Learn about the symptoms of this potential medical emergency. Acute Chemical poisoning -- Varnish makers' and painters' Naptha - unconsciousness Unconsciousness is a state in which:- • Unable to responds to people and activities. Choking on an object can result in unconsciousness as well.. Brief unconsciousness (or fainting) is often a result from dehydration, low blood sugar, or temporary low blood pressure.It can also be caused by serious heart or nervous system problems. As there are many causes of unconsciousness, a timely and focused history and neurologic examination are critical to defining the differential diagnosis. The pathophysiology of epilepsy and seizures is diverse, accounting for the many different types of seizure disorders. The brain tolerates only limited physical or metabolic injury, so that impaired consciousness is often a sign of impending irreparable damage to the brain. State of disturbed consciousness with motor restlessness, transient hallucinations, disorientation, and sometimes delusions . Coma or impaired consciousness may result from structural disorders, which typically cause focal damage, or nonstructural disorders, which most often cause diffuse damage (see table Common Causes of Coma or Impaired Consciousness). Y1 - 2013/8/9. 4.4 lb. how you will use this image and then you will be able to add this image to your shopping basket. Delirium. When Ca 2+ levels are higher than 4 mmol/l a hypercalcemic crisis appears – confusion, unconsciousness and cardiac arrest in systole. The systemic response following a burn can be massive. Pathophysiology. In most countries, courts must consider whether unconsciousness in a situation can be accepted as a defense; it can vary from case to case. The excess fluid increases the size of the ventricles and puts pressure on the brain.Cerebrospinal fluid normally flows through the ventricles and bathes the brain and spinal column. The thalamus plays a crucial role in maintaining arousal. Integration of the cerebral cortex and the RAS enables us to be aware and knowledgeable about activities in our environment. Section 1 ICU organization and management, Part 9.4 Agitation, confusion, and delirium, Chapter 228 Causes and diagnosis of unconsciousness, Chapter 229 Management of unconsciousness in the ICU, Chapter 230 Non-pharmacological neuroprotection in the ICU, Part 9.9 Non-traumatic subarachnoid haemorrhage, Section 10 The metabolic and endocrine systems, Section 12 The skin and connective tissue, Section 19 General surgical and obstetric intensive care, Section 21 Recovery from critical illness. On standing, 300 to 800 ml of blood shift from the thorax to the lower extremities. For questions on access or troubleshooting, please check our FAQs, and if you can't find the answer there, please contact us. There … Pathophysiology of Loss of Consciousness It is important to distinguish between unconsciousness from a neurologic cause and other uses of the term ‘‘unconscious- PERIOD MAY BE MOMENTARY OR MAY LAST FOR MONTH. O2 deprivation: is a major pathophysiologic factor in unconsciousness ie Air way obstruction --> permanent brain damage in 4 – 5 mint. All Rights Reserved. Burn pathophysiology can be broken into local and systemic response. Readers must therefore always check the product information and clinical procedures with the most up to date published product information and data sheets provided by the manufacturers and the most recent codes of conduct and safety regulations. Animals Nearly a quarter of older adults in the U.S. have type 2 diabetes, and this population is continuing to increase with the aging of the population. This lowers the venous return and hence the cardiac output. Carotid arteries. The pathophysiology of this entity is complex, involving hypoxic stress on the basis of interference with oxygen transport to the cells and possibly impairing electron transport. Carbon monoxide can also affect leukocytes, platelets and the endothelium, inducing a cascade of effects resulting in oxidative injury. Unconsciousness presentation 1 1. disturbance of consciousness characterized by impaired ability to think clearly, and to perceive, respond to, and remember current stimuli; disorientation. Cardiac arrest is the cessation of cardiac mechanical activity resulting in the absence of circulating blood flow. 5.5-22 lb. Author information: (1)Department of Neurology, Yale University School of Medicine, New Haven, CT 06520-8018, USA. This unconscious experience is explained by our understanding of pathophysiology. Pathophysiology of drowning. Learn vocabulary, terms, and more with flashcards, games, and other study tools. It can also be caused by substance (drug) and alcohol use. In contrast, the larger doses that are required to induce unconsciousness will result in amnesia of events as a secondary effect, as well as substantially suppressing the effects of noxious stimuli. © Oxford University Press, 2020. Oxford University Press makes no representation, express or implied, that the drug dosages in this book are correct. It is a common medical problem, accounting for around 5% of acute medical admissions and 3% of emergency department visits.1 Syncope secondary to cardiac causes carries the worst prognosis, with a one year mortality rate of 20–30%.2 An understanding of the events preceding … Asphyxia, the failure or disturbance of the respiratory process brought about by the lack or insufficiency of oxygen in the brain. Coma, state of unconsciousness, characterized by loss of reaction to