{"title":"Neurogenic Cardiac Manifestations","authors":"S. Braksick, E. Wijdicks","doi":"10.1093/MED/9780190862923.003.0017","DOIUrl":"https://doi.org/10.1093/MED/9780190862923.003.0017","url":null,"abstract":"Paroxysmal sympathetic hyperactivity (PSH) is a form of acute dysautonomia that can occur after several types of acute (usually severe) structural brain injury. PSH typically occurs after traumatic brain injury (TBI) with diffuse axonal injury, yet it can also occur after aneurysmal subarachnoid hemorrhage, encephalitis, massive fat or air embolism, or profound anoxic-ischemic brain injury, often with each condition leading to prolonged unconsciousness. The development of PSH is associated with longer hospital stays, and it may be associated with increased mortality and worse outcomes.","PeriodicalId":308040,"journal":{"name":"Mayo Clinic Critical and Neurocritical Care Board Review","volume":"5 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2019-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"115240859","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Clinical Management of Kidney Transplant Recipients","authors":"James A. Onigkeit","doi":"10.1093/MED/9780190862923.003.0073","DOIUrl":"https://doi.org/10.1093/MED/9780190862923.003.0073","url":null,"abstract":"Kidney transplant is common. More than 19,000 kidney transplants were performed in the United States in 2017. About two-thirds were deceased donor transplants, and about one-third were living donor transplants. The clinical management of a kidney transplant recipient begins in the operating room. Posttransplant complications can be divided into 2 categories: surgical and medical.","PeriodicalId":308040,"journal":{"name":"Mayo Clinic Critical and Neurocritical Care Board Review","volume":"13 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2019-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"125186810","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Adrenal Insufficiency in Neurocritically Ill Patients","authors":"Carla Venegas-Borsellino, Santiago Naranjo-Sierra","doi":"10.1093/MED/9780190862923.003.0038","DOIUrl":"https://doi.org/10.1093/MED/9780190862923.003.0038","url":null,"abstract":"The hypothalamic-pituitary-adrenal (HPA) axis is a complex system that equilibrates blood levels of glucocorticoid hormones. Cortisol levels are dynamic and normally fluctuate in response to constant feedback; functional deficiency in this system results in adrenal insufficiency (AI). An elevated corticosteroid level is needed as a protective response to stress during acute illness or major surgery, but corticosteroid secretion can be altered by splanchnic and central nervous system influence, fever, acidosis, and proinflammatory cytokines. Critical illness–related corticosteroid insufficiency (CIRCI) is a relatively insufficient HPA response; often encountered in critical care patients, it can worsen outcomes.\u0000","PeriodicalId":308040,"journal":{"name":"Mayo Clinic Critical and Neurocritical Care Board Review","volume":"1 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2019-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"130597441","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Consequences of Acute Metabolic Changes to the Brain","authors":"S. Braksick, S. Hocker","doi":"10.1093/MED/9780190862923.003.0012","DOIUrl":"https://doi.org/10.1093/MED/9780190862923.003.0012","url":null,"abstract":"Acute hypertension is a common clinical problem that accounts for almost 25% of emergency department visits in the United States. It can occur in patients who have preexisting hypertension or in patients who were previously normotensive. This chapter provides an overview of cerebral autoregulation and the mechanisms of action and side effect profiles of different antihypertensive medications used to treat acute hypertension.","PeriodicalId":308040,"journal":{"name":"Mayo Clinic Critical and Neurocritical Care Board Review","volume":"2 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2019-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"124007770","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Asthma in the Critically Ill Patient","authors":"Jonathan Danaraj, Augustine S. Lee","doi":"10.1093/MED/9780190862923.003.0021","DOIUrl":"https://doi.org/10.1093/MED/9780190862923.003.0021","url":null,"abstract":"Asthma is a common condition that affects an estimated 24 million children and adults in the United States (prevalence, 8%-10%). Globally, over 300 million people are affected and the number is expected to increase. The age distribution is bimodal, but in most patients, asthma is diagnosed before age 18 years (male to female ratio, 2:1 in children; 1:1 in adults). Susceptibility to asthma is multifactorial with both genetic and environmental factors. The strongest risk factor is atopy, a sensitivity to the development of immunoglobulin E (IgE) to specific allergens. A person with atopy is 3- to 4-fold more likely to have asthma than a person without atopy. Other risk factors include birth weight, prematurity, tobacco use (including secondary exposure), and obesity.","PeriodicalId":308040,"journal":{"name":"Mayo Clinic Critical and Neurocritical Care Board Review","volume":"37 