Ebook Irwin & rippe''s manual of intensive care medicine (6/E): Part 1

(BQ) Part 1 book Irwin & rippe''s manual of intensive care medicine has contents: Procedures and techniques and minimally invasive monitoring in the ICU, cardiovascular problems and coronary care, pulmonary problems in the intensive care unit,... and other contents.

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Editors Richard S Irwin, M D

Professor of Medicine and Nursing

University of Massachusetts and Graduate School of Nursing

Chair, Critical Care Operations

UMass Memorial Medical Center

Worcester, Massachusetts

Craig M Lilly, M D

Vice Chair, Critical Care Operations

Director, elCU Program

U Mass Memorial Medical Center

Professor of Medicine, Anesthesia, and Surgery Departments of Medicine and Surgery

University of Massachusetts Medical School Worcester, Massachusetts

James M Rippe, M D

Professor of Biomedical Sciences

University of Central Florida

Orlando, Florida Founder and Director

Rippe Lifestyle Institute

Shrewsbury, Massachusetts/Orlando, Florida

Founder and Director

Rippe Health Orlando, Florida

This edition is based on Irwin and Rippe's Intensive Care Medicine, seve nth ed ition, ed ited by R icha rd S I rwin and Ja mes M R i ppe

• Wolters Kluwer I Lippincott Williams & Wilkins Health

Philadelphia • Baltimore • New York• London

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Acquisitions Editor: Keith Donnellan

Managing Editor: Nicole T Dernoski

Marketing Manager: Dan Dressler

Production Project Manager: Bridgett Dougherty

Senior Manufacturing Manager: Bech Welsh

Design Coordinator Teresa Mallon

Compositor: SPi Global

Sixth Edition

Two Commerce Square

Printed in China

Library of Congress Cataloging-in-Publication Data

Manual of intensive care medicine I [edited by] Richard S Irwin, Craig M Lilly and James M Rippe - Sixth edition

I Irwin, Richard S., editor of compilation II Rippe, James M., editor

[DNLM: 1 Intensive Care-Handbooks 2 Intensive Care Units-Handbooks WX 39]

Some drugs and medical devices presented in chis publication have U.S Food and Drug Administration (FDA) clearance for limited use in restricted research settings le is the responsibility of the health care provid ers to ascertain the FDA status of each drug or device planned for use in their clinical practice

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To Our Families

and Adam; Leslie, Jonathan, Catherine, Stephanie,

Hart, Jaelin, Devon, and Jamie

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C o ntributors

Assistant Professor of Internal Medicine

Division of Renal Medicine

University of Massachusetts Medical School

BCPS

Clinical Pharmacy Specialist

Department of Pharmacy Services

Brigham and Womens Hospital

Department of Internal Medicine

Massachusetts General Hospital

Associate Professor of Surgery

University of Minnesota Medical School

Minneapolis, Minnesota

Burns Program Director

Regions Burn Center

Washington, District of Columbia

Assistant Professor Department of Anesthesiology and Critical Care

Former Instructor in Surgery and

Cardiothoracic Surgery Department of Surgery

Kevin E Anger, PharmD, BCPS

Clinical Pharmacist Specialist Department of Pharmacy Services Brigham and Womens Hospital Boston, Massachusetts

Antonio Aponte-Feliciano, MD Assistant Professor of Anesthesiology, Surgery, and Critical Care Medicine

Department of Anesthesiology University of Massachusetts Medical School

Neil Aronin, MD Professor and Chief Division of Endocrinology and Metabolism Department of Medicine

Worcester, Massachusetts Seth M Arum, MD, FACE Assistant Professor of Medicine

Division of Endocrinology and Metabolism University of Massachusetts Medical School Worcester, Massachusetts

v i i

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v i i i I Contr i b utors

Professor of Medicine and Radiology

Director, Noninvasive Cardiology

Riad Azar, MD

Associate Professor of Medicine

Washington University School of Medicine

Division of Gastroenterology

Department of Internal Medicine

Barnes-Jewish Hospital - North Campus

St Louis, Missouri

Karen K Ballen, MD

Director, Leukemia Program

Boston, Massachusetts

Gisela I Banauch, MD, MS

Assistant Professor of Medicine

Division of Pulmonary, Allergy, Critical

Care, and Sleep Medicine

Director, Medical Affairs

Merck & Co., Inc

Upper Gwynedd, Pennsylvania

Division of Infectious Diseases and Immunology

Isabelita R Bella, MD Associate Professor of Neurology Department of Neurology University of Massachusetts Medical School Worcester, Massachusetts

Michael F Bellamy, MD, MRCP Consultant Cardiologist

Department of Cardiology

Imperial College Healthcare

NHS Trust

Hammersmith Hospital London, United Kingdom David Cachia, MD Chief Resident Department of Neurology University of Massachusetts Medical School Worcester, Massachusetts

Jason P Caplan, MD

Associate Professor of Psychiatry Chief of Psychiatry

Creighton University School of Medicine at

St Joseph's Hospital and Medical Center Phoenix, Arizona

Assistant Professor of Neurology and Surgical

Critical Care Department of Neurology University of Massachusetts Medical School Worcester, Massachusetts