external stimuli and absence of spontaneous nervous activity, usually associated with injury to the cerebrum. One would hardly deny we were conscious during this period. Unconsciousness - first aid Definition Unconsciousness is when a person is unable to respond to people and activities. Sudden cardiac arrest is the abrupt loss of heart function, breathing and consciousness. An unconscious person is usually completely unresponsive to their environment or people around them. However, one commonality across epilepsies is a disrupted balance between excitatory (via glutamatergic signaling) and inhibitory (via GABAergic signaling) drive at the synaptic level that can result in seizure activity. Freud and his followers felt that d This can be relevant in cases of sexual assault, euthanasia, or patients giving informed consent with regard to starting or stopping a medical treatment. Unconsciousness may occur as the result of traumatic brain injury, brain hypoxia (inadequate oxygen, possibly due to a brain infarction or cardiac arrest), severe intoxication with drugs that depress the activity of the central nervous system (e.g., alcohol and other hypnotic or sedative drugs), severe fatigue, anaesthesia, and other causes. General , local metabolic & C.N.S. In jurisprudence, unconsciousness may entitle the criminal defendant to the defense of automatism, i.e. Email this page; Link this page ; Print; Please describe! Sign up to an individual subscription to the Oxford Textbook of Critical Care. New York: Lange Medical Books/McGraw-Hill Medical Publishing Division; 2003,143-188. 1. 6, 7 Recently, a Japanese team reported a young patient with convulsions and unconsciousness; he was diagnosed with aseptic encephalitis with SARS-CoV-2 ribonucleic acid in cerebrospinal fluid (CSF). 1. Table 1. Sigmund Freud, the founder of psychoanalysis, stated that such unconscious processes may affect a person’s behaviour even though he cannot report on them. We have all driven down a familiar road with no recollection of the events. 1. The condition usually results from a problem with your heart's electrical system, which disrupts your heart's pumping action and stops blood flow to your body. 3. Lack of adequate oxygenation to the cerebral cortex can produce unconsciousness in a little as 10 seconds.1 Thrombotic events most often affect the internal carotids, middle cerebral, or basilar arteries.8,11 Strokes that are the result of emboli are frequently considered to be cardiac in origin. Coma may accompany a number of metabolic disorders or physical injuries to the brain from disease or trauma. But the pressure of too much cerebrospinal fluid associated with hydrocephalus can damage brain tissues and cause a range of impairments in brain fun… Jugular veins. These are called altered mental status or … Except where otherwise stated, drug dosages and recommendations are for the non-pregnant adult who is not breastfeeding. Access to the complete content on Oxford Medicine Online requires a subscription or purchase. Pathophysiology: the most important factor in pathogeneses of unconsciousness is Hypotension. Trachea. Pathophysiology of Loss of Consciousness It is important to distinguish between unconsciousness from a neurologic cause and other uses of the term ‘ ‘unconscious- Med J Aust. The pathophysiology of an unconscious patient is complex. Solenski NJ. Loss of consciousness should not be confused with the notion of the psychoanalytic unconscious, cognitive processes that take place outside awareness, and with altered … PRINTED FROM OXFORD MEDICINE ONLINE (www.oxfordmedicine.com). Hydrocephalus is the buildup of fluid in the cavities (ventricles) deep within the brain. Hence epileptic seizures, neurological dysfunctions and sleepwalking may be considered acceptable excusing conditions because the loss of control is not foreseeable, but falling asleep (especially while driving or during any other safety-critical activity) may not, because natural sleep rarely overcomes an ordinary person without warning. Also added to a blackout is the subsequent unconsciousness that occurs. Pearn J. PMID: 4000018 [PubMed - indexed for MEDLINE] MeSH Terms. May 26, 2016 - Explore Timothy Joseph's board "Pathophysiology Flowcharts" on Pinterest. Pathophysiology:-Mechanism of Unconsciousness-Inadequate delivery of blood or oxygen to the brain-Systemic or local metabolic deficiencies-Direct or reflex effects on nervous system-Psychic mechanisms affecting levels of consciousness with their respective mechanism of action Intersection between pathophysiology and the onset of consciousness at birth: implications for NMS foals Behaviours associated with survival become possible by the time of birth ... progression from prenatal unconsciousness to post natal consciousness Coma may accompany a number of metabolic disorders or physical injuries to the brain from disease or trauma. Complete or near complete lack of responsiveness to people and other environmental stimuli. Loss of consciousness should not be confused with the notion of the psychoanalytic unconscious, cognitive processes that take place outside awareness (e.g., implicit cognition), and with altered states of consciousness such as sleep, delirium, hypnosis, and other altered states in which the person responds to stimuli, including trance and psychedelic experiences. The pathophysiology of epilepsy and seizures is diverse, accounting for the many different types of seizure disorders. 