Intensiv medicin

This book presents the most recent evidence-based facts on perioperative fluid management and discusses fluid management from basic sciences to clinical applications and the patients' outcomes. Recent advances in understanding the Revised Starling principle with new concepts in tissue perfusion and the most recent techniques of perioperative goal directed fluid management are described. The endothelial glycocalyx functions and the influence of fluid management on its integrity are covered in detail; moreover, the techniques for its protection are also discussed. The dilemma of perioperative use of hydroxyethyl starch solutions and the resurgence of interest in using human albumin as an alternative colloid is explored. The problems of using unbuffered solutions during the perioperative period and comparison between restrictive versus liberal fluid management are discussed in full. Perioperative Fluid Management will be of interest to anesthesiologists and also intensivists.

Sei appassionato di medicina e chirurgia e vorresti conoscere qualcosa di più su come fare una vera sutura?Sei uno studente di medicina o un professionista nel settore medico e hai bisogno di un manuale pratico e semplice per ripassare i punti fondamentali dei nodi di sutura al momento giusto? "Suture Chirurgiche" è il manuale semplice e pratico, da sfogliare quando ne hai più bisogno, per tenere sempre a mente i principi di sutura e i principali nodi e tecniche che ti troverai ad affrontare sul campo.Un libro pratico non solo dal punto di vista tecnico ma a 360° sulla sutura chirurgica, che non tralascia aspetti importanti di contorno come i rapporti con il team e il paziente, l'anestesia, la possibilità dell'insorgere di infezioni e il post-intervento. Nel libro troverai informazioni pratiche, sintetiche e precise su: Gli strumenti essenziali che ti permetteranno di fare una sutura perfettaI principali nodi di sutura e come eseguirli nella praticaCome gestire il rapporto con il paziente e con il team durante il processo di suturaLe 10 principali infezioni che le ferite chirurgiche possono contrarreLe principali tecniche di sutura di base ed avanzate Un intero viaggio nel mondo delle ferite e come porre rimedio anche alle più profonde grazie a una sutura professionale.Cosa stai aspettando? Aggiungi questo libro al carrello per iniziare!

This book provides a comprehensive overview of improving critical care survivorship. Comprised of four sections, the text presents interventions that can be used to improve patient outcomes and reduce the burden of post-intensive care syndrome across the arc of care, from the ICU to returning home. The first section of the text focuses on preventing adverse outcomes in the ICU, with an emphasis on implementing early mobilization, engaging and supporting families, and employing various forms of therapy. The second section revolves around enhancing recovery post-ICU, focusing on physical and neurocognitive rehabilitation programs, peer support, and poly-pharmacy management. Community reintegration is the subject of the third section, with emphasis on socioeconomic reintegration, healthcare utilization, and volunteerism in ICU recovery. The book concludes with a section on future considerations, specifically spotlighting preliminary ideas that address long-term sequelae and international collaboration to solve critical care challenges. Written by experts in the field, Improving Critical Care Survivorship: A Guide for Prevention, Recovery, and Reintegration is a valuable resource for critical care clinicians and researchers interested in improving the quality of patient survival after ICU admission.

This book gathers the proceedings of the 17th International Conference on Intracranial Pressure and Neuromonitoring, held in Leuven, Belgium in September 2019. It provides an overview of the current understanding, underlying research and future perspectives concerning pathophysiology, biophysics, monitoring and management in traumatic and non-traumatic acute brain injury, hydrocephalus and spinal cord injury, including cerebrovascular autoregulation impairment in neurological as well as non-neurological diseases. The peer-reviewed contributions were prepared by specialists in neurosurgery, neurointensive care and neuroanesthesiology, as well as prominent experts from the fields of physiology, clinical and biomedical engineering, mathematics and informatics. The book continues the time-honored tradition of publishing key presentations from the ICP Conferences in order to facilitate their dissemination within the clinical and research community.