Stewart R Carter, MD Resident

Department of Surgery Loyola University Health System Maywood, Illinois

David A Chad, MD Associate Professor of Neurology Harvard Medical School Massachusetts General Hospital EMC Laboratory

Neuromuscular Diagnostic Center Boston, Massachusetts

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Dinesh Chandokt, MD, FACC,

Division of Infectious Diseases

Division of Pulmonary and Critical Care

Elifce 0 Cosar, MD

Clinical Associate Professor

Co-Director of Thoracic Anesthesia

University of Massachusetts Medical

School

Eric Cucchi, PA-C

Adjunct Professor, Massachusetts College of

Assistant Professor of Medicine and Pathology and Laboratory Medicine Perelman School of Medicine University of Pennsylvania Philadelphia, Pennsylvania Adam D Currier, MD Assistant Professor

Associate Clinical Professor Department of Medicine

Laura A Davis, MB, BCh, BAO

Resident Department of Cardiac Surgery Yale University School of Medicine Yale University

Surgical Director Yale-New Haven Hospital - Heart & Vascular Center

New Haven, Connecticut

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Cardiology Service Chief

Parkland Memorial Hospital

Kern Wildenthal, MD, PhD, Distinguished

Harvard Medical School

Division of Rheumatology and Immunology

Divisions of Hematology/Medical Oncology

and Laboratory Medicine

Oregon Health and Sciences University

Associate Professor Division of Trauma/Critical Care University of Cincinnati Cincinnati, Ohio

Professor of Neurology, Chairman Emeritus University of Massachusetts Medical School Worcester, Massachusetts

Ty B Dunn, MD, MS, FACS Assistant Professor

Division of Transplantation Department of Surgery University of Minnesota Minneapolis, Minnesota Kevin M Dushay, MD, FCCP Assistant Professor of Medicine Alpert Medical School of Brown University Pulmonary, Critical Care & Sleep Medicine Rhode Island Hospital

Providence, Rhode Island

Kevin M Dwyer, MD, FACS Director of Trauma

Vice-Chair of Surgery Stamford Hospital

Stamford, Connecticut James M Ecklund, MD, FACS

Chairman, Department of Neurosciences

!nova Faiifax Hospital

Professor of Neurosurgery George Washington University Professor of Surgery

Uniformed Services University Falls Church, Virginia Richard T Ellison III, MD Professor of Medicine, Microbiology, and Physiological Systems Division of Infectious Diseases Department of Medicine

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Ashkan Emadi, MD, PhD

University of Maryland Greenebaum Cancer

Center

Baltimore, Maryland

Timothy A Emhoff, MD, FACS

Chief, Trauma and Surgical Critical Care

Mayo Medical School

Director, Valvular Heart Disease Clinic

Consultant, Cardiovascular Diseases and

Suzana K Everett Makowski, MD,

MMM

Co-Chief of Palliative Medicine

School

Pang-Yen Fan, MD

Associate Professor of Clinical Medicine

Contrib utors x i John Fanikos, RPh, MBA

Director of Pharmacy Business Department of Pharmacy Services Brigham and Womens Hospital Boston, Massachusetts

Boston University School of Medicine Boston Medical Center

Boston, Massachusetts Adam S Fein, MD

Fellow

Cardiac Electrophysiology Department of Medicine Division of Cardiology

Beth Israel Deaconess Medical Center Harvard Medical School

Boston, Massachusetts Philip Fidler, MD, FACS

Associate Professor of Surgery Georgetown School of Medicine Co-Director

The Burn Center at MedStar Washington Hospital Center

Washington, District of Columbia Kimberly A Fisher, MD Assistant Professor of Medicine Division of Pulmonary/Critical Care Medicine University of Massachusetts Medical School Worcester, Massachusetts

Patrick F Fogarty Assistant Professor of Medicine Director

Penn Comprehensive Hemophilia and Thrombosis Center

Hospital of the University of Pennsylvania Philadelphia, Pennsylvania

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Joseph J Frassica, MD, FAAP, FCCP

Vice President and Chief Medical Informatics

Officer/Chief Technology Officer

Philips Healthcare-Patient Care and

Palliative Care Physician

Division of Palliative Care

Brian J Gallay, MD, PhD

Department of Medicine

UC Davis School of Medicine

University of California, Davis Medical

Center

Sacramento, California

Neeta Garg, MD

Clinical Associate Professor of Neurology

Multiple Sclerosis Center

University of Massachusetts Medical Center

Eli V Gelfand, MD, FACC

Director of Ambulatory Cardiology

Cardiovascular Division

Beth Israel Deaconess Medical Center

Terry B Gernsheimer, MD Professor of Medicine

Division of Hematology

University of Washington School of

Medicine Seattle, Washington

Assistant Professor of Medicine Department of Medicine Division of Pulmonary, Allergy, and Critical Care Medicine