18-66 lb. Doctors often call this a coma or being in a comatose state. [Functional Pathophysiology of Consciousness] Neuropsychiatr. Methods. The pathophysiology of this entity is complex, involving hypoxic stress on the basis of interference with oxygen transport to the cells and possibly impairing electron transport. [Context Link] 9. Loss of consciousness is associated with lesions that disrupt neuronal systems in the brainstem and diencephalon that mediate arousal or thalamocortical or corticocortical systems that mediate awareness. Burn injury represents a complex clinical entity with significant associated morbidity and remains the second leading cause of trauma-related death. Blumenfeld H(1), Taylor J. Causes of Altered Level of Consciousness. Normally this leads to reduced stimulation of baroreceptors in the carotid sinus and aortic arch and mechanoreceptors (vagal C fibres) in the wall of the left ventricle. Explaining some first aid in a way that will increase understanding as well as rote learning. Changes in consciousness are seen in a range of physiological and pathological settings including sleep, anaesthesia, brain lesions, metabolic disturbances, and complex partial or generalized seizures. Coma, state of unconsciousness, characterized by loss of reaction to external stimuli and absence of spontaneous nervous activity, usually associated with injury to the cerebrum. Changes in consciousness are seen in a range of physiological and pathological settings including sleep, anaesthesia, brain lesions, metabolic disturbances, and complex partial or generalized seizures. Previous Next: Indications for … Adult Neck Structures and the Compression Pressures Needed to Cause Unconsciousness and Death (Open Table in a new window) Neck Structure. Unconsciousness is when a person suddenly becomes unable to respond to stimuli and appears to be asleep. Pathophysiology. Intersection between pathophysiology and the onset of consciousness at birth: implications for NMS foals . 2009;23(2):115-33. Mosquitoes or ticks inoculate arbovirus, and rabies virus is transferred via an infected animal bite or exposure to animal secretions. Decreased consciousness can affect your ability to remain awake, aware, and oriented. Most NICU patients have head trauma, cerebrovascular accident (CVA), neurosurgery, or other known sources of intracranial insult that could lead to an ALOC. Learn about the symptoms of this potential medical emergency. Background: Although considerable research has been done on pathophysiology, metabolic and physical causes, and prognostic indicators, little is known about unconsciousness or coma from the perspective of the patient. Save to Lightbox. Copyright © Brain . It is caused by two primary mechanisms. UNCONSCIOUSNESS BY, REVATHY.A IST YEAR MSc (N) 2. Rarely, the delayed onset of asphyxia, sometimes lethal, may result from unrecognized laryngeal damage sustained during an episode of neck compression. Objective: To describe the experiences of patients who were once documented as being unconscious. Given the high and increasing number of publications reporting neurologic involvements of SARS-Cov-2, we thought that providing an update for neurologic complications of COVID-19 would be useful for physicians and especially young trainees in neurology and neurosurgery. 18. When excessive heat is transferred to the skin, it radiates outward from the point of initial contact and forms a local response with three zones in all directions. Stupor is a state of insensitivity bordering on unconsciousness. Unconsciousness is an abnormal state resulting from disturbance of sensory perception to the extent that the patient is not aware of what is happening around him. The position of unconsciousness or unconsciousness is that of the human body in which its consciousness and muscular power are exhausted. See more ideas about sepsis, septic shock, sepsis pathophysiology. Pathophysiology: Levels of Unconsciousness Vocabulary. In neurobiological terms, consciousness may be viewed as having an arousal dimension and an awareness dimension phenotypically expressed as the capacity to respond to self or environmental … A blackout is a phenomenon in which both long-term and short-term memory is impaired, creating an inability for those moments to be recalled in the future. Coma - total unreactivity to outer stimuli, no spontanous motor response, eyes are closed, breathing is shallow, vegetative responses present. Confusion. If you have purchased a print title that contains an access token, please see the token for information about how to register your code. 33 lb . UNCONSCIOUSNESS IT IS AN ABNORMAL STATE RESULTING FROM DISTURBANCE OF SENSORY PERCEPTION TO THE EXTENT THAT THE PATIENT IS NOT AWARE OF WHAT IS HAPPENING AROUND HIM. Lack of adequate oxygenation to the cerebral cortex can produce unconsciousness in a little as 10 seconds.1 ... Ganong WF, eds. Unconsciousness is a state which occurs when the ability to maintain an awareness of self and environment is lost. Vertebral arteries. In many countries, it is presumed that someone who is less than fully conscious cannot give consent to anything. Causes of Unconsciousness without any prevalence information The following causes of Unconsciousness are ones for which we do not have any prevalence information. When one consumes a lot of alcohol in a short amount of time, a blackout occurs. • Alteration of mental state. Portals of entry are virus specific. Syncope is a transient loss of consciousness secondary to inadequate cerebral perfusion with oxygenated blood. A blackout is a