← All decks
Anaesthesiology
Critical Care Medicine
Built from Barash Clinical Anesthesia, 9th Edition
What’s inside
11 sections · 181 slides
Overview
- Definition and scope of critical care medicine
- Roadmap
- Key messages of this topic
- Key messages of this topic (continued)
Systems and processes of care
- Origins of intensive care and the first intensivists
- Role of anaesthesiologists in critical care
- Definition of high-quality care
- Staffing models and multidisciplinary rounds
- Checklists on ICU rounds
- Suggested daily intensive care unit checklist
- Protocols and care bundles
- Choosing Wisely recommendations in critical care
- Intensive care bed with monitoring and support equipment
- Central monitoring station in an intensive care unit
Neurologic and neurosurgical critical care
- Neuromonitoring techniques available in the ICU
- Severity assessment in traumatic brain injury
- Blood pressure targets and radiological prognosis
- Primary and secondary brain injury
- Pathway from primary impact to secondary brain injury
- Goals of neuroresuscitation
- Evidence base and sedation after traumatic brain injury
- ICU management of patients with severe traumatic brain injury
- Propofol and barbiturates for refractory pressure
- Dexmedetomidine in brain injury
- Hyperventilation for raised intracranial pressure
- Hypothermia, steroids and magnesium after head injury
- Seizure prophylaxis, fluids and craniectomy
- Causes and outcome of subarachnoid haemorrhage
- Outcome and pathophysiology of subarachnoid haemorrhage
- Rebleeding and timing of aneurysm securing
- Cerebral vasospasm and delayed cerebral ischaemia
- Transcranial Doppler and angioplasty for vasospasm
- Nimodipine and other drugs for vasospasm
- Triple-H therapy and its replacement
- Hydrocephalus, seizures and complications after the bleed
- Hyponatraemia after subarachnoid haemorrhage
- Separating SIADH from cerebral salt wasting
- Epidemiology and causes of acute ischaemic stroke
- Reperfusion therapy in acute ischaemic stroke
- Antithrombotic therapy and blood pressure after stroke
- Cerebral oedema and malignant middle cerebral artery syndrome
- Anoxic brain injury and temperature after cardiac arrest
Shock and haemodynamic monitoring
- Definition and classification of shock
- Causes of each shock type
- Mortality of shock states
- Mortality figures in shock
- Causes and initial investigation of cardiogenic shock
- Compensatory responses and vasodilator therapy
- Reperfusion and mechanical support in cardiogenic shock
- Intra-aortic balloon catheter
- Septic shock as a form of distributive shock
- Demographics and immune mechanism of septic shock
- Cascade from pathogen recognition to organ failure in sepsis
- Definitions of sepsis and septic shock
- Cardiac dysfunction and lactate elevation in sepsis
- Principles of treating septic shock
- Management of sepsis and septic shock
- Screening protocols and resuscitation bundles in sepsis
- Purpose of monitoring in shock states
- Limitations of mean arterial and central venous pressure
- Pulmonary artery catheter and echocardiography
- Dynamic respiratory indices and fluid responsiveness
- Limitations of dynamic respiratory indices
- Less-invasive cardiac output monitors
- Lactate as a resuscitation target and its limits
- Venous oximetry in shock
- Outcome evidence for venous oximetry
- Interpreting monitoring data in context
- A practical approach to choosing monitors
Acute respiratory failure and mechanical ventilation
- Definition and scope of acute respiratory failure
- Modes of positive pressure ventilation
- Choice of ventilatory mode and outcome
- Bilateral diffuse infiltrates on a chest radiograph
- Tidal volume, barotrauma and haemodynamic effects
- Auto-PEEP in obstructive lung disease
- Ventilatory strategy in severe airflow obstruction
- Ventilator-induced lung injury
- Two mechanical routes to ventilator-induced lung injury
- Setting tidal volume on predicted body weight
- Predicted body weight formula
- Non-invasive positive pressure ventilation
- High flow nasal cannula oxygen
- Liberation from ventilation and readiness to extubate
- Definition and causes of acute respiratory distress syndrome
