain, 142
DDAVP (ADH analogue), brain stem death,
116–117
debridement, 81
decision-making, patients with chronic
obstructive pulmonary disease, 30, 36
deep burns, 153
deep vein thrombosis
Guillain–Barré syndrome, 170
spinal trauma, 216
dehydration, 90
INDEX
237
© Cambridge University Press www.cambridge.org
Cambridge University Press0521681014 - Core Cases in Critical CareEdited by Saxon Ridley, Gary Smith and Anna BatchelorIndexMore information
delirium, 188 (Table)
demyelinating polyneuropathy, chronic
inflammatory, 172
dermal burns, 152–153
devascularisation, uterus, 128
dextrose solutions
head injury and, 145
status epilepticus, 202
diabetes insipidus, brain stem death,
116–117
diabetes mellitus
coma, 187–188
pancreatitis, 138
dialysis, 54–57
diazepam, status epilepticus, 200
digestive tract see gastrointestinal tract
digital ischaemia, vasopressors, 82
dilutional effects
coagulopathy, 123, 124 (Table)
massive transfusion, 100
diphtheria, neuromuscular failure, 166
(Table), 167
disseminated intravascular coagulation
brain stem death, 117
laboratory findings, 124 (Table)
pre-eclampsia, 125
treatment, 127
diuresis
forced, 230–231
hypothermia, 108, 113
diuretics
see also frusemide; loop diuretics
variceal bleeding, 102
diving reflex, 106
dobutamine
cardiac index maintenance, 80
neuromuscular failure, 168
domestic accidents, spinal injury incidence,
208
domperidone, gastrointestinal haemorrhage,
102
dopamine, 7 (Table)
for oliguria, 46
septic shock, 80
dopexamine, 7 (Table)
septic shock, 80
Doppler ultrasound, transoesophageal, 5–6
doxapram, chronic obstructive pulmonary
disease, 29–30
drowning see near-drowning
drugs
anaphylaxis from, 63–71
extra-corporeal removal, 57–58
poisoning, identification, 225–228
dynamic hyperinflation, 18, 24–26
chronic obstructive pulmonary disease,
33–34
detection, 34
dysequilibrium syndrome, haemodialysis,
58–59
dysrhythmias see arrhythmias (cardiac)
Eaton–Lambert syndrome, 166 (Table), 167
eclampsia, 122, 124
edrophonium, myasthenia gravis diagnosis,
167
electrical burns, 154
heart, 157
electrocardiography
chronic obstructive pulmonary disease,
28
electrical burns, 157
myocardial monitoring, 7
near-drowning, 107
TCA poisoning, 226, 227 (Fig.)
electroencephalography
coma, 193
status epilepticus, 201
electrophrenic ventilation, 217
embolisation (angiographic), uterine
devascularisation, 128
emesis, for poisoning, 229
emphysema, 87
encephalopathy, portal–systemic, 96, 97–99
end-expiratory occlusion, intrinsic PEEP
quantification, 34
endobronchial mucus suffocation, 176, 184
endocrine coma, 187–196
endoscopy, gastrointestinal haemorrhage,
43–44, 96, 101
prognostic features, 43 (Table)
endotracheal intubation see tracheal
intubation
energy failure, cellular, brain damage, 142
INDEX
238
© Cambridge University Press www.cambridge.org
Cambridge University Press0521681014 - Core Cases in Critical CareEdited by Saxon Ridley, Gary Smith and Anna BatchelorIndexMore information
enoximone, 7 (Table)
septic shock, 80
enteral nutrition
burns, 157–158
Guillain–Barré syndrome, 170
lung injury management, 20
for near-drowning, 113
pancreatitis, 137
epidural analgesia, chest trauma, 20
epilepsy
see also seizures
status epilepticus, 197–206
epinephrine (adrenaline), 7 (Table)
asthma, 179
near-drowning, 111
septic shock, 80
epithelial burns, 152
equipment
obstetric haemorrhage treatment
packs, 127
renal filtration, 56 (Fig.)