phenomenon in which both long-term and short-term memory is impaired, creating an inability for those moments to be recalled in the future. Nevertheless, the diagnostic value of GCS for severe TBI in the multiple-injured patient is unknown. It involves a complete, or near-complete, lack of responsiveness to people and other environmental stimuli. PRINTED FROM OXFORD MEDICINE ONLINE (www.oxfordmedicine.com). PLAY. Alert : - Normal consciousness. Pricing. & cardiac arrest in 5-10 mint. • Loss or lack of consciousness. Public users are able to search the site and view the abstracts for each book and chapter without a subscription. Thus, unconsciousness and death may occur without significant compromise of the airway. The hold is applied until unconsciousness ensues; the subject is then immediately cuffed, and the hold released before the onset of any irreversible cerebral ischemic damage. Levels of Unconsciousness. Brain ischemia is a condition in which there is insufficient blood flow to the brain to meet metabolic demand. Unconsciousness can occur as a result of brain injury, lack of oxygen or poisoning as well as numerous other conditions. Stupor (precome)– deep unconsiousness; person reacts to painful stimuli pain stimuli; reactions are delayed little localized, sporadic movements, verbalisation. [Article in German] Author Kurt A Jellinger 1 Affiliation 1 Institut für Klinische Neurobiologie, Wien. Asphyxia can be caused by injury to or obstruction of breathing passageways, as in strangulation or the Encephalitis: Practice Essentials, Background, Pathophysiology The state, in a normally conscious being, of not being consicious, Learn how and when to remove this template message, depress the activity of the central nervous system, https://en.wikipedia.org/w/index.php?title=Unconsciousness&oldid=991243757, Symptoms and signs: Cognition, perception, emotional state and behaviour, Articles needing additional references from June 2007, All articles needing additional references, Creative Commons Attribution-ShareAlike License, This page was last edited on 29 November 2020, at 01:46. An understanding of the local and systemic pathophysiology of burns has led to significant improvements in mortality. Correlation of experimental and clinical observations of blunt head injuries. a state uncontrollably of one's own actions, an excusing condition that allows a defendant to argue that they should not be held criminally liable for their actions or omissions. Surgical treatment for hydrocephalus can restore and maintain normal cerebrospinal fluid levels in … Older adults are at high risk for the development of type 2 diabetes due to the combined effects of genetic, lifestyle, and aging influences. hal.blumenfeld@yale.edu Model systems are needed for the scientific investigation of consciousness. Pathophysiology. The Integrated Information Theory2predicts that in states associated with unconsciousness, such as in slow wave sleep early in the night, deep general anesthesia, and “vegetative” states, there is a breakdown in connectivity within the corticothalamic network. Clinical Cytogenetics and Molecular Genetics, Anesthesiology: A Problem-Based Learning Approach, The European Society of Cardiology Textbooks, International Perspectives in Philosophy and Psychiatry, Oxford Specialty Training: Basic Sciences, Oxford Specialty Training: Revision Texts, Oxford Specialty Training: Revision Notes, Sign up to an individual subscription to the, Section 1 ICU organization and management, Chapter 3 Rapid response teams for the critically ill, Chapter 4 In-hospital transfer of the critically ill, Chapter 5 Pre- and inter-hospital transport of the critically ill and injured, Chapter 6 Regional critical care delivery systems, Chapter 7 Integration of information technology in the ICU, Chapter 8 Multiple casualties and disaster response in critical care, Chapter 9 Management of pandemic critical illness, Chapter 10 Effective teamwork in the ICU, Chapter 11 Communication with patients and families in the ICU, Chapter 12 Telemedicine in critical care, Chapter 13 Clinical skills in critical care, Chapter 14 Simulation training for critical care, Chapter 17 Policies, bundles, and protocols in critical care, Chapter 18 Managing biohazards and environmental safety, Chapter 19 Managing ICU staff welfare, morale, and burnout, Chapter 20 ICU admission and discharge criteria, Chapter 21 Resource management and budgeting in critical care, Chapter 22 Costs and cost-effectiveness in critical care, Chapter 23 Evidence-based practice in critical care, Part 1.7 Medico-legal and ethical issues, Chapter 27 Medico-legal liability in critical care, Part 1.8 Critical illness risk prediction, Chapter 28 The role and limitations of scoring systems, Chapter 29 Severity of illness scoring systems, Chapter 31 Genetic and molecular expression patterns in critical illness, Chapter 33 Bronchodilators in critical illness, Chapter 34 Vasopressors in critical illness, Chapter 35 Vasodilators in critical illness, Chapter 36 Inotropic agents in critical illness, Chapter 37 Anti-anginal agents in critical illness, Chapter 38 Anti-arrhythmics in critical illness, Chapter 39 Pulmonary vasodilators in critical illness, Chapter 40 Gastrointestinal motility drugs in critical illness, Chapter 41 Stress ulcer prophylaxis and treatment drugs in critical illness, Chapter 42 Sedatives and anti-anxiety agents in critical illness, Chapter 43 Analgesics in critical illness, Chapter 44 Antidepressants in critical illness, Chapter 