Worcester, Massachusetts John G Gianopoulos, MD

The Mary Isabelle Caestecker Professor and Chair

Department of Obstetrics and Gynecology Loyola University Stritch School of Medicine Loyola University Health System

Maywood, Illinois Michael M Givertz, MD

Medical Director Heart Transplant and Circulatory Assist Associate Professor of Medicine Harvard Medical School

Cardiovascular Division

Boston, Massachusetts Richard H Glew, MD

Professor of Medicine, Microbiology, and Physiological Systems

Vice Chair of Medicine, Undergraduate Medical Education and Faculty Affairs University of Massachusetts Medical School Worcester, Massachusetts

Richard P Goddeau Jr, DO

Assistant Professor of Neurology Department of Neurology University of Massachusetts Medical School

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Michael R Gold, MD, PhD

Chief of Cardiology

Michael E Assry Professor of Medicine

Division of Cardiology

Medical University of South Carolina

Charleston, South Carolina

Darrell M Gray II, MD

Barth A Green, MD, FACS

Professor and Chairman

Clinical Pharmacy Practice Manager

Department of Pharmacy Services

Clemenceau Medical Center Affiliated with

johns Hopkins International

Beirut, Lebanon

Contrib utors xii i David M Harlan, MD

Professor Division of Diabetes Department of Medicine University of Massachusetts Medical School

Worcester, Massachusetts Lawrence J Hayward, MD, PhD Professor of Neurology

Department of Neurology University of Massachusetts Medical School

Worcester, Massachusetts Stephen 0 Heard, MD Professor of Anesthesiology and Surgery Chair of Anesthesiology

Department of Anesthesiology University of Massachusetts Medical

School Worcester, Massachusetts

St jamess Hospital Dublin, Ireland Vanessa Humphreville, MD

General Surgery Staff

Transplant Surgery Fellow Department of Transplant Surgery University of Minnesota Minneapolis, Minnesota

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x i v Contr i b u tors

Eric Iida, MD

School

Richard S Irwin, MD

Professor of Medicine and Nursing

and Graduate School of Nursing

Chair, Critical Care Operations

The Burn Center

Washington Hospital Center

Jay A Johannigman, MD, FACS

Professor of Surgery

Division of Trauma, Critical Care, and

Acute Care Surgery

University of Cincinnati - College of

Medicine

Cincinnati, Ohio

Deirdre L Kathman, DO

Fellow Division of Pulmonary, Allergy, and Critical Care Medicine

UMass Memorial Medical Center Worcester, Massachusetts

Adam W Katz, MPAS, PA-C Staff Physician Assistant

Department of Critical Care UMass Memorial Medical Center Worcester, Massachusetts

J audat Khan, MD Fellow

Division of Renal Medicine UMass Memorial Medical Center Worcester, Massachusetts Muhib Khan, MD

Vascular Neurology Fellow UMass Memorial Medical Center Worcester, Massachusetts Daniel A Kim, MD Resident

Department of Medicine Johns Hopkins Bayview Medical Center Baltimore, Maryland

Irene A Kim, MD

EN T Resident Department of Head and Neck Surgery University of California, Los Angeles Los Angeles, California

Assistant Professor

Department of Surgery Division of Trauma Services University of Massachusetts Medical School Worcester, Massachusetts

Dagmar Klinger, MD Assistant Professor of Medicine Division of Renal Medicine University of Massachusetts Medical School Worcester, Massachusetts

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Scott E Kopec, MD

Director, Pulmonary and Critical Care

Clinical Associate Professor of Medicine

Division of Pulmonary, Allergy, and Critical

Care Medicine

Jason Kurland, MD

Howard B Levene, MD, PhD

Neurological Surgery Spine Fellow

University of Miami Miller School of Medicine

Department of Neurological Surgery

Lois Pope LIFE Center

Miami, Florida

Craig M Lilly, MD

Vice Chair, Critical Care Operations

Director, eICU Program

UM ass Memorial Medical Center

Professor of Medicine, Anesthesia, and

Surgery

Departments of Medicine and Surgery

Instructor of Medicine Division of Pulmonary and Critical Care Medicine

Washington University School of Medicine Barnes-Jewish Hospital

St Louis, Missouri

Randall R Long, MD, PhD

Medical Specialties/Neurology Dartmouth-Hitchcock Keene Keene, New Hampshire

Fred A Luchette, MD, MSc

The Ambrose and Gladys Bowyer Professor

of Surgery Department of Surgery Loyola University Medical Center Maywood, Illinois

Michael D Mancenido, DO, AAHNS Staff Physician

AIDS Care Rochester, New York

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xv i Contr i b u tors

Sunil Mankad, MD, FACC, FCCP,

PASE

Mayo Clinic College of Medicine

Director, Transesophageal Echocardiography

Associate Director, Cardiology Fellowship

Division of Critical Care Medicine

Pulmonary and Critical Care Fellow

Division of Pulmonary, Allergy, and Critical

Care Medicine

Robert M Mentzer Jr, MD

Professor of Surgery and Physiology

Wayne State University School of Medicine

Fred Hutchinson Cancer Research Center

Department of Medical Oncology

Jahan Montague, MD

Assistant Professor of Medicine Division of Renal Medicine University of Massachusetts Medical