The Medical-Legal Aspects of Acute Care Medicine: A Resource for Clinicians, Administrators, and Risk Managers is a comprehensive resource intended to provide a state-of-the-art overview of complex ethical, regulatory, and legal issues of importance to clinical healthcare professionals in the area of acute care medicine; including, for example, physicians, advanced practice providers, nurses, pharmacists, social workers, and care managers. In addition, this book also covers key legal and regulatory issues relevant to non-clinicians, such as hospital and practice administrators; department heads, educators, and risk managers. This text reviews traditional and emerging areas of ethical and legal controversies in healthcare such as resuscitation; mass-casualty event response and triage; patient autonomy and shared decision-making; medical research and teaching; ethical and legal issues in the care of the mental health patient; and, medical record documentation and confidentiality. Furthermore, this volume includes chapters dedicated to critically important topics, such as team leadership, the team model of clinical care, drug and device regulation, professional negligence, clinical education, the law of corporations, tele-medicine and e-health, medical errors and the culture of safety, regulatory compliance, the regulation of clinical laboratories, the law of insurance, and a practical overview of claims management and billing. Authored by experts in the field, The Medical-Legal Aspects of Acute Care Medicine: A Resource for Clinicians, Administrators, and Risk Managers is a valuable resource for all clinical and non-clinical healthcare professionals.

There is a growing need for a book on emergency general surgery in the elderly, as adults age 65 and older are the fastest growing segment of the population worldwide, and their number is expected to double to 89 million between now and 2050. Based on these changing demographics, it is expected that there will be a concurrent rise in the demand for a variety of surgical services, including vascular surgery (with a projected growth of 31%) and general surgery (with a projected growth of 18%), as well as in all sub-disciplines of surgery (thoracic, cardiac, oncology, hepatobiliary, transplant, plastic colorectal, orthopedic, gynecologic, urology and neurosurgery).In addition, older surgical patients often require a different level of care than younger patients during the preoperative, intraoperative and postoperative phases. Many of our geriatric population have multiple chronic illnesses beyond the one for which surgery is required, and therefore are prone to developing postoperative complications, functional decline, loss of independence, and other undesirable outcomes. In response, this book offers surgeons, geriatrists and nurses state-of-the-art surgical approaches and essential information on the complex perioperative care of the elderly.

This book is a clinical manual that covers the whole spectrum of swallowing and its disorders. It starts with physiology of swallowing, pathophysiology of disordered deglutition, diagnostic methods (clinical and instrumental) and ends with an in-depth¿s and up-to-date presentation of current treatment options. The clinically most relevant topics of dysphagia management on the stroke unit and the intensive care unit are dealt with in separate chapters. Also the closely intertwined issue of nutritional management is specifically addressed. Most importantly, the book covers all obligatory topics of the Flexible Endoscopic Evaluation of Swallowing (FEES)-curriculum, an educational initiative that started in Germany in 2014 and is currently being extended to other European and non-European countries. The book is richly illustrated and an online video section provides a number of typical patient cases. FEES is probably the most commonly chosen method for the objective assessment of swallowing and its disorders. It is used in stroke units, intensive care facilities, geriatric wards but also in rehabilitation clinics and within dedicated outpatient services. This book on neurogenic dysphagia therefore addresses a wide range of different medical disciplines, such as neurologists, geriatricians, intensive care physicians, rehabilitation physicians, gastroenterologists, otolaryngologists, phoniatrists and also speech-language pathologists.

This book provides a practically applicable guide to the use of ultrasound in the care of acutely and critically ill patients.  It is laid out in two sections. The first section attempts to take a comprehensive approach to specific systems of examination taking an organ focused approach covering techniques including Focussed Assessment with Sonography for Trauma (FAST) scanning and venous sonography. The second section presents a range of specific cases enabling the reader to develop an understanding of how to apply these methodologies effectively into their day-to-day clinical practice.Ultrasound in the Critically Ill: A Practical Guide describes how to use ultrasound technologies in day-to-day clinical practice. Therefore, it is an ideal resource for all trainee and practicing physicians who utilize these technologies on a day-to-day basis. 