45 Antiseizure agents in critical illness, Chapter 46 Inhalational anaesthetic agents in critical illness, Chapter 47 Muscle relaxants in critical illness, Chapter 48 Neuroprotective agents in critical illness, Chapter 49 Hormone therapies in critical illness, Chapter 50 Insulin and oral anti-hyperglycaemic agents in critical illness, Chapter 51 Anticoagulants and antithrombotics in critical illness, Chapter 52 Haemostatic agents in critical illness, Part 2.7 Antimicrobial and immunological drugs, Chapter 53 Antimicrobial drugs in critical illness, Chapter 55 Immunotherapy in critical illness, Chapter 57 Crystalloids in critical illness, Chapter 58 Diuretics in critical illness, Chapter 59 Airway management in cardiopulmonary resuscitation, Chapter 60 Artificial ventilation in cardiopulmonary resuscitation, Chapter 61 Pathophysiology and causes of cardiac arrest, Chapter 62 Cardiac massage and blood flow management during cardiac arrest, Chapter 63 Defibrillation and pacing during cardiac arrest, Chapter 64 Therapeutic strategies in managing cardiac arrest, Chapter 65 Post-cardiac arrest arrhythmias, Chapter 66 Management after resuscitation from cardiac arrest, Chapter 67 Ethical and end-of-life issues after cardiac arrest, Chapter 69 Choice of resuscitation fluid, Chapter 70 Therapeutic goals of fluid resuscitation, Chapter 71 Normal physiology of the respiratory system, Chapter 72 Blood gas analysis in the critically ill, Chapter 73 Pulse oximetry and capnography in the ICU, Chapter 74 Respiratory system compliance and resistance in the critically ill, Chapter 75 Gas exchange principles in the critically ill, Chapter 76 Gas exchange assessment in the critically ill, Chapter 77 Respiratory muscle function in the critically ill, Chapter 78 Imaging the respiratory system in the critically ill, Chapter 79 Upper airway obstruction in the critically ill, Chapter 80 Standard intubation in the ICU, Chapter 81 The difficult intubation in the ICU, Chapter 82 The surgical airway in the ICU, Chapter 83 Dyspnoea in the critically ill, Chapter 84 Pulmonary mechanical dysfunction in the critically ill, Chapter 85 Hypoxaemia in the critically ill, Chapter 86 Hypercapnia in the critically ill, Chapter 87 Cardiovascular interactions in respiratory failure, Chapter 88 Physiology of positive-pressure ventilation, Chapter 89 Respiratory support with continuous positive airways pressure, Chapter 90 Non-invasive positive-pressure ventilation, Chapter 91 Indications for mechanical ventilation, Chapter 92 Design and function of mechanical ventilators, Chapter 93 Setting rate, volume, and time in ventilatory support, Chapter 94 Respiratory support with positive end-expiratory pressure, Chapter 95 Volume-controlled mechanical ventilation, Chapter 96 Pressure-controlled mechanical ventilation, Chapter 98 High-frequency ventilation and oscillation, Chapter 100 Failure to ventilate in critical illness, Chapter 101 Ventilator trauma in the critically ill, Chapter 102 Assessment and technique of weaning, Chapter 103 Weaning failure in critical illness, Chapter 104 Extracorporeal respiratory and cardiac support techniques in the ICU, Chapter 105 Treating respiratory failure with extracorporeal support in the ICU, Chapter 106 Aspiration of gastric contents in the critically ill, Chapter 107 Inhalation injury in the ICU, Part 4.10 Acute respiratory distress syndrome, Chapter 108 Pathophysiology of acute respiratory distress syndrome, Chapter 109 Therapeutic strategy in acute respiratory distress syndrome, Chapter 110 Pathophysiology and causes of airflow limitation, Chapter 111 Therapeutic approach to bronchospasm and asthma, Chapter 112 Therapeutic strategy in acute or chronic airflow limitation, Part 4.12 Respiratory acidosis and alkalosis, Chapter 113 Pathophysiology and therapeutic strategy of respiratory acidosis, Chapter 114 Pathophysiology and therapeutic strategy of respiratory alkalosis, Chapter 115 Pathophysiology of pneumonia, Chapter 116 Diagnosis and management of community-acquired pneumonia, Chapter 117 Diagnosis and management of nosocomial pneumonia, Chapter 118 Diagnosis and management of atypical pneumonia, Part 4.14 Atelectasis and sputum retention, Chapter 119 Pathophysiology and prevention of sputum retention, Chapter 120 Lung recruitment techniques in the ICU, Chapter 121 Chest physiotherapy and tracheobronchial suction in the ICU, Chapter 122 Toilet bronchoscopy in the ICU, Chapter 123 Pathophysiology of pleural cavity disorders, Chapter 124 Management of pneumothorax and bronchial fistulae, Chapter 125 Management of pleural effusion and haemothorax, Chapter 126 Pathophysiology and causes of haemoptysis, Chapter 127 Therapeutic approach in haemoptysis, Chapter 128 Normal physiology of the cardiovascular system, Chapter 130 Arterial and venous cannulation in the ICU, Chapter 131 Blood pressure monitoring in the ICU, Chapter 132 Central venous pressure monitoring in the ICU, Chapter 133 Pulmonary artery catheterization in the ICU, Chapter 134 Mixed and central venous oxygen saturation monitoring in the ICU, Chapter 135 Right ventricular function in the ICU, Chapter 136 Cardiac output assessment in the ICU, Chapter 137 Oxygen transport in the critically ill, Chapter 138 Tissue perfusion monitoring in the ICU, Chapter 139 Lactate monitoring in the ICU, Chapter 140 Measurement of extravascular lung water in the ICU, Chapter 141 Doppler echocardiography in the ICU, Chapter 142 Monitoring the microcirculation in the ICU, Chapter 143 Imaging the cardiovascular system in