transport of patient, 145–147
ergometrine, 128
examination (clinical)
coma, 191–192
pancreatitis, 132
renal failure, 52
spinal trauma, 213
expiratory airflow
asthma, 177
chronic obstructive pulmonary disease, 24
extra-corporeal circulation
plasma exchange, Guillain–Barré
syndrome, 171
rewarming, 112 (Table)
extra-corporeal drug removal, 57–58
extra-corporeal membrane oxygenation, 19
extubation, asthma, 184
faecal peritonitis, 81–82
fasciotomy, 216
fentanyl, tracheal intubation in asthma, 181
fibre-optic tracheal intubation, 168
fibrinogen depletion
level for correction, 6
massive transfusion, 100
fibroproliferation, pulmonary, 20
filtration
see also haemofiltration
cerebrospinal fluid, Guillain–Barré
syndrome, 171
massive transfusion, 99–100
flaccid paralysis, spinal trauma, 210
flail chest, 12–13, 16
flow time corrected for heart rate (FTc), 5
fluid challenge, hypovolaemia
measurement, 4
fluid loss, gastrointestinal tract, 85–94
fluid resuscitation, 6
asthma, 180
burns, 156
fluid loss from bowel, 90–91
obstetric haemorrhage, 126–127
sepsis, 79
flumazenil, 228
Foley catheter, uterine haemorrhage, 128
foods, anaphylaxis, 64 (Table)
forced diuresis, 230–231
forced expiratory volume in 1 second
(FEV1), asthma, 177
fosphenytoin, 200
fractional excretion, sodium, 52
fractures
ribs, 12–13, 144, 145
skull, signs, 192
fresh frozen plasma (FFP), 127
frusemide
see also loop diuretics
for raised intracranial pressure, 194
full thickness burns, 153
functional residual capacity (FRC)
asthma, 178 (Fig.)
postoperative, 86
fundi, coma, 191–192
GABAA receptors, ammonia, 98
gallstones, pancreatitis, 135, 137, 138
gamma-aminobutyric acid receptors,
A type, ammonia, 98
gamma-globulin, Guillain–Barré syndrome,
171
gastric lavage, 229
gastric outflow obstruction, 88
spinal trauma, 210
INDEX
239
© Cambridge University Press www.cambridge.org
Cambridge University Press0521681014 - Core Cases in Critical CareEdited by Saxon Ridley, Gary Smith and Anna BatchelorIndexMore information
gastrin, 87–88
gastritis, causes, 40
gastrointestinal haemorrhage
endoscopy, 43–44, 96, 101
prognostic features, 43 (Table)
haemodialysis, 58
oesophageal varices, 95–104
oliguria, 39–48
gastrointestinal tract
fluid loss, 85–94
hypoxaemia on, 108, 113
motility, 88
postoperative, 86–87
removal of poisons, 229–230
selective decontamination (SDD), 102
translocation of bacteria, 81–82, 136
GCS (Glasgow Coma Scale), 188 (Table),
191
Glasgow Coma Scale (GCS), 188 (Table),
191
Glasgow score, pancreatitis, 133
glomerular filtration rate, renal control, 41
glucose
see also hypoglycaemia
blood levels for treatment of septic shock,
81
excess, near-drowning, 112
glutamatergic system, portal–systemic
encephalopathy, 99
glutamine, portal–systemic encephalopathy,
99
glycaemia see glucose
glyceryl trinitrate, 7 (Table)
Guillain–Barré syndrome, 169
glycopyrrolate, 169
gram-positive bacteria, intensive care,
203
Grey Turner’s sign, 132
Guillain–Barré syndrome, 164–167
H2-receptor antagonists, 44
burns, 154
haematemesis, 40
haemodiafiltration, poisoning, 231
haemodialysis
poisoning, 231
renal failure, 54–57
haemodynamics
see also circulation
abdominal aortic aneurysm repair, 1–9
brain stem death, 116
Guillain–Barré syndrome, 169
near-drowning, 107–108, 110
PEEP on, 17, 33
pre-eclampsia, 124
sepsis, 76, 79–80
transport of trauma patient, 145
haemofiltration, 54–57
equipment, 56 (Fig.)