School Worcester, Massachusetts

Majaz Moonis, MD, MRCPI(I),

DM, FAAN Professor of Neurology Director, Stroke Services and Vascular Fellowship Program

Worcester, Massachusetts Director, Sleep Center Day Kimball Hospital Putnam, Connecticut John P Mordes, MD Professor of Medicine and Endocrinology Division of Endocrinology and Metabolism University of Massachusetts Medical School Worcester, Massachusetts

Susanne Muehlschlegel, MD, MPH Assistant Professor of Neurology, Anesthesia/ Critical Care, and Surgery

Division of Neurocritical Care University of Massachusetts Medical School Worcester, Massachusetts

Marie Mullen, MD Clinical Associate Professor of Emergency Medicine

Department of Emergency Medicine University of Massachusetts Medical School Worcester, Massachusetts

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Saori A Murakami, MD

Attending Psychiatrist

Assistant Medical Director

Child and Adolescent Psychiatry Inpatient Unit

McLean Hospital

Brighton, Massachusetts

Ashok Nambiar, MD

Associate Clinical Professor

Department of Laboratory Medicine

Director

Division of Transfasion Medicine

University of California, San Francisco

Chief Gastroenterology Division

Associate Professor of Medicine and

Director, Advanced Bronchoscopic and

School

UMass Memorial Sleep Disorders Center

Worcester, Massachusetts Alan Orquiola, MD Assistant Professor Department of Anesthesiology University of Massachusetts Medical School Worcester, Massachusetts

Suchitra Pandey, MD Assistant Professor Department of Laboratory Medicine Assistant Medical Director Transfasion Service and Blood Center University of California, San Francisco

Medical Center San Francisco, California Nereida A Parada, MD Clinical Associate Professor of Medicine Section of Pulmonary Diseases, Critical Care, and Environmental Medicine Tulane University School of Medicine New Orleans, Louisiana

Rupal Patel, MD General Surgery Resident UMass Memorial Medical Center Worcester, Massachusetts Marie T Pavini, MD, FCCP

Assistant Professor, Department of Medicine

University of Vermont School of Medicine Assistant Director, Department of Critical Care

Rutland Regional Medical Center Rutland, Vermont

David Paydarfar, MD Professor

Department of Neurology University of Massachusetts Medical School Worcester, Massachusetts

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Clinical Fellow in Medicine

Beth Israel Deaconess Medical Center

John Querques, MD

Assistant Professor of Psychiatry

Pulmonary Associates of Richmond, Inc

Vice Chief of Staff

Bon Secours St Francis Medical Center

Midlothian, Virginia

Anil Rajendra, MD

Cardiology Fellow

Division of Cardiology

Medical University of South Carolina

Charleston, South Carolina

Paula D Ravin, MD Clinical Associate Professor of Neurology Department of Neurology

Worcester, Massachusetts Kara A Regan, MD

Fellow Department of Internal Medicine Division of Gastroenterology Barnes Jewish Hospital Washington University in St Louis

St Louis, Missouri Harvey S Reich, MD, FACP, FCCP Director, Critical Care Medicine Rutland Regional Medical Center Clinical Associate Professor of Medicine University of Vermont College of Medicine

Rutland, Vermont Jennifer Reidy, MS, MD Palliative Care Physician Division of Palliative Care Assistant Professor

UMass Memorial Medical Center Worcester, Massachusetts

Peter E Rice, MD Assistant Professor of Surgery

University of Medicine and Dentistry of New Jersey

University Hospital New Jersey Medical Center

New York, New York

Noah B Rindos, MD

Resident Department of Obstetrics & Gynecology Boston Medical Center

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James M Rippe, MD

Professor of Biomedical Sciences

University of Central Florida

Orlando, Florida

Rippe Lifestyle Institute

Shrewsbury, Massachusetts/Orlando, Florida

Assistant Professor of Neurology

Director of Neuromuscular Division

and EMG Laboratory

Wayra Salazar-Moreno, MD

Infectious Disease Fellow

Division of Infectious Disease

UM ass Memorial Medical Center

Frantisek Sandor, MD, PhD

Pulmonary and Critical Care Fellowship

Internal Medicine - Pulmonary and

Critical Care

Pulmonary and Critical Care Physician

Penobscot Respiratory - Pulmonary and

QE II Health Science Centre Professor of Medicine Dalhousie University

Halifax, Nova Scotia, Canada Diane M.F Savarese, MD Clinical Instructor of Medicine Harvard Medical School Attending Physician

Division of Hematology Oncology Beth Israel Deaconess Medical Center Boston, Massachusetts

Senior Deputy Editor

Up ToDate Waltham, Massachusetts

Gregory S Sayuk, MD, MPH Assistant Professor

Department of Medicine and Psychiatry Associate Program Director, GI Fellowship Program

Washington University School of Medicine Saint Louis, Missouri

Oren P Schaefer, MD

Clinical Associate Professor of Medicine University of Massachusetts Medical School