the ICU, Part 5.3 Acute chest pain and coronary syndromes, Chapter 144 Causes and diagnosis of chest pain, Chapter 145 Pathophysiology of coronary syndromes, Chapter 146 Diagnosis and management of non-STEMI coronary syndromes, Chapter 147 Diagnosis and management of ST-elevation of myocardial infarction, Chapter 148 Pathophysiology, diagnosis, and management of aortic dissection, Chapter 150 Diagnosis and management of shock in the ICU, Chapter 151 Pathophysiology and causes of cardiac failure, Chapter 152 Therapeutic strategy in cardiac failure, Chapter 153 Intra-aortic balloon counterpulsation in the ICU, Chapter 154 Ventricular assist devices in the ICU, Chapter 155 Causes and diagnosis of tachyarrhythmias, Chapter 156 Therapeutic strategy in tachyarrhythmias, Chapter 157 Causes, diagnosis, and therapeutic strategy in bradyarrhythmias, Chapter 158 Causes and diagnosis of valvular problems, Chapter 159 Therapeutic strategy in valvular problems, Chapter 160 Pathophysiology and causes of endocarditis, Chapter 161 Prevention and treatment of endocarditis, Chapter 162 Pathophysiology and causes of severe hypertension, Chapter 163 Management of severe hypertension in the ICU, Chapter 164 Pathophysiology of severe capillary leak, Chapter 165 Management of acute non-cardiogenic pulmonary oedema, Chapter 166 Pathophysiology and causes of pericardial tamponade, Chapter 167 Management of pericardial tamponade, Chapter 168 Pathophysiology and causes of pulmonary hypertension, Chapter 169 Diagnosis and management of pulmonary hypertension, Chapter 170 Pathophysiology and causes of pulmonary embolism, Chapter 171 Diagnosis and management of pulmonary embolism, Chapter 172 Normal physiology of the gastrointestinal system, Chapter 173 Normal physiology of the hepatic system, Chapter 174 Imaging the abdomen in the critically ill, Chapter 175 Hepatic function in the critically ill, Chapter 176 Pathophysiology and causes of upper gastrointestinal haemorrhage, Chapter 177 Diagnosis and management of upper gastrointestinal haemorrhage in the critically ill, Chapter 178 Diagnosis and management of variceal bleeding in the critically ill, Chapter 179 Pathophysiology and causes of lower gastrointestinal haemorrhage, Chapter 180 Diagnosis and management of lower gastrointestinal haemorrhage in the critically ill, Chapter 181 Vomiting and large nasogastric aspirates in the critically ill, Chapter 182 Ileus and obstruction in the critically ill, Chapter 183 Diarrhoea and constipation in the critically ill, Chapter 184 Pathophysiology and management of raised intra-abdominal pressure in the critically ill, Chapter 185 Perforated viscus in the critically ill, Chapter 186 Ischaemic bowel in the critically ill, Chapter 187 Intra-abdominal sepsis in the critically ill, Chapter 188 Acute acalculous cholecystitis in the critically ill, Chapter 189 Management of the open abdomen and abdominal fistulae in the critically ill, Chapter 190 Pathophysiology, diagnosis, and assessment of acute pancreatitis, Chapter 191 Management of acute pancreatitis in the critically ill, Chapter 192 Pathophysiology and causes of jaundice in the critically ill, Chapter 193 Management of jaundice in the critically ill, Chapter 194 Pathophysiology and causes of acute hepatic failure, Chapter 195 Diagnosis and assessment of acute hepatic failure in the critically ill, Chapter 196 Management of acute hepatic failure in the critically ill, Chapter 197 The effect of acute hepatic failure on drug handling in the critically ill, Chapter 198 Extracorporeal liver support devices in the ICU, Part 6.9 Acute on chronic hepatic failure, Chapter 199 Pathophysiology, diagnosis, and assessment of acute or chronic hepatic failure, Chapter 200 Management of acute or chronic hepatic failure in the critically ill, Chapter 201 Normal physiology of nutrition, Chapter 202 The metabolic and nutritional response to critical illness, Chapter 203 Pathophysiology of nutritional failure in the critically ill, Chapter 204 Assessing nutritional status in the ICU, Chapter 205 Indirect calorimetry in the ICU, Chapter 206 Enteral nutrition in the ICU, Chapter 207 Parenteral nutrition in the ICU, Chapter 208 Normal physiology of the renal system, Part 8.2 Renal monitoring and risk prediction, Chapter 209 Monitoring renal function in the critically ill, Chapter 210 Imaging the urinary tract in the critically ill, Part 8.3 Oliguria and acute kidney injury, Chapter 211 Pathophysiology of oliguria and acute kidney injury, Chapter 212 Diagnosis of oliguria and acute kidney injury, Chapter 213 Management of oliguria and acute kidney injury in the critically ill, Chapter 214 Continuous haemofiltration techniques in the critically ill, Chapter 215 Haemodialysis in the critically ill, Chapter 216 Peritoneal dialysis in the critically ill, Chapter 217 The effect of renal failure on drug handling in critical illness, Chapter 218 The effect of chronic renal failure on critical illness, Chapter 219 Normal anatomy and physiology of the brain, Chapter 220 Normal anatomy and physiology of the spinal cord and peripheral nerves, Chapter 221 Electroencephalogram monitoring in the critically ill, Chapter 222 Cerebral blood flow and perfusion monitoring in the critically ill, Chapter 223 Intracranial pressure monitoring in the ICU, Chapter 224 Imaging the central nervous system in the critically ill, Chapter 225 Pathophysiology and therapeutic strategy for sleep disturbance in the ICU, Part 9.4 Agitation, confusion, and delirium, Chapter 226 Causes and epidemiology