BOOK
Gastrointestinal Issues in Critical Care, An Issue of Critical Care Clinics, E-Book
Rahul S. Nanchal | Ram M. Subramanian
(2016)
Additional Information
Book Details
Abstract
This issue of Critical Care Clinics focuses on Gastrointestinal Critical Care. Articles include: Non variceal Upper Gastrointestinal bleeds; Lower Gastrointestinal bleeds; Mesenteric Ischemia; Peritonitis; The open abdomen and intra abdominal infections; Gut motility issues in critical illness; Gut as the motor of multiple organ dysfunction; Intra abdominal hypertension and abdominal compartment syndrome; Abdominal circulatory interactions in critical illness; Severe acute pancreatitis and necrotizing pancreatitis; and Nutrition in the critically ill.
Table of Contents
| Section Title | Page | Action | Price |
|---|---|---|---|
| Front Cover | Cover | ||
| Gastrointestinal Issues in \rCritical Care | i | ||
| Copyright \r | ii | ||
| Contributors | iii | ||
| CONSULTING EDITOR | iii | ||
| EDITORS | iii | ||
| AUTHORS | iii | ||
| Contents | vii | ||
| Preface: Gastrointestinal Issues in Critical Care\r | vii | ||
| Mesenteric Ischemia\r | vii | ||
| Controversies in Critical Care Nutrition Support\r | vii | ||
| Gut Motility Issues in Critical Illness\r | vii | ||
| The Gut as the Motor of Multiple Organ Dysfunction in Critical Illness\r | vii | ||
| Abdominal Compartment Hypertension and Abdominal Compartment Syndrome\r | viii | ||
| Nonvariceal Upper Gastrointestinal Bleeding\r | viii | ||
| Lower Gastrointestinal Hemorrhage\r | viii | ||
| Role of the Open Abdomen in Critically Ill Patients\r | ix | ||
| Abdominal Circulatory Interactions\r | ix | ||
| Severe Acute Pancreatitis and Necrotizing Pancreatitis\r | ix | ||
| CRITICAL CARE CLINICS\r | x | ||
| FORTHCOMING ISSUES | x | ||
| July 2016 | x | ||
| October 2016 | x | ||
| January 2017 | x | ||
| RECENT ISSUES | x | ||
| January 2016 | x | ||
| October 2015 | x | ||
| July 2015 | x | ||
| Preface:Gastrointestinal \rIssues in Critical Care | xi | ||
| Mesenteric Ischemia | 155 | ||
| Key points | 155 | ||
| INTRODUCTION | 155 | ||
| EPIDEMIOLOGY AND COMORBIDITIES ASSOCIATED WITH ACUTE MESENTERIC ISCHEMIA | 156 | ||
| CLINICAL PRESENTATION OF ACUTE MESENTERIC ISCHEMIA | 156 | ||
| LABORATORY TESTS IN ACUTE MESENTERIC ISCHEMIA | 156 | ||
| IMAGING STUDIES IN ACUTE MESENTERIC ISCHEMIA | 157 | ||
| MESENTERIC ANATOMY AND PHYSIOLOGY | 158 | ||
| PATHOPHYSIOLOGY OF ACUTE MESENTERIC ISCHEMIA | 159 | ||
| INITIAL TREATMENT OF PATIENTS WITH ACUTE MESENTERIC ISCHEMIA | 162 | ||
| OPEN SURGICAL TREATMENT OF ACUTE MESENTERIC ISCHEMIA | 162 | ||
| ENDOVASCULAR TREATMENT OF ACUTE MESENTERIC ISCHEMIA | 163 | ||
| NONSURGICAL TREATMENT OF ACUTE MESENTERIC ISCHEMIA | 163 | ||
| OUTCOME IN ACUTE MESENTERIC ISCHEMIA | 164 | ||
| PROGNOSTIC SCORING SYSTEMS IN ACUTE MESENTERIC ISCHEMIA | 164 | ||
| INTENSIVE CARE MANAGEMENT OF PATIENTS WITH ACUTE MESENTERIC ISCHEMIA | 166 | ||
| ACUTE MESENTERIC ISCHEMIA OCCURRING IN THE INTENSIVE CARE UNIT | 166 | ||
| SUMMARY | 167 | ||
| REFERENCES | 167 | ||
| Controversies in Critical Care Nutrition Support | 173 | ||