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2019-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"128679453","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Acute Perforations of the Gastrointestinal Tract","authors":"L. Tsamalaidze, J. Stauffer","doi":"10.1093/MED/9780190862923.003.0042","DOIUrl":"https://doi.org/10.1093/MED/9780190862923.003.0042","url":null,"abstract":"Acute perforations of the gastrointestinal tract (GI) with subsequent release of gastric or intestinal contents into the peritoneal space have multiple causes and portend a high mortality depending on the cause. The key symptom is a sudden appearance of abdominal pain followed by signs of peritoneal irritation, severe sepsis, or shock. A proper imaging evaluation should lead to surgical intervention and aggressive supportive management.","PeriodicalId":308040,"journal":{"name":"Mayo Clinic Critical and Neurocritical Care Board Review","volume":"1 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2019-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"129009555","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Radiography and Computed Tomography of the Chest","authors":"B. McComb","doi":"10.1093/MED/9780190862923.003.0109","DOIUrl":"https://doi.org/10.1093/MED/9780190862923.003.0109","url":null,"abstract":"A portable chest radiograph frequently complements the clinical evaluation of a patient in the intensive care unit (ICU). Standard posteroanterior (PA) chest radiographs are obtained from a distance of 72 inches with the patient erect and facing the detector. The x-ray tube is behind the patient, and the beam passes from posterior to anterior. In the ICU, the PA radiograph is replaced by the portable anteroposterior radiograph, which is obtained from a 40-inch distance with the tube in front of the patient and the patient supine or semierect.","PeriodicalId":308040,"journal":{"name":"Mayo Clinic Critical and Neurocritical Care Board Review","volume":"1 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2019-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"115772399","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Antibiotics, Antivirals, and Antifungals","authors":"D. S. Aviles, W. Hellinger","doi":"10.1093/MED/9780190862923.003.0137","DOIUrl":"https://doi.org/10.1093/MED/9780190862923.003.0137","url":null,"abstract":"Antimicrobial therapy should not be initiated before infection with a susceptible pathogen is suspected or confirmed or before appropriate diagnostic specimens, including those for cultures, are collected. Recognizing indications for antibiotic administration and appropriately selecting antimicrobial agents based on clinical and microbiologic findings is required. Distinguishing between empiric prescribing, when infection syndromes and pathogens are suspected, and therapeutic prescribing, when infection syndromes are confirmed and pathogens identified, is critically important. Working knowledge of antimicrobial drug dosing, adjustment of dosing for renal or hepatic insufficiency, drug-drug interactions, and antimicrobial allergies or intolerances is required, and ready access to and liberal use of reference guides help ensure good patient care.","PeriodicalId":308040,"journal":{"name":"Mayo Clinic Critical and Neurocritical Care Board Review","volume":"13 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2019-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"127527587","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Paralytic and Obstructive Ileus","authors":"J. Canabal","doi":"10.1093/MED/9780190862923.003.0040","DOIUrl":"https://doi.org/10.1093/MED/9780190862923.003.0040","url":null,"abstract":"Ileus is the most common manifestation of acute gastrointestinal injury which exhibits grades of severity in the critically ill. Appropriate characterization of ileus as adynamic or mechanical in origin determines its management. This chapter discusses the most important causes, clinical and radiologic findings, and appropriate management of ileus that develops in patients in the intensive care unit.","PeriodicalId":308040,"journal":{"name":"Mayo Clinic Critical and Neurocritical Care Board Review","volume":"14 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2019-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"127127361","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Consequences of Acute Hypertension to the Brain","authors":"Katherine M. Oshel, H. Wadei","doi":"10.1093/MED/9780190862923.003.0013","DOIUrl":"https://doi.org/10.1093/MED/9780190862923.003.0013","url":null,"abstract":"The components of consciousness are classically separated into 2 major groups: level of alertness (being awake) and content of thinking (being aware). Major acute neurologic disorders affect both components. These 2 components are interrelated but sometimes dissociated. Coma is often due to an extensive structural (anoxic-ischemic) injury or to diffuse physiologic dysfunction (eg, intoxication, seizures, or acute metabolic derangement).","PeriodicalId":308040,"journal":{"name":"Mayo Clinic Critical and Neurocritical Care Board Review","volume":"488 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2019-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"129879362","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}