of agitation, confusion, and delirium in the ICU, Chapter 227 Assessment and therapeutic strategy for agitation, confusion, and delirium in the ICU, Chapter 228 Causes and diagnosis of unconsciousness, Chapter 229 Management of unconsciousness in the ICU, Chapter 230 Non-pharmacological neuroprotection in the ICU, Chapter 231 Pathophysiology and causes of seizures, Chapter 232 Assessment and management of seizures in the critically ill, Chapter 233 Causes and management of intracranial hypertension, Chapter 235 Diagnosis and assessment of stroke, Chapter 236 Management of ischaemic stroke, Chapter 237 Management of parenchymal haemorrhage, Part 9.9 Non-traumatic subarachnoid haemorrhage, Chapter 238 Epidemiology, diagnosis, and assessment on non-traumatic subarachnoid haemorrhage, Chapter 239 Management of non-traumatic subarachnoid haemorrhage in the critically ill, Chapter 240 Epidemiology, diagnosis, and assessment of meningitis and encephalitis, Chapter 241 Management of meningitis and encephalitis in the critically ill, Chapter 242 Pathophysiology, causes, and management of non-traumatic spinal injury, Chapter 243 Epidemiology, diagnosis, and assessment of neuromuscular syndromes, Chapter 244 Diagnosis, assessment, and management of myasthenia gravis and paramyasthenic syndromes, Chapter 245 Diagnosis, assessment, and management of tetanus, rabies, and botulism, Chapter 246 Diagnosis, assessment, and management of Guillain–Barré syndrome, Chapter 247 Diagnosis, assessment, and management of hyperthermic crises, Chapter 248 Diagnosis, assessment, and management of ICU-acquired weakness, Section 10 The metabolic and endocrine systems, Chapter 249 Normal physiology of the endocrine system, Chapter 250 Disorders of sodium in the critically ill, Chapter 251 Disorders of potassium in the critically ill, Chapter 252 Disorders of magnesium in the critically ill, Chapter 253 Disorders of calcium in the critically ill, Chapter 254 Disorders of phosphate in the critically ill, Part 10.3 Metabolic acidosis and alkalosis, Chapter 255 Pathophysiology and causes of metabolic acidosis in the critically ill, Chapter 256 Management of metabolic acidosis in the critically ill, Chapter 257 Pathophysiology, causes, and management of metabolic alkalosis in the critically ill, Chapter 258 Pathophysiology of glucose control, Chapter 259 Glycaemic control in critical illness, Chapter 260 Management of diabetic emergencies in the critically ill, Chapter 261 Pathophysiology and management of adrenal disorders in the critically ill, Chapter 262 Pathophysiology and management of pituitary disorders in the critically ill, Chapter 263 Pathophysiology and management of thyroid disorders in the critically ill, Chapter 264 Pathophysiology and management of functional endocrine tumours in the critically ill, Chapter 265 The blood cells and blood count, Chapter 267 Blood product therapy in the ICU, Chapter 269 Pathophysiology of disordered coagulation, Chapter 270 Disseminated intravascular coagulation in the critically ill, Chapter 271 Prevention and management of thrombosis in the critically ill, Chapter 272 Thrombocytopenia in the critically ill, Chapter 273 Pathophysiology and management of anaemia in the critically ill, Chapter 274 Pathophysiology and management of neutropenia in the critically ill, Chapter 275 Sickle crisis in the critically ill, Section 12 The skin and connective tissue, Part 12.1 Skin and connective tissue disorders, Chapter 276 Assessment and management of dermatological problems in the critically ill, Chapter 277 Vasculitis in the critically ill, Chapter 278 Rheumatoid arthritis in the critically ill, Part 12.2 Wound and pressure sore management, Chapter 279 Principles and prevention of pressure sores in the ICU, Chapter 280 Dressing techniques for wounds in the critically ill, Chapter 281 Microbiological surveillance in the critically ill, Chapter 282 Novel biomarkers of infection in the critically ill, Chapter 283 Definition, epidemiology, and general management of nosocomial infection, Chapter 284 Healthcare worker screening for nosocomial pathogens, Chapter 285 Environmental decontamination and isolation strategies in the ICU, Chapter 286 Antimicrobial selection policies in the ICU, Chapter 287 Oral, nasopharyngeal, and gut decontamination in the ICU, Chapter 288 Diagnosis, prevention, and treatment of device-related infection in the ICU, Chapter 289 Antibiotic resistance in the ICU, Part 13.3 Infection in the immunocompromised, Chapter 290 Drug-induced depression of immunity in the critically ill, Chapter 292 Diagnosis and management of malaria in the ICU, Chapter 293 Diagnosis and management of viral haemorrhagic fevers in the ICU, Chapter 294 Other tropical diseases in the ICU, Chapter 295 Assessment of sepsis in the critically ill, Chapter 296 Management of sepsis in the critically ill, Chapter 297 Pathophysiology of septic shock, Chapter 298 Management of septic shock in the critically ill, Chapter 299 Innate immunity and the inflammatory cascade, Chapter 300 Brain injury biomarkers in the critically ill, Chapter 301 Cardiac injury biomarkers in the critically ill, Chapter 302 Renal injury biomarkers in the critically ill, Chapter 303 The host response to infection in the critically ill, Chapter 304 The host response to trauma and burns in the critically ill, Chapter 305 The host response to hypoxia in the critically ill, Chapter 306 Host–pathogen interactions in the critically ill, Chapter 307 Coagulation and the endothelium in acute injury