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Critical care clinicians must be knowledgeable about the anatomic, physiologic, and biochemical processes that are critical to the restoration of a functioning microvascular affecting organ perfusion. These basic physiologic processes critical to tissue perfusion and cellular oxygenation are presented in this issue on Monitoring Tissue Perfusion and Oxygenation. A working knowledge of oxygen delivery and oxygen consumption at the microvascular level will provide critical information needed for clinicians to continuously question the adequacy of tissue perfusion given our current lack of microvascular bedside monitoring.
This book describes various aspects of the basic physiological processes critical to tissue perfusion and cellular oxygenation, including the roles of the circulatory system, respiratory system, blood flow distribution and microcirculation. In the context of monitoring critically ill patients in the early hours of circulatory shock, it is essential to recognize changes in traditional parameters such as mean arterial pressure and cardiac output, and to assess the need for active intervention. However, even if global macrocirculatory variables are restored, abnormalities in tissue oxygenation may persist. Tissue hypoperfusion is connected to the development of organ failure and, if it goes unrecognized, may worsen the prognosis. As a result, there is a growing interest in methods for monitoring regional perfusion in peripheral tissues to predict or diagnose ongoing hypoperfusion. In this work, eminent experts from a range of disciplines convey a working knowledge of how regional monitoring in shock can complement the conventional global parameters of oxygen transport, and demonstrate that real-time bedside assessment of tissue oxygenation is readily achievable using noninvasive monitoring techniques. Accordingly, the book offers a valuable, easy-to-use guide for the entire ICU team and other clinicians.
Now in paperback, the second edition of the Oxford Textbook of Critical Care is a comprehensive multi-disciplinary text covering all aspects of adult intensive care management. Uniquely this text takes a problem-orientated approach providing a key resource for daily clinical issues in the intensive care unit. The text is organized into short topics allowing readers to rapidly access authoritative information on specific clinical problems. Each topic refers to basic physiological principles and provides up-to-date treatment advice supported by references to the most vital literature. Where international differences exist in clinical practice, authors cover alternative views. Key messages summarise each topic in order to aid quick review and decision making. Edited and written by an international group of recognized experts from many disciplines, the second edition of the Oxford Textbook of Critical Careprovides an up-to-date reference that is relevant for intensive care units and emergency departments globally. This volume is the definitive text for all health care providers, including physicians, nurses, respiratory therapists, and other allied health professionals who take care of critically ill patients.
Nutrition is an important aspect of care for any patient entering the hospital, but the patient admitted to the intensive care unit (ICU) is at an even higher risk for nutritional compromise. Nutrition affects all ages, from the neonate to the geriatric patient, and all patient populations. Evidence-based practice guidelines regarding appropriate nutritional support within the critical care setting are published. Yet, researchers continue to identify that despite published evidence, countless ICU patients continue to lack adequate and timely nutritional support on admission. Each of the authors in this issue promotes nutrition in their careers and individual practice areas, which brings knowledge from many different arenas throughout the nation. This issue discusses nutrition throughout the lifespan, special patient populations, implementation of guidelines, and how nutrition is being utilized as medical therapy.
Dr. Michael Pinsky has assembled an expert team of authors on the topic of Hemodynamic Monitoring. Articles topics include: The interface between monitoring and physiology at the bedside; Defining goals of resuscitation in the critically ill; Minimally invasive hemodynamic monitoring; Bedside ultrasound for the intensivist; Invasive hemodynamic monitoring; Functional hemodynamic monitoring; Using what you get: dynamic physiological signatures of critical illness; and Effect of organizational issues on resuscitation effectiveness.
This issue contains a series of articles focused on various initiatives aimed at improving the quality of patient care delivery and promoting safe passage across the continuum of care. Exemplary, evidence-based nursing practice is the cornerstone of quality care, and this issue highlights many ways in which nurses have led changes to optimize patient outcomes. In addition, quality care enhances cost-effectiveness by reducing avoidable complications and diminishing avoidable hospital readmissions, a concept more important than ever due to value-based purchasing and the Affordable Care Act. Articles are specifically devoted to prevention of delirium in critical care patients, palliative care in the intensive care unit, prevention of pressure ulcers, fall prevention in high-risk patients, prevention readmissions, preventing sepsis mortality, and nursing interventions in the elderly critical care patient, to name a few.
Hematology, An Issue of Critical Care Nursing Clinics
This issue of Endocrinology Clinics brings the reader up to date on the important advances in research surrounding acute diabetic complications. Guest edited by Leonid Poretsky and Eliana Liao, the topics covered include retinopathy, neuropathy, gastrointestinal complications, diabetic foot, dental complications, dermatologic complications, and more.
Dr. Squiers has assembled the leading nurses in the country on the management of fluids and electrolytes to write state-of-the-art reviews on this important topic. Readers will come away with current knowledge and management strategies to improve patient outcomes in the following areas: Colloids vs crystalloids in trauma resuscitation; Colloids vs crystalloids in post cardiopulmonary bypass patients; Potassium and magnesium serum levels in Aifb prophalxysis; Review of outcomes in hypernatremia in ICP management; Does evidence drive fluid volume restriction in chronic HF; Assessment of volume status in patients with mechanical cardiac support devices; Assessment of volume status utilizing ultrasounds examination; Managing electrolyte disturbances in tumor lysis syndrome; Post-cystectomy electrolyte issues with neobladder hypophosphatemia effects on weaning mechanical ventilation; and Does fluid resuscitation affect long-term cognitive function in sepsis?
In this issue of Critical Care Nursing Clinics, guest editor Dr. Melissa Nunn, Instructor of Clinical Nursing at LSU Health New Orleans School of Nursing, brings her considerable expertise to the topic of Pediatric Intensive Care Nursing. Top experts in the field present systematic, evidence-based processes for decision making and care, addressing topics such as palliative communication in the PICU; dialysis care in the PICU; caring for hematology/oncology emergencies in the PICU; nurse-led rounds in the PICU; asthma care protocol implementation in the PICU; and more. Contains 12 relevant, practice-oriented topics including acute pain management protocols in the PICU; kangaroo care implementation; unplanned extubations in the PICU; pediatric delirium screening in the ICU; battling alarm fatigue within the PICU; and more. Provides in-depth clinical reviews on pediatric intensive care nursing, offering actionable insights for clinical practice. Presents the latest information on this timely, focused topic under the leadership of experienced editors in the field. Authors synthesize and distill the latest research and practice guidelines to create clinically significant, topic-based reviews.