rewarming with, 112 (Table)
poisoning, 231
haemoglobin
carbon monoxide on, 153
levels
sepsis treatment, 79
transfusion, 6, 126
haemolysis, fresh water aspiration, 109
haemolytic anaemia, micro-angiopathic,
pre-eclampsia, 125
haemoperfusion, poisoning, 231
haemorrhage
see also gastrointestinal haemorrhage
aortic aneurysm rupture, 3
burns surgery, 159
obstetric, 121–130
treatment packs, 127
spinal trauma, 209
transfusion, 6
haemothorax, 16
head injury, transfer of patient, 141–149
heart block, Guillain–Barré syndrome, 169
heart rate, 2
heavy metal poisoning, chelating agents,
228
Heimlich manoeuvre, not in near-drowning,
109
Helicobacter pylori, eradication therapy, 45
Heliox, asthma, 184
HELLP syndrome, 125
corticosteroids, 129
mortality and recurrence risk, 129
heparin
for disseminated intravascular coagulation,
127
INDEX
240
© Cambridge University Press www.cambridge.org
Cambridge University Press0521681014 - Core Cases in Critical CareEdited by Saxon Ridley, Gary Smith and Anna BatchelorIndexMore information
Guillain–Barré syndrome, 170
haemodialysis, 56
high frequency oscillator ventilation, 19
high molecular weight hydroxyethyl
starches, 126
high pressure ventilation, 18–19
high tension electrical burns, 154
hip replacement, oliguria after, 49–61
history-taking
coma, 190
renal failure, 51–52
humidifier, cascade, 112 (Table)
hydralazine, pre-eclampsia, 128–129
hydrocortisone
brain stem death, 117
septic shock, 80–81
hydrofluoric acid, burns, 154
hydrogen ions
see also acid–base balance; acidosis;
alkalosis; pH
water dissociation, 92
hydroxyethyl starches, high molecular
weight, 126
hyperbaric oxygen, carbon monoxide
poisoning, 155
hypercalcaemia, crush injury, 211
hypercapnia, 12
see also respiratory acidosis
bicarbonate levels, 27, 87
chronic obstructive pulmonary disease, 32
oxygen therapy, 28
hyperglycaemia, near-drowning, 112
hyperinflation see dynamic hyperinflation
hyperkalaemia, 52
effects, 51
electrical burns, 154
management, 216–217
massive transfusion, 123 (Table)
near-drowning, 112
suxamethonium, 168
hypertension, drugs and poisons causing, 223
(Table)
hyperventilation
drugs and poisons causing, 223 (Table)
head injury, 144
hypocalcaemia, crush injury, 211
hypocapnia, 144
hypoglycaemia, 190, 192–193, 194
poisoning, 226 (Table)
status epilepticus, 202
hyponatraemia, near-drowning, 112
hypoperfusion, 4
hypophosphataemia, haemodialysis, 59
hypotension
see also shock
after abdominal aortic aneurysm repair, 1–9
brain stem death, 116
drugs and poisons causing, 223 (Table)
Guillain–Barré syndrome, 168
plasma exchange, 171
haemodialysis, 58
management, 225
spinal trauma, 209
hypothermia
arterial blood gases, 110
brain stem death, 116
burns, 154, 158
coma, 191
diuresis, 108, 113
drugs and poisons causing, 223 (Table)
electrocardiography, 107
massive transfusion, 99
near-drowning, 106
rewarming, 111–112
treatment, 79
hypovolaemia
crush injury, 211
gastrointestinal haemorrhage, 39
management, 6
measurement, 4–5
renal failure, 41–42
shock, 40–41
monitoring, 43
signs, 52
spinal trauma, 212–213
trauma, 145
vasoconstrictors, 6, 44
hypoxaemia, 12
gastrointestinal tract, 108, 113
haemodialysis, 59
kidney, 41
liver, 108, 113
near-drowning, 110
oxygen therapy, 89
INDEX
241
© Cambridge University Press www.cambridge.org
Cambridge University Press0521681014 - Core Cases in Critical CareEdited by Saxon Ridley, Gary Smith and Anna BatchelorIndexMore information
trauma, management, 15–16
ventilation for, 11–12, 16–19
hypoxia
cellular, lactate, 90
cerebral, 105–119, 142
spinal, 209
hysterectomy, obstetric haemorrhage, 128
IgE antibodies, 66
ileus
postoperative, 86–87, 88
spinal trauma, 210, 216
immediate action drill, allergic reactions, 68
immobilisation, spinal, 212
cervical, 144, 212
immunocompromise, compensatory
anti-inflammatory response
syndrome, 76
industrial accidents, spinal injury incidence, 208
infections
see also bacterial infections
burns, 155, 158, 160
chronic obstructive pulmonary disease,
26–27
Guillain–Barré syndrome, 164–167
intensive care, 202–205
lung, Guillain–Barré syndrome, 170
near-drowning, 108, 113
pancreatitis from, 135
status epilepticus, 202
inflammation
pulmonary contusion, 13
therapy, ARDS, 20