in the critically ill, Chapter 308 Ischaemia-reperfusion injury in the critically ill, Chapter 309 Repair and recovery mechanisms following critical illness, Chapter 310 Neural and endocrine function in the immune response to critical illness, Chapter 311 Adaptive immunity in critical illness, Chapter 312 Immunomodulation strategies in the critically ill, Chapter 313 Immunoparesis in the critically ill, Chapter 314 Pathophysiology and management of anaphylaxis in the critically ill, Chapter 315 Role of toxicology assessment in poisoning, Chapter 316 Decontamination and enhanced elimination of poisons, Part 15.2 Management of specific poisons, Chapter 317 Management of salicylate poisoning, Chapter 318 Management of acetaminophen (paracetamol) poisoning, Chapter 319 Management of opioid poisoning, Chapter 320 Management of benzodiazepine poisoning, Chapter 321 Management of tricyclic antidepressant poisoning, Chapter 322 Management of poisoning by amphetamine or ecstasy, Chapter 323 Management of digoxin poisoning, Chapter 324 Management of cocaine poisoning, Chapter 326 Management of cyanide poisoning, Chapter 327 Management of alcohol poisoning, Chapter 328 Management of carbon monoxide poisoning, Chapter 329 Management of corrosive poisoning, Chapter 330 Management of pesticide and agricultural chemical poisoning, Chapter 331 Management of radiation poisoning, Chapter 332 A systematic approach to the injured patient, Chapter 333 Pathophysiology and management of thoracic injury, Chapter 334 Pathophysiology and management of abdominal injury, Chapter 335 Management of vascular injuries, Chapter 336 Management of limb and pelvic injuries, Chapter 337 Assessment and management of fat embolism, Chapter 338 Assessment and management of combat trauma, Chapter 339 Pathophysiology of ballistic trauma, Chapter 340 Assessment and management of ballistic trauma, Chapter 341 Epidemiology and pathophysiology of traumatic brain injury, Chapter 342 Assessment of traumatic brain injury, Chapter 343 Management of traumatic brain injury, Chapter 344 Assessment and immediate management of spinal cord injury, Chapter 345 Ongoing management of the tetraplegic patient in the ICU, Chapter 346 Pathophysiology and assessment of burns, Chapter 347 Management of burns in the ICU, Chapter 348 Pathophysiology and management of drowning, Chapter 349 Pathophysiology and management of electrocution, Part 17.3 Altitude- and depth-related disorders, Chapter 350 Pathophysiology and management of altitude-related disorders, Chapter 351 Pathophysiology and management of depth-related disorders, Chapter 352 Pathophysiology and management of fever, Chapter 353 Pathophysiology and management of hyperthermia, Chapter 354 Pathophysiology and management of hypothermia, Chapter 355 Pathophysiology and management of rhabdomyolysis, Chapter 356 Pathophysiology and assessment of pain, Chapter 357 Pain management in the critically ill, Chapter 358 Sedation assessment in the critically ill, Chapter 359 Management of sedation in the critically ill, Section 19 General surgical and obstetric intensive care, Part 19.1 Optimization strategies for the high-risk surgical patient, Chapter 360 Identification of the high-risk surgical patient, Chapter 361 Peri-operative optimization of the high risk surgical patient, Part 19.2 General post-operative intensive care, Chapter 362 Post-operative ventilatory dysfunction management in the ICU, Chapter 363 Post-operative fluid and circulatory management in the ICU, Chapter 364 Enhanced surgical recovery programmes in the ICU, Chapter 365 Obstetric physiology and special considerations in ICU, Chapter 366 Pathophysiology and management of pre-eclampsia, eclampsia, and HELLP syndrome, Chapter 367 Obstetric Disorders in the ICU, Part 20.1 Specialized surgical intensive care, Chapter 368 Intensive care management after cardiothoracic surgery, Chapter 369 Intensive care management after neurosurgery, Chapter 370 Intensive care management after vascular surgery, Chapter 371 Intensive care management in hepatic and other abdominal organ transplantation, Chapter 372 Intensive care management in cardiac transplantation, Chapter 373 Intensive care management in lung transplantation, Chapter 374 ICU selection and outcome of patients with haematological malignancy, Chapter 375 Management of the bone marrow transplant recipient in ICU, Chapter 376 Management of oncological complications in the ICU, Section 21 Recovery from critical illness, Part 21.1 In-hospital recovery from critical illness, Chapter 378 Promoting physical recovery in critical illness, Chapter 379 Promoting renal recovery in critical illness, Chapter 380 Recovering from critical illness in hospital, Part 21.2 Complications of critical illness, Chapter 381 Physical consequences of critical illness, Chapter 382 Neurocognitive impairment after critical illness, Chapter 383 Affective and mood disorders after critical illness, Part 21.3 Out-of-hospital support after critical illness, Chapter 384 Long-term weaning centres in critical care, Chapter 386 Rehabilitation from critical illness after hospital discharge, Part 22.1 Withdrawing and withholding treatment, Chapter 387 Ethical decision making in withdrawing and withholding treatment, Chapter 388 Management of the dying patient, Part 22.2 Management of the potential organ donor, Chapter 389 Beating heart organ donation, Chapter 390 Non-heart-beating organ donation, Chapter 391 Post-mortem examination in the ICU. 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