| Key points | 173 | ||
| INTRODUCTION | 173 | ||
| PHYSIOLOGIC BASIS FOR NUTRITION SUPPORT | 174 | ||
| NUTRITIONAL RISK | 175 | ||
| LOCATION OF ENTERAL NUTRITION DELIVERY | 177 | ||
| EARLY VERSUS DELAYED ENTERAL NUTRITION | 178 | ||
| AUTOPHAGY AND PERMISSIVE UNDERFEEDING | 179 | ||
| Autophagy | 179 | ||
| Permissive Underfeeding | 180 | ||
| PARENTERAL NUTRITION | 181 | ||
| Enteral Versus Parenteral Nutrition | 181 | ||
| Supplemental Parenteral Nutrition | 181 | ||
| NUTRITION SUPPORT IN SHOCK | 182 | ||
| SUMMARY | 186 | ||
| REFERENCES | 186 | ||
| Gut Motility Issues in Critical Illness | 191 | ||
| Key points | 191 | ||
| INTRODUCTION | 191 | ||
| GUT COMPONENTS | 192 | ||
| SIGNS AND SYMPTOMS OF ACUTE GASTROINTESTINAL INJURY | 192 | ||
| GASTROINTESTINAL BLEEDING | 192 | ||
| ISCHEMIA-REPERFUSION INJURY | 192 | ||
| GASTROINTESTINAL DYSMOTILITY | 193 | ||
| MOTOR FUNCTION OF THE PROXIMAL GASTROINTESTINAL TRACT | 194 | ||
| GASTROINTESTINAL TRACT BARRIER DYSFUNCTION | 194 | ||
| INCREASED MORBIDITY AND MORTALITY WITH ACUTE GASTROINTESTINAL INJURY | 195 | ||
| Nutritional Deficits | 195 | ||
| Gastrointestinal Tract–associated Infection | 196 | ||
| Aspiration of Enteral Feeding | 196 | ||
| The Gut Hypothesis of Sepsis | 196 | ||
| STANDARDIZING DEFINITIONS/TREATMENT RECOMMENDATIONS | 196 | ||
| SUMMARY | 198 | ||
| REFERENCES | 198 | ||
| The Gut as the Motor of Multiple Organ Dysfunction in Critical Illness | 203 | ||
| Key points | 203 | ||
| OVERVIEW | 203 | ||
| THE GUT IN HEALTH | 204 | ||
| Epithelium | 204 | ||
| Immune System | 204 | ||
| Microbiome | 204 | ||
| PRECLINICAL INSIGHTS INTO THE ROLE OF THE GUT AS THE MOTOR OF MULTIPLE ORGAN DYSFUNCTION SYNDROME | 204 | ||
| The Gut Lymph Hypothesis | 204 | ||
| Apoptosis | 205 | ||
| Hyperpermeability | 205 | ||
| Altering the Microbiome | 206 | ||
| GUT FAILURE IN CRITICALLY ILL PATIENTS | 207 | ||
| Clinical Diagnosis of Gut Failure | 207 | ||
| TARGETING THE MICROBIOME | 207 | ||
| Probiotics, Prebiotics, and Synbiotics | 207 | ||
| Selective Decontamination of the Digestive Tract | 208 | ||
| Fecal Transplant | 208 | ||
| Nutrition | 209 | ||
| REFERENCES | 209 | ||
| Abdominal Compartment Hypertension and Abdominal Compartment Syndrome | 213 | ||
| Key points | 213 | ||
| INTRODUCTION | 213 | ||
| DEFINITION AND CAUSES OF INTRA-ABDOMINAL HYPERTENSION/ABDOMINAL COMPARTMENT SYNDROME | 214 | ||
| DIAGNOSIS: PHYSIOLOGIC MARKERS OF ABDOMINAL COMPARTMENT SYNDROME | 215 | ||
| DIAGNOSIS: MEASUREMENT OF ABDOMINAL PRESSURE | 217 | ||
| TREATMENT | 218 | ||
| SUMMARY | 219 | ||
| REFERENCES | 220 | ||
| Nonvariceal Upper Gastrointestinal Bleeding | 223 | ||
| Key points | 223 | ||
| INTRODUCTION | 223 | ||
| EPIDEMIOLOGY | 224 | ||
| PATIENT EVALUATION OVERVIEW | 224 | ||
| Approach to the Upper Gastrointestinal Bleed | 224 | ||
| Risk Stratification | 225 | ||
| Differential Diagnosis | 225 | ||
| Treatment | 225 | ||
| Emergent evaluation and resuscitation | 225 | ||
| Goals of resuscitation | 227 | ||
| Transfusion strategies | 227 | ||
| Correction of coagulopathy | 229 | ||