inflection points, pulmonary static
pressure–volume curve, 18
information, to patients with chronic
obstructive pulmonary disease, 30, 36
inhalational anaesthetics, asthma, 184
tracheal intubation, 181
inhalers, asthma, 183
injection therapy, endoscopic, 43
inotropes
brain stem death, 116
near-drowning, 111
neuromuscular failure, 168
septic shock and, 79
insect bites and stings, anaphylaxis, 64 (Table)
inspiratory to expiratory time ratio
ARDS, 18
asthma, 182, 184
intensive care
asthma, 177–179, 185
chronic obstructive pulmonary disease,
bed occupancy rates, 24
infections, 202–205
non-invasive ventilation, 30–31
variceal haemorrhage, 103
intracranial pressure, 114, 142
coma, 194
monitoring, 141
intravenous immunoglobulin,
Guillain–Barré syndrome, 171
intravesical pressure, 81
intrinsic PEEP (PEEPi), 18, 25
asthma, 177
chronic obstructive pulmonary disease,
33–34
detection, 34
intubation see tracheal intubation
inverse ratio ventilation (IRV), 18
iodine, in contrast media, 66
ipatropium bromide, asthma, 179
ipecacuanha syrup, 229
ischaemic heart disease
abdominal aortic aneurysm repair, 3
platelet counts, 6
isoprenaline, heart block, 169
J-waves, hypothermia, 107
ketamine, 181
kidney
see also renal failure
hypoperfusion, 41
hypothermia, 108
pre-eclampsia, 124
labetalol
Guillain–Barré syndrome, 169
pre-eclampsia, 128
lactate
accumulation
haemodialysis, 59
near-drowning, 112
INDEX
242
© Cambridge University Press www.cambridge.org
Cambridge University Press0521681014 - Core Cases in Critical CareEdited by Saxon Ridley, Gary Smith and Anna BatchelorIndexMore information
haemofiltration replacement fluid, 57
hypoxia vs exogenous, 90
from reperfusion, 6
lactulose, gastrointestinal haemorrhage, 102
Laplace’s law, 3
laser photocoagulation, endoscopic, 44
latex, anaphylaxis, 64 (Table)
lavage, pancreatic bed, 137
lead poisoning, neuromuscular failure, 166
(Table)
leucotriene antagonists, asthma, 180
life support equipment
see also ventilators
transport of patient, 145
lipase, pancreatic, 132
liver
see also cirrhosis
hypoxaemia on, 108, 113
pre-eclampsia, 124
transplantation, 103, 104
organ donation, 115–117
log rolling, 213
loop diuretics
see also frusemide
for oliguria, 45
lorazepam
status epilepticus, 200
ventilation, head injury, 144
low tension electrical burns, 154
lumbar puncture, coma, 193
lung
see also pulmonary oedema
contusion, trauma, 11–22
infections, Guillain–Barré syndrome, 170
near-drowning, 108
poisoning, 223
magnesium
asthma, 180
eclampsia treatment, 124, 129
normal levels, 7
magnetic resonance imaging, coma, 193
Mallory–Weiss tears, 40
mannitol
oliguria, 45–46
raised intracranial pressure, 147, 194
manual compression of chest wall, 184
massive transfusion, 99–100, 123–124
matrix, liver cirrhosis, 97
melaena, 40
metabolic acidosis
fluid loss from bowel, 91
near-drowning, 110–111, 112
poisoning, 226 (Table)
renal failure, 52
from saline infusion, 126
metabolic dysfunction, coma, 187–196
metaraminol, spinal trauma, 212–213
metered dose inhalers, asthma, 183
methaemoglobinaemia, drugs and poisons
causing, 226 (Table)
methicillin-resistant Staphylococcus aureus
(MRSA), 204–205
methylhistamine, urine measurement, 69
methylprednisolone
for pulmonary fibroproliferation, 20
spinal trauma, 213
metoclopramide, gastrointestinal
haemorrhage, 102
microaggregates, massive transfusion, 99–100
micro-angiopathic haemolytic anaemia,
pre-eclampsia, 125
Miller–Fischer variant, Guillain–Barré
syndrome, 164
miosis, drugs and poisons causing, 223
(Table)
misoprostol, non-steroidal anti-inflammatory
drugs and, 45
molecular weight, extra-corporeal drug
removal, 57–58
monitoring
hypovolaemic shock, 43
transport of patient, 145
montelukast, asthma, 180
morphine, tracheal intubation in asthma, 181
mortality
aortic aneurysm repair, 8
ARDS, 21
asthma, 175, 176, 185
burns, 151–152, 159–160
chronic obstructive pulmonary disease, 36
gastrointestinal haemorrhage, 47
surgery, 44
maternal, 129
INDEX
243
© Cambridge University Press www.cambridge.org
Cambridge University Press0521681014 - Core Cases in Critical CareEdited by Saxon Ridley, Gary Smith and Anna BatchelorIndexMore information
organ failure, 59, 82, 93
pancreatitis, 138
renal failure, 59