- Evolution of the ARDS definition
- Berlin definition criteria for acute respiratory distress syndrome
- Incidence, mortality and mechanics of ARDS
- The baby lung concept
- Lung-protective ventilation in ARDS
- Mortality benefit of low tidal volume ventilation
- Recruitment strategies in ARDS
- Prone positioning and paralysis in severe ARDS
- Intensive care team turning a ventilated patient into the prone position
- Extracorporeal membrane oxygenation in severe ARDS
- Extracorporeal membrane oxygenation circuit
- Rescue therapies and fluid management in ARDS
- Corticosteroids in ARDS
Acute kidney injury
- Classification and outcomes of acute kidney injury
- KDIGO classification of acute kidney injury
- Causes and initial evaluation of acute kidney injury
- Supportive care and contrast nephropathy prevention
- Intensity, timing and mode of renal replacement therapy
Endocrine, nutrition and transfusion
- Hyperglycaemia in critical illness
- Intensive insulin trials and current glucose targets
- Adrenal insufficiency and its diagnosis
- Relative adrenal insufficiency
- Corticosteroids in septic shock
- Thyroid abnormalities and euthyroid sick syndrome
- Recognising true hypothyroidism in critical illness
- Growth hormone in critical illness
- Anaemia and traditional transfusion thresholds
- Risks of red blood cell transfusion
- Evidence for restrictive transfusion in the ICU
- Alternatives to transfusion and prevention of anaemia
- Caloric and protein targets in critical illness
- Route and optimisation of enteral feeding
- Timing of parenteral nutrition
- Immunonutrition and micronutrients
- Refeeding syndrome
Sedation, analgesia and delirium
- Indications and goals of ICU sedation and analgesia
- Assessment scales for sedation
- Dexmedetomidine for ICU sedation
- Propofol for ICU sedation
- Benzodiazepines, opioids and analgesic adjuncts
- Delirium and the case for light sedation
- Non-pharmacological prevention of delirium
- Long-term neurocognitive outcomes after intensive care
Nosocomial infection in the ICU
- Nosocomial infection in intensive care
- Sinusitis in the ventilated patient
- Ventilator-associated pneumonia: incidence and mortality
- Early-onset and late-onset ventilator-associated pneumonia
- Timing splits ventilator-associated pneumonia into two different diseases
- Preventing ventilator-associated pneumonia
- Diagnostic sampling in ventilator-associated pneumonia
- De-escalation and duration of antibiotic therapy
- Suggested empiric antibiotic regimens for common intensive care unit infections
- Suggested empiric antibiotic regimens for common intensive care unit infections (continued)
- Catheter-related bloodstream infection: definition and prevention
- Sites of percutaneous central venous catheter insertion
- Central venous catheter kit laid out on a sterile field
- Catheter duration, coatings and heparin flushes
- Catheter-related bacteraemia: organisms and management
- Catheter-associated urinary tract infection
- Invasive fungal infection: risks and diagnosis
- Candida species and their clinical significance
- Treating Candida and choosing an antifungal
- Disseminated candidiasis and prophylaxis
- Treatment of documented candidaemia
Bleeding, clots, weakness and end-of-life care
- Stress ulceration and gastrointestinal haemorrhage
- Stress ulcer prophylaxis
- Incidence of venous thromboembolism in critical illness
- Caprini venous thromboembolism risk assessment model
- Caprini venous thromboembolism risk assessment model (continued)
- Upper extremity deep vein thrombosis
- Prophylaxis for venous thromboembolism in the ICU
- Diagnosis of venous thromboembolism in the ICU
- Treatment of venous thromboembolism and filters
- ICU-acquired weakness: definition and confirmation
- ICU-acquired weakness: risk, prevention and diagnosis
- End-of-life and palliative care in the ICU
- Comfort-focused care as an alternative
Summary and references
- Interventions that clearly reduce mortality
- Interventions that failed or caused harm
- Key thresholds and targets in critical care
- Recurring themes across intensive care
- References
- References
- References
- References
- References
- Barash, Cullen, and Stoelting's Clinical Anesthesia, 9th Edition