Mass Lung & Allergy, P C

Worcester, Massachusetts Vanessa Schroder, MD Surgical Critical Care Fellow Department of Surgery

Duke University Medical Center Durham, North Carolina

Benjamin M Scirica, MD, MPH

Investigator, TIMI Study Group Levine Cardiac Intensive Care Unit Assistant Professor of Medicine Harvard Medical School Associate Physician

Cardiovascular Division Brigham and Womens Hospital Boston, Massachusetts

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Department of Emergency Medicine

Department of Surgery

Division of Trauma, Burn, and Surgical Care

Hani Seoudi, MD, FACS

Virginia Commonwealth University School

of Medicine

Falls Church, Virginia

Mark L Shapiro, MD, FACS

Chief, Acute Care Surgery

Associate Director, Trauma

Duke University Medical Center

Durham, North Carolina

Michael Sigman, MD

Resident

Department of General Surgery

Loyola University Medical Center

Maywood, Illinois

Bruce J Simon, MD

Associate Professor

Division of Trauma Services

Department of Anesthesiology/Critical Care Medicine

Heidi L Smith, MD, PhD Assistant Professor of Medicine Mass Biologics

Boston, Massachusetts Nicholas A Smyrnios, MD, FACP, FCCP

Associate Chief, Division of Pulmonary,

Allergy, and Critical Care Medicine Director, Medical Intensive Care Units Professor of Medicine

Piotr Sobieszczyk, MD, RVT Associate Director

Cardiac Catheterization Laboratory Cardiovascular Division

Brigham and Womens Hospital Boston, Massachusetts

Suman L Sood, MD Assistant Professor of Medicine Department of Internal Medicine Division of Hematology/Oncology University of Michigan School of Medicine Ann Arbor, Michigan

Andres F Sosa, MD

Assistant Professor Interventional Pulmonary

Division of Pulmonary, Allergy and Critical Care Medicine

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Aruna Sree, MD

Infectious Disease Consultant

Department of Infectious Disease/Internal

Medicine

Somerset Medical Centre

Somerville, New Jersey

Director, Office for Clinical Careers

Ned H Cassem Professor of Psychiatry in the

field of Psychosomatic Medicine/Consultation

Director, Cardiac Electrophysiology Program

Michael B Streiff, MD, FACP

Associate Professor of Medicine and Pathology

Johns Hopkins University School of Medicine

Baltimore, Maryland

Thejas N Swamy, MD

Renal Fellow

Mya Sanda Thein, MD

Post-Doctoral Fellow

Department of Hematology/Medical Oncology

University of Maryland Greenebaum Cancer

Beth Israel Deaconess Medical Center Harvard Medical School

General Surgery Residency University of Massachusetts Medical School Worcester, Massachusetts

Professor Division of Transplantation Department of Surgery University of California, Davis Medical Center

Sacramento, California

Susan Hongha T Vu, MD

Gastroenterology Fellow Washington University in St Louis

St Louis, Missouri

J Matthias Walz, MD, FCCP Associate Professor of Anesthesiology and Surgery

Department of Anesthesiology Division of Critical Care Medicine University of Massachusetts Medical School Worcester, Massachusetts

Michael Y Wang, MD, FACS

Professor Department of Neurosurgery and Rehabilitation Medicine University of Miami School of Medicine Lois Pope LIFE Center

Miami, Florida

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Department of General Surgery

Loyola University Medical Center

Maywood, Illinois

Mark M Wilson, MD

Associate Director of Medical Intensive Care

Department of Neurological Surgery

George Washington University Medical Center

Assistant Clinical Professor of Surgery

UCSF-Fresno Medical Education Program

Community Regional Medical Center

Office of Continuing Medical Simulation Center

Robert W Yeh, MD, MSc

Instructor in Medicine Harvard Medical School Massachusetts General Hospital Boston, Massachusetts Luke Yip, MD Department of Veterans Affairs National Center for Patient Safety Ann Arbor, Michigan

David D Yuh, MD Professor and Chief, Section of Cardiac Surgery

Yale University School of Medicine Surgical Director

Yale-New Haven Hospital - Heart & Vascular Center

New Haven, Connecticut Jiaying Zhang, MD

Vascular Neurology Fellow Department of Neurology University of Massachusetts Medical School

Worcester, Massachusetts Iva Zivna, MD

Assistant Professor of Infectious Disease and Immunology

Division of Infectious Diseases and Immunology

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Preface

We are delighted to present the sixth edition of the Manual of Intensive Care Medicine Previous editions have established this Manual as a leading source of information in the ever-evolving, diverse, and complicated field of critical care and intensive care medicine The practical format and user-friendly, portable size of the Manual have made it a particularly valuable aid in the bedside practice of intensive care and a valuable reference for students, interns, residents, fellows, nurse practitioners and physician assistants, nurses, and respiratory care practitioners practicing in the critical care medicine environment