status epilepticus, 198
TCA poisoning, 226
motor neurone disease, 166 (Table)
Guillain–Barré syndrome vs, 165
MRSA (methicillin-resistant Staphylococcus
aureus), 204–205
mucus suffocation, endobronchial, 176, 184
multiple organ dysfunction syndrome
(MODS), 74 (Table)
multiple organ failure (MOF), 81–82, 92–93
multiple trauma, burns, 158
muscle relaxants see neuromuscular blocking
drugs
muscle weakness, ventilatory failure, 163–173
myasthenia gravis, Guillain–Barré syndrome
vs, 165–167
mydriasis, drugs and poisons causing, 223
(Table)
myocardial specific creatinine kinase, 7
myocardium, 2
abdominal aortic aneurysm repair on, 3
management, 7–8
rewarming, 111
transoesophageal Doppler, 5
myoglobinuria, burns, 157
myopathy
corticosteroids, 35
non-depolarising neuromuscular blocking
agents, 181
n-acetylcysteine
bronchoscopic lavage, 184
paracetamol poisoning, 229
naloxone, 228
naso-gastric tubes
non-invasive ventilation, 90
spinal trauma, 213
National Acute Spinal Cord Injury Study
(NASCIS), trials, 213
near-drowning, 105–119
prognosis, 117–118
nebulised drugs, asthma, 179
ventilation, 182–183
neck rigidity, coma, 192
necrosectomy, pancreatitis, 137
nerve conduction velocity, Guillain–Barré
syndrome, 165 (Table)
neurological examination, coma, 191–192
neurological failure, peripheral, 164–173
neuromuscular blocking drugs
anaphylaxis, 64
asthma, 181
chronic obstructive pulmonary disease,
34–35
Guillain–Barré syndrome, 168, 169
head injury, 144
status epilepticus and, 201
neuropathy
critical illness, 82
peripheral neurological failure, 164–173
nifedipine, Guillain–Barré syndrome, 169
nitrates, pre-eclampsia, 129
nitric oxide
ARDS, 19–20
asthma, 184
nitrites, cyanide poisoning, 156
NMDA (N-methyl-D-aspartate) stimulation,
portal–systemic encephalopathy, 99
non-bicarbonate buffer anions, 91–92
non-depolarising neuromuscular blocking
agents, myopathy, 181
non-invasive ventilation (NIV)
asthma, 180
chronic obstructive pulmonary disease,
30–31
mortality, 36
gastric inflation, 90
Guillain–Barré syndrome, 168–169
spinal trauma, 217
non-ionic contrast media, 66–67
non-steroidal anti-inflammatory drugs
(NSAIDs)
gastrointestinal haemorrhage, 40, 47
on renal function, 41–42
norepinephrine, 7 (Table)
septic shock, 80
norfloxacin, gastrointestinal haemorrhage, 102
nosocomial infection, pneumonia, 203–204
nutrition
see also enteral nutrition
total parenteral nutrition, burns, 157
INDEX
244
© Cambridge University Press www.cambridge.org
Cambridge University Press0521681014 - Core Cases in Critical CareEdited by Saxon Ridley, Gary Smith and Anna BatchelorIndexMore information
obstetric haemorrhage, 121–130
treatment packs, 127
octreotide, oesophageal varices, 102
oculovestibular reflex test, brain stem death,
115 (Table)
oedema, chronic obstructive pulmonary
disease, 26
oesophagus
Doppler ultrasound via, 5–6
pressure, asthma, 178 (Fig.)
varices, 40, 95–104
oliguria
gastrointestinal haemorrhage, 39–48
hip replacement, 49–61
hypoperfusion, 4
management, 45–46
obstetric haemorrhage, 126–127
opiates
tracheal intubation in asthma, 181
ventilation, chronic obstructive pulmonary
disease, 34
organ donation, brain stem death, 115–117
organ failure
mortality, 59, 82, 93
multiple (MOF), 81–82, 92–93
oro-gastric tubes, spinal trauma, 213
osmolality
contrast media, 67
dehydration, 90
osmolar gap, poisoning, 226 (Table)
overdoses of drugs, 221–232
oxygen consumption, Shoemaker’s goal, 79
oxygen delivery, Shoemaker’s goal, 79
oxygen dissociation curve, massive
transfusion, 123 (Table)
oxygen tension
age, 86
inspired
ARDS management, 17
transport of patient, 144
oxygen therapy
asthma, 179
brain stem death, 116
carbon monoxide poisoning, 155
chronic obstructive pulmonary disease, 28,
89
oxytocics, obstetric haemorrhage, 127–128
packing, uterus, 128
pain
see also analgesia
pancreatitis, 132
respiratory failure from, 12
pancreatic bed lavage, 137
pancreatitis, acute-on-chronic, 131–139
pancuronium, tracheal intubation in asthma,
181
panda eyes, 192
paracetamol
antidote, 228–229
Guillain–Barré syndrome, 170
paraldehyde, status epilepticus, 201
paralysis, spinal trauma, 210
Parkland formula, fluid resuscitation, burns,
156
peak expiratory flow rate (PEFR), asthma, 177