Egal, ob Sie Weiterbildungsteilnehmer sind oder bereits erfahrene Fachpflegekraft in der Anästhesie und Intensivmedizin, mit diesem Arbeitsbuch können Sie Ihr Fachwissen gezielt überprüfen und festigen: Multiple-Choice-Fragen, Zuordnungsfragen und Abbildungen zum Beschriften helfen Ihnen dabei.Aus dem Inhalt: Physiologische und pathophysiologische Zusammenhänge, Wirkungen und Nebenwirkungen von Medikamenten, Dosierungen, Beatmung, Therapie und Symptome von intensivpflichtigen Krankheitsbildern, postoperative Versorgung nach schweren Operationen, Anzeichen von Komplikationen, Covid-19 und vieles mehr. Die ideale Ergänzung zu den großen Standardwerken der pflegerischen Fachweiterbildung wie z.B. "Larsens Anästhesie und Intensivmedizin für die Fachpflege". Die 4. Auflage ist komplett aktualisiert und um Fallbeispiele zu typischen Komplikationen in der Anästhesie und Intensivmedizin erweitert.

This atlas covers the basics of ultrasound physics, provides the necessary background to successfully perform TEE and TTE procedures, and provides tips and tricks that will prove invaluable in the critical care environment. It also features an abundance of high quality photographs, illustrations and videos as well as numerous case studies to test the reader's ability to apply knowledge to real-life clinical situations. Written by experts in the field, The Atlas of Critical Care Echocardiography is a concise, visual guide designed for use by all physicians who see cardiac patients in the ICU.

In its first edition, Principles of Clinical Medicine for Space Flight established itself as the authoritative reference on the contemporary knowledge base of space medicine and standards of care for space flyers. It received excellent notices and is used in the curricula of civilian and military training programs and used as a source of questions for the Aerospace Medicine Certifying Examination under the American Board of Preventive Medicine. In the intervening few years, the continuous manning of the International Space Station has both strengthened existing knowledge and uncovered new and significant phenomena related to the human in space.  The Second Edition incorporates this information. Gaps in the first edition will be addressed with the addition new and revised chapters. This edition is extensively peer reviewed and represents the most up to date knowledge.

This book provides a comprehensive overview of critical care obstetrics. The text reviews different diseases and complications that can cause a pregnant patient to go into critical condition, while outlining treatment and management strategies for effective patient care. Critical scenarios covered include obstetric hemorrhage, pulmonary edema in preeclampsia, cardiac arrest, septic shock, abdominal hypertension, uterine rupture, and acute renal failure. Written by experts in the field, Obstetric Catastrophes: A Clinical Guide is a valuable resource for critical care intensivists, obstetricians, and any practitioners involved in the treatment and management of the obstetric patient in critical condition.

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

Testo maneggevole, conciso, agile, e da considerarsi una guida pratica, indispensabile alla gestione e conduzione delle urgenze addominali.Scritto e coordinato da un maestro della chirurgia mondiale con grande esperienza nel campo della chirurgia addominale d'urgenza, questo volume da ritenersi uno strumento essenziale e "e;salvavita"e; per il chirurgo di guardia, da avere sempre pronto ed a portata di mano.Come comportarsi di fronte ad una urgenza addominale (senza perdere tempo e brancolare nel buio)? Quali accertamenti sono necessari? Quali invece si possono evitare? Che atteggiamento chirurgico si deve intraprendere?In maniera chiara, semplice e puntuale, ogni dubbio viene qui affrontato e chiarito.