As in the previous edition of this work, the sixth edition of the Manual is intended

to parallel our major textbook Irwin and Rippe's Intensive Care Medicine This latter, hardcover book is now in its seventh edition and continues to be a leading source of intensive care knowledge both in the United States and throughout the world

We are pleased to announce that the sixth edition of the Manual will be available not only in print but also online and as an app for e-readers Choice of format allows busy bedside providers access to the information they need the way they like

to receive it These resources allow immediate access to the information that allows busy professionals to optimally manage the complicated issues encountered in the care

of critically ill adults As in previous editions, we have challenged the section editors and authors to not only update all the content contained within the Manual, such

as the important role that bedside ultrasonography plays in caring for the critically ill, but also emphasize salient concepts and focus on key, clinically relevant points Annotated references are provided at the close of each chapter to guide the interested reader through key articles in the relevant literature Each chapter reflects the best available evidence with a focus on patient safety, and, where appropriate, videos have been added to exemplify points and findings

The Manual of Intensive Care Medicine opens with an extensive section on Procedures and Techniques The remaining 1 5 sections are divided among organ system problems and other common and important issues, such as palliative care and ethical issues, and transplantation In each chapter within these sections, discussions of key conditions that present in the intensive care unit environments are presented together with targeted discussions focusing on treatment

We are delighted to welcome new section editors in the following areas: Dr Gail Scully in Infectious Disease Problems; Dr Samir Malkani in Endocrine Problems;

Dr Timothy A Emhoff in Shock and Trauma; Dr Sonia Chimienti, who joined

Dr Christoph Troppmann as a co-section editor in the Transplantation section; and

Dr Jennifer Reidy, who is the section editor of a new section in the book on Palliative Care and Ethical Issues in the Intensive Care Unit

As in the previous edition, the management of overdoses and poisonings is covered so comprehensively in the Pharmacology, Overdoses, and Poisonings section that the section mimics a textbook unto itself For this, we have special thanks to the section editor Luke Yip, who created the easy-to-use tabular format of this section

We are also indebted to our other section editors who have continued to contribute

in an extraordinary way by updating their sections: Dr Stephen 0 Heard, who has overseen the Procedures and Techniques and Minimally Invasive Monitoring section; Dr Akshay S Desai, Cardiovascular Problems and Coronary Care; Dr J Mark Madison, Pulmonary Problems; Dr Pang-Yen Fan, Renal Problems; Dr Dominic ] Nompleggi, Gastrointestinal and Hepatobiliary Problems; Dr Patrick F Fogarty,

x x ii i

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x x i v I Preface

Hematologic Problems; Dr Fred A Luchette, Surgical Problems; Drs David Paydarfar and David A Drachman, Neurologic Problems; Dr Paul F Dellaripa, Rheumatologic and Immunologic Problems; Dr John Querques, Psychiatric Issues; and

Dr Joseph Frassica, Appendix

We wish ro acknowledge that many of the chapter authors for the current Manual have also made major contributors to our larger-format textbook, Irwin and Rippe 's Intensive Care Medicine Although the Manual of Intensive Care Medicine has been edited and revised with the expert guidance of many section editors, many of the chapters were developed based on the expert knowledge of the original textbook contributors, reorganized, and rewritten in a style necessary for the scope of this portable text

We also wish to once again acknowledge and thank a number of individuals without whose assistance the sixth edition of this Manual would not have been possible First and foremost, Dr Rippe's Editorial Director, Elizabeth Grady, who continues to

do a superb job in organizing and expediting all aspects of the manuscript preparation for this book and many others Without Beth's superb editorial skills, projects such

as this would not be possible Gina Giangregorio and Linda Doherty, Dr Irwin's and

Dr Lilly's administrative assistants, and Cynthia French, Dr Irwin's clinical coordinator, also have provided important assistance in managing their complex clinical and academic endeavors Carol Moreau, executive assistant to Dr Rippe, expertly juggles the diverse aspects of his clinical, research, and travel calendar to carve out time for projects of this magnitude Debra Adamonis, office assistant to Beth Grady and Carol Moreau provides wonderful daily logistical support

A special word of thanks to the editorial team members at Lippincott Williams & Wilkins, who support all of our medical editing projects and have supported the process every step of the way We wish to particularly thank our Senior Acquisitions Editor, Brian Brown, for his support throughout the process of writing this book Nicole Dernoski, Senior Product Manager, also provided logistical support and expertise throughout the editorial process on this and previous editions of the Manual Finally, we wish to thank our families: Diane Irwin; Rachel, Andrew, Truman, and Bailey Koh; Sara, Benjamin, Jacob, and Isaac Diiorio; Jamie, Andrew, Emmett, and Asher Mcintosh; Rebecca and Adam Slater; Stephanie, Hart, Jaelin, Devon, and Jamie Rippe; and Leslie, Jonathan, and Catherine Lilly, who continue to love and support us in all of our efforts, both personal and academic, and make it all worthwhile