PEEP, 17
asthma and, 182
brain stem death, 116
chronic obstructive pulmonary disease,
33–34
Guillain–Barré syndrome, 168
near-drowning, 110
PEEPi see intrinsic PEEP
penicillin, anaphylaxis, 64
peripheral neurological failure, 164–173
peritonitis, faecal, 81–82
pH
see also acidosis; alkalosis; hydrogen ions
poisoning, 225, 227
urine, manipulation, 230–231
phenobarbital, status epilepticus, 200–201
phenytoin
head injury, 144
seizures, 200, 225
phosphodiesterase inhibitors, 8
physiotherapy, spinal trauma, 216
placenta, obstetric haemorrhage and, 123
plasma exchange, Guillain–Barré
syndrome, 171
platelet counts
haemorrhage, 123–124
ischaemic heart disease, 6
for massive transfusion, 100
pre-eclampsia, 125
INDEX
245
© Cambridge University Press www.cambridge.org
Cambridge University Press0521681014 - Core Cases in Critical CareEdited by Saxon Ridley, Gary Smith and Anna BatchelorIndexMore information
platelet transfusions, 127
pneumonia
chronic obstructive pulmonary disease, 29
community acquired, 203–204
Guillain–Barré syndrome, 170
postoperative, 85
ventilator associated, 204
pneumothorax
see also tension pneumothorax
asthma
emergency treatment, 183–184
signs, 176
PEEP, 33
trauma, 15–16
poisoning, 221–232
poliomyelitis, 166 (Table), 167
polyneuropathy, post-infective, 164–167
portal hypertension, 97
portal–systemic encephalopathy, 96, 97–99
positive pressure ventilation, 13
see also PEEP
chronic obstructive pulmonary disease,
33–34
continuous positive airways pressure
(CPAP), asthma, 180, 182
post-infective polyneuropathy, 164–167
postoperative care, criteria for high risk, 78
postoperative haemorrhage, Caesarean
section, 121–130
post-partum haemorrhage see obstetric
haemorrhage
post-renal failure, 50–51
posture, management of ARDS, 20
prone position, 18
potassium, normal levels, 7
predictable drug reactions, 64
pre-eclampsia, 122, 124
prevention of complications, 128–129
recurrence risk, 129
pregnancy, thrombosis risk, 123
preload (cardiac), 2
premedication, contrast media reactions, 68
pre-renal failure, 41–42, 50
pressure control, mechanical ventilation, 17
pressure-limited ventilation, asthma, 182
pressure sores, prevention, 216
pressure–volume curve, pulmonary static, 18
pro-inflammatory mediators, 75
prone position, ARDS management, 18
propofol
anaphylaxis, 64
status epilepticus, 201
prostacyclin
ARDS, 20
haemodialysis, 56
prostaglandins
carboprost, 128
for obstetric haemorrhage, 127
protein binding, extra-corporeal drug
removal, 57–58
protein requirements, burns, 158
prothrombin time, value for correction, 6
protocol-driven weaning programmes, 35
proton pump inhibitors (PPIs), 44, 45
pseudostatus epilepticus, 198
pulmonary artery catheters, 4–5
infections, 204
transport of patient, 145
pulmonary capillary wedge pressure, 2
monitoring, 4–5
pre-eclampsia, 124
pulmonary fibroproliferation,
methylprednisolone for, 20
pulmonary oedema
pre-eclampsia, 124
spinal trauma, 213
pulmonary static pressure–volume curve, 18
pulse oximetry, poisoning and, 225
pupils
examination, 191
poisoning, 223 (Table)
purple glove syndrome, phenytoin, 200
pyrexia, 198, 199, 202–205
burns, 158
coma, 191
drugs and poisons causing, 223 (Table),
224
QTc interval, TCA poisoning, 226,
227 (Fig.)
quality of life, chronic obstructive pulmonary
disease, 36
quinolones, selective decontamination of
digestive tract (SDD), 102
INDEX
246
© Cambridge University Press www.cambridge.org
Cambridge University Press0521681014 - Core Cases in Critical CareEdited by Saxon Ridley, Gary Smith and Anna BatchelorIndexMore information
radiology
ARDS, 13–14
chronic obstructive pulmonary
disease, 28
coma, 193
embolisation, uterine devascularisation,
128
ileus, 92
near-drowning, 110
pancreatitis, 133–135
renal failure, 53
spinal trauma, 213–214
Ranson score, pancreatitis, 133
receptor down-regulation, septic shock, 80
reflexes, coma, 191
renal clearance, extra-corporeal drug removal
and, 57–58
renal failure, 49–51
burns, 157
diagnosis, 51–53
hypovolaemia, 41–42
near-drowning, 113
rhabdomyolysis, 210, 216
renal replacement therapy, 53–59
renal rescue therapy, 53
reperfusion, 6
replacement fluids, haemofiltration, 57
respiratory acidosis, 27
see also hypercapnia
chronic obstructive pulmonary
