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Clinician's Pocket Reference: The Scut Monkey, 11e
Complications in Critical Care
Sections: Acute Respiratory Distress Syndrome (ARDS), Causes: , Treatment:, Upper Gastrointestinal Hemorrhage, Prophylaxis, Management of Ulceration, Shock, Hypovolemic Shock: , Cardiogenic Shock: , Septic Shock: , Surviving Sepsis Campaign Guidelines:, Neurogenic Shock: , Acute Renal Failure (ARF), Contrast Nephropathy: , Abdominal Compartment Syndrome, Diagnosis: , Treatment: , Acalculous Cholecystitis, Diagnosis: , Treatment: , Acute Adrenal Insufficiency, Infection, Ventilator-Associated Pneumonia: , Line Sepsis: , Deep Venous Thrombosis (DVT) and Pulmonary Embolism (PE), Prevention of DVT: , Diagnosis of PE, Treatment.
Topics Discussed: abdominal compartment syndrome; adrenal insufficiency, acute; cardiogenic shock; care of intensive care unit patient; cholecystitis without calculus; deep vein thrombosis; neurogenic shock; positive end-expiratory pressure; pulmonary embolism; radiographic contrast agent nephropathy; respiratory distress syndrome, acute; sepsis, catheter-related; septic shock; shock; shock, hypovolemic; upper gastrointestinal bleeding; ventilator-associated pneumonia.
Excerpt:
"ARDS is acute pulmonary injury manifested by marked respiratory
distress and hypoxia. Pulmonary capillaries become more permeable,
resulting in noncardiogenic pulmonary edema. ARDS has been defined
by the American–European Consensus Conference as:The causes of ARDS are multifactorial and include but are not
limited to:Inadequate circulating blood volume (at least 20% loss)
is caused by dehydration or acute hemorrhage. Hemodynamic parameters
show decreased CVP, PAOP, and EDVI with a consequent decrease in
CO and increase in SVR. Table 20–9
lists
the current classification and physiologic changes associated with
hypovolemic shock.Iatrogenic cause of ARF. If use of contrast agents is unavoidable
in high-risk patients (eg, diabetic patients with chronic renal
insufficiency) the following strategies may reduce the risk:Consider the diagnosis in the setting of worsening lung compliance,
abdominal distention, and oliguria. Hypotension is a late finding.
Measurement of bladder pressure confirms the diagnosis. Although
the clinical scenarios can be highly variable, organ dysfunction
may be present with pressures as low as 10 mm Hg...."
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