Richard S Irwin, MD Craig M Lilly, MD James M Rippe, MD

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Co ntents

Secti o n 1 • Procedures a n d Tec h n i q u es a n d

M i n i ma l ly I nvasive M o n ito r i ng i n t h e I C U

Section Ed itor - Stephen 0 Heard

• Ai rway M a nage m e nt a n d E n d otra c h e a l

I ntu bati o n 1

El ifce 0 Cosa r a nd Ada m D C u rrier

Anto n i o Aponte- Fe l i c i a n o , A l a n O rq u io l a , Theofi los P M atheos, and Ste p h e n 0 H e a rd

• Card i overs i o n a n d Defibri l lati o n

Ava n i T M ehta a nd Pa u l o J O l ive i ra

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M a rie T Pavi n i

U l ises Torres a nd R u pa l Patel

Anto n i o A ponte-Fe l ic i a n o , J o rge D Ya rze bs k i , a n d

Kevi n M D ushay

• Asp i rati on of J o i nts

H a rvey S Reich

1 06

Natha nael A Slate r a n d J M atth ias Wa lz

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Contents x x v i i

Den n is A Tighe, D i nesh C h a n d o k , a nd G e ra rd P Au rige m m a

M a rie T Pavi n i a nd R ic h a rd S I rw i n

lml l nte rventional U ltraso u n d i n the I C U

liil G isela I B a n a u c h a n d Ada m W Katz

the I ntensive Care U n it 1 43

J e n n ife r R e idy, J u l ia M G a l lagher, a n d S uza na K Everett M a kowski Secti o n 3 • Card i ovasc u l a r Pro b l ems

and Coronary Care

Section Ed itor - Akshay S Desai

ml M a nage m e nt of the Resusc itated

Ragh u R Seethala a n d B e nja m i n M Sci rica

BJ!I M a nagem e nt of Hypotension a n d Card i oge n i c liil S h o c k 1 56

M ichael M G ivertz

II The Card i o myopath i es: D i agnosis a n d I C U

G W i l l i a m Dec

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x x v i i i I Contents

nl Va lvu l a r Heart D isease 1 80

Akshay S Desa i , M ichael F B e l l a my, a nd M a u rice En riq uez-Sa ra no

llil A n d rea Loise l l e a nd S u n i l M a n ka d

1 90

nt The Acute Aortic Syn d ro m es

1111 Eva l uati o n a n d Ma nage m e nt of Hypertension

Benja m i n M Sci rica

Ada m S Fe i n a n d Ka ren E Thomas

1BJ1 M a nage m e nt of U nsta b l e Angi na a n d N o n-ST

- E l evati on Myoca rd i a l I nfa rct i o n 224

Yu ri B Pride a nd E l i V G e lfa nd

I a n J Neeland a n d J a m es A d e Lemos

S r i n ath Ad usu m a l l i a n d R o bert W Yeh

• Ve ntri c u l a r Tac hyca rd ia 258

B ruce A Ka p l a n a n d W i l l i a m G Steve nson

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Section Ed itor - J Mark Madison

nt A Phys i o l og i ca l Approach to M a naging

M a rk M Wi lson a n d R ic h a rd S I rwin

.m Acute Res p i rato ry D i stress Syndrome

-Fra ntisek Sa ndor, M a rk M Wi lso n , a n d R i c h a rd S I rwi n

J M a r k Mad ison a n d R ic h a rd S I rw i n

.a C h ro n i c Obstru ctive P u l monary D isease

-Sea n O ' R e i l ly a n d Deird re L Kath m a n

Respi ratory Fa i l u re 3 1 9

Ava n i T M ehta a nd M a rk M Wi lson

II Acute Res p i rato ry Fa i l u re i n

M itra G hase m i a n d O re n P Schaefer

Pa u l o J O l ive i ra a n d R i c h a rd S I rw i n

-N icholas A S m yrn ios a nd R ic h a rd S I rw i n

303

3 1 2

Trang 32

x x x I Contents

II P u l m o na ry Hype rte n s i o n i n the I nte ns ive

Ana Cojoca ru a n d K i m berly A Fisher

llr!I P l e u ra l D isease i n the C riti ca l ly I l l

A n d res F Sosa , C rescens Pel lecc h i a , a n d M a rk M Wi lson

II M echa n i ca l Ve nti l ati o n : I nvasive

Scott E Kopec, S u m era R A h m a d , a n d R i c h a rd S I rw i n

• M echa n i ca l Ve nti l ati o n :

B i o l og i c a l Agents o f M ass Destruction 378

M ichael L Ba rretti a n d M a rk M Wi lson

1!11 D isord e rs of Tem p e ratu re Contro l :

J iaying Zha ng, Susa n ne M ue h lsch lege l , a n d M a rk M Wi lson 1!11 D isord e rs of Tem p e ratu re Contro l :