disease, 32
management, 17
poisoning, 226 (Table)
respiratory alkalosis, poisoning, 226 (Table)
respiratory distress syndrome see acute
respiratory distress syndrome
respiratory failure
see also ventilatory failure
chest trauma, 11–22
chronic obstructive pulmonary disease,
23–37
coma, 192
poisoning, 222
spinal trauma, 209
respiratory function
age, 86
status epilepticus, 202
respiratory muscles
resting, 32–33
weakness, chronic obstructive pulmonary
disease treatment, 35
respiratory rates, ventilation in asthma, 182
resuscitation
see also fluid resuscitation
ABC algorithm, 3–4
coma, 190
near-drowning, 109–111
pancreatitis, 136–137
shock, 42
variceal bleeding, 101
rewarming, hypothermia, 111–112
rhabdomyolysis, 210
rheumatoid arthritis, postoperative care, 73
ribs, fractures, 12–13, 144, 145
road traffic accidents, spinal injury
incidence, 208
rocuronium, tracheal intubation
asthma, 181
neuromuscular failure, 168
Rule of 9s, 156
SAGM (saline, adenine, glucose and
mannitol) solution, 99, 100
salbutamol, asthma, 179
salicylate poisoning
gastric lavage, 229
urine alkalinisation, 231
saline infusion
metabolic acidosis from, 126
see also SAGM solution
sclerotherapy, oesophageal varices, 101
sedation
drugs and poisons causing, 223 (Table)
Guillain–Barré syndrome, 169
ventilation
chronic obstructive pulmonary disease,
34–35
head injury, 144
seizures
drugs and poisons causing, 223 (Table)
eclampsia, 124
head injury and ventilation, 144
management, 194, 200–202, 225
near-drowning, 113–114
INDEX
247
© Cambridge University Press www.cambridge.org
Cambridge University Press0521681014 - Core Cases in Critical CareEdited by Saxon Ridley, Gary Smith and Anna BatchelorIndexMore information
status epilepticus, 197–206
TCA poisoning, 227
selective decontamination of digestive tract
(SDD), 102
self-poisoning, 221–232
Sengstaken Blakemore tube
oesophageal varices, 102
uterine haemorrhage, 128
sepsis
near-drowning, 113
systemic, 73–84
shock
hypovolaemia, 40–41
monitoring, 43
sepsis, 76, 79–80
Shoemaker’s goals, 79
shunt, pulmonary, trauma, 12
sieving coefficient, extra-corporeal drug
removal, 58
skin, poisoning signs, 223 (Table)
skin prick testing, allergies, 69
skull fractures, signs, 192
sleep, 188 (Table)
sodium
fractional excretion, 52
retention, variceal bleeding, 102
sodium valproate, status epilepticus, 201
somatostatin, oesophageal varices, 102
spinal clearance, 213–214, 215 (Fig.)
spinal cord perfusion pressure, 213
spinal shock, 209
spine, trauma, 207–219
splenectomy, postoperative management,
20–21
sporting accidents, spinal injury incidence,
208
Staphylococcus aureus, methicillin-resistant
(MRSA), 204–205
Starling’s law, 2
static pressure–volume curve, pulmonary, 18
status epilepticus, 197–206
steroids see corticosteroids
stomach, secretion, 87–88
storage effects, red cells in SAGM, 100–101
Streptococcus pneumoniae, 203–204
stress response, burns, 154
stress ulcers, spinal trauma, 216
stroke volume, 2
transoesophageal Doppler, 5
strong ion difference (SID), 92
stupor, 188 (Table)
subphrenic abscess, 92
sugar see glucose
superficial burns, 152–153
surgery
burns, 159
debridement, 81
for gastrointestinal haemorrhage, 44
Guillain–Barré syndrome after, 164
postoperative care, criteria for high risk, 78
suxamethonium
asthma, 181
danger
neuromuscular failure, 168, 169
spinal trauma, 210
sympathetic nervous system, spinal trauma, 209
sympathomimetic drugs, 8
see also vasoconstrictors
synchronised intermittent mandatory
ventilation
asthma, 182
weaning, 35
syntocinon, obstetric haemorrhage, 127–128
systemic inflammation, ARDS, 13
systemic inflammatory response syndrome
(SIRS), 74–78
criteria for diagnosis, 132
systemic sepsis, 73–84
systemic vascular resistance
level for treatment of septic shock, 80
transoesophageal Doppler, 5
tachycardia, tachypnoea, drugs and poisons
causing, 223 (Table)
TCAs (tricyclic antidepressants), poisoning,
226–227
bicarbonate for, 229
temperature
see also hypothermia; pyrexia;
thermoregulation
peripheral vs core, 4
tension pneumothorax, 4
from mechanical ventilation, 15–16
PEEP, 33
INDEX
248
© Cambridge University Press www.cambridge.org