| Pharmacologic treatment options | 231 | ||
| Chronic management | 232 | ||
| Nonpharmacologic treatment options | 232 | ||
| Disease-specific treatment options | 233 | ||
| Infection | 233 | ||
| Malformation | 235 | ||
| Malignancy | 235 | ||
| Mechanical | 235 | ||
| Iatrogenic | 236 | ||
| Peptic ulcer disease | 236 | ||
| Special consideration | 236 | ||
| FUTURE DIRECTION | 236 | ||
| REFERENCES | 237 | ||
| Lower Gastrointestinal Hemorrhage | 241 | ||
| Key points | 241 | ||
| DEFINITION | 242 | ||
| EPIDEMIOLOGY | 242 | ||
| CRITERIA FOR SEVERITY AND RISK STRATIFICATION | 242 | ||
| ETIOLOGIES | 243 | ||
| CLINICAL PRESENTATION | 243 | ||
| INITIAL MANAGEMENT | 244 | ||
| RESUSCITATION STRATEGIES | 244 | ||
| COLONOSCOPY | 245 | ||
| COMMON ETIOLOGIES | 247 | ||
| Diverticular Bleeding | 247 | ||
| Angiodysplasia | 248 | ||
| OTHER MODALITIES OF DIAGNOSIS AND THERAPY | 248 | ||
| Radionuclide Studies | 248 | ||
| Angiography Therapy | 249 | ||
| Surgical Therapy | 249 | ||
| OTHER ETIOLOGIES OF LOWER GASTROINTESTINAL BLEEDING | 249 | ||
| Postpolypectomy Bleeding | 249 | ||
| Ischemic Colitis | 250 | ||
| Dieulafoy Lesion | 250 | ||
| Obscure Bleeding | 250 | ||
| SUMMARY | 251 | ||
| REFERENCES | 252 | ||
| Role of the Open Abdomen in Critically Ill Patients | 255 | ||
| Key points | 255 | ||
| ABDOMINAL COMPARTMENT SYNDROME | 256 | ||
| DIAGNOSIS OF ABDOMINAL COMPARTMENT SYNDROME | 256 | ||
| MANAGEMENT OF THE OPEN ABDOMEN | 257 | ||
| CAUSES OF ABDOMINAL COMPARTMENT SYNDROME | 257 | ||
| COMPLICATIONS OF THE OPEN ABDOMEN TECHNIQUE | 258 | ||
| EARLY COMPLICATIONS | 259 | ||
| Wound Management | 259 | ||
| Surgical Site Infections | 259 | ||
| Intra-Abdominal Infection | 259 | ||
| Gastrointestinal Fistula | 260 | ||
| LATE COMPLICATIONS | 260 | ||
| Ventral Hernia | 260 | ||
| SUMMARY | 261 | ||
| REFERENCES | 261 | ||
| Abdominal Circulatory Interactions | 265 | ||
| Key points | 265 | ||
| RELATIONSHIP BETWEEN RIGHT ATRIAL PRESSURE, ABDOMINAL PRESSURE, AND VENOUS RETURN | 266 | ||
| RELATIONSHIP BETWEEN VENTRICULAR FUNCTION AND ABDOMINAL PRESSURE | 269 | ||
| CLINICAL APPLICATIONS | 270 | ||
| Prone Positioning | 270 | ||
| Ascites | 272 | ||
| Laparoscopic Surgery | 272 | ||
| Weaning from Mechanical Ventilation | 273 | ||
| SUMMARY | 274 | ||
| REFERENCES | 274 | ||
| Severe Acute Pancreatitis and Necrotizing Pancreatitis | 279 | ||
| Key points | 279 | ||
| INTRODUCTION | 279 | ||
| Severe Acute Pancreatitis | 279 | ||
| PATIENT EVALUATION OVERVIEW | 283 | ||
| Clinical Features | 283 | ||
| History | 283 | ||
| Physical examination | 283 | ||
| PHARMACOLOGIC TREATMENT OPTIONS | 284 | ||
| Management | 284 | ||
| Fluid Resuscitation | 286 | ||
| Respiratory Care | 286 | ||
| Cardiovascular Care | 286 | ||
| Metabolic Complications | 286 | ||
| Infectious Disease and Antibiotics | 287 | ||
| NONPHARMACOLOGIC TREATMENT OPTIONS | 287 | ||
| Endoscopy | 287 | ||
| Nutrition | 287 | ||
| RADIOLOGIC AND SURGICAL TREATMENT OPTIONS | 288 | ||
| EVALUATION OF OUTCOME AND LONG-TERM RECOMMENDATIONS | 288 | ||
| SUMMARY | 289 | ||
| REFERENCES | 289 | ||
| Index | 291 |