By Luca M. Bigatello, Hasan Alam, Rae M. Allain
Written by means of the multidisciplinary in depth care unit employees on the Massachusetts basic health center, the 5th version of this best-selling instruction manual is a realistic, entire, and present consultant to scientific and surgical serious care. In a easy define layout designed for quick reference, this pocket-sized booklet provides trustworthy, hospital-tested protocols that replicate modern so much complex severe care practices. This version contains new chapters on catastrophe preparedness within the ICU, caliber development and prophylaxis, non-antibiotic treatments for sepsis, and use of ultrasound within the ICU. An appendix presents supplemental drug details.
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Additional resources for Critical Care Handbook of the Massachussetts General Hospital, 5th Edition
Georgopoulos D, Prinianakis G, Kondili E. Bedside waveforms interpretation as a tool to identify patient-ventilator asynchronies. Intensive Care Med 2006;32:34-47. Grasso S, Stripoli T, DeMicheleM, et al. ARDSnet ventilatory protocol and alveolar hyperinflation: role of positive end-expiratorypressure. Am J Respir Crit Care Med 2007;176(8): 761-767. Hess D. Detection and monitoring of hypoxemia and oxygen therapy. Respir Care 2000; 45:65-80. 43 44 Hess DR, Bigatello LM. The chest wall in acute lung injury/acute respiratory distress syndrome.
2. Pleural effusions are visible as hypoechoic areas bordered by the chest wall, the lung parenchyma, and the diaphragm. The echogenicity of pleural effusion fluid is determined by the makeup of the effusion. Transudates are echo free. Exudates, hemothorax, and empyema are often echoic and loculated (Fig. 3-2). 6%). 3. Other chest pathology. Use of chest ultrasonography to evaluate lung parenchyma for consolidation, atelectasis, edema, and lung abscess has been reported. Any process that reduces the aeration of the lung allows for greater ultrasound beam penetration and increased visualization of parenchymal structure.
The thickness of a piezoelectric crystal determines the frequency of the sound it emits. As a result, each ultrasound probe produces waves at a characteristic frequency, measured in hertz (cycles/second). Waves with higher frequency produce greater resolution. Need for resolution must be balanced against need for penetration to deep tissues, as lower-frequency beams undergo less attenuation and are thus able to travel further through tissue. F. Doppler systems take advantage of the frequency change that occurs in the echoed signal when an object moves toward or away from the ultrasound source.
Critical Care Handbook of the Massachussetts General Hospital, 5th Edition by Luca M. Bigatello, Hasan Alam, Rae M. Allain