Cambridge University Press0521681014 - Core Cases in Critical CareEdited by Saxon Ridley, Gary Smith and Anna BatchelorIndexMore information
terlipressin, oesophageal varices, 101–102
thermal coagulation, endoscopic, 43–44
thermoregulation
see also hypothermia; pyrexia
spinal trauma, 210
thiopentone
anaphylaxis, 64
status epilepticus, 201
thiosulphate, cyanide poisoning, 156
thrombosis
prevention after obstetric haemorrhage,
128
risk, pregnancy, 123
thyroid function, brain stem death, 117
tidal volume, ventilator settings, 17
total parenteral nutrition, burns, 157
total weak acid concentration (Atot), 92
toxidromes, 222, 223 (Table)
T-piece trials, ventilator weaning, 35
trace elements, burns, 158
tracheal intubation
asthma, 180–181
burns, 155
complications, 15
head injury, 143
neuromuscular failure, 168
spinal trauma, 212
tracheostomy
chronic obstructive pulmonary disease,
35–36
neuromuscular failure, 168
tramadol, Guillain–Barré syndrome,
170
transfer
burns patient, 159
trauma patient, 141–149
transfusion
haemorrhage, 6
massive, 99–100, 123–124
transjugular intrahepatic portosystemic
shunt (TIPS), 103
translocation, bacteria from bowel, 81–82,
136
transoesophageal Doppler ultrasound, 5–6
transplantation
liver, 103, 104
organ donation, 115–117
trauma
see also fractures
chest, 11–22
crush injuries, 208, 210–211, 216–217,
218
spine, 207–219
transfer of patient, 141–149
tricyclic antidepressants see TCAs
troponin I, 7–8, 157
trypsinogen-2, 132
tryptase, 66, 69
Turner’s sign, 132
ultrasound
pancreatitis, 134
renal failure, 53
transoesophageal, 5–6
unpredictable drug reactions, 64
uraemia, 51, 52
urinary catheters, spinal trauma, 213
urine
methylhistamine measurement, 69
osmolality, vs plasma, 90
pH manipulation, 230–231
pre-renal oliguria vs acute tubular
necrosis, 42 (Table)
renal failure, 52
uterine haemorrhage, 121–130
packing, 128
valproate sodium, status epilepticus, 201
vancomycin, 205
varices, oesophageal, 40, 95–104
vascular resistance see systemic vascular
resistance
vasoconstrictors
asthma and sedation, 180
in hypovolaemia, 6, 44
for oliguria, 45
vasodilation
contrast media reaction, 67
spinal trauma, 209
vasodilators
postoperative, 8
pre-eclampsia, 128–129
vasogenic oedema, brain, 142
vasopressin, oesophageal varices, 101–102
INDEX
249
© Cambridge University Press www.cambridge.org
Cambridge University Press0521681014 - Core Cases in Critical CareEdited by Saxon Ridley, Gary Smith and Anna BatchelorIndexMore information
vasopressors
burns, 157
septic shock, 80, 82
vecuronium, tracheal intubation in asthma,
181
venous access
burns, 159
fluid resuscitation, 6
haemodialysis, 54–55, 58
venous return, 2
PEEP on, 17
ventilation
asthma, 180–184
burns, 155–156
cascade humidifier, 112 (Table)
chronic obstructive pulmonary disease,
31–36
Guillain–Barré syndrome, 168–169
head injury, 144
for hypoxaemia, 11–12, 16–19
lung injury from, 14
near-drowning, 109–110
pancreatitis, 137
tension pneumothorax from, 15
transport of patient, 144
trauma, 144
spinal, 214, 217
see also non-invasive ventilation; positive
pressure ventilation
ventilation: perfusion mismatch, trauma, 12
ventilator associated pneumonia, 204
ventilators, 16–17
settings for asthma, 182, 184
volatile anaesthetic administration, 184
ventilatory failure
see also respiratory failure
muscle weakness, 163–173
viral infections
chronic obstructive pulmonary
disease, 26, 27
pancreatitis from, 135
vital capacity (VC), Guillain–Barré
syndrome, 168
vitamin deficiency, haemodialysis, 59
volatile anaesthetics see inhalational
anaesthetics
volume-limited ventilation, asthma, 182
volume of distribution, extra-corporeal drug
removal and, 57–58
volume replacement see fluid resuscitation
von Willebrand disease, 122–123
wakefulness, 188
warm shock, 76
water
aspiration, 108
ionic dissociation, 92
waterfall analogy, dynamic hyperinflation,
26 (Fig.)
weaning, mechanical ventilation
asthma, 184
chronic obstructive pulmonary
disease, 35
white blood cells, massive transfusion and,
100
whole bowel irrigation, 230
work of breathing, intrinsic PEEP on,
33–34
INDEX
250
© Cambridge University Press www.cambridge.org
Cambridge University Press0521681014 - Core Cases in Critical CareEdited by Saxon Ridley, Gary Smith and Anna BatchelorIndexMore information