Much research over the past 30 to 40 years has shown that the inflammatory response, while critical for host defense during microbial infection, may itself play a central role in the pathogenesis of sepsis. Although key mediators responsible for this injury have been identified, efforts clinically to augment our conventional antimicrobial and supportive therapies during sepsis with agents modulating the inflammatory response have been unsuccessful. As a result, the mortality associated with this lethal syndrome, especially when complicated by shock, has remained persistently high. Unfortunately, during this same period of time, the incidence of sepsis has accelerated as other fields of medicine have relied increasingly on therapies that predispose to infection. While frustrating, overall this experience in the field of sepsis has not been without value. Most importantly, it has helped define on several different levels the complexity of the septic patient. Recognizing and addressing this complexity as discussed by each of the contributors to Evolving Concepts in Sepsis and Septic Shock may now provide new inroads into the treatment of sepsis.

Frau beit biertischtanzenden Mann und dies fhrt zu einem mehrwchigen Krankenhausaufenthalt. Reale klinische Flle zum problemorientierten LernenFalldarstellung - Fragen - Auflsung mit Hintergrundwissen Jeder Fall erzeugt einen exemplarischen AHA-Effekt"e;Schulen Sie Ihren Blick fr Differenzialdiagnostik, Diagnose und Therapie.Dran denken"e; ist wichtig! - Nur was man kennt, erkennt man auch. Der reale klinische Alltag bietet die verschiedensten VariantenVon der normalen"e; Pneumokokken-Pneumonie bis zu Parasiten auf der Intensivstation.Alle Inhalte von anerkannten Fachleuten verfasst. Spannend - jeder Fall eine kleine detektivische Aufgabe!Htten Sie's gewusst?Infektionskrankheiten nehmen zu, Infektionen gehen uns alle an, mit Infektionen wird jeder in der klinischen Praxis konfrontiert. Deshalb wendet sich dieses Buch an jeden praktisch ttigen Arzt: Internisten, Allgemeinmediziner, Pdiater, Intensivmediziner, Infektiologen, an Medizinische Mikrobiologen ... und an alle Medizinstudenten, die fall- und problemorientiert lernen.

Die Diagnose von Alkoholmibrauch und -abhangigkeit, Abstinenz und Alkoholruckfall sowie alkoholbedingter Folgeschadigungen stellt im klinischen Alltag eine groe Herausforderung dar. Die moglichst fruhzeitige und sichere Diagnose spielt sowohl fur die Psychiatrie, aber auch fur die Neurologie, die innere Medizin, die Allgemeinmedizin und auch fur forensische Fragestellungen, einschlielich der Verkehrsmedizin, eine groe Rolle. Das vorliegende Buch gibt einen Uberblick uber die aktuellen psychiatrischen Klassifikationssysteme bei Alkoholmibrauch und -abhangigkeit, weiterfuhrende Diagnoseinstrumente zur Psychodiagnostik, aber auch zur Wertigkeit klinisch-chemischer Marker, die insbesondere bei klinisch nicht eindeutigem Befund diagnostische Sicherheit liefern konnen. Das Buch liefert somit auch bei schwierigen klinischen Fragen kompetente Entscheidungshilfen.

Great progress has been made since the first description of the acute respiratory distress syndrome by the Denver group in 1967 (Lancet). Although we introduced the term 'adult respiratory distress syndrome' in our second and more detailed description of the syndrome (ehest, 1971), this was probably amistake for the simple reason that children also suffer the same syndrome fo11owing acute lung insults. Today, the syndrome of acute respiratory distress in adults (ARDS) is recognized as a worldwide problem, but the prevalence of disease varies in different parts of the world. A huge amount of research has focused on the mechanisms of acute lung injury and yet the exact sequence of events and media tors in inflammatory cascade, which result in acute respiratory failure from ARDS, is not known but many possibilities exist. The definition of ARDS has been gradua11y modified in recent years and investigators around the world are now co11aborating in order to establish more uniform concepts in identification, risk factors and mechanisms of lung injury, which someday will result in improved approaches to management. Already, at least some centers are showing improved outcomes in ARDS, achieving an approximate 60% survival rate. In the past, most large series documented only about a 40% survivability taking a11 causes of ARDS. This apparent progress is likely attributable to more meticulous and disciplined care than any specific pharmacologic attack on the basic mechanism resulting in ARDS.