Saef I zzy, S u sa n n e M ue h lsc h l egel a n d M a rk M Wi lson

Ste p h e n J Krinzma n , S u n i l Raja n , and R ic h a rd S I rw i n

Trang 33

11'11 Acute I nfecti ous P n e u m o n i a

-A n n a G R u d n icki a n d A n d res F Sosa

404

Conte nts x x x i

Secti o n 5 • Rena l Pro b l ems i n the I nte ns ive

Care U n it

Section Ed itor - Pang-Yen Fan

1!1.11 M eta bo l i c Ac i dosis a n d M eta bo l i c

J a h a n M o ntague a n d J ason Kurland

11!1 D isord e rs of Plasma S od i u m a n d

J a u d at Kha n , Eric I id a , a n d Pang-Yen Fa n

IZI Acute Ki d n ey I nj u ry i n the I ntensive

Konsta nti n Abra m ov a n d Thejas N Swa my

Deep Ad h i ka r i a n d Dagma r Kli nger

Secti o n 6 • I nfectious D isease Pro b l ems

i n the I ntensive Care U n it

Section Ed itor -G a i l Scu l ly

II App roa ch to Feve r i n the I ntensive Care U n it Pat i e nt 44 1

Son i a N C h i m ienti a n d R ic h a rd H G lew

• The Use of Anti m i c ro b i a l s i n the Treatm ent of

I nfection i n the C riti ca l ly I l l Pati ent 45 1 Wayra Salaza r- M o reno a n d David M B e b i nger

Trang 34

x x x i i I Contents

H e i d i L S m ith

Wayra Salaza r- M ore n o a n d G a i l Scu l ly

Aruna Sree and Ra u l Dava ro

• Tu berc u l osis i n the I nte ns ive

M ichael D M a ncen i d o and J e n n ifer S Daly

llJll S evere C o m m u n ity-Acq u i red Resp i ratory

Trang 35

Conte nts I x x x i i i Secti o n 7 • Gastro i ntestina l a n d H epatob i l ia ry Pro b l ems i n the I ntens ive Ca re U n it

Section Ed itor - Dom i n i c J N o m p l eggi

SD Gastro i ntesti n a l B l eed i ng: Pri n c i p les of

Darre l l M G ray 1 1 a n d C Prakash Gyawa l i

Fa iz A M i rza a n d C P ra kash Gyawa l i

Susan H ongha T Vu a nd C Prakash Gyawa l i

• Gastro i ntesti n a l M oti l ity Pro b l ems i n th e Criti c a l Care S etti ng 54 1

G regory S Say u k

• Fu l m i na nt C o l itis and Toxi c

H e ba N l s ka n d a r a n d C P ra kash Gyawa l i

Kev i n M Koren blat

Trang 36

x x x i v I Contents

1!!11 S evere a n d Co m p l i cated B i l i a ry Tract

Ta re k A b o u H a m d a n a n d R iad Aza r

• The Basi c Pri n c i p l es of N utriti o n a l S u pport

i n the I ntens ive Care U n it 58 1

Les l i e J Doma l i k a n d David M H a r l a n

11!11 D i a b etic Comas: Ketoac i d osis a n d

Sa m i r M a l ka n i a nd John P M o rd es

• Thyro i d D isorders i n the I C U

A l a n P Fa rwe l l

600

1!'11 Hypoadre n a l Crisis a n d the Stress

lill M a nage m e nt of th e Patient on C h ron i c

Trang 37

Contents I x x xv Secti o n 9 • H emato l ogic Pro b l ems in th e

Criti c a l Care Patients 690

Mya Sanda Thei n , Ash ka n Emad i , a nd M ichael B Streiff

• Ane m i a i n th e C riti ca l Ca re Pati ent 7 1 3 Thomas G Deloughery

Bn Tra nsfusion Thera py: B l ood C o m p o n e nts

- a n d Tra nsfus i o n Com p l i cati o ns 7 24

Trang 38

-Cynt h i a E We ber, Sewit A m d e , a n d Fred A Luchette

Im.I Esophagea l Perfo rati o n a n d Ac ute

Trang 39

-J e n n ife r K P l ichta , Donald S Steve n s , a nd Fred A Luchette

llill i n the I ntensive Ca re Setting 884

M ichael Sigma n , N o a h B R i ndos, a nd J o h n G G i a nopou los

Secti o n 1 2 • S h o c k a n d Tra u ma

Section Ed itor - Ti m othy A E m h off

1111 Kev i n M Dwyer a nd Ti m othy A E m h off

Dim H e m o rrhagic S h o c k a n d Resusc itat i o n

lliliil C h risto p h e r P M ic h etti a n d Ti m othy A E m h off

lr.m Tra u m a : An Overview

Ti m othy A E m h off

9 1 0

900

� Tra nsporti ng the Criti ca l ly I l l Pat i e nt 9 1 5

1111 G i na R Dorlac, Jay A J o ha n n igma n , a n d N a m H e u i Kim

J o s h u a J Wi n d , J o s h u a M Am merma n , J a m es M Eckl u n d ,

a n d N a m H e u i K i m

Trang 40

M uscu l oske l eta l Tra uma 955

Section Ed itors - David A Drachman a n d David Paydarfar

lllil i n the I ntensive Care U n it 973

David A D rach m a n

Raphael A Ca ra ndang, Lawrence J Haywa rd , and

David A D rac h m a n

• M eta b o l i c Encepha l o pathy

Pa u l a D Ravin

986

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