ECMO and Ventricular Assist Devices
I. EXTRACORPOREAL LIFE SUPPORT (ECLS/ECMO) A. The development of ECLS/ECMO as a temporary assist device is a direct extension of the principles of cardiopulmonary bypass, which usually involves intrathoracic venoarterial (VA) cannulation….
Acute Kidney Injury
I. DEFINITION A. The RIFLE criteria (Risk, Injury, Failure, Loss, and ESRD) were developed in 2004 to standardize the definition of acute kidney injury (AKI), formerly called acute renal failure (ARF). Prior…
Telemedicine and Remote Electronic Monitoring Systems in ICU
I. INTRODUCTION A. “Telemedicine,” as defined by the American Telemedicine Association, is the use of medical information exchanged from one site to another via electronic communications to improve a patient’s clinical health…
Infectious Disease
Obtaining Blood Cultures I. INTRODUCTION A. The management of infectious disease is a crucial skill for the intensivist. Epidemiological studies suggest that more than 70% of adult patients in an ICU receive…
Endocrine Disorders and Glucose Management
I. GLUCOSE HOMEOSTASIS, INSULIN RESISTANCE, AND INSULIN DEFICIENCY A. Normal Blood Glucose Dynamics. In the normal fasting state, blood glucose (BG) is regulated between 70 and 110 mg/dL and does not increase…
Airway Management
Patient Positioning Direct Laryngoscopy I. INTRODUCTION: Endotracheal intubation is indicated in the setting of acute respiratory failure (hypoxemic or hypercarbic) when noninvasive positive pressure ventilation (NIPPV) has failed or is contraindicated,…
Nutrition in Critical Illness
I. INTRODUCTION. The delivery of calories and protein to a critically ill patient should be considered a high priority that is integral to care, rather than a supportive